Low-Fat Diet Won't Stop Cancer or Heart Disease

[ingridsf]

I was eating a BLT when I read, "The largest study ever to ask whether a low-fat diet keeps women from getting cancer or heart disease has found that the diet had no effect...." http://www.nytimes.com/2006/02/07/health/0...artner=homepage

[Gifted Gourmet]

An invitation to go out and enjoy a Whopper tomorrow?

I can't help but think that Dr. Dean Ornish will continue to push his diet which is primarily grains and vegetables ... which he has long proven lowered heart disease ...

There will, without any doubt whatsoever in my mind, be further discussion on this study and fats ...

In the meantime, in between time, ain't we got fun? Man, that Burger King creepy, slightly weird guy is reallly looking better by the moment ....

[hjshorter]

I can't help but think that Dr. Dean Ornish will continue to push his diet which is primarily grains and vegetables ... which he has long proven lowered heart disease ...

His original tome is the most joyless thing I've ever read in my life.

Thanks for the link, ingridsf. Very interesting.

[JanMcBaker]

I'd love to see a large scale study that compares a group eating processed foods to one eating non- or minimally processed foods. I'd be very curious to see what the rates of cancer and heart disease would be in the two groups after that!

Edited by me to add-- But would the processors of highly processed foods allow such a study to take place?

Edited February 8, 2006 by JanMcBaker (log)

[johnnyd]

I'd love to see a large scale study that compares a group eating processed foods to one eating non- or minimally processed foods.  I'd be very curious to see what the rates of cancer and heart disease would be in the two groups after that!

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Now we're talking.

Think of the funds devoted to suppressing said large scale study results too!

[Gifted Gourmet]

just don't ask Morgan Spurlock (Super Size Me) his opinion ...

[JohnL]

Front page of today's NY Times (someone will provide a link I am sure).

Headline:

Low-Fat Diet Does Not Cut Health Risks, Study Finds.

Basically the story covers results from "the largest study (49,000 women followed over eight years) ever to ask whether a low fat diet reduces the risk of getting cancer or heart disease has found that the diet HAS NO EFFECT."

The most prescient quote is from Dr Jules Hirsch, physician in chief emeritus at Rockefeller University:

"They (the results) should put a stop to to this era of thinking that we have all the information we need to change the whole national diet and make everybody healthy."

Interesting.

Edited February 8, 2006 by JohnL (log)

[srhcb]

Just because a high fat diet can contribute to cancer or heart disease there was never really any reason to believe a low fat diet would have an opposite effect.

It may seem logical, thus worthy of study, (although I don't know 415 million dollars worth?), but our bodies mechanisms don't function in accordance with grammatical rules of the English language. A premise based on an opposite doesn't change cause and effect into effect and cause.

Common sense would seem to provide a better conclusion; that too much or too little of anything isn't good.

SB (too bad "common sense" has become an oxymoron)

[lesfen]

This study was also conducted on post-menopausal women with an average age of 62. Maybe a study about changing your habits earlier in life would be in order as well.

[FabulousFoodBabe]

SB (too bad "common sense" has become an oxymoron)

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You got that right!

I saw this on the news last night, about low-fat diets not doing a heck of a lot to stop whatever it is they were trying to stop. I don't put much stock into studies of people who've had a diet or lifestyle inflicted on them for a couple of years when they reach 60 or 70.

Yanno, I'm not so sure I want to live to be 100. By all rational accounts, my family members should not have lived anywhere near the 90-100 most all of them have. If I know I'm going to live that long, I'll have to save more money now to afford yucky nursing home food in 50 years. by then, though, they should have orthopedic Manolos all over the place.

[west2100]

I will always maintain it's not so much the percent of diet that's fat that contributes to heart disease, it's simply too many calories and obesity. However, the kinds of fats make a huge difference. Lard and olive oil, both fat, have very different effects.

[annecros]

I'd love to see a large scale study that compares a group eating processed foods to one eating non- or minimally processed foods.  I'd be very curious to see what the rates of cancer and heart disease would be in the two groups after that!

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I think this is the rub. Somebody should study it.

[annecros]

SB (too bad "common sense" has become an oxymoron)

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You got that right!

I saw this on the news last night, about low-fat diets not doing a heck of a lot to stop whatever it is they were trying to stop. I don't put much stock into studies of people who've had a diet or lifestyle inflicted on them for a couple of years when they reach 60 or 70.

Yanno, I'm not so sure I want to live to be 100. By all rational accounts, my family members should not have lived anywhere near the 90-100 most all of them have. If I know I'm going to live that long, I'll have to save more money now to afford yucky nursing home food in 50 years. by then, though, they should have orthopedic Manolos all over the place.

←

Agreed. If nothing else, at least we have learned that inflicting culinary torture upon an old person makes no difference. They've lived this long, and by gosh, shouldn't they be enjoying thier golden years, without the added insult of oatmeal at every turn until they can't stand to see another bowl, and taking bacon away from them?

[Patrick S]

I don't think the results for breast and colorectal cancer are too surprising, given the inconsistent findings in previous studies examining the relationship between diet and cancer. The findings about heart disease and stroke are much more unexpected.

West2100:

I will always maintain it's not so much the percent of diet that's fat that contributes to heart disease, it's simply too many calories and obesity. However, the kinds of fats make a huge difference. Lard and olive oil, both fat, have very different effects.

And in support of this, the paper that covered cardiovascular disease did note that "[t]rends toward greater reductions in CHD risk were observed in those with lower intakes of saturated fat or trans fat". On the other hand, given that the study had almost 50,000 participants and 8 years of follow-up, and still found only a statistically insignificant trend towards reduced CHD in those with lower intake of sat and trans fat, it may be that even differences in the types of fats consumed have only a very modest impact on CHD risk.

[JanMcBaker]

I'd love to see a large scale study that compares a group eating processed foods to one eating non- or minimally processed foods.  I'd be very curious to see what the rates of cancer and heart disease would be in the two groups after that!

←

Now we're talking.

Think of the funds devoted to suppressing said large scale study results too!

←

Amen! Your comment triggered the edit to my original post.

[jsolomon]

From my tip-of-the-iceberg understanding of ontogeny, philogeny, genomics, and proteomics, I think it would be equally instructive to re-conduct this study using 15-25 year-olds as the test subjects. Possibly, even younger people. Cellular, organ-level, and systemic feedback mechanisms evolve and respond more in younger humans, and can get "stuck" in certain states depending on many factors.

I think it would be quite instructive to study them before they're "stuck".

Of course, I also am a large supporter of eating what you would like and exercising the calories off (and there are lots of fun types of exercise--the less socially acceptable the better).

[ingridsf]

What I'm savoring, like Schadenfreund-flavored Altoid ("curiously German"), is what I hope will be a dampening effect on the pharmaceutical industry. Brand-name drugs like Lipitor got a huge boost when the standard for what constituted "high cholesterol" was changed. Because the number was lowered, many more people were prescribed the medication and, in cases like my uninsured friend, suffered needless anxiety because he couldn't afford it.

On the other hand, Emeril's message, "Pork fat rules!" will probably grease the way to him becoming the next Surgeon General. The night before last (right before the study hit the news) he had a show where he made fresh andouille, stuffed it a pork chop, wrapped it all up in bacon and smothered it in ham hock gravy. If you listened carefully, you could hear Jane Brody sobbing in the background.

Edited February 8, 2006 by ingridsf (log)

[doctorandchef]

THe study should be interpreted with caution.

In the accompanying editorial in JAMA (Journal of the American Medical Association), there were some issues that were raised. this is a direct quote:

"The study population was healthier than anticipated. Specifically, fewer CVD events occurred than were expected. In addition, the intervention had minimal effect on the major, diet-related CVD risk factors. Its impact on blood pressure was small because the intervention did not implement dietary modifications that lower blood pressure—eg, reduced salt intake, increased potassium intake, the DASH (Dietary Approach to Stop Hypertension) diet, and weight loss.7 The intervention reduced intakes of fats that increase risk of CVD (saturated fat and trans fatty acids) but also of those that might be protective (polyunsaturated fats and monounsaturated fats). Most participants were overweight or obese (mean body mass index, 29.1), but the intervention did not address weight, the primary risk factor for diabetes. Over the course of follow-up, the intervention group lost only 0.4 kg more weight than the comparison group.6 Moreover, while there were statistically significant contrasts in several dietary factors between the intervention and comparison groups, the magnitude of the effects were modest for those nutrients and foods most likely to affect CVD risk factors and outcomes. In post hoc power calculations, the authors estimate that the study had only 40% power to detect a 14% reduction in CVD over the 8.1 years of follow-up. "

The next logical question one might ask is does extended follow-up add sufficient power to detect a benefit of the intervention? For instance, passive follow-up of participants in the Multiple Risk Factor Intervention Trial (MRFIT) and the Modification of Diet in Renal Disease (MDRD) trial documented statistically significant benefits from interventions, despite nonsignificant results during the initial trial period.8-9 While it seems unlikely that longer follow-up in the WHI Dietary Modification Trial will be useful for detecting a difference in CVD outcomes between the randomized groups, such longer follow-up could enhance power for observational analyses.

[doctorandchef]

In other words, the current recommendations for lower fat diets have NOT changed nor will they be changed whatsoever based on this study i.e keep total fat intake to <35% total calories, <10% saturated fats etc.

There are other studies looking at increasing mono and polyunsaturated fats plus more fish consumption (>2 servings per week) with positive results.

If you have heart disease or diabetes, I would certainly not abandon your "healthy eating choices" based on the headlines you will see in the coming weeks i.e. headlines to the effect of "low fat diets not helpful for heart disease". IF you have any questions, please ask your doctor or registered dietician if you are lucky enough to have one.

Cheers.

[DTBarton]

I've been following this for a long time. It first really came to my attention several years ago in an article by a cardiologist where he stated that half his cardiac disease/heart attack patients had the common risk factors, mainly high cholesterol levels and some high blood pressure. He went on to say, though, that over many years, half of his patients DID NOT! So he couldn't vouch for any real correlation between the risk factors and actual problems.

Evidence is starting to mount in this direction. I've believed for some time that genetics accounts for the vast majority of your susceptibility to cardiac disease (and cancer, for that matter). You can fiddle around the edges by doing common sense smart stuff. Use moderation in portions, don't allow yourself to get morbidly obese, don't smoke or drink too heavily, don't be sedentary, etc. But to believe that simply following a low fat diet and monitoring body numbers is going to give you a huge edge seems like a stretch. I know some people who obsess so much over their cholesterol levels and blood pressure that I'd swear the stress they're inducing in themselves over it is more harmful than anything they're eating.

Plus, for us food nuts, obviously a life without good food is not really worth living anyway!

Following is a column (http://www.washtimes.com/commentary/20060218-100154-2237r.htm) with more details about this notion and comments on the fact that the medical establishment still insists that low fat diets are gospel despite significant clinical evidence that they're not. I think this is due to several factors. First, no one wants to admit they've been wrng for so long. Second, there's gold in them there blood pressure and cholesterol drugs for the pharmaceutical compnaies (I don't blame the companies, they're filling the demand created by doctors). Third, and most important, I think, is the current state of medical liability. Doctors tend to prescribe medication at any sign of the alleged risk factors to shield them from liability in the event a patient has a heart attack and the doctor didn't try to give them the prescriptions. This leaves the doc open to lawsuits from the family.

Any thoughts? Are you believers in the low fat gospel or think it's trumped up somewhat?

As a matter of fat

By John Luik

February 19, 2006

Those new studies showing low-fat diets don't reduce cancer and heart disease aren't the real story. The real story is that the health establishment has known for decades how ineffective such "lifestyle changes" are, and that they don't intend to change their advice to Americans regardless of what the science shows.

There's always been strong evidence the central tenet in the religion of preventive medicine -- low-fat diets will reduce or prevent cancer and heart disease -- is false. The advice dished out by the health establishment about lifestyles is mostly based on "indirect evidence." In the language of science, that means we really have no evidence at all

Edited February 20, 2006 by DTBarton (log)

[Jensen]

Following is a column with more details about this notion and comments on the fact that the medical establishment still insists that low fat diets are gospel despite significant clinical evidence that they're not.

The column doesn't actually provide any evidence to support their position. It refers to studies but often doesn't tell the reader where the study took place, who conducted it, or give a reference to the published results. It's really very vague and tenuous.

In total, three studies are mentioned and, based on that overwhelming sample size, the author has decided that all other studies are bunk?

The article also suggests that studies which appear to refute the orthodoxy are often dismissed based on the gender of the study subjects. Now, correct me if I'm wrong, but I was always under the impression that the vast majority of medical studies were conducted on men, especially when it came to cardiac studies.

Sorry, but the entire article reads like propaganda of some sort to me and, as such, it doesn't come across as the least bit credible.

[Gifted Gourmet]

Wasn't this the essence of the study so widely discussed here and everywhere last week? The lower fats did not protect any of the women in the study ...NYT article here Low-Fat Diet Does Not Cut Health Risks, Study Finds and the charts today also in the NYT confirm details as well.

[Patrick S]

Wasn't this the essence of the study so widely discussed here and everywhere last week? The lower fats did not protect any of the women in the study ...NYT article here  Low-Fat Diet Does Not Cut Health Risks, Study Finds  and the charts today also in the NYT confirm details as well.

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Yes, that is in essence what the recent studies found. But there is still plenty of room for interpretation left for advocates of low-fat diets. For instance, the difference in fat intake was not huge between the two groups: by the end of the study period, the "low-fat" group was only consuming about 8% less of their calories from fat than did the control group (29% vrs 37%).

A die-hard low-fat advocate could just say "Of course an 8% reduction in fat intake will not result in a statistically significant reduction in CHD in 8 years in postmenopausal women! You'd have to reduce your fat intake to no more than 20% of calories, and you have to start that intervention before menopause." Personally I am convinced that total calories is much more important than calories from fat, but this is the type of criticism advocates of low-fat diets will likely be making -- that the studies are perfectly valid as far as they go, but that the interventions were not drastic enough.

[tejon]

A friend of mine's mother was actually one of the post-menopausal women in that study. She did eat a low-fat diet during the study, but it consisted almost entirely of overly processed "lowfat" products like Snackwells cookies, etc. This was evidently typical of most of the participants as well. I have to wonder if the study results would have been different if all the participants had eaten more nutritionally balanced foods, with one group eating a higher percentage of fat than the other.

[Patrick S]

Looking back at the results of the Nurse's Health Study, the recent results don't seem so suprising. The paper by Hu et al (1998) reported an analysis involving more participants (80,082 women), a younger population (34 to 59), and a longer follow-up (14 years) than the WHI study. They reported that while total fat intake was not significantly associated with risk of CHD, individual fats were associated with CHD. In particular, while saturated and trans fats were associated with increased CHD risk, mono- and polyunsaturated fats were associated with decreased CHD risk. This would seem to fit really well with the results from WHI -- which showed no relation of total fat to CHD risk, but trends toward increased risk with higher saturated and trans fat intake.

Hu et al, 1998. Dietary Fat Intake and the Risk of Coronary Heart Disease in Women. New England Journal of Medicine 337:1491-1499.

Edited February 21, 2006 by Patrick S (log)