poorly designed study published in JAMA

[Guest guest]

You may read this McDougall news online at http://www.drmcdougall.com/misc/2007other/070723study.htm

 

 

Study Fails to Show Benefits of Fruits and Veggies for Breast

Cancer Patients

Women are Blamed, but the Investigators Were at Fault

 

The meat and dairy industry must have been laughing all the way

to the bank on Tuesday July 17, 2007 when headlines worldwide

announced the results of a seven-year diet experiment, known as The

Women’s Healthy Eating and Living (WHEL) Randomized Trial, of more

than 3,000 women with breast cancer. This government funded

study (kicked off by a $5 million grant from the late Wal-Mart heir

John Walton with an additional $30 million in support from the

National Cancer Institute) found no benefit from recommending that

women with breast cancer eat more fruits and vegetables, and less

fat. The chances of fewer recurrences and better survival were

not seen in women previously treated for breast cancer after changes

in diet achieved during this study. As a result of this paper,

originally published in the Journal of the American Medical

Association, more people now believe healthier eating will not help

women prevent or treat breast cancer.

 

Incontrovertible Facts Show Women Made Few Changes

 

Data collected by asking the study participants about what they

ate suggested they were eating more fruits and vegetables and less fat

after being given instructions dictated by the study guidelines. But

people don’t always tell the truth—they often want to please the

investigators, so they tell them what they think they want to hear,

which in this case was clearly inaccurate.

 

The women described as eating “a dietary pattern very high in

vegetables, fruit, and fiber and low in fat” did not lose any body

weight at any time during the study—in fact, they gained a small

amount. They were, on average, obese at 161.7 pounds (73.5 Kg)

when they began the study and 6 years later they were still obese,

weighing 163 pounds (74.1 Kg). (See below, table 2: Dietary

Pattern and Body Weight by Group.) Nor did their average weights

differ from the women who were not advised to change their diet (the

control group).

 

Proof that the data collected from asking the women what they ate

was inaccurate is shown in table 2. The women eating “a dietary

pattern very high in vegetables, fruit, and fiber and low in fat”

were reported to have decreased their daily calorie intake by an

average of 181 calories (1719 initially, and 1538 six years later),

yet they gained weight. At every sixth month data collection

they reported consuming at least 100 fewer calories daily than before

the experiment began. A 100-calorie-plus daily deficit over a month

would cause a one pound weight loss, over a year that would be 12

pounds, and over the entire 6 years of study the women should have

achieved trim body weight. They gained weight!

 

Looking over table 2 you will also see the differences in foods

consumed between the two groups were caused by the control group

reporting that they ate less fruit and more fat over the study

period—not by any improvement in the intervention group’s diet,

other than 2 more vegetable servings a day. Yet, rather then

writing about the minor absolute changes in the diet made by the

intervention group, they boasted of the relative differences between

the intervention and control groups—reporting impressive figures

like: “At 4 years, relative differences in mean intake between study

groups were +65% for vegetable servings, +25% for fruit servings, +30%

for fiber, and -13% for energy intake from fat.

 

Pierce, J. P. et al. JAMA 2007;298:289-298. Copyright

restrictions may apply. JAMA

 

The Authors Deceived the Public

 

Fraud is intentional deception resulting in injury to another

person. The authors deceived the public by claiming they were able to

cause the “adoption of a dietary pattern very high in vegetables,

fruit, and fiber and low in fat.”

 

Their concluding statement was, “… during a mean 7.3-year

follow-up, we found no evidence that adoption of a dietary pattern

very high in vegetables, fruit, and fiber and low in fat vs a 5-a-day

fruit and vegetable diet prevents breast cancer recurrence or death

among women with previously treated early stage breast cancer.”

These words reflect the tone of the entire article—one of a

successful experiment, not a failure—and led the public and press to

believe that women in the intervention group made substantial changes

in their diet. The result was headlines like: “No Cancer Benefit

Found In Mega-Veggie-Diet Study,” “Dietary Hopes Dashed for Breast

Cancer Patients,” “Intensive Diet Doesn't Prevent Breast Cancer:

Study,” “Healthiest Diet Made Little Difference to Breast Cancer

Survivors,” and “Fruits, Veggies Don't Stop Cancer Return.”

But the conscientious reader studies table 2 and correctly concludes:

Even if the data reported were an accurate reflection of what these

women did, two more vegetable servings a day is not a diet “very

high in vegetables, fruit, and fiber and low in fat.”

 

Neither lack of intelligence nor carelessness caused the report

to be written in a manner that led the public and press to incorrect

conclusions; I believe the authors intentionally deceived the public.

One possible motivation for distorting the truth was to save face.

They wasted $35 million dollars (much of it taxpayer money) by feeding

women with breast cancer an ineffective diet. Rather than admit

their mistakes, they chose to distort the real meaning of the findings

of their study, and effectually, deprive women of an opportunity to

become healthier by eating more fruits and vegetables.

 

Sixty years of scientific research, involving tens of thousands

of published articles, has identified the rich Western diet as the

cause of breast cancer and many scientific studies have shown that a

meaningful change in diet will allow women with breast cancer to live

longer and healthier. Yet, one poorly-executed, well-publicized,

study may turn the tide for better health for women.

 

When Asked, Women Will Change

 

Breast cancer is a fatal disease and women will do almost

anything to live. They will endure poisoning by toxic

chemotherapy, burning with radiation, and mutilation from

breast-amputating mastectomy; in the hopes of living a few more days.

Obviously, if asked to do so, and given proper support from their

doctors and dietitians, they would do something as simple, safe,

cost-effective, and enjoyable as eating oatmeal and bean burritos

while avoiding beefsteaks and cheese omelets. In The Women’s Healthy

Eating and Living (WHEL) Randomized Trial they continued the same

meat-, dairy-, oil-, and environmental chemical-laden diet that got

them in trouble in the first place, with minor modifications.

The investigators, not the women, should be held responsible for the

fact that even the instructions to eat, “5 vegetable servings plus

16 oz of vegetable juice; 3 fruit servings; 30 g of fiber; and 15% to

20% of energ y intake from fat,” were followed poorly. The

full cancer-inhibiting benefits of low-fat, plant-foods were never

offered to these women.

 

A true test of diet for the prevention and treatment of breast

cancer would follow the model of the diet of women worldwide who have

the least chance of contracting breast cancer and the best chance of

surviving it. These are women who follow a diet based on

starches, like from rural Asia (rice), Africa (millet), Mexico (corn),

New Guinea (sweet potatoes) and Peru (potatoes). The few women,

who do get breast cancer in these societies, also live longer than

their Western counterparts.

 

Unfortunately, a serious diet study on breast cancer is no more

likely to occur than would a study on heart disease, obesity, or

type-2 diabetes—diseases well accepted to be due to the Western

diet. Current financial incentives are focused on maintaining

the status quo. So, until the revolution against the controlling

interests of big business occurs you will be left to your own means to

protect yourself and your family.

 

Additional Note: Information on The Women's Health Initiative

Randomized Controlled Dietary Modification Trial, a study also failing

to show important benefits of diet for breast cancer for similar

reasons, is found in my February 2006 newsletter.

 

2007 John McDougall

McDougall Wellness Center P.O. Box 14039, Santa Rosa, CA

95402

http://www.drmcdougall.com