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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. "

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>

>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

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> 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

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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)...

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