BMJ 1996;313:1259 (16 November)

Letters

Relative risks should not have been adjusted for body mass index

EDITOR,--In their prospective study of 43 757 health professionals in the United States, Alberto Ascherio and colleagues found that the multivariate relative risk of myocardial infarction was increased to 1.22 (95% confidence interval 0.96 to 1.56) and that of fatal coronary heart disease was increased to 2.21 (1.38 to 3.54) for men in the top versus the lowest fifth of saturated fat intake.1 They conclude that these data do not support the strong association between intake of saturated fat and risk of coronary heart disease suggested by international comparisons.

The authors' conclusion is questionable because the relative risks were also adjusted for differences in body fatness (body mass index), which is generally believed to be promoted by a high fat diet and is a strong risk factor for coronary heart disease. By adjusting the relative risks for body fatness the authors eliminated the effect of a high fat diet on . . . [Full text of this article]


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Relevant Article

Dietary fat and risk of coronary heart disease in men: cohort follow up study in the United States
Alberto Ascherio, Eric B Rimm, Edward L Giovannucci, Donna Spiegelman, Meir Stampfer, and Walter C Willett
BMJ 1996 313: 84-90. [Abstract] [Full Text]

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