Guest guest Posted February 12, 2006 Report Share Posted February 12, 2006 This item just in from the IVU-Veg-News. The other side to the latest fat study. Of interest, I think, to many of us. love, pat ------- http://msnbc.msn.com/id/11225530/site/newsweek/ " The Facts About Fat In his debut column, our nutrition expert explains why all low-fat diets are not the same WEB EXCLUSIVE Newsweek Updated: 6:07 p.m. ET Feb. 7, 2006 Feb. 7, 2006 - The Journal of the American Medical Association on Tuesday reported the results of the Women's Health Initiative dietary modification study, which followed nearly 49,000 middle-aged women for more than eight years, comparing those on a regular diet to those on a low-fat diet. The women in the dietary change group were asked to eat less fat and more fruits, vegetables, and whole grains each day to see if it could help prevent heart disease and cancer. The women in the comparison group were not asked to change their diets. What did researchers find? According to the study: Low-fat diets don't protect against heart disease, or stroke, or breast cancer, or colon cancer. OK, so maybe you're a little confused? A little crazed? You're not alone. For many years, doctors (like me) have been telling you about the benefits of a low-fat diet. It's as American as apple pie (well, maybe that's the wrong metaphor...). So you may be thinking now, " You mean all those doughnuts and butter that I didn't eat were for nothing? Those doctors can't make up their minds! From now on, I'll eat what I want, take my Lipitor and forget about it. " With a large number of women in a randomized controlled trial in a major peer-reviewed journal, these findings must be true. Right? Well, no--not exactly. The investigators acknowledged that the study had some serious limitations. These include: # The study participants did not reduce their dietary fat very much--29 percent of their diet was comprised of fat, not the study's goal of 20 percent. Even this may be an overestimation, since it's very common for people to report that they're following a diet better than they really are. # They did not increase their consumption of fruits and vegetables very much. # The comparison group also reduced its consumption of fat almost as much and increased its consumption of fruits and vegetables, making it harder to show between-group differences. Neither group significantly changed its consumption of grains. # As a result, LDL-cholesterol ( " bad cholesterol " ) decreased only 2.6 percent more in the low-fat diet group than in the comparison group, hardly any difference at all. Blood pressure decreased hardly at all in either group, by only about 2 percent in both groups. # The study did not last long enough to expect to see a difference in preventing cancer. Also, this study didn't distinguish between fats that are beneficial and ones that are harmful. The omega-3 fatty acids found in salmon, mackerel, halibut, walnuts, and flax may reduce your risk of a heart attack by 50 percent or more, according to several studies. Only 3 grams a day of fish oil provide these benefits. Some studies suggest that omega-3 fatty acids may also reduce your risk of some types of cancer, although more research is needed. The fatty acids have been shown to help reduce inflammation, which may be an important factor in both heart disease and cancer. The real lesson of the Women's Health Initiative study is this: if you don't change much, you don't improve much. Small changes in diet don't have much effect on preventing heart disease and cancer in those at high risk. Here's the good news: in this study, the risk of a heart attack was reduced in the subgroup of patients who consumed the lowest amount of saturated fat, trans fat, and the highest amount of fruits and vegetables. This finding is consistent with many other studies showing that the majority of people with heart disease who make only moderate reductions in dietary fat and cholesterol show continued worsening of their coronary artery disease. However, bigger changes in diet and lifestyle may prevent heart attacks in almost everyone. Last year, for example, the landmark INTERHEART study of almost 30,000 men and women in 52 countries found that nine factors related to diet and lifestyle accounted for 94 percent of the risk of a heart attack in women and 90 percent of the risk of a heart attack in men. This was seen in all geographic regions and in every racial and ethnic group worldwide. In addition to preventing disease, your body often has a remarkable capacity to begin healing itself if you give it a chance to do so. My colleagues and I documented that most people who already have coronary heart disease can reverse its progression just by making intensive changes in diet and lifestyle, without drugs or surgery. These include a diet much lower in saturated fat and trans fatty acids and high in fruits, vegetables, whole grains, legumes, and soy products, as well as moderate exercise, stress management techniques (such as yoga and meditation), and support groups. These studies used the latest in high-tech, state-of-the-art measures to prove the power of simple, low-cost, and low-tech lifestyle changes. Also, these patients showed a 40 percent average reduction in LDL-cholesterol after one year without cholesterol-lowering drugs. In our research, we found that the more people changed their diet and lifestyle, the more their heart disease reversed. But in order to get heart disease to reverse, they needed to make bigger changes in diet and lifestyle than were seen in the Women's Health Initiative study. More intensive changes in diet and lifestyle also may affect cancer as well as heart disease. Last year, we published a randomized controlled trial showing that more intensive changes in diet and lifestyle stopped or reversed the progression of prostate cancer when compared with a randomized control group. As in our earlier cardiac studies, the more people changed their diet and lifestyle, the more they improved. Even severely blocked coronary arteries became measurably less blocked after one year and showed even more improvement after five years in direct proportion to the degree of change in diet and lifestyle. Similarly, there was a direct correlation between the degree of diet and lifestyle change and the changes in PSA and in the inhibition of prostate tumor growth. What's true for prostate cancer is likely to be true for breast cancer as well. In the Women's Health Initiative, the incidence of breast cancer was 9 percent lower in the study group than the comparison group, although not enough to be statistically significant. But a study reported last year by Rowan T. Chlebowski at the American Society for Clinical Oncology found that women who reduced their dietary fat intake to only 20 percent (about 33 grams of fat per day) reduced their risk of breast cancer recurrence by 42 percent after five years when compared with a randomized comparison group who consumed 51 grams of fat per day. However, this effect was only seen in estrogen-negative breast cancer. Another study from the Harvard Nurses' Health Study published last year reported that walking at least three hours per week significantly reduced the risk of death from breast cancer. Fat is only part of the story. What we include in our diets is at least as important as what we exclude. There are at least a thousand substances that have health benefits-phytochemicals, bioflavonoids, carotenoids, retinols, isoflavones, genistein, lycopene, and so on. With few exceptions, these beneficial substances are found in fruits, vegetables, whole grains, legumes, and soy products. You have a wide spectrum of dietary choices; it's not all or nothing. If you go on a diet and feel constrained, you are more likely to drop it. But if you see your food choices each day as part of a spectrum, then you are more likely to feel free and empowered. If you indulge yourself one day, you can eat more healthfully the next. If you're a couch potato one day, exercise a little more the next. Then, you're less likely to feel restricted. Studies have shown that those who eat the healthiest diets are the ones that allow themselves some indulgences. Not everyone needs to make bigger changes in diet and lifestyle. If you're at high risk or are trying to reverse heart disease or prevent the recurrence of cancer, then you probably need to make bigger changes in diet and lifestyle than someone who just wants to lose a few pounds and is otherwise healthy (and needs only the proverbial " ounce of prevention " ). If you just want to lower your cholesterol or blood pressure, you can begin by making moderate changes in diet and lifestyle. If that's enough to achieve your goals, great; if not, then consider making bigger changes. It's not just about living longer, but also about living better. These are diet and lifestyle changes that make you feel good. Dr. Dean Ornish is founder and president of the non-profit Preventive Medicine Research Institute and a clinical professor of medicine at the University of California, San Francisco. He is the author of several books, including the New York Times' bestsellers " Eat More, Weight Less " and " Love & Survival. " For more information, please go to ww.ornish.com or ww.pmri.org. " Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 12, 2006 Report Share Posted February 12, 2006 > >http://msnbc.msn.com/id/11225530/site/newsweek/ > >The Facts About Fat > >[...] > >This finding is consistent with many other studies showing that the >majority of people with heart disease who make only moderate >reductions in dietary fat and cholesterol show continued worsening of >their coronary artery disease. However, bigger changes in diet and >lifestyle may prevent heart attacks in almost everyone. > >Last year, for example, the landmark INTERHEART study of almost 30,000 >men and women in 52 countries found that nine factors related to diet >and lifestyle accounted for 94 percent of the risk of a heart attack >in women and 90 percent of the risk of a heart attack in men. This >was seen in all geographic regions and in every racial and ethnic >group worldwide. > > > Curiously, this study which claims to identify 94% (or 90% for men) of the risk of a heart attack does not address dietary fat at all. For this reason, it seems odd to me that Dr. Ornish even brings it up. The reference to " diet " in the INTERHEART study only pertains to fruit and vegetable intake - and we know that you can eat fruits and vegetables and still eat lots of fat. Blood lipids are mentioned, but I think that blood lipids are largely genetic for a lot of people. Here's a page on the study if you're interested (requires a free membership to view): http://www.medscape.com/viewarticle/489738 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 12, 2006 Report Share Posted February 12, 2006 > Curiously, this study which claims to identify 94% (or 90% for men) of > the risk of a heart attack does not address dietary fat at all. And he does not say it does, actually. >For this > reason, it seems odd to me that Dr. Ornish even brings it up. He brought it up with regard to 'greater' rather than 'lesser' dietary changes in a study, actually. > reference to " diet " in the INTERHEART study only pertains to fruit and > vegetable intake - and we know that you can eat fruits and vegetables > and still eat lots of fat. Blood lipids are mentioned, but I think > that blood lipids are largely genetic for a lot of people. But not always. This 'genetic' aspect is still at a more or less hypothetical stage, isn't it? However, I'm not arguing the point or any point here - absolutely not qualified to do so myself. Do I take it that since you have mentioned him in two separate emails regarding this 'fat' study, that you don't think much of Dr Ornish's theories and diet? Is that because you think that it is too hard to follow, or is it because you think it is ineffective, or is it because you don't think a low-fat or fat-free diet is a good thing in general? Just wondering - just asking - not trying to put you on the spot ;-) Best love, Pat Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 12, 2006 Report Share Posted February 12, 2006 Pat wrote: > Do I take it that since you have mentioned him in two separate emails regarding this 'fat' > study, that you don't think much of Dr Ornish's theories and diet? Is that because you > think that it is too hard to follow, or is it because you think it is ineffective, or is it because > you don't think a low-fat or fat-free diet is a good thing in general? Just wondering - just > asking - not trying to put you on the spot ;-) I'm ambivalent, I guess. I think it's hard to follow. Unless you really like cooking (and have time to do so), your diet is going to be very boring and repetitive. I was privy to partake of a meal with the Ornish group at a hospital in Des Moines (where I did an internship in the cardiac rehab dept), and it was fairly tasty - but lots of work. Many favorite foods are likely to get eliminated - not reduced, but completely eliminated. That's hard for most people to do. There are also many stories out there from people who tried and tried with a low-fat vegetarian diet, and they were hungry all the time or couldn't lose weight. Different people seem to need different things. I think that the principle might be solid (and advisable for people with significant heart disease), but it just doesn't work for everyone. I also met Dr. Ornish once, at a book signing. It was a long time ago, but I still remember it negatively. I think I asked him a pointed question (don't recall what), and he wasn't happy about it. I also brought an old copy of one of his books instead of buying one of the new ones there, and he didn't seem to pleased about that either. Pat, I think I figured out the html problem (I hope)... Quote Link to comment Share on other sites More sharing options...
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