Risk of cardiovascular disease or stroke not significantly decreased with low-fat diet

In an article in the February 8 JAMA, Barbara V. Howard, Ph.D., of Medstar Research Institute/Howard University, Washington, D.C., and colleagues with the Women's Health Initiative (WHI, a study which included nearly 50,000 women) analyzed data from the WHI Dietary Modification Trial to determine the effect of a diet low in fat intake and high in consumption of vegetables, fruits and grains on cardiovascular disease (CVD) and coronary heart disease (CHD) risk.

After an average of 8.1 years of follow-up, levels of low-density lipoprotein cholesterol and diastolic blood pressure were significantly reduced. Levels of high-density lipoprotein cholesterol, triglycerides, glucose and insulin did not significantly differ in the intervention vs. comparison groups. The researchers found that the diet had no significant effects on incidence of CHD, stroke, CVD, or heart attack. Trends toward greater reductions in CHD risk were observed in those with lower intakes of saturated fat or trans fat or higher intakes of vegetables/fruits.

"To achieve a significant public health impact on CVD events, a greater magnitude of change in multiple macronutrients and micronutrients and other behaviors that influence CVD risk factors may be necessary," the authors conclude.

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(JAMA. 2006;295:655-666. Available pre-embargo to the media at www.jamamedia.org)

Editor's Note: For funding/support information and the financial disclosures of the authors, please see the JAMA article.

Editorial: Dietary Modification and CVD Prevention A Matter of Fat

In an accompanying editorial, Cheryl A. M. Anderson, Ph.D., M.P.H., and Lawrence J. Appel, M.D., M.P.H., of Johns Hopkins University Bloomberg School of Public Health and School of Medicine, Baltimore, discuss the findings of Howard et al.

"Despite null findings from the WHI Dietary Modification Trial, dietary changes can have powerful, beneficial effects on CVD risk factors and outcomes. To reduce the risk of CVD, individuals should maintain a desirable body weight, be physically active, avoid tobacco exposure, and eat a diet consistent with national guidelines. Additional results from the WHI Dietary Modification Trial, likely forthcoming, should provide valuable evidence that will refine these recommendations and further enhance CVD prevention efforts in women." (JAMA. 2006;295:693-695. Available pre-embargo to the media at www.jamamedia.org)


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