Coronary risk factors in people from the Indian subcontinent.
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Biomedical subjects
Publications and source records attributed to J J Segall.
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International data show stronger correlations of mortality from ischaemic heart disease with per capita supply of dairy products excluding fat than with dairy fat, and of estimated lactose than with dairy fat or margarine and other processed fats (positively) and vegetable oils and fats, fat of fish or wine (negatively). Butter and cheese, which have a low content of lactose, show moderate and zero correlations, respectively. Populations with low or intermediate prevalence of adult lactose absorbers have a lower supply of dairy products excluding butter (and therefore of lactose), and a lower mortality from ischaemic heart disease, than populations with a high prevalence of absorbers. Specific national and ethnic data suggest that a diet low or relatively low in lactose, in populations with low or relatively low prevalence of lactose absorbers, is more consistently associated with protection against ischaemic heart disease than are high intakes of unsaturated fatty acids, wine, alcohol or dietary fibre. In seven countries with a high consumption of dairy products (six at least with a high prevalence of lactose absorbers), trends in ischaemic heart disease mortality appear to have reflected changes in the supply of milk (and therefore of lactose), but not consistently of butter or inversely of unsaturated fatty acids. The findings reviewed in this paper call for further investigation of the subject, epidemiologically and biochemically.
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The prevalence of primary adult lactose malabsorption (LM) in 23 ethnic groups was matched with national data on milk consumption and mortality rates from ischaemic heart disease (IHD). In 6 other ethnic groups prevalence of LM was related to unquantified assessments of milk consumption and frequency of IHD. On the available data, populations with a prevalence of LM over 30%, and whose consumption of milk is low or is largely in low lactose form, have a lower risk of IHD mortality than populations with a prevalence of LM under 30% and a high milk consumption. There is evidence against attributing these findings to genetic linkage between susceptibility to IHD mortality and persistent lactose absorption, or to differences in socio-economic development, cigarette consumption or intake of animal fats. The findings are compatible with an hypothesis that, if the correlation reported previously between milk consumption and IHD mortality is causal, lactose could be the responsible dietary factor.
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Epidemiological and clinical evidence is presented on an association between the quantity of milk consumed and the incidence of ischaemic heart disease. It is suggested that the daily intake of liquid milk for adults should be at most one-third of a pint (less than 0-21).
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