Studies: Diet doesn't lower risks

Cutting certain fats rather than total fat may be important, scientists said.
Older women who turn to a diet low in fats and high in fruits, vegetables and grains don't generally lower the risk of breast and colon cancers or heart disease, according to new studies.
The three studies, published today in The Journal of the American Medical Association, were done through the Women's Health Initiative (WHI), a 15-year look at the causes and prevention of diseases affecting women after menopause.
The studies included 48,835 American women, ages 50 to 79. Forty percent were randomly assigned to go on a low-fat diet, with only 20 percent or less of their daily calories coming from fat. The other women were not asked to make any dietary changes. The dieting women were also asked to eat five or more daily servings of fruits and vegetables and six servings of grains.
Although the research is considered the most valid of the many done on the effects of a low-fat diet, the scientists noted that most of the women put on the diet didn't meet the goal of 20 percent. On average, the women reduced fat intake to 24 percent in the first year they were in the study, but crept up to 29 percent by the eighth year. The fat share of their diets at the start of the study was between 35 percent and 38 percent.
"If we had achieved an even higher adherence rate, I believe the study's results would have been more dramatic," said Ross Prentice, a biostatistician at the Fred Hutchinson Cancer Research Center in Seattle. He was the lead author of the study on breast cancer.
Over an average follow-up period of eight years, the women in the low-fat-diet group reduced their overall rate of breast cancer by 9 percent compared with women in the control group, a difference not considered statistically significant.
For colorectal cancer, the rate in the diet group was 0.13 percent per year, virtually the same as the 0.12 percent per year in the control group. The low-fat group's heart-disease rate was only 3 percent less than the control group's, and the dieters' low-density lipoprotein (LDL) or "bad" cholesterol was only 2.4 percent lower.
But researchers say they did see benefits from the low-fat diet, particularly regarding some breast-cancer rates among women who were eating very-high-fat diets to start with. And the scientists noted recent research that suggests cutting certain fats from the diet, especially saturated and trans fats, may be more important than curbing total fat consumption.
What matters
"Nutrition knowledge has progressed dramatically since the study began," said Mara Vitolins, a registered dietitian and co-author of all three studies. "Today, we know that reducing total fat may not be enough; we need to focus on the types of fat we eat," added Vitolins, an associate professor of public health at Wake Forest University Baptist Medical Center.
Marcia Stefanick, a professor at the Stanford University Prevention Research Center and chairwoman of the WHI steering committee, said the dieting women were not asked to distinguish between "good fat" -- unsaturated fats found in fish, nuts and vegetable oil -- and the saturated fats and trans fats found in processed foods, meats and some dairy products.
Current dietary guidelines call for keeping saturated fats to less than 10 percent of daily calories and limiting consumption of trans fats.

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