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Response to: Correspondence on ‘Omega-3 supplementation and cardiovascular disease: formulation-based systematic review and meta-analysis with trial sequential analysis’ by Kountouras et al
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  • Published on:
    A potential influence of omega-3 supplementation on metabolic syndrome and/or Helicobacter pylori-related risk of cardio-cerebrovascular disorders
    • Jannis Kountouras, Professor of Medicine Department of Medicine, Second Medical Clinic, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki 52642, M
    • Other Contributors:
      • Apostolis Papaefthymiou, Gastroenterologist
      • Elisabeth Vardaka, Nutritionist
      • Dimitrios Chatzopoulos, Gastroenterologist
      • Maria Tzitiridou-Chatzopoulou, Pediatrician
      • Michael Doulberis, Gastroenterologist

    To the Editor,

    In an initial review and meta-analysis, Rizos et al1 stated that omega-3 supplementation at low and higher dosages showed no or weak associations with cardiovascular disease (CVD) outcomes. Then, we reported more recent reviews that displayed a protective activity of omega-3 supplementation against CVD outcomes.2 Moreover, we reported that both metabolic syndrome (MetS) and Helicobacter pylori infection (Hp-I) increase the risk of cardio-cerebrovascular events, the endpoint of MetS,2 and omega-3 acids are beneficial against these disorders.2 Next, a corresponding piece commenting on our own paper by Rizos et al,3 reported that some recent data showed, for instance, low and/or high dosage of omega-3 supplementation was not associated with CVD outcomes.3 However, multiple trials continue to use low dosage of omega-3, which demonstrated substantial CVD benefits and other recent data showed that higher dosage of omega-3 (4 g/day) also induced a remarkable reduction in CVD events.4 The current contradictory findings can be attributed to several contributors including diverse types of omega-3 fatty acids (only eicosapentaenoic acid (EPA) or combination of EPA plus docosahexaenoic acid), their dosage (higher vs. lower dose), diverse comparators (corn or mineral oil), the severity degree of the CVD risk and/or the usage of statins.5 Therefore, according to Jo et al.’s claim,5 further large-scale prospective studies are warranted to elucidate this “hype”.5...

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    Conflict of Interest:
    None declared.