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Letters to the Editor |
US Department of Agriculture, Agricultural Research Service, Grand Forks Human Nutrition Research Center, PO Box 9034 Grand Forks, ND 58202-9034
Dear Sir:
Liu et al (1) found that "higher intakes of whole-grain foods were associated with lower risks of both fatal and nonfatal" coronary heart disease among thousands of women studied since 1984. The association was not fully explained by the contribution of whole grains to intakes of dietary fiber, folate, or vitamins B-6 and E. The authors suggested the possibility of "additional protective effects of other constituents." An accompanying editorial (2) mentioned more than a baker's dozen of possibly protective constituents concentrated in whole grains, including copper.
That copper nutriture may affect risk of coronary heart disease first was suggested in the Journal in 1973 (3). The original hypothesis (4) was modified and has evolved into the copper deficiency theory (5, 6) of the etiology and pathophysiology of ischemic heart disease because of numerous, consonant experiments in animals and people. In brief, the Western diet is frequently low in copper. Copper deficiency is the only nutritional insult that elevates cholesterol (7), blood pressure (8), and uric acid; has adverse effects on electrocardiograms (7, 9); impairs glucose tolerance (10), to which males respond differently than do females; and which promotes thrombosis and oxidative damage. More than 75 anatomic, chemical, and physiologic similarities between animals deficient in copper and people with ischemic heart disease have been identified. Copper deficiency is offered as the simplest and most general explanation for ischemic heart disease.
One wonders whether comparison of higher with lower quintiles of whole-grain intake (1) would show higher amounts of copper in the former. Such a result would be compatible with the positive correlation between coronary artery health at angiogram and leukocyte copper (11); a higher leukocyte copper concentration in Japanese people in Okinawa, where the prevalence of heart disease is lower than in Japanese people in Brazil (12); a positive correlation between cardiac output and cardiac copper in patients with coronary heart disease (13); and lower superoxide dismutase activity in angiogram patients with a history of myocardial infarction than in similar patients without such a history (14).
REFERENCES
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