Letters Section Editor: Jody W. Zylke, MD, Senior Editor.
Author Affiliations: Lipid Disorders Clinic, University Hospital of Ioannina, Ioannina, Greece (Drs Rizos and Elisaf) (firstname.lastname@example.org); and Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece (Dr Ntzani).
In Reply: Mr Lewis suggests that the dietary or supplemental intake and the source of omega-3 PUFAs are 2 factors that may not have been adequately addressed in our study. We included studies with different omega-3 doses and various proportions of EPA and DHA and performed a meta-regression analysis that did not show a statistically significant association between the cardiovascular outcomes and omega-3 dose. Two studies with intakes of more than 3 g per day and relative risks for all-cause mortality of less than 1.0 had small sample sizes, whereas the third showed a relative risk of 1.0. Regarding the source of omega-3 PUFAs, we included studies without making a distinction about the specific origin because none of the studies provided such information.
Rizos EC, Ntzani EE, Elisaf MS. Omega-3 Fatty Acid Supplementation and Cardiovascular Disease Events—Reply. JAMA. 2013;309(1):27. doi:10.1001/jama.2012.116657