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To the Editor.—In their analysis of the Framingham Heart Study, Dr Gillman and colleagues¹ suggest that "[q]uestions of potential bias and confounding naturally accompany findings that are surprising or counterintuitive." The finding that they refer to is "an inverse association between fat intake and the development of ischemic stroke among men." Indeed, the data in Table 2 of the article suggest that a more complete examination of the results is needed before their conclusion can be accepted. The group made up of subjects with the lowest percentage intake of energy from fat differs markedly from the group with the highest percentage of energy from fat in the following ways. The energy intake of the lowest-fat group is about 54.8% of that in the highest-fat group (7879 kJ/d compared with 14389 kJ/d). The lowest-fat group's alcohol intake is about 190.4 g/wk compared with 160.0 g/wk for the highest-fat group. The . . . [Full Text of this Article]

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Inverse Association of Dietary Fat With Development of Ischemic Stroke in Men
Matthew W. Gillman, L. Adrienne Cupples, Barbara E. Millen, R. Curtis Ellison, and Philip A. Wolf
JAMA. 1997;278(24):2145-2150.
ABSTRACT