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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).

Exclusion of studies in Japanese populations did not greatly alter these findings. At EPA and DHA intakes between 0 and 250 mg/d, CHD mortality risk was lower by 14.3% (95% CI, 8% to 21%; P<.001) per each 100 mg/d, . . . [Full Text of this Article]

Dariush Mozaffarian, MD, DrPH
dmozaffa@hsph.harvard.edu

Eric Rimm, ScD
Harvard School of Public Health
Boston, Mass

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