[joey m]

Escapee,

Some of what you posted holds water, but most does not. Your condemnation of fruits and vegetables makes little sense when you view the vast majority of studies out there, and it makes little sense even in light of some of the studies you posted.

The key isn't just to find studies that support your point, but to analyze the studies to see if they are in fact good studies.

Here is a response to the Journal of the American Medical Association, Vol. 295 No. 6, February 8, 2006, pp. 629-642. from Susan Mayne, PhD, a professor in the Yale University School of Medicine Department of Epidemiology & Public Health, and associate director at the Yale Cancer Center.

Study shows that more research is warranted

News of this study has generated a lot of interest, but unfortunately caused just as much confusion. Women are wondering if they should bother to eat a carrot stick rather than an ice cream bar, if it really doesn't make a difference anyway.

As a nutritional epidemiologist, this topic fascinates me. I think that women shouldn't discount this study.

Unfortunately, the media seems to have overly simplified the results by just saying that a low-fat diet hasn't helped reduce the risk of breast cancer.

Women still got less cancer
The media oversimplification of these results is unfortunate. While the study didn't prove by statistical standards that a low-fat diet cuts one's risk of breast cancer, the women who ate less fat, got less cancer — in fact, 9 percent less. Further, the benefit was both more dramatic (22 percent lower risk) and statistically significant in women with the highest fat intake at baseline.

And while I consider 9 percent still less, scientists won't determine whether a study proves an effect unless it hits a statistically significant level. Scientists will say, "How do we know that this reduction didn't just happen by chance?"
“All in all, the dietary modification group got fewer cases of breast cancer, and when they did get cancer, there was a 23 percent reduction in breast cancer mortality.”

While the dietary modification group did better than the comparison group, it wasn't statistically significant enough to call the study a success. That may change with additional follow-up. All in all, the dietary modification group got fewer cases of cancer, and when they did get cancer, there was a 23 percent reduction in breast cancer mortality.

Study difficult to carry out
From the start, the study had challenges. Scientists knew it would be hard to carry out, especially because it was such a large study and involved women who had only "volunteered" to modify their diets.

One of the first problems was really making sure that women were adhering to the new diet. Could they have been cheating and not owning up to it?

There is no biomarker that would show the researchers what the women were eating. Scientists couldn't test to see if their diet was low in fat. The closest marker they had was to check their body weight. The dietary modification group initially lost weight, but found it hard to sustain year after year. They did not see a big loss of weight in the later years. This likely means that women found it tough to stick to the diet as the years progressed. I have to say, it was a tough intervention to follow.

Women cut both good and bad fats
Second, the women were asked to cut all fats. At the time the study was started in the early 1990s, the role of specific fats in breast cancer was not clear. Today, however, we know that fats like fish oil and olive oil are actually good for us for cardiovascular disease prevention and possibly cancer prevention. So in the study group, women were also cutting the good fats that help our bodies.

Another problem with the study was that it only included women age 50 and over. Perhaps at age 50 it's too late to start eating more healthfully and to undo the damage of decades of poor eating. Perhaps it takes a lifelong dietary pattern of eating well to make a difference? These are questions we all need to consider.
“I personally believe that a good diet is a lifelong process.”

I personally believe that a good diet is a lifelong process. Cancer affects us through genetics and lifestyle. We can't change our genes, but we can modify our lifestyle by not smoking, eating well, maintaining an appropriate body weight and exercising.

Dr. Mayne is echoing much of what I said in my previous post.

Further, if you look at the study you posted:

Results By year 6, mean fat intake decreased by 8.2% of energy intake in the intervention vs the comparison group, with small decreases in saturated (2.9%), monounsaturated (3.3%), and polyunsaturated (1.5%) fat; increases occurred in intakes of vegetables/fruits (1.1 servings/d) and grains (0.5 serving/d).

You also quoted the study: Abstract: Low-Fat Dietary Pattern and Risk of Cardiovascular Disease: The Women's Health Initiative Randomized Controlled Dietary Modification Trial, February 8, 2006, Howard et al. 295 (6): 655

This is another terribly done study that shows next to nothing. Did you read the actual study?

Let me quote some of the findings and then I'll discuss it:

Results By year 6, mean fat intake decreased by 8.2% of energy intake in the intervention vs the comparison group, with small decreases in saturated (2.9%), monounsaturated (3.3%), and polyunsaturated (1.5%) fat; increases occurred in intakes of vegetables/fruits (1.1 servings/d) and grains (0.5 serving/d).

This study basically compared two groups who both ate unhealthy diets, so why would we presume their health would get better.

According to the study's authors, the "low fat diet" they told the women in the study to eat is as follows:

...postmenopausal women in the intervention group were advised to reduce total fat intake to 20% of energy and to consume at least 5 servings of fruits and vegetables and 6 servings of grains daily; women in the control group continued their usual eating pattern.

What happened, though, is that the women in the low fat group actually ate just about one more serving of fruit or vegetable per day, fell far short of the even the modest 20%-of-energy-from-fat goal, and consumed the same number of calories as the women who did not modify their diets.

Gina Kolata reports in The New York Times:

In the first year, the women on the low-fat diets reduced the percentage of fat in their diet to 24 percent of daily calories, and by the end of the study their diets had 29 percent of their calories as fat. In the first year, the women in the control group were eating 35 percent of their calories as fat, and by the end of the study their dietary fat content was 37 percent. The two groups consumed about the same number of calories.

So neither of these are low fat diets, and even if they were, low fat dieting isn't the key to longevity.

Now, if they had increased fruit and vegetable servings by 5 a day, I think we would have a very different study. Increasing fruits and vegetables by one serving combined, when you are talking about post-menopausal women is really nothing.

Even then, look at this quote from that study:

Trends toward greater reductions in CHD risk were observed in those with lower intakes of saturated fat or trans fat or higher intakes of vegetables/fruits.

Best,
Joey