Diet Study Shows Little Effect on Disease in Women

Diet Research

The nearly decade-long dietary modification trial of the national Women's Health Initiative (WHI), which tested the effect of a diet low in total fat and high in fruits, vegetables and whole grains, showed that that diet had no statistically significant effect on rates of breast cancer, colon cancer, heart disease and stroke.
Results of the three arms of the trial were published today (Feb. 8, 2006) in three papers in the Journal of the American Medical Association.
The University at Buffalo is one of the 40 WHI clinical trial sites. This dietary modification arm of the WHI included 1,138 Western New Yorkers among the 48,835 postmenopausal women who participated across the U.S.
Jean Wactawski-Wende, Ph.D., UB associate professor of social and preventive medicine, is a co-author on the papers reporting the breast and colon cancer results. Maurizio Trevisan, M.D., professor and dean of the UB School of Public Health and Health Professions, is a co-author on the heart disease paper.
"The women achieved a remarkable change in dietary fat, but not as much as planned," said Wactawski-Wende. "There is no question that a diet low in fat and high in fruits, vegetables and grains is very healthy. This trial tested the diet's effects on specific conditions. The fact that it showed little effect on those specific conditions does not mean that anyone should abandon a proven healthy diet."
Results showed the dietary change group went from 38 percent to 24 percent of calories from total fat in the first year, to 29 percent in the sixth year. The comparison group, in which women followed their regular diets, averaged 35 percent of calories from fat at year one and 37 percent at year six.
Women in both groups started at 35-38 percent of calories from fat. The low-fat diet group also increased their consumption of vegetables, fruits, and grains.
"If we had achieved what we planned, 20 percent of calories from fat, the changes may have reached statistical significance," she said.
"This study has shown us once again that it is very hard to change behavior. However, those who made those greatest reductions in total dietary fat had the greatest benefits."
"On the issue of breast cancer, results indicated that women who started with the highest fat intake and had greater changes in fat intake showed stronger evidence that they could be reducing their risk," Wactawski-Wende said.
Overall results showed that the intervention group achieved a nine-percent reduction in risk of breast cancer, compared to the comparison group.
"This means that, out of 10,000 women, 42 women in the dietary change group and 45 in the comparison group developed breast cancer each year," said Wactawski-Wende. "This difference was not large enough to be statistically significant -- meaning it could have been due to chance. Longer follow-up may be needed to show the effects of diet on cancer risk over time."
There was no overall benefit on heart disease. Noting that the study focused on total fat intake rather than the type of fat, Trevisan said that for heart disease, specific types of fat, such as saturated fat and trans-fats may be more important than total fat."
"In women who achieved the greatest reduction in saturated fat in this study, we saw the greatest benefit on heart disease and certain blood markers," he said.
The study also found that women following this low-fat and somewhat higher carbohydrate diet did not increase their body weight, triglycerides or indicators of increased risk of diabetes, such as blood glucose or insulin levels.
No effect on colorectal cancer was seen but there was a reduction in the number of colon polyps reported.
Women who took part in the dietary modification trial were assigned randomly to the comparison group and the intervention group. The comparison group maintained their usual diet, while the intervention group was asked to decrease fat intake to 20 percent of total calories, increase fruits and vegetables combined to five or more servings per day, and increase grains to six or more servings per day.
Both groups were tracked for an average of 8.1 years.
The WHI diet proved to be safe, the results showed, and is consistent with current U.S. Dietary guidelines. An ongoing five-year follow-up study may help researchers understand the longer term effects of this low fat dietary intervention, the authors noted.

Who Loses Weight After Gastric Bypass Surgery

It is known that gastric bypass surgery does not give equally successful weight loss results to all patients. A new research suggests that diabetics and those with a larger stomach pouches lose less weight than the others do.
Gastric bypass surgery is a procedure when stomach size is being changed to limit the possible amount of food intake. This is being done by creating a stomach pouch which is smaller than the stomach and it helps lose weight quickly, effectively, and safely. However, from 5% to 15% of patients do not significantly benefit from the surgery, and this study reveals who exactly doesn’t benefit from this weight loss surgery.
The study comes from a team of researchers from University of California, San Francisco and examines 361 patients who underwent a weight loss surgery during the period between 2003 and 2006. Participants were followed for a year and 310 patients finished the study. It was defined that 40% excess weight loss is not a good result, but over 40% is a good one.
At the beginning of the study the average body mass index (BMI) was 52, after the study it was 34. Most patients lost weight significantly, but there were 38 patients (12.3%) who reported poor weight loss. Researchers found that diabetics and those with larger stomach pouch after a surgery lost less weight than others did.
Researchers suggest that diabetes drugs may stimulate fat and cholesterol increase while trying to control blood sugar levels. For those with a larger stomach pouch the study suggests sizing balloon used to define the new size of stomach should be replaced by an algorithm, which should take into account patient’s anatomical landmarks to estimate the optimal size.
Overall, researchers urge the need of improving gastric bypass surgery results because it is a very effective weight loss treatment, which becomes more and more popular. This study suggests changes in diabetes drugs to improve the weight loss surgery outcomes and help patients fight excess weigh and changes in terms of defining stomach pouch size before the surgery.

Rich Diet, Poor Diet? You Can Lose Weight on a Budget

Diet and Weight Loss for Low Budget

"How can people on a modest income eat a healthy diet and lose weight when they can't afford it?" The question stumped author Kimberly Floyd during a health seminar and she became determined to find the answer. Her new book "MoneyWise Weight Loss: The Faith-based Plan for Building a Better Body on a Budget" contains the strategies she uncovered.

Having lost 85 pounds herself, the former Registered Nurse found that conventional weight loss programs cost up to $14 a day. After reading that the average low income family can only spend $25 per person per week on food, she decided to see if she could still eat healthy while spending that amount each week.
"I did it for a month and it was challenging," Floyd said. "In my research, I discovered that there is indeed a 'rich people's diet' and a 'poor people's diet.' The rich diet consists of lots of fruits and vegetables, lean protein, and whole grains. The poor diet is high in sugar, fat, and starch. These foods contribute to obesity. In this country, higher obesity statistics run along socioeconomic lines."
To prove her point, Floyd sited an August 2006 article by Dr. Adam Drewnoski in the American Journal of Clinical Nutrition. In the article Drewnoski states, "There is no question that the rates of obesity and type 2 diabetes in the United States follow a socioeconomic gradient, such that the burden of disease falls disproportionately on people with limited resources, racial-ethnic minorities, and the poor."
Floyd went on to discuss her difficulty in saving money on fruits and vegetables during her challenge. "To save money, many experts advise you to buy fruits and vegetables in season. But what are the seasons? After a lot of digging, I found the answers, and then combined other food budgeting strategies with the principles I used to lose weight. That's how 'MoneyWise Weight Loss' was born."
She concludes "Achieving our optimal weight is one way that we can regain our energy, joy, and live the abundant life that we are called to live. My dream is to make wellness affordable for everyone."