etters to the Editor
Letters to the Editor are welcome. If found suitable by the Editors, they will be published as spacepennits. By submiting a Letter to the Editor, the author gives pennission for its publication in the journal. Letters should not duplicate similar material being submitted or published elsewhere. Letters refiering to a recent joumal article should be received within 3 months of the article's publication. The Editors reserve the right to edit and abridge letters, to solicit responses from authors and others, and to publish such responses. Pleasesubmityourletterinduplicate, double-spaced (including references), and do not exceed 400 words of text. Reprints can be ordered through the corresponding author, whose address is listed at the end of the letter.
Editorial on Nutrition Draws Praise and Criticism 1. T7e Benefits of Controlling Fat and Choleserol Intake Thank you for an issue with a nutrition focus (Vol. 80, No. 11). In response to Dr. Willet's editorial overview, "Challenges for Public Health Nutrition in the 1990's,"' I seek to clarify two aspects of the editorial, hoping this will help those tIying to make or guide wise food choices in daily practice. 1. The control of total fat intake has a direct bearing on individual weight and obesity. Eveiy gram of fat has 9 calories compared with 7 from alcohol, 4 from carbohydrates, and 4 from protein. Obesity is the most prevalent risk factor for heart
1524 American Journal of Public Health
disease in the United States. Fat reduction is among the easiest ways to cut caloric intake. 2. At the October 1990 Detroit Center for Disease Control Conference, Dr. Jeremiah Stamler also presented data indicating that dietary cholesterol/dietary lipid is an independent variable that adds to heart disease risk over and above that of serum cholesterol. He stated that the cost-benefit ratio is 3:8 for dietary lipid/ dietary cholesterol intervention and ranks second to smoking at 6.4 (serum cholesterol is 1.0 and systolic blood pressure is 1.6). Thank you for restating reasonable priorities of obesity prevention, reduction of dietary cholesterol and animal fat, and increased consumption of fruits and vegetables. As a public health nutrition supervisor in a major metropolitan area health department I believe it would be helpful to public health practitioners with nutrition intervention responsibilities (almost 30%o of public health nurse activity) to have, from time to time, in-depth review articles with a nutrition practice, science-based balance, and public health perspective. No other journal can offer this! L M. Jean Brancheau Egan, R1, MPH Requests for reprints should be sent to M. Jean Brancheau Egan, Supervisor, Public Health Nutrition, Health and Nutrition Services, Oakland County, Michigan, 1200 N Telegraph Road, Pontiac, MI 48053-1082.
Reference 1. Willett W. Challenges for public health nutrition in the 1990s. Am J Public Health.
1990;80:1295-1298. Editorial.
2. Link between Dietary Fat and Heart Disease As a public health administrator and dietitian I find the statement published in
the journal, "The classic diet/heart hypothesis probably contains some element of truth"' outrageous. It is certainly necessary to examine both sides of controversial issues; however, to go out on a limb and start sawing is reckless and irresponsible. An overwhelming number of valid and well-documented studies clearly indicated that dietary fats are strongly correlated with coronary heart disease. Although many of the mechanisms and specific food constituents are not well documented, the connection is convincing. I expect more from a renowned journal such as theAmencan Joumal ofPublc Health. [ Jim Thomas, MS, RD Requests for reprints should be sent to Jim Thomas, MS, RD, Isanti County Public Health Services, 1557 South Highway 293, Cambridge, MN 55008.
Reference 1. Willett W. Challenges for public health nutrition in the 1990s. Am J Public Health. 1990;80:1295-1298. Editorial.
3. Moderate Consumption of Alcohol Ca(ies Serious Risks I am writing regarding the editorial published in the November 1990 issue of the journal, entitled "Challenges for Public Health Nutrition in the 1990s."'1 Most of what is reported in the editorial represents accurate and important information on nutrition and health. However, a glaring inaccuracy appears on p 1295 regarding the status of current research on the link between diet and coronary heart disease: "Only two consistent findings have emerged: ... a strong protective effect of moderate alcohol intake." Data on the relationship between moderate alcohol consumption and coronary heart disease are anything but consistent. Recent research has called this
November 1991, Vol. 81, No. 11
Letters to the Editor are welcome. If found suitable by the Editors, they will be published as spacepennits. By submiting a Letter to the Editor, the author gives pennission for its publication in the journal. Letters should not duplicate similar material being submitted or published elsewhere. Letters refiering to a recent joumal article should be received within 3 months of the article's publication. The Editors reserve the right to edit and abridge letters, to solicit responses from authors and others, and to publish such responses. Pleasesubmityourletterinduplicate, double-spaced (including references), and do not exceed 400 words of text. Reprints can be ordered through the corresponding author, whose address is listed at the end of the letter.
Editorial on Nutrition Draws Praise and Criticism 1. T7e Benefits of Controlling Fat and Choleserol Intake Thank you for an issue with a nutrition focus (Vol. 80, No. 11). In response to Dr. Willet's editorial overview, "Challenges for Public Health Nutrition in the 1990's,"' I seek to clarify two aspects of the editorial, hoping this will help those tIying to make or guide wise food choices in daily practice. 1. The control of total fat intake has a direct bearing on individual weight and obesity. Eveiy gram of fat has 9 calories compared with 7 from alcohol, 4 from carbohydrates, and 4 from protein. Obesity is the most prevalent risk factor for heart
1524 American Journal of Public Health
disease in the United States. Fat reduction is among the easiest ways to cut caloric intake. 2. At the October 1990 Detroit Center for Disease Control Conference, Dr. Jeremiah Stamler also presented data indicating that dietary cholesterol/dietary lipid is an independent variable that adds to heart disease risk over and above that of serum cholesterol. He stated that the cost-benefit ratio is 3:8 for dietary lipid/ dietary cholesterol intervention and ranks second to smoking at 6.4 (serum cholesterol is 1.0 and systolic blood pressure is 1.6). Thank you for restating reasonable priorities of obesity prevention, reduction of dietary cholesterol and animal fat, and increased consumption of fruits and vegetables. As a public health nutrition supervisor in a major metropolitan area health department I believe it would be helpful to public health practitioners with nutrition intervention responsibilities (almost 30%o of public health nurse activity) to have, from time to time, in-depth review articles with a nutrition practice, science-based balance, and public health perspective. No other journal can offer this! L M. Jean Brancheau Egan, R1, MPH Requests for reprints should be sent to M. Jean Brancheau Egan, Supervisor, Public Health Nutrition, Health and Nutrition Services, Oakland County, Michigan, 1200 N Telegraph Road, Pontiac, MI 48053-1082.
Reference 1. Willett W. Challenges for public health nutrition in the 1990s. Am J Public Health.
1990;80:1295-1298. Editorial.
2. Link between Dietary Fat and Heart Disease As a public health administrator and dietitian I find the statement published in
the journal, "The classic diet/heart hypothesis probably contains some element of truth"' outrageous. It is certainly necessary to examine both sides of controversial issues; however, to go out on a limb and start sawing is reckless and irresponsible. An overwhelming number of valid and well-documented studies clearly indicated that dietary fats are strongly correlated with coronary heart disease. Although many of the mechanisms and specific food constituents are not well documented, the connection is convincing. I expect more from a renowned journal such as theAmencan Joumal ofPublc Health. [ Jim Thomas, MS, RD Requests for reprints should be sent to Jim Thomas, MS, RD, Isanti County Public Health Services, 1557 South Highway 293, Cambridge, MN 55008.
Reference 1. Willett W. Challenges for public health nutrition in the 1990s. Am J Public Health. 1990;80:1295-1298. Editorial.
3. Moderate Consumption of Alcohol Ca(ies Serious Risks I am writing regarding the editorial published in the November 1990 issue of the journal, entitled "Challenges for Public Health Nutrition in the 1990s."'1 Most of what is reported in the editorial represents accurate and important information on nutrition and health. However, a glaring inaccuracy appears on p 1295 regarding the status of current research on the link between diet and coronary heart disease: "Only two consistent findings have emerged: ... a strong protective effect of moderate alcohol intake." Data on the relationship between moderate alcohol consumption and coronary heart disease are anything but consistent. Recent research has called this
November 1991, Vol. 81, No. 11
