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WHI low-fat diet flawed; some benefit shown.(Gynecology)
BETHESDA, MD. -- The biggest problem with the diet modification study of the Women's Health Initiative was the diet. Not enough women stuck with it, and it had an outdated design.
Despite these flaws, the trial's results, first reported in February, came close to proving that a reduced-fat diet--followed by thousands of postmenopausal women for an average of 8.1 years--could significantly reduce the incidence of invasive breast cancer.
"It's not an optimal diet; it's not feasible" for many women, commented Dr. JoAnn E. Manson at a conference on the Women's Health Initiative sponsored by the Department of Health and Human Services. The average level of fat reduction that most women achieved in their diet was not as substantial as had been planned, blunting the diet's effects.
Despite this shortcoming, the results showed "signals" that a low-fat diet produced some benefits, including a trend toward a reduced number of invasive breast cancers, a bigger reduction in breast cancers among women who had the highest level of fat in their diet at baseline, and a reduction in the incidence of colonic polyps or adenomas, said Dr. Manson, chief of the division of preventive medicine at Brigham and Women's Hospital, Boston, and a principal investigator for the WHI.
The study failed to show that the reduced-fat diet with increased consumption of fruits, vegetables, and grains could lower the incidence of cardiovascular disease.
"You need a 20%-30% decrease in low-density lipoprotein cholesterol to get an effect" on cardiovascular disease. "In this study, the effect was way too low," commented Dr. Lewis H. Kuller, professor of epidemiology at the University of Pittsburgh and a principal investigator for the WHI. The diet was also "too low in polyunsaturated fats. You blunt the LDL effect by reducing polyunsaturated fats," he said in an interview.
In this respect, the diet reflected what was known when it was designed in the early 1990s. Today, researchers have a better understanding of the benefit of polyunsaturated fat for cardiovascular disease and of the danger from saturated fat.
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Source: HighBeam Research, WHI low-fat diet flawed; some benefit shown.(Gynecology)