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Reply to A Sebastian et al

Creighton University 601 North 30th Street Suite 4841 Omaha, NE 68131 E-mail: rheaney{at}creighton.edu

Dear Sir:

The letter by Sebastian et al provides important clarification and reinforcement concerning a topic that, at least in certain segments of the general public, is highly contentious. I am particularly pleased to see the public comment piece excerpted by Sebastian et al, which makes all the essential points and, additionally, makes the crucial distinctions that are so often ignored in the popular nutrition community. It is important to have a group as distinguished as that of Sebastian et al weighing in on this side of the issue.

Their hypothesis, concerning the ratio of animal to vegetable foods, although plausible, is still just an hypothesis. It will be difficult to test convincingly. Moreover, as I noted in my editorial, the fact that the bone mineral density of the subjects at entry into the study was not lower for those with high dietary animal-to-vegetable protein ratios does not support their hypothesis.

My major concern, reinforced by extensive interaction with popular science and nutrition journalists, lies in the distraction from the importance of maintaining a high calcium intake. Negative effects on calcium retention of an acid residue diet occur principally in those with low calcium intakes, simply because many such individuals are already adapting maximally to the stress of low intake and have no further capacity to augment absorption efficiency to offset additional renal losses. Clearly, more work needs to be done in this area of nutrient-nutrient interactions.

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