All cereals may not be equal

3 Truro Drive Sale, Cheshire M33 5DF United Kingdom

Dear Sir:

I wish to comment on the article by Liu et al in your September 1999 issue (1), which found an inverse relation between the prevalence of coronary heart disease and whole-grain consumption in a large prospective study of nurses. In 1988, I carried out a statistical study (2) in which the consumption of 60 food items in 21 countries belonging to the Organization of Economic Cooperation and Development (OECD) was correlated with mortality from coronary disease. My results, regarding cereal consumption, were as follows in Table 1:

View this table:
TABLE 1.. Correlation between cereal consumption and mortality from coronary disease  
As far as correlation with coronary disease is concerned, all cereals appear to be different. A negative correlation was found only with rice consumption, and even this could be due to an indirect linkage. Coronary mortality in eastern Asia could be low on account of low fat and milk consumption but give the appearance of a negative correlation with high rice consumption. Similarly, the high positive correlation with oats consumption could be indirect. Appreciable quantities of oats are consumed only in a few countries of northern Europe. The true correlation could be between coronary disease mortality and environmental temperature. The world leaders in coronary disease mortality are Russia and its neighbors, which all have cold climates. In warmer countries, coronary mortality tends to be lower, and very low in the tropics. In my opinion, the connection between coronary disease and grain consumption must be treated with caution.

REFERENCES

1. Liu S, Stampfer MJ, Hu FB, et al. Whole-grain consumption and risk of coronary heart disease: results from the Nurses' Health Study. Am J Clin Nutr 1999;70:412–9.
2. Seely S. Diet and coronary arterial disease: a statistical study. Int J Cardiol 1988;20:183–92.