G Lynch

meant by "more effective." This unqualified assertion is likely to confuse the many people who already use or recommend All-Bran as an "effective" means of avoiding constipation whatever its soluble:insoluble fibre ratio or influence on plasma lipids, mineral absorption, faecal bulking, bowel transit time, etc. Furthermore, it is difficult to see why "wholemeal bread and crispbreads" are the only items to be recommended for a weight reducing diet from a list which includes acceptable alternatives such as granary bread, Hovis, HiBran, and Vitbe (presumably Vitbe Wheatgerm). Appreciation of patient preference appears to be totally forsaken in these inflexible recommendations for breakfast cereals and bread, which thus ignore the possibility of including suitable second best choices in an attempt to encourage dietary compliance. An important opportunity to stimulate the growing interest in nutrition among medical practitioners has been missed. Nutrition educators who hope to be heeded must avoid the traditionally condescending attitude which is scattered throughout this series of articles. ANNE BRUCE