Letter by Hnid Regarding Article, "Low-Calorie Vegetarian Versus Mediterranean Diets for Reducing Body Weight and Improving Cardiovascular Risk Profile: CARDIVEG Study (Cardiovascular Prevention With Vegetarian Diet)".

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HomeCirculationVol. 138, No. 6Letter by Hnid Regarding Article, “Low-Calorie Vegetarian Versus Mediterranean Diets for Reducing Body Weight and Improving Cardiovascular Risk Profile: CARDIVEG Study (Cardiovascular Prevention With Vegetarian Diet)” Free AccessLetterPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessLetterPDF/EPUBLetter by Hnid Regarding Article, “Low-Calorie Vegetarian Versus Mediterranean Diets for Reducing Body Weight and Improving Cardiovascular Risk Profile: CARDIVEG Study (Cardiovascular Prevention With Vegetarian Diet)” Karim Hnid, MD Karim HnidKarim Hnid Mitochondria Interest Group, Cardiovascular Medicine, Nouaceur, Morocco. Search for more papers by this author Originally published6 Aug 2018https://doi.org/10.1161/CIRCULATIONAHA.118.035006Circulation. 2018;138:653–654To the Editor:I read with great interest the article by Sofi and colleagues1 about the CARDIVEG trial. I congratulate the authors for their prophylactic work, which effectively contributes to the fight against cardiovascular disease worldwide.Synergistic and interactive combinations of nutrients in Mediterranean diets confer a beneficial effect against cardiovascular disease.1,2 Lacto-ovo vegetarian diets also contribute to lower obesity, lower blood pressure, and decreased incidents of diabetes mellitus.1,2 This study compares the 2 diets in terms of primary and secondary outcomes.I think that an essential factor of both diets is pesticide residues, the causalities of which in relation to cardiovascular morbi-mortalities and diabetes mellitus have been confirmed, and these could interfere with these results.3 Pesticides are widely used in food production to control pests.This standard agricultural practice of using plant-protection products cannot protect food from pesticide residues, which create a health risk to consumers and animals.3,4 All treated food can transmit harmful chemical products resistant to biotic and abiotic degradation to humans through pesticide residues.3,4Indeed, food contamination has been a worldwide public health concern, and the contaminations of food with pesticides is an important subject for scientific researchers in their respective studies.3 This has contributed to the fact that several countries impose draconian measures to limit those contaminations.However, in the United States, where the Food and Drug Administration is uncompromising, the 2004 study of National Health and Nutrition Examination Survey (NHANES) data5 by Dana B. Barr and colleagues clearly showed that 70% of children presented detectable levels of ≥1 pesticide, of which the essential source was diet.Therefore, integrating an analysis of patients’ pesticide residue levels, and including above-normal levels as study exclusion criteria, would have allowed a better performance of both diets in terms of primary and secondary outcomes.DisclosuresNone.Footnoteshttps://www.ahajournals.org/journal/circ