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[Correspondence] Associations of fats and carbohydrates with cardiovascular disease and mortality—PURE and simple?

The Prospective Urban Rural Epidemiological (PURE) study,1 which included 18 cohorts from low-income, middle-income, and high-income countries worldwide, reported that high carbohydrate intake was associated with an increased risk of total mortality, whereas high intake of total fat and individual types of fat were associated with reduced total mortality. These results contribute valuable evidence to the field of nutrition, but using questionnaires to infer the amount, quality, and composition of intake of fats is error prone because of the complexity of foods and the possibility of implausible questionnaire entries.

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