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We read with deep interest the article by Hill et al1 who examined whether high-dose fish oil was superior to low-dose supplementation for symptomatic and structural outcomes in knee osteoarthritis (OA). This study suggested that The Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain and function scores were improved in high-dose and low-dose fish oil groups compared with baseline, and high-dose groups had no additional benefit for people with symptomatic knee OA compared with low-dose groups. We really appreciate the work that has been done by the authors, but there are some worthwhile issues that need to be explored.
Since this study might encourage supplementation of fish oil (eicosapentaenoic acid (EPA)+docosahexaenoic acid (DHA)) in many patients with knee OA, we think, first, safety issues should be the object of particular scrutiny. Recent review …