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From The JAMA Web Sites
April 14, 1999

Risk of Stroke in Users of Oral Contraceptives

Author Affiliations

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor

JAMA. 1999;281(14):1274. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-14-jac90002

In Reply: Drs Walker and Segal state that sub-Saharan Africans have a much lower incidence of colon cancer than Anglo-Saxons yet the Africans consume only 300 to 450 mg of calcium daily. Clearly, in addition to calcium, the African population eats little meat and consumes much less fat and far more fiber than European and American populations. Their lifestyle and diet are typical of people in less well-developed countries of the world who regularly have low colon cancer rates. In the presence of a low-fat, high-fiber diet, it would not be expected that dietary calcium would lower colon cancer incidence, in contrast to the role it has been shown to have in populations that have a Western diet.1 Incidentally, studies from Latin countries now show a protective effect of calcium on colon cancer incidence.2

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