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EDITOR,--Paul Knekt and colleagues report an inverse association between intake of flavonoids and incidence of coronary mortality.1 Their data also show that the protective effect of flavonoids was associated with a diet high in intake of apples and onions.1 I would like to draw attention to a point that Knekt and colleagues mention in their discussion: "thus it cannot be excluded that the association in the present study between intake of flavonoids and coronary mortality may be due to other substances in fruits and vegetables--for example, fibre, carotenoids, and vitamin C--or due to differences in intake of fatty acids closely correlated with high flavonoid intake."
Fruits and vegetables contain antinutrients--for example, phytic acid, saponins, tannins, flavonoids, phyto-oestrogens, and protease inhibitors--that have been found to be associated with a cholesterol lowering effect and, therefore, with a reduction in the risk of heart disease.2
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