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                                                                      [[National Heart, Lung, and Blood Institute
                                                                      (NHLBI)]{.underline}](http://www.nhlbi.nih.gov/index.htm)

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|       |   FOR IMMEDIATE                         CONTACT:\            |
|       |   RELEAS                                                     |
|       | E\                              NHLBI Communications Office\ |
|       |   Monday, February                      (301) 496-4236\      |
|       |   7, 2006                                                    |
|       |     [[E-mail]{.underline}](mailto:nhlbi_news@nhlbi.nih.gov): |
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|       |                                     nhlbi_news@nhlbi.nih.gov |
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|       | | **\                                                     |  |
|       | | News from the Women\'s Health Initiative: Reducing      |  |
|       | | Total Fat Intake May Have Small Effect on Risk of       |  |
|       | | Breast Cancer, No Effect on Risk of Colorectal Cancer,  |  |
|       | | Heart Disease, or Stroke**                              |  |
|       | |                                                         |  |
|       | | Following an eating pattern lower in total fat did not  |  |
|       | | significantly reduce the incidence of breast cancer,    |  |
|       | | heart disease, or stroke, and did not reduce the risk   |  |
|       | | of colorectal cancer in healthy postmenopausal women,   |  |
|       | | according to the latest clinical trial results from the |  |
|       | | National Institutes of Health\'s Women\'s Health        |  |
|       | | Initiative (WHI).                                       |  |
|       | |                                                         |  |
|       | | The study was designed to evaluate a low-fat dietary    |  |
|       | | pattern\'s effect on the risk of cancer. However,       |  |
|       | | investigators also evaluated the data to review the     |  |
|       | | effect on cardiovascular disease. The results from the  |  |
|       | | largest ever clinical trial of low-fat diet are         |  |
|       | | reported in three papers in the February 8 edition of   |  |
|       | | the *Journal of the American Medical Association*.      |  |
|       | |                                                         |  |
|       | | Among the 48,835 women who participated in the trial,   |  |
|       | | there were no significant differences in the rates of   |  |
|       | | colorectal cancer, heart disease, or stroke between the |  |
|       | | group who followed a low-fat dietary plan and the       |  |
|       | | comparison group who followed their normal dietary      |  |
|       | | patterns. Although the women in the study who reduced   |  |
|       | | their total fat intake had a 9 percent lower risk of    |  |
|       | | breast cancer than did women who made no dietary        |  |
|       | | changes, the difference was not large enough to be      |  |
|       | | statistically significant --- meaning it could have     |  |
|       | | been due to chance.                                     |  |
|       | |                                                         |  |
|       | | By the end of the first year, the low-fat diet group    |  |
|       | | reduced average total fat intakes to 24 percent of      |  |
|       | | calories from fat, but did not meet the study\'s goal   |  |
|       | | of 20 percent. At year six, the low-fat diet group was  |  |
|       | | consuming 29 percent of calories from fat. The          |  |
|       | | comparison group 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.          |  |
|       | |                                                         |  |
|       | | Women were aged 50-79 at trial enrollment in 1993-98    |  |
|       | | and were followed for an average of 8.1 years. The      |  |
|       | | study diet focused on reducing total fat, and unlike    |  |
|       | | diets used to reduce heart disease risk, did not        |  |
|       | | differentiate between \"good fats\" found in fish,      |  |
|       | | nuts, and vegetable oils, and \"bad\" fats like         |  |
|       | | saturated fat and *trans* fat found in processed foods, |  |
|       | | meats, and some dairy products. The study design        |  |
|       | | reflected a widely believed but untested theory that    |  |
|       | | reduction of total fat would reduce risks of breast or  |  |
|       | | colorectal cancers. For heart disease, it was           |  |
|       | | anticipated that reduction in total fat would be        |  |
|       | | accompanied by a reduction in saturated fats, which are |  |
|       | | known to contribute to heart disease risk.              |  |
|       | |                                                         |  |
|       | | \"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, M.D.             |  |
|       | |                                                         |  |
|       | | The U.S. Dietary Guidelines for Americans recommend     |  |
|       | | that adults keep total fat intake between 20 and 35     |  |
|       | | percent of calories, and saturated fats less than 10    |  |
|       | | percent of calories, with most fats coming from sources |  |
|       | | of polyunsaturated fats and monounsaturated fats, such  |  |
|       | | as fish, nuts, and vegetable oils. For people with      |  |
|       | | heart disease or at high risk for heart disease,        |  |
|       | | targets for saturated fats may be further lowered.      |  |
|       | |                                                         |  |
|       | | \"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, M.D., WHI project officer. |  |
|       | |                                                         |  |
|       | | The study also found that following a                   |  |
|       | | high-carbohydrate, low-fat eating pattern does not      |  |
|       | | increase body weight, triglycerides or indicators of    |  |
|       | | increased risk of diabetes such as blood glucose or     |  |
|       | | insulin levels in women.                                |  |
|       | |                                                         |  |
|       | | \"Study data indicate that women who started with the   |  |
|       | | highest fat intake and who had greater changes in fat   |  |
|       | | intake, show stronger evidence for reduction in their   |  |
|       | | risk of breast cancer. Longer follow-up may be needed   |  |
|       | | to show the effects of diet on cancer risk over time,\" |  |
|       | | said Leslie G. Ford, M.D., National Cancer Institute.   |  |
|       | |                                                         |  |
|       | | Though the overall risk of colorectal cancer was        |  |
|       | | unchanged in the dietary trial, secondary analyses      |  |
|       | | suggested a possible benefit in women who were taking   |  |
|       | | aspirin or combined hormone therapy (estrogen plus      |  |
|       | | progestin); however, these findings could have occurred |  |
|       | | by chance. Polyps and adenomas (thought to be           |  |
|       | | precursors of cancer) were reduced by 9%, suggesting    |  |
|       | | that a benefit for colorectal cancer risk might emerge  |  |
|       | | over time.                                              |  |
|       | |                                                         |  |
|       | | The WHI is the most comprehensive study to date of the  |  |
|       | | causes and prevention of the major diseases affecting   |  |
|       | | the health of older women. Over 15 years, the study\'s  |  |
|       | | findings on heart disease, breast and colorectal        |  |
|       | | cancer, and osteoporosis have stimulated many changes   |  |
|       | | in clinical practice. The WHI is also one of the        |  |
|       | | largest studies of its kind ever undertaken in the      |  |
|       | | United States and is considered a model for future      |  |
|       | | studies of women\'s health.                             |  |
|       | |                                                         |  |
|       | | This study of low-fat dietary pattern is one of the     |  |
|       | | three randomized clinical trials that make up the WHI.  |  |
|       | | The others included trials of hormone therapy ---       |  |
|       | | estrogen plus progestin and estrogen alone. Both trials |  |
|       | | were stopped early, estrogen plus progestin in 2002 and |  |
|       | | estrogen alone in 2004 because of increased risk of     |  |
|       | | diseases like stroke, blood clots, and breast cancer.   |  |
|       | | Results of a third clinical trial studying the effects  |  |
|       | | of calcium and Vitamin D supplementation on             |  |
|       | | osteoporosis-related bone fractures and on colorectal   |  |
|       | | cancer will be published in February 2006.              |  |
|       | |                                                         |  |
|       | | Resources:                                              |  |
|       | |                                                         |  |
|       | | -   For current recommendations on eating patterns for  |  |
|       | |     heart health, please see the new Your Guide to a    |  |
|       | |     Healthy Heart book available at                     |  |
|       | |     [[http://emall.n                                    |  |
|       | | hlbihin.net/]{.underline}](http://emall.nhlbihin.net/). |  |
|       | |                                                         |  |
|       | | -   For information on women and heart disease, see     |  |
|       | |     [[www.he                                            |  |
|       | | arttruth.gov]{.underline}](http://www.hearttruth.gov/). |  |
|       | |                                                         |  |
|       | | -   For information on weight loss, see Aim for a       |  |
|       | |     Healthy Weight,                                     |  |
|       | |     [[http://www.nhlbi.nih.gov/health/public/heart/o    |  |
|       | | besity/lose_wt/index.htm]{.underline}](http://www.nhlbi |  |
|       | | .nih.gov/health/public/heart/obesity/lose_wt/index.htm) |  |
|       | |                                                         |  |
|       | | -   For information on eating for general health, see   |  |
|       | |     [[www.health.gov/dietary                            |  |
|       | |     guidelines/                                         |  |
|       | | dga2005/recommendations.htm]{.underline}](http://www.he |  |
|       | | alth.gov/dietaryguidelines/dga2005/recommendations.htm) |  |
|       | |                                                         |  |
|       | | -   For more on the Women\'s Health Initiative, see     |  |
|       | |     [[http://www.nhlbi.ni                               |  |
|       | | h.gov/whi/]{.underline}](http://www.nhlbi.nih.gov/whi/) |  |
|       | |                                                         |  |
|       | | To interview a scientist about this study, contact the  |  |
|       | | NHLBI Communications Office at (301) 496-4236.          |  |
|       | |                                                         |  |
|       | | WHI --- a Legacy to Future Generations, a conference on |  |
|       | | the past, present, and future of WHI, including         |  |
|       | | synthesis of findings generated from the WHI            |  |
|       | | observational study and all four clinical trials ---    |  |
|       | | estrogen plus progestin                                 |  |
|       | | ([[ht                                                   |  |
|       | | tp://www.nhlbi.nih.gov/new/press/02-07-09.htm]{.underli |  |
|       | | ne}](http://www.nhlbi.nih.gov/new/press/02-07-09.htm)), |  |
|       | | estrogen alone                                          |  |
|       | | ([[ht                                                   |  |
|       | | tp://www.nhlbi.nih.gov/new/press/04-04-13.htm]{.underli |  |
|       | | ne}](http://www.nhlbi.nih.gov/new/press/04-04-13.htm)), |  |
|       | | dietary modification, and calcium/vitamin D --- will be |  |
|       | | held February 28-March 1, 2006 on the NIH campus. For   |  |
|       | | more information and a conference agenda, go to:        |  |
|       | | [[http://www.nhlbi.nih.gov/whi/references.htm]{.un      |  |
|       | | derline}](http://www.nhlbi.nih.gov/whi/references.htm). |  |
|       | | For more information on the Women\'s Health Initiative, |  |
|       | | see                                                     |  |
|       | | [[http://www.nhlbi.n                                    |  |
|       | | ih.gov/whi]{.underline}](http://www.nhlbi.nih.gov/whi). |  |
|       | |                                                         |  |
|       | | *NHLBI is part of the National Institutes of Health     |  |
|       | | (NIH), the Federal Government\'s primary agency for     |  |
|       | | biomedical and behavioral research. NIH is a component  |  |
|       | | of the U.S. Department of Health and Human Services.    |  |
|       | | NHLBI press releases and other materials including      |  |
|       | | information about the WHI and eating for heart health   |  |
|       | | are available online at www.nhlbi.nih.gov.*             |  |
|       | |                                                         |  |
|       | | The National Institutes of Health (NIH) --- *The        |  |
|       | | Nation\'s Medical Research Agency* --- includes 27      |  |
|       | | Institutes and Centers and is a component of the U. S.  |  |
|       | | Department of Health and Human Services. It is the      |  |
|       | | primary Federal agency for conducting and supporting    |  |
|       | | basic, clinical, and translational medical research,    |  |
|       | | and it investigates the causes, treatments, and cures   |  |
|       | | for both common and rare diseases. For more information |  |
|       | | about NIH and its programs, visit                       |  |
|       | | [*[                                                     |  |
|       | | http://www.nih.gov]{.underline}*](http://www.nih.gov/). |  |
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