Letters Section Editor: Robert M. Golub, MD, Senior Editor.
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.
Lucas M, Harris WS. Risks and Benefits of Fish Intake. JAMA. 2007;297(6):585-586. doi:10.1001/jama.285.6.732