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To the Editor: In their Clinical Review, Drs Mozaffarian and Rimm¹ provide analyses that balance the risks and benefits of consuming fish and n-3 polyunsaturated fatty acids (n-3 PUFAs). We are concerned, however, with the analysis in their Figure 2, which suggests that the benefits for death from coronary heart disease (CHD) plateau at a 250-mg/d intake of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). This conclusion was based on a comparison of CHD mortality rates and intake of n-3 PUFAs, but it included 4 Japanese cohorts with EPA and DHA intakes greater than 2000 mg/d. Because of these 4 data points, the benefits appeared not to extend beyond 250 mg/d.

The rate of CHD death among Japanese individuals is very low, and their intake of EPA and DHA is very high compared with Western populations, but it seems inappropriate to include those cohorts in this analysis because of the . . . [Full Text of this Article]

Michel Lucas, MSc
michel.lucas@crchul.ulaval.ca
Laval University
Québec City, Québec

William S. Harris, PhD
Sanford School of Medicine
University of South Dakota
Sioux Falls

RELATED LETTERS

Risks and Benefits of Fish Intake
Tomi-Pekka Tuomainen, Sari Voutilainen, Staffan Skerfving, and Jukka T. Salonen
JAMA. 2007;297(6):585-586.
EXTRACT | FULL TEXT  

Risks and Benefits of Fish Intake—Reply
Dariush Mozaffarian and Eric Rimm
JAMA. 2007;297(6):586.
EXTRACT | FULL TEXT