Macronutrient estimations in hunter-gatherer diets.

with our data and study design. The comment of Kalman and Colker regarding nutrient analysis is also incorrect. Besides the analysis of macronutrients and isoflavones, we also calculated total cholesterol and saturated, monounsaturated, and polyunsaturated fat, as stated in the paper. Soy intake was also known because the only form of soy consumed was the one provided in the test protein (1). Regarding the non-HDL-cholesterol values, non-HDL cholesterol is by definition any cholesterol that is not associated with HDL particles, and it corresponds to the cholesterol from all apolipoprotein B–containing lipoproteins [ie, VLDL, IDL, LDL, and lipoprotein(a)] (6). We labeled non-HDL cholesterol as VLDL + LDL cholesterol because the traditional definition of LDL entails LDL + IDL + lipoprotein(a) (7). We chose to report non-HDL cholesterol because it has been shown to be a good indicator of coronary heart disease (6). We agree that measuring actual concentrations of LDL and VLDL cholesterol separately would provide additional useful information, especially because LDL cholesterol is used historically to determine risk of coronary heart disease (8). LDL cholesterol is also commonly determined through use of the Friedewald formula (9). However, it is well known that this formula is not accurate if triacylglycerol concentrations are > 4.66 mmol/L (400 mg/dL) (10). Moreover, when triacylglycerol concentrations are between 2.3 and 4.5 mmol/L (200–400 mg/dL), LDL-cholesterol values obtained by the Friedewald formula show considerable variability as compared with those from ultracentrifugation (10). Most patients in our study fell into 1 of the 2 previous categories, so we chose not to use the Friedewald formula.