Digestive and nutritional factors may explain lower prevalence of coronary disease in indigenous peoples

doi:10.1136/bmj.327.7412.449-b

BMJ 2003;327:449-450 (23 August), doi:10.1136/bmj.327.7412.449-b

Letter

Digestive and nutritional factors may explain lower prevalence of coronary disease in indigenous peoples

The first 150 words of the full text of this article appear below.

EDITOR—The report Health Disparities Experienced by AmericanIndians and Alaska Natives, which was summarised in the BMJ's news section,¹ shows that American Indians and Alaska Nativeshave a much higher prevalence of diabetes than all other USracial populations, but it does not refer to the reverse of this disparity in coronary heart disease.

Pima Indians and Alaska Natives experience less coronary heartdisease than American whites and, outside the United States,Afro-Caribbeans, and South African blacks also have less coronaryheart disease than white people despite a high prevalence ofdiabetes. Greenland Eskimos, the Masai, Tibetan highlanders,and some Polynesians and Melanesians are other indigenous peoples who experience less coronary heart disease than expected.²All these peoples have in common a low prevalence of persistenthigh lactase activity in adulthood, which is associated witha low intake of lactose from milk.³

These digestive and nutritional . . . [Full text of this article]

Jeffrey J Segall, general practitioner (retired)

308 Cricklewood Lane, London NW2 2PX j.segall@doctors.org.uk