MyJourney
Fri, Jul-21-06, 00:31
http://www.thincs.org/Malcolm2006.htm#june11
June 11, 2006
How To Bury $400M
Once again, I get to tell you, “I told you so.” This time about the Women’s Health Initiative’s heart intervention study. Many will probably be familiar with this study by now. For those who are not, I have summarized it below.
48,835 women aged 50 to 79 included
Study lasted 8.1 years
Major intervention in diet (This was not a passive observational trial. This was a randomized, interventional, controlled clinical study involving almost 50,000 women. The gold standard.)
Those randomized to the intervention group were intensively counseled to reduce their daily fat intake to 20 percent of calories, to increase their intake of fruits and vegetables to at least five servings daily, and to increase grain consumption to at least six servings daily. By year six, the intervention group was consuming, on average, 29 percent of calories as fat, compared to 37 percent in the control group. The corresponding figures for saturated fat were 9.5 percent and 12.4 percent, respectively.
Findings
Among the study population as a whole, there were no significant differences in coronary heart disease (CHD) or stroke incidence, CHD or stroke mortality, or total mortality. In addition, the low-fat diet produced no reduction in the incidence or mortality rates of breast cancer, colorectal cancer, or total cancer either.
And what was the response?
“The results of this study do not change established recommendations on disease prevention. Women should continue to get regular mammograms and screenings for colorectal cancer, and work with their doctors to reduce their risks for heart disease including following a diet low in saturated fat, trans fat and cholesterol,” said National Heart, Lung, and Blood Institute Director Elizabeth G. Nabel, MD.
“This study shows that just reducing total fat intake does not go far enough to have an impact on heart disease risk. While the participants’ overall change in LDL “bad” cholesterol was small, we saw trends towards greater reductions in cholesterol and heart disease risk in women eating less saturated and trans fat,” said Jacques Rossouw, MD, WHI project officer. (We saw trends?)
Judy O'Sullivan, a cardiac nurse at the British Heart Foundation, said: "Numerous studies have confirmed there are huge heart benefits from maintaining a healthy lifestyle, which involves a balanced diet and regular physical activity. It is easy to identify a number of important reasons why this study did not agree with previous research.”
Now for my favorite quote: “There may have been some ‘disappointment’ that the studies didn't always give clear answers,” acknowledged Nabel, who is heart chief at the National Institutes of Health. "The findings are what they are…. Now we're in a second wave of putting the findings into perspective."
“Putting the findings into perspective.” I think we know what that means. That means completely ignoring them. Perhaps the findings merely represent a “paradox.” If not, I am sure that you can find plenty of other reasons to sweep this $400 million trial into the dustbin.
But you know, such findings hardly come as a surprise. My tardiness at responding to this study is primarily due to another project I am working on. As part of this project, I was looking through the statistics, produced by the World Health Organization, on saturated fat consumption and heart disease rates in 46 countries across Europe.
Below I have created two graphs. Graph one looks at countries with the lowest consumption of saturated fat, and compares this to their rate of heart disease. Graph two looks at the countries with the highest consumption of saturated fat, and compares this to the rate of heart disease. (All figures are from the MONICA study, all figures from 1998, or within two years of that date, when figures from 1998 were missing.)
http://www.thincs.org/image005.gif
http://www.thincs.org/image006.gif
I know that such graphs can be a little difficult to follow, and may lack impact. Here is a little summary:
The French consumed three times as much saturated fat as was consumed in Azerbaijan, and had one-eighth the rate of heart disease.
Every single country in the top eight of saturated fat consumption had a lower rate of heart disease than every single country in the bottom eight of saturated fat consumption.
And still we are told that a high saturated fat diet causes heart disease.
Thank you and goodnight.
June 11, 2006
How To Bury $400M
Once again, I get to tell you, “I told you so.” This time about the Women’s Health Initiative’s heart intervention study. Many will probably be familiar with this study by now. For those who are not, I have summarized it below.
48,835 women aged 50 to 79 included
Study lasted 8.1 years
Major intervention in diet (This was not a passive observational trial. This was a randomized, interventional, controlled clinical study involving almost 50,000 women. The gold standard.)
Those randomized to the intervention group were intensively counseled to reduce their daily fat intake to 20 percent of calories, to increase their intake of fruits and vegetables to at least five servings daily, and to increase grain consumption to at least six servings daily. By year six, the intervention group was consuming, on average, 29 percent of calories as fat, compared to 37 percent in the control group. The corresponding figures for saturated fat were 9.5 percent and 12.4 percent, respectively.
Findings
Among the study population as a whole, there were no significant differences in coronary heart disease (CHD) or stroke incidence, CHD or stroke mortality, or total mortality. In addition, the low-fat diet produced no reduction in the incidence or mortality rates of breast cancer, colorectal cancer, or total cancer either.
And what was the response?
“The results of this study do not change established recommendations on disease prevention. Women should continue to get regular mammograms and screenings for colorectal cancer, and work with their doctors to reduce their risks for heart disease including following a diet low in saturated fat, trans fat and cholesterol,” said National Heart, Lung, and Blood Institute Director Elizabeth G. Nabel, MD.
“This study shows that just reducing total fat intake does not go far enough to have an impact on heart disease risk. While the participants’ overall change in LDL “bad” cholesterol was small, we saw trends towards greater reductions in cholesterol and heart disease risk in women eating less saturated and trans fat,” said Jacques Rossouw, MD, WHI project officer. (We saw trends?)
Judy O'Sullivan, a cardiac nurse at the British Heart Foundation, said: "Numerous studies have confirmed there are huge heart benefits from maintaining a healthy lifestyle, which involves a balanced diet and regular physical activity. It is easy to identify a number of important reasons why this study did not agree with previous research.”
Now for my favorite quote: “There may have been some ‘disappointment’ that the studies didn't always give clear answers,” acknowledged Nabel, who is heart chief at the National Institutes of Health. "The findings are what they are…. Now we're in a second wave of putting the findings into perspective."
“Putting the findings into perspective.” I think we know what that means. That means completely ignoring them. Perhaps the findings merely represent a “paradox.” If not, I am sure that you can find plenty of other reasons to sweep this $400 million trial into the dustbin.
But you know, such findings hardly come as a surprise. My tardiness at responding to this study is primarily due to another project I am working on. As part of this project, I was looking through the statistics, produced by the World Health Organization, on saturated fat consumption and heart disease rates in 46 countries across Europe.
Below I have created two graphs. Graph one looks at countries with the lowest consumption of saturated fat, and compares this to their rate of heart disease. Graph two looks at the countries with the highest consumption of saturated fat, and compares this to the rate of heart disease. (All figures are from the MONICA study, all figures from 1998, or within two years of that date, when figures from 1998 were missing.)
http://www.thincs.org/image005.gif
http://www.thincs.org/image006.gif
I know that such graphs can be a little difficult to follow, and may lack impact. Here is a little summary:
The French consumed three times as much saturated fat as was consumed in Azerbaijan, and had one-eighth the rate of heart disease.
Every single country in the top eight of saturated fat consumption had a lower rate of heart disease than every single country in the bottom eight of saturated fat consumption.
And still we are told that a high saturated fat diet causes heart disease.
Thank you and goodnight.