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Low-Fat Dietary Pattern among Postmenopausal Women Influences Long-Term Cancer, Cardiovascular Disease, and Diabetes Outcomes.

Published on Sep 1, 2019in Journal of Nutrition4.416
· DOI :10.1093/JN/NXZ107
Ross L. Prentice102
Estimated H-index: 102
(Fred Hutchinson Cancer Research Center),
Aaron K. Aragaki41
Estimated H-index: 41
(Fred Hutchinson Cancer Research Center)
+ 11 AuthorsJacques E. Rossouw46
Estimated H-index: 46
Abstract
Background The preferred macronutrient dietary composition, and the health consequences of dietary fat reduction specifically, have been debated for decades. Here we provide a comprehensive overview of long-term health outcomes in the Women's Health Initiative Dietary Modification (DM) trial.
  • References (27)
  • Citations (2)
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References27
Newest
#1David S. Ludwig (Harvard University)H-Index: 67
#2Walter C. Willett (Harvard University)H-Index: 300
Last. Marian L. Neuhouser (Fred Hutchinson Cancer Research Center)H-Index: 65
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For decades, dietary advice was based on the premise that high intakes of fat cause obesity, diabetes, heart disease, and possibly cancer. Recently, evidence for the adverse metabolic effects of processed carbohydrate has led to a resurgence in interest in lower-carbohydrate and ketogenic diets with high fat content. However, some argue that the relative quantity of dietary fat and carbohydrate has little relevance to health and that focus should instead be placed on which particular fat or carb...
47 CitationsSource
#1Rowan T. Chlebowski (Los Angeles Biomedical Research Institute)H-Index: 79
#2Garnet L. Anderson (Fred Hutchinson Cancer Research Center)H-Index: 70
Last. Cynthia A. Thomson (UA: University of Arizona)H-Index: 55
view all 18 authors...
Background: In the Women's Health Initiative Dietary Modification trial, a low-fat dietary pattern reduced deaths after breast cancer. Mortality from other cancer sites has not been reported. Methods: A low-fat dietary pattern influence on deaths from and after site-specific cancers was examined during 8.5 years (median) of dietary intervention and cumulatively during 17.7 years (median) of follow-up. A total 48 835 postmenopausal women, ages 50-79 years, were randomly assigned from 1993 to 1998...
3 CitationsSource
#1Rowan T. Chlebowski (City of Hope National Medical Center)H-Index: 11
#1Rowan T. Chlebowski (City of Hope National Medical Center)H-Index: 79
Last. Ross L. Prentice (Fred Hutchinson Cancer Research Center)H-Index: 102
view all 13 authors...
Importance In a randomized clinical trial, a low-fat eating pattern was associated with lower risk of death after breast cancer. However, the extent to which results were driven by dietary influence on survival after breast cancer diagnosis was unknown. Objective To determine the association of a low-fat dietary pattern with breast cancer overall survival (breast cancer followed by death from any cause measured from cancer diagnosis). Design, Setting, and Participants This is a secondary analysi...
11 CitationsSource
#1Sara Bretschger (Brigham and Women's Hospital)H-Index: 2
#1Sara B. Seidelmann (Brigham and Women's Hospital)H-Index: 12
Last. Scott D. Solomon (Brigham and Women's Hospital)H-Index: 114
view all 10 authors...
Summary Background Low carbohydrate diets, which restrict carbohydrate in favour of increased protein or fat intake, or both, are a popular weight-loss strategy. However, the long-term effect of carbohydrate restriction on mortality is controversial and could depend on whether dietary carbohydrate is replaced by plant-based or animal-based fat and protein. We aimed to investigate the association between carbohydrate intake and mortality. Methods We studied 15 428 adults aged 45–64 years, in four...
110 CitationsSource
#1Barbara V. Howard (Georgetown University)H-Index: 103
#2Aaron K. Aragaki (Fred Hutchinson Cancer Research Center)H-Index: 41
Last. Ross L. Prentice (Fred Hutchinson Cancer Research Center)H-Index: 102
view all 13 authors...
OBJECTIVE We performed a secondary analysis to evaluate the effect of the Women’s Health Initiative dietary intervention on incident diabetes and diabetes treatment in postmenopausal women. RESEARCH DESIGN AND METHODS A total of 48,835 women were randomized to a comparison group or an intervention group that underwent a behavioral/nutritional modification program to decrease fat and increase vegetable, fruit, and grain intake for an average of 8.1 years. Ninety-three percent of participants comp...
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#1Mahshid Dehghan (Population Health Research Institute)H-Index: 24
#2Andrew Mente (McMaster University)H-Index: 33
Last. R MapangaH-Index: 4
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Summary Background The relationship between macronutrients and cardiovascular disease and mortality is controversial. Most available data are from European and North American populations where nutrition excess is more likely, so their applicability to other populations is unclear. Methods The Prospective Urban Rural Epidemiology (PURE) study is a large, epidemiological cohort study of individuals aged 35–70 years (enrolled between Jan 1, 2003, and March 31, 2013) in 18 countries with a median fo...
329 CitationsSource
#1Ross L. Prentice (Fred Hutchinson Cancer Research Center)H-Index: 102
#2Aaron K. Aragaki (Fred Hutchinson Cancer Research Center)H-Index: 41
Last. Barbara V. Howard (Georgetown University)H-Index: 103
view all 12 authors...
: Background: The influence of a low-fat dietary pattern on the cardiovascular health of postmenopausal women continues to be of public health interest.Objective: This report evaluates low-fat dietary pattern influences on cardiovascular disease (CVD) incidence and mortality during the intervention and postintervention phases of the Women's Health Initiative Dietary Modification Trial.Design: Participants comprised 48,835 postmenopausal women aged 50-79 y; 40% were randomly assigned to a low-fat...
25 CitationsSource
#1Rowan T. Chlebowski (Los Angeles Biomedical Research Institute)H-Index: 11
#1Rowan T. Chlebowski (Los Angeles Biomedical Research Institute)H-Index: 79
Last. Ross L. Prentice (Fred Hutchinson Cancer Research Center)H-Index: 102
view all 17 authors...
PurposeEarlier Women’s Health Initiative Dietary Modification trial findings suggested that a low-fat eating pattern may reduce breast cancers with greater mortality. Therefore, as a primary outcome-related analysis from a randomized prevention trial, we examined the long-term influence of this intervention on deaths as a result of and after breast cancer during 8.5 years (median) of dietary intervention and cumulatively for all breast cancers diagnosed during 16.1 years (median) of follow-up.Pa...
29 CitationsSource
#1Cheryl L. Rock (UCSD: University of California, San Diego)H-Index: 68
#2Shirley W. Flatt (UCSD: University of California, San Diego)H-Index: 44
Last. Loki Natarajan (UCSD: University of California, San Diego)H-Index: 50
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Abstract Background Obesity is a risk factor for postmenopausal breast cancer incidence and premenopausal and postmenopausal breast cancer mortality, which may be explained by several metabolic and hormonal factors (sex hormones, insulin resistance, and inflammation) that are biologically related. Differential effects of dietary composition on weight loss and these metabolic factors may occur in insulin-sensitive vs. insulin-resistant obese women. Objective To examine the effect of diet composit...
30 CitationsSource
#1Béatrice Lauby-Secretan (IARC: International Agency for Research on Cancer)H-Index: 15
#2Chiara Scoccianti (IARC: International Agency for Research on Cancer)H-Index: 18
Last. Kurt Straif (IARC: International Agency for Research on Cancer)H-Index: 63
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The International Agency for Research on Cancer convened a workshop on the relationship between body fatness and cancer, from which an IARC handbook on the topic will appear. An executive summary of the evidence is presented.
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The American Cancer Society (ACS) publishes the Diet and Physical Activity Guideline to serve as a foundation for its communication, policy, and community strategies and, ultimately, to affect dietary and physical activity patterns among Americans. This guideline is developed by a national panel of experts in cancer research, prevention, epidemiology, public health, and policy, and they reflect the most current scientific evidence related to dietary and activity patterns and cancer risk. The ACS...
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#1Lee HooperH-Index: 54
#2Nicole MartinH-Index: 5
Last. Asmaa AbdelhamidH-Index: 17
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Background Reducing saturated fat reduces serum cholesterol, but effects on other intermediate outcomes may be less clear. Additionally, it is unclear whether the energy from saturated fats eliminated from the diet are more helpfully replaced by polyunsaturated fats, monounsaturated fats, carbohydrate or protein. Objectives To assess the effect of reducing saturated fat intake and replacing it with carbohydrate (CHO), polyunsaturated (PUFA), monounsaturated fat (MUFA) and/or protein on mortality...
4 CitationsSource
#1Lee HooperH-Index: 54
#2Nicole MartinH-Index: 5
Last. Asmaa AbdelhamidH-Index: 17
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BACKGROUND: Reducing saturated fat reduces serum cholesterol, but effects on other intermediate outcomes may be less clear. Additionally, it is unclear whether the energy from saturated fats eliminated from the diet are more helpfully replaced by polyunsaturated fats, monounsaturated fats, carbohydrate or protein. OBJECTIVES: To assess the effect of reducing saturated fat intake and replacing it with carbohydrate (CHO), polyunsaturated (PUFA), monounsaturated fat (MUFA) and/or protein on mortali...
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#1Charlotte Holme Nielsen (UCPH: University of Copenhagen)H-Index: 2
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Human milk is rich in nutritional factors, such as alpha-lactalbumin (α-Lac), and important for neonatal development, but nutrient supplementation may be required for optimal growth. Using a pig model, we hypothesized that α-Lac-enriched whey protein concentrate (WPC) supplementation improves neonatal development. Cesarean-delivered preterm pigs were fed either dilute bovine milk (REF) or REF milk supplemented with WPC with normal (STANDARD-ALPHA) or high (HIGH-ALPHA) α-Lac. Clinical, gut, immun...
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