What are your thoughts about different recommended intakes?
A recent review of the population data indicated that 5 or more servings of fish per week was associated with a significantly better protection against cardiovascular disease and associated mortality and associated fish consumptions. The American Heart Association have equated 900mg of DHA/EPA (combined) per day with 7 fatty fish servings per week (in their recommendations for the secondary management of coronary heart disease). Thus, 5 fish servings per week can be calculated to provide the approximate equivalent of 643 mg of DHA/EPA (combined) per day. This agrees very well with the recommended intake (ISSFAL workshop) of 650mg of DHA/EPA (combined) per day for the maintenance of cardiovascular health in those who are considered to be generally healthy. It is difficult to conclude that 650 mg is superior to 500 mg per day based on the limited dosage studies in the evidence-based literature comparing these intake targets. It is somewhat tempting to suggest that the recommended intakes in those with coronary heart disease of 900 mg DHA/EPA per day (recommended by the American Heart Association) may possibly also be a reasonable target for the prevention of cardiovascular disease. However, recommended intakes for those with pre-existing disease have often times employed higher target intakes than for the prevention of a disease. It remains to be seen whether this traditional rationale is the best interests of an overall aggressive strategy for the prevention of chronic disease or not.