http://www.nejm.org/doi/full/10.1056/NEJMoa1200303


Mediterranean trumps low fat though they don't exactly trumpet the fact that the control was low fat!

It's a shame there wasn't a low carb arm. If there had been, what would the conclusion have looked like? Probably something like, "Those not eating the Med diets or the control diet faired better but we don't want you eating that particular diet because it'll kill you!"

They were going wild over this on the evening news last night.

Yes, this news is everywhere, and is top headline today (a reprint of Gina Kolata's NYT article http://www.nytimes.com/2013/02/26/h...tudy-finds.html) in our local newspaper which often considers basketball the most newsworthy...after all, this is is NC. The NYT foodie commentators are very busy between this study and the Magazine cover story on addictive junk food.

Dr. Eenfeldt has had two posts on it, today with what they ate:
http://www.dietdoctor.com/what-the-...iet-looked-like

So, a higher fat diet leads to a slightly lower risk of "A primary end-point event" !

I wonder how the low-fat gurus will skew the results to prove the opposite?

Of course, even though the study "shows" higher fat to be protective, they are emphasizing that no red meat was part of it.

No added sugar, fruit whole with lots of fiber, no HFCS, no refined grain... gee I wonder how long its going to take public health folks to realize ground truth:

REFINED CARBS ARE KILLING PEOPLE.

Dr. Ornish is having conniption fits.

They also limited cookies, or white bread, and other refined grains to three per week.

The control wasn't really a lowfat diet.

But the other two were high-ER in fat than the control diet unless I have misread the details

Yeah, because the LF arm of the study had so much trouble with compliance, just like with the Nurses Study. Maybe we're not meant to eat low fat?

Egg-zactly.

I'll tell y'all right now, no matter what anyone says, or what any study shows, or "shows", I'll never go back to low fat. Fat and protein gonna kill me? Okay then.

Yeah, Ornish still has an out. The more mainstream, conventional advice to aim for a slightly lower fat intake (30 vs 40 percent, etc.) is more threatened by this study. Of course, there doesn`t seem to have ever been much evidence for slight fat reduction, even in rodents. And rodents in sterile cages aren`t even good models for wild rodents, let alone human beings, so even if someone finds some, it won`t matter.

Thinking about this further, I'm glad the low fat arm had so much trouble with compliance. That means that the fat content was not necessarily the most important difference in the diet. Perhaps, just perhaps, it was the reduction of refined carbs in the Mediterranean diet arm that led to their better results? Perhaps more scientists will analyze the results for other conclusions.

About compliance for this study. The low-fat group did not get free food. Granted, that group is the control group, but imagine if they were given an equivalent amount of fresh veggies. In the MED group, they got free extra-virgin olive oil. That's expensive stuff, not something you'd just throw away even if it's free. So you use it, and get any benefit that can be gotten from it. So, given free fresh veggies, they'd have used them too, and gotten any benefit that can be gotten from that.

The low-fat group wasn't actually a control group since they got dietary advice like the other groups. For it to be a real control group, there must be no intervention whatsoever, i.e. intervention vs non-intervention.

The MED group had several elements to the intervention. We can't be certain it's the olive oil that made the difference, if at all. In this thread, we discuss an experiment where olive had virtually no effect compared to other fats like lard and butter. Granted, it's just a n1 experiment, yet I can't help but think maybe the olive oil had nothing to do with the improvements seen with the MED group, and instead most of the improvements came from the reduction of refined carbs like sugar and wheat flour. And if we consider low-carb studies that do reduce refined carbs intake and see a significant effect just from that, put the two together and it's easy to see the real reason why the MED group saw improvements.