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To the Editor,A paper by Wong [1] reported an inverse correlationbetween incident solar radiation and coronary heart disease(CHD) mortality rates in Western Europe. It was hypoth-esized that the associated was mediated by vitamin D3synthesis. This hypothesis is supported by a recent meta-analysis of prediagnostic serum 25-hydroxyvitamin D[25(OH)D] levels and incidence of cardiovascular disease[2]. However, vitamin D production is due only to ultra-violet-B (UVB) irradiance, not total insolation. SinceNordic countries experience about a six-month vitamin Dwinter [3], oral intake of vitamin D is higher in northernEurope than in southern Europe, resulting in higher serum25(OH)D levels in the north, as shown in Figure 8 in [1].An alternate explanation for the correlation with inci-dence solar radiation is the variation of the prevalence ofapolipoprotein E epsilon4 (ApoE4) allele, which is a sig-nicant risk factor for CHD [4]. At higher latitudes, freshfruits and vegetables are less readily available than at lowerlatitudes (see Figure 1 in [1]); as a consequence, preva-lence of the ApoE4 allele increases with latitude. Based ondata in Gerdes et al. [5], the prevalence of ApoE4 risesfrom 8.3% in Greece to 22% in Finland with a slope of0.53% per degree latitude [6]. ApoE4 causes the liver toproduce more cholesterol and the pancreas more insulin inorder to store more food as fat when food is more abundant[6]. Average solar insolation falls from 4.7 kWh/m

Prevalence of apolipoprotein E epsilon4 allele may explain the geographical variation of coronary heart disease mortality rates in Western Europe