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February 14, 2007

Risks and Benefits of Fish Intake—Reply

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2007;297(6):585-586. doi:10.1001/jama.297.6.586-a

In Reply: Mr Lucas and Dr Harris highlight the important evidence for a nonlinear benefit of EPA and DHA intake for preventing CHD death. Pooling evidence from 20 prospective observational studies and randomized clinical trials, we found that the majority of benefit occurs with modest intake—some consumption is much better than none at all. At EPA and DHA intakes between 0 and 250 mg/d, CHD mortality risk was lower by 14.6% (95% confidence interval [CI], 8% to 21%; P<.001) per each 100 mg/d, while at intakes greater than 250 mg/d, risk was not further lowered (0.0% lower risk per each 100 mg/d; 95% CI, −0.9% to 0.8%; P = .94).