Sir.—The article by Cohen et al on "Chronic Nonspecific Diarrhea" (Journal 133:490-492, 1979) contains some disturbing concepts and raises important questions.
What is "diarrhea"? What is the normal stool pattern of humans who consume diets rich in fruit and other fibers? The five children reported were receiving diets that in most respects correspond exactly to those recommended as "dietary goals for the United States": increased consumption of complex carbohydrates and "naturally occurring" sugars, from about 28% of energy intake to about 48% of energy intake; reduced overall fat consumption, from approximately 40% to about 30% of energy intake; reduced saturated fat consumption, to about 10% of total energy intake. This is supposed to be accomplished by increased consumption of fruits, vegetables, and whole grains; by decreased consumption of foods rich in total fat, and partial replacement of saturated fats with polyunsaturated fat; by decreased consumption of animal fat,