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R. T. Ravenholt, MD
Food and Drug Administration Rockville, Md

JAMA. 1986;256(3):348.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Contrary to the conclusion of Williams et al¹ that persons with familial hypercholesterolemia should modify their diets to avoid early death from coronary heart disease, their findings show four forebears with hypercholesterolemia who probably ate ordinary diets but nevertheless lived normal life spans. Most important, perhaps, is that they were all nonsmokers.¹

Cigarette smoking is the juggernaut among environmental determinants of premature death from cancer and atherosclerotic cardiovascular disease,² a fact that becomes readily apparent whenever well-quantified lifetime smoking experience³ is carefully weighed against lesser determinants such as lifetime dietary patterns. . . . [Full Text PDF of this Article]

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