Low fat diet ineffective?

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Category : Medical Rants

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

The largest study 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 $415 million federal study involved nearly 49,000 women ages 50 to 79 who were followed for eight years. In the end, those assigned to a low-fat diet had the same rates of breast cancer, colon cancer, heart attacks and strokes as those who ate whatever they pleased, researchers are reporting today.

“These studies are revolutionary,” said Dr. Jules Hirsch, physician in chief emeritus at Rockefeller University in New York City, who has spent a lifetime studying the effects of diets on weight and health. “They should put a stop to this era of thinking that we have all the information we need to change the whole national diet and make everybody healthy.”

The study, published in today’s issue of The Journal of the American Medical Association, was not just an ordinary study, said Dr. Michael Thun, who directs epidemiological research for the American Cancer Society. It was so large and so expensive, Dr. Thun said, that it was “the Rolls-Royce of studies.” As such, he added, it is likely to be the final word.

“We usually have only one shot at a very large-scale trial on a particular issue,” he said.

The results, the study investigators agreed, do not justify recommending low-fat diets to the public to reduce their heart disease and cancer risk. Given the lack of benefit found in the study, many medical researchers said that the best dietary advice, for now, was to follow federal guidelines for healthy eating, with less saturated and trans fats, more grains, and more fruits and vegetables.

Of course, whenever you see a large study like this, the critics comes out immediately. I always recall the Nietzsche quote – “There are no facts, only interpretations.” We have data now, but data often resembles a Rorshach test. We see in this study what we want to see.

A few samplings might make the point.

Not everyone was convinced. Some, like Dr. Dean Ornish, a longtime promoter of low-fat diets and president of the Preventive Medicine Research Institute in Sausalito, Calif., said that the women did not reduce their fat to low enough levels or eat enough fruits and vegetables, and that the study, even at eight years, did not give the diets enough time.

Others said that diet could still make a difference, at least with heart disease, if people were to eat the so-called Mediterranean diet, low in saturated fats like butter and high in oils like olive oil. The women in the study reduced all kinds of fat.

The diets studied “had an antique patina,” said Dr. Peter Libby, a cardiologist and professor at Harvard Medical School. These days, Dr. Libby said, most people have moved on from the idea of controlling total fat to the idea that people should eat different kinds of fat.

But the Mediterranean diet has not been subjected to a study of this scope, researchers said.

And Barbara V. Howard, an epidemiologist at MedStar Research Institute, a nonprofit hospital group, and a principle investigator in the study, said people should realize that diet alone was not enough to stay healthy.

“We are not going to reverse any of the chronic diseases in this country by changing the composition of the diet,” Dr. Howard said. “People are always thinking it’s what they ate. They are not looking at how much they ate or that they smoke or that they are sedentary.”

Except for not smoking, the advice for a healthy lifestyle is based largely on indirect evidence, Dr. Howard said, but most medical researchers agree that it makes sense to eat well, control weight and get regular exercise.

The BBC runs the story with a different spin – Diet doubts attacked by experts

A US study of over 19,500 women found cutting back on fat for almost a decade failed to offer significant protection against some cancers and heart disease.

But British experts say salt levels were not cut, and many of the women were overweight or obese.

So what do we know? I would bet money that just decreasing the fat in my diet is unlikely to help me. What do I do? I try to move towards a Meditarrean diet, and try to exercise and maintain a desired weight. I do not smoke.

The last sentence is the key. You can play with your diet; you can run marathons (at least until your COPD gets you); but smoking is the greatest risk factor that I know.

So what is a health conscious person to do? Make your best guess. I have stated mine. Here I will quote one the greatest Jewish philosophers of all time – Maimonides – “The risk of a wrong decision is preferable to the terror of indecision. ”

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Comments (4)

If low-fat is a fad, than that throws down the gauntlet on any number of seemingty self-evident diet strategies. Interesting.

I discussed portions of my opinions of this study on a web-based food discussion board. The gist is, I believe that by 50, many of our diet-related pathologies have already been set well in motion. It would be interesting to see this study repeated on a younger population.

Of course, instead of a set of pertinent negatives, I would also like to see medical dietary recommendations recast into things like: learn to make 45-minute vegetable soup. Bake your own bread. Discuss your plans over meals. Try a raw fruit-based dessert.

This, of course, begs the questions: can physicians prescribe cooking lessons as a valid therapy?

Remember, the diet industry is a huge business in this country and a major shift in dietary guidelines will have a large impact, not only on the companies involved, but doctors who are involved in weight loss.

Nice Maimonides quote.

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