Journal article
Low-Fat Dietary Pattern among Postmenopausal Women Influences Long-Term Cancer, Cardiovascular Disease, and Diabetes Outcomes
The Journal of nutrition, Vol.149(9), pp.1565-1574
09/01/2019
DOI: 10.1093/jn/nxz107
PMCID: PMC6736441
PMID: 31175807
Abstract
ABSTRACT Background The preferred macronutrient dietary composition, and the health consequences of dietary fat reduction specifically, have been debated for decades. Here we provide a comprehensive overview of long-term health outcomes in the Women's Health Initiative Dietary Modification (DM) trial. Objective The DM trial aimed to examine whether a low-fat dietary pattern would reduce the risk of invasive breast cancer, colorectal cancer, and, secondarily, coronary heart disease (CHD), with various other health outcomes also considered. Methods The DM trial is a randomized controlled trial conducted at 40 centers in the US, among 48,835 postmenopausal women aged 50–79 y with baseline intake of ≥32% energy from fat. Participants were randomly assigned to a low-fat dietary pattern intervention group or to a usual-diet comparison group, during 1993–1998. Intervention goals were to reduce fat intake from ∼35% to 20% of total energy, in conjunction with increasing vegetables and fruit to 5 servings/d and grains to 6 servings/d. Results Over an 8.5-y (median) intervention period, intervention and comparison group differences included lower fat by 8–10%, and higher carbohydrate by 8–10%, of total energy, in conjunction with higher consumption of vegetables, fruit, and grains. Time-to-outcome analyses did not show significant differences between intervention and comparison groups for invasive breast cancer, colorectal cancer, or CHD, either over the intervention period or over longer-term cumulative follow-up. Additional analyses showed significant intervention group benefits related to breast cancer, CHD, and diabetes, without adverse effects. Over a 19.6-y (median) follow-up period, HRs (95% CIs) were 0.84 (0.74, 0.96) for breast cancer followed by death, and 0.87 (0.77, 0.98) for diabetes requiring insulin. Conclusions Reduction in dietary fat with corresponding increase in vegetables, fruit, and grains led to benefits related to breast cancer, CHD, and diabetes, without adverse effects, among healthy postmenopausal US women. This trial was registered at clinicaltrials.gov as NCT00000611.
Details
- Title: Subtitle
- Low-Fat Dietary Pattern among Postmenopausal Women Influences Long-Term Cancer, Cardiovascular Disease, and Diabetes Outcomes
- Creators
- Ross L Prentice - Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USAAaron K Aragaki - Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USABarbara V Howard - Department of Medicine, Georgetown University Medical Center, and MedStar Health Research Institute, Hyattsville, MD, USARowan T Chlebowski - Oncology/Hematology, Division of Medicine, Los Angeles Biomedical Research Institute, Torrance, CA, USACynthia A Thomson - College of Public Health, Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USALinda Van Horn - Department of Preventive Medicine, Northwestern University, Chicago, IL, USALesley F Tinker - Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USAJoAnn E Manson - Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USAGarnet L Anderson - Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USALewis E Kuller - Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USAMarian L Neuhouser - Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USAKaren C Johnson - Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, TN, USALinda Snetselaar - Preventive Nutrition Education, Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USAJacques E Rossouw - National Heart, Lung, and Blood Institute, Bethesda, MD, USA
- Resource Type
- Journal article
- Publication Details
- The Journal of nutrition, Vol.149(9), pp.1565-1574
- DOI
- 10.1093/jn/nxz107
- PMID
- 31175807
- PMCID
- PMC6736441
- ISSN
- 0022-3166
- eISSN
- 1541-6100
- Grant note
- DOI: 10.13039/100000002, name: National Institutes of Health; DOI: 10.13039/100000050, name: National Heart, Lung, and Blood Institute, award: HHSN268201600018C, HHSN268201600001C, HHSN268201600002C, HHSN268201600003C, HHSN268201600004C
- Language
- English
- Date published
- 09/01/2019
- Academic Unit
- Epidemiology; Fraternal Order of Eagles Diabetes Research Center; Internal Medicine
- Record Identifier
- 9984215047102771
Metrics
4 Record Views