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A low fat dietary pattern intervention did not reduce breast cancer, colorectal cancer, or CVD in postmenopausal women

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 Q Does a dietary modification intervention promoting a low fat dietary pattern reduce risk of breast cancer, colorectal cancer, or cardiovascular disease (CVD) in postmenopausal women?


Embedded ImageDesign:

3 reports of different outcome measures of a randomised controlled trial (Women’s Health Initiative [WHI]).

Embedded ImageAllocation:


Embedded ImageBlinding:

blinded (physician adjudicators verifying outcomes, {data collectors, data analysts, and monitoring committee}*).

Embedded ImageFollow up period:

mean 8.1 years.

Embedded ImageSetting:

40 clinical centres in the US.

Embedded ImageParticipants:

48 835 postmenopausal women 50–79 years of age (mean age 62 y) with baseline fat intake ⩾32% of total calories. Exclusion criteria were previous cancer (except for non-melanoma skin cancer) in the past 10 years, medical conditions with predicted survival <3 years, type 1 diabetes, adherence concerns such as alcoholism or dementia, or frequent consumption of meals prepared away from home.

Embedded ImageIntervention:

low fat dietary pattern intervention (n = 19 541) or no dietary intervention (n = 29 294). The dietary modification intervention promoted dietary change with the goals of reducing total fat to 20% of energy intake and increasing fruits and vegetables to ⩾5 servings per day and grains to ⩾6 servings per day. A specially trained nutritionist led 18 group sessions in the first year and quarterly sessions thereafter. Each participant received her own fat gram goal according to her height. Participants self monitored their fat, fruit, and vegetable intake and also engaged in individual interview sessions that used reflective listening techniques, targeted message campaigns, and personalised feedback on fat intake. Control group …

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