TY - JOUR
T1 - Low-fat dietary pattern among postmenopausal women influences long-Term cancer, cardiovascular disease, and diabetes outcomes
AU - Prentice, Ross L.
AU - Aragaki, Aaron K.
AU - Howard, Barbara V.
AU - Chlebowski, Rowan T.
AU - Thomson, Cynthia A.
AU - Van Horn, Linda
AU - Tinker, Lesley F.
AU - Manson, Joann E.
AU - Anderson, Garnet L.
AU - Kuller, Lewis E.
AU - Neuhouser, Marian L.
AU - Johnson, Karen C.
AU - Snetselaar, Linda
AU - Rossouw, Jacques E.
N1 - Publisher Copyright:
Copyright © American Society for Nutrition 2019.
PY - 2019/9/1
Y1 - 2019/9/1
N2 - 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.
AB - 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.
KW - cancer
KW - carbohydrate
KW - cardiovascular disease
KW - diabetes
KW - health benefits and risks
KW - low-fat dietary pattern
KW - nutritional behavioral intervention
KW - randomized controlled trial
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U2 - 10.1093/jn/nxz107
DO - 10.1093/jn/nxz107
M3 - Article
C2 - 31175807
AN - SCOPUS:85072058240
SN - 0022-3166
VL - 149
SP - 1565
EP - 1574
JO - Journal of Nutrition
JF - Journal of Nutrition
IS - 9
ER -