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To the Editor: The results of the study on Mediterranean diet and mortality by Mr Knoops and colleagues¹ may be confounded by the breadth of the populations that were compared. The analysis did not control for factors related to national heritage, both cultural and genetic. In effect, Swedes or Finns consuming one type of diet may have served as controls for Greeks or Italians consuming another diet. To be valid, studies of Mediterranean diets should compare diet and lifestyle within Italian or within Greek populations.

John E. Craighead, MD
jecibc@bellsouth.net
University of Vermont
Ferrisburgh

1. Knoops KT, de Groot LC, Kromhout D, et al. Mediterranean diet, lifestyle factors, and 10-year mortality in elderly European men and women: the HALE Project. JAMA. 2004;292:1433-1439. FREE FULL TEXT

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2005;293:674.

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