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Nutrigenetics, omega-3 and plasma lipids/lipoproteins/apolipoproteins with evidence evaluation using the GRADE approach: a systematic review
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  • Published on:
    Letter To The Editor; Dosage and Inclusion Criteria

    I found this study to be informative and well put together. The quality is highly marked thanks to the tools this study has used such as GRADE. I also believe it useful to include both observational studies and interventional studies. However, I am concerned with the inclusion criteria of this systematic review. Although many studies that are included fit strict criteria, I find it difficult to understand why other studies are included at all. For example, studies administering a dosage of 1g/daily or less of EPA and/or DHA are included to measure effectiveness. However, it is evident that such a small dose (less than 1g/day) is often ineffective.1,2 A dosage less than 2g/daily has been shown to be either too small to measure, has limited benefit, or has no effect.3,4,5 This can skew the data in a direction that makes EPA and/or DHA appear to not be as effective as their true therapeutic value. Even in cases where a benefit is seen at a low dose, how much and what other effects are missed because of this dosage? This is a common error seen among review articles in regards to EPA and/or DHA. In this particular case, the dose may indeed determine the effect.
    1. Kris-Etherton PM, Harris WS, Appel LJ; American Heart Association. Nutrition Committee. Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease [published correction appears in Circulation. 2003 Jan 28;107(3):512.]. Circulation. 2002;106(21):2747-2757. doi:10.1161/01.cir.0000...

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    Conflict of Interest:
    None declared.