It’s Not Low-Fat, It’s Which Fat

The results of the largest primary prevention trial of a dietary change are in – and they show that low-fat diets don’t reduce the risk of breast or colon cancer, or of cardiovascular disease. Almost 50,000 postmenopausal women at 40 centers in the USA were followed for over 8 years. Forty percent of them were induced to reduce their fat intake to 20% of calorie intake, and to increase their fruit and vegetable intake to five-a-day servings; the other 60% formed the control group, and didn’t make dietary changes.

Although the diet appeared to have no effect on the two cancers or cardiovascular disease, there were small but significant decreases in cholesterol and diastolic blood pressure. This raises the possibility that the study wasn’t long enough to have produced definitive improvement in actual cardiovascular disease.

There’s no need to repeat this study - the design was good, even if the results disappoint. Next time one should study changes in the types of fat consumed, rather than the quantity. More unsaturated fats (mono- and poly-unsaturated fatty acids) and less saturated and trans fats are clearly necessary, in the light of information that’s emerged since this study was started in 1993. Omega-3 fatty acids should be emphasized, and the fruits, vegetables, and nuts must retain a prominent place.

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