Not so good news for a low fat diet

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Three papers in JAMA report on a large randomized trial in 50-70 years old women that indicates that a low-fat diet has no significant effect on cardiovascular disease, colorectal cancer, and invasive breast cancer. Even if we ignore the statistical significance issues, the central estimates of the effect are quite small: with only 9% for breast cancer and basically no effect for cardiovascular disease and colorectal cancer.

Two things worth noting here. This was actually a pretty aggressive intervention: 37% Calories from fat in the control group and as opposed to 28.8% Calories from fat in the intervention group--though this fell short of the study targets. Second, only a very modest improvement in cardiovascular risk factors (a few percent) was achieved, although, as noted, this doesn't seem to translate into an improvement in actual events. The bottom line, then, is that either you need a much more aggressive intervention--and given the study data, this will be hard to obtain in healthy people--or that we need to consider giving up on the low fat project entirely.

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I'm not sure how much I believe the study, for a number of reasons. First, 28.8% is still a pretty high percentage of your calories from fat compared to the levels achieved by studies like Dean Ornish's work. There very well may be threshold effects here. Second, I'm not sure how much I believe the methodology by which the diets of the people in the study were measured -- I'm not even entirely sure that they did lower their dietary fat intake significantly. Too much of it is based on self reporting.

Well, this is a fair point, but then I think you need to explain what interventions you think will actually work in the sense that compliance will be high enough to be worth bothering with.

Oh dear. There's fat and there's fat. The big glob fat -- LDL -- BAD! the little glob fat -- HDL -- GOOD! other stuff makes food taste good but has unnecessary calories. I don't eat meat from mammels (cows, sheep, pigs, goats, buffalo) and have not for 18 years. Just because eating our close kin results in a big increase in colon cancer -- fat or no fat. I eat lots and lots of cabbage, kale (ugh!) brocolli, sauerkraut, cauliflour, and watercress. (Correlates with lower cancer risk.) I eat lots and lots of tomato sauce in and over almost anything else because of the lycopene content. I eat currants, walnuts, figs, grapes, mangos, pomegranite juice, and OJ. I exercise 30 minutes three times a week by vigorous walking with light weights pumping in my hands so as to divide the stress, and I walk to most places rather than taking the bus or subway. I drink half a bottle or more of Finger Lakes Pinot Noir with dinner (for resviratrol). I take a small selenium and also vit. D supplement daily, and a multivitamin. I try to get some additional fresh fruit every day, and greens like collards or turnip tops. Carrots and garlic are also daily staples. My pastas and breads are always whole wheat. I avoid dairy products and poultry that are not organic because of the hormones. About half the time I buy organic fruits and vegetables. I put turmeric and crushed or chopped garlic in almost everything. I have a cup of coffee in the morning and a cup of tea in the afternoon. And MOST important... I make sure no matter how tired I may be I masturbate at least once a day. I am very healthy.

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