Today's newspapers are blaring with crazy headlines. The New York Times, for instance, says that a "Low-Fat Diet Does Not Cut Health Risks, Study Finds."
Dr. Fuhrman draws no such conclusions. "This study compared two groups that both ate unhealthy diets," he says. "Look closely and you will see that the researchers compared a typical, disease-causing American diet, with one that was just marginally better, but still terribly unhealthy."
According to the study's authors, the "low fat diet" they told the women in the study to eat is as follows:
...postmenopausal women in the intervention group were advised to reduce total fat intake to 20% of energy and to consume at least 5 servings of fruits and vegetables and 6 servings of grains daily; women in the control group continued their usual eating pattern.
As it turned out, the women in the low fat group actually ate just about one more serving of fruit or vegetable per day, fell far short of the even the modest 20%-of-energy-from-fat goal, and consumed the same number of calories as the women who did not modify their diets. As Gina Kolata reports in The New York Times
In the first year, the women on the low-fat diets reduced the percentage of fat in their diet to 24 percent of daily calories, and by the end of the study their diets had 29 percent of their calories as fat. In the first year, the women in the control group were eating 35 percent of their calories as fat, and by the end of the study their dietary fat content was 37 percent. The two groups consumed about the same number of calories.
Preventing tough diseases like heart disease and cancer with diet requires an approach that is aggressive, multi-faceted, and nuanced. Dr. Fuhrman says research has already shown that simple interventions like those studied here are not effective:
The studies published this week in JAMA are nothing new. Those who conducted those studies should already be aware of hundreds of others studies that demonstrate "low fat" is not the key factor in disease causation. High phytochemical intake, including critical antioxidants in (high-fat) nuts, seeds and avocados contain heart disease and cancer fighting compounds. Eating more low-fat foods such as egg whites, chicken, and pasta does not expose us to the disease-fighting compounds in berries, seeds, nuts, cruciferous vegetables, tomatoes and carrots.
Here are ten reasons why it still makes sense to eat a diet rich in vegetables
, fruits, beans, legumes, nuts, and seeds:
1. Fruits and vegetables are the right things to eat, and among the best things they could have studied. But an increase of roughly one serving of vegetables and fruits per day--which is what was found in the study--does little to ward off cancer or heart disease. As described on DiseaseProof yesterday, I advocate a diet in which vegetables are 30-70% of calories, and fruit is 20-50% of calories.
2. A fixation on fat content is misleading. I do advocate little to no animal fats or oils (including olive oil). The fat from nuts and avocados is healthy and necessary, and for most of my patients I do not restrict it.
3. In this study, participants were encouraged to eat more grains, when in my diet--largely to achieve the potent anti-cancer and anti-heart disease benefits--I advocate replacing grains with vegetables as the basis of the diet.
4. Children were not included in this study. As we have discussed in greater detail previously, the best way to see the effects of diet on cancer is to examine the diets of children.
5. Even with this non-optimal diet, this study did find a correlation between diet and breast cancer. As The New York Times reports: "The women on low-fat diets had a 9 percent lower rate of breast cancer; the incidence was 42 per thousand per year in women in the low-fat diet group, compared with 45 per thousand per year in women consuming their regular diet."
6. The most important factor in preventing heart disease is LDL cholesterol. In this study, minor dietary changes were studied--and were found to make minor reductions in this all-important statistic. Imagine if they had studied serious dietary improvements.
7. Eating a diet heavy in bread, pasta, white meat, and processed foods can be low in fat, but is a very poor source of the micronutrition, especially phytonutrients, that contribute mightily to overall health. Many of the most important dietary interventions that we recommend were simply not studied.
8. The study was of post-menopausal women. The later in life they are started, the smaller effects dietary interventions can have.
9. Every time very healthy diets have been studied, they yield tremendous results. Consider the references below, as well as this evidence about diet and cancer, and diet and heart disease. In addition, the anecdotal evidence of my 15-year medical practice shows that not one of my active patients has had a heart attack.
10. For you hardened skeptics: there is no downside whatsoever to eating healthy food like fruits, vegetables, beans, legumes, nuts, and seeds. Try it for six weeks. (The details are in Eat to Live.) You'll feel great.
Dr. Fuhrman has day-to-day experience helping people prevent cancer and heart disease with diet. He sees it working every day in his practice, and says this study fails to focus on some of the most important findings in nutrition research.
To win the war on cancer; these positive diet change must occur when we are young.
When our cells are growing they expose their DNA to the damaging effects of low nutrient and low phytochemical intake. The low consumption of fruits, vegetables, beans, and nuts (only 5 percent of calories consumed by children) results in our unstoppable and growing cancer epidemic. Research scientists have been forced to accept the idea that the causes of cancer are usually set into motion more than 50 years before diagnosis. Our big artillery in the war on cancer is truly our in our kitchen; but we must start feeding our kids right to unleash the big guns.
Even though the factors initiating cancer causation cannot be eliminated with late-life dietary changes, nutritional excellence even later in life can have dramatic effects at lowering cholesterol and preventing heart disease. But a much more aggressive change in diet is required to achieve that degree of protection than what was looked at in these recent studies. It has already been established that a diet-style which contains a much larger percent of calories from unrefined plant foods (ninety percent) has dramatic effects on the occurrence of heart disease.
My vegetable-based diet was studied in the medical journal Metabolism in 2001 and was found to lower LDL cholesterol 33 percent and have dramatic effects on cardiac disease markers. Similar plant-based dietary approaches, either vegetarian or near-vegetarian containing mostly vegetables, bean, fruits, and nuts, have also been shown to offer dramatic protection against heart disease, even when adopted later in life.
And finally, some relevant studies to consider:
Jenkins DJ, Kendall CW, Popovich DG, et al. Effect of a very-high-fiber vegetable, fruit, and nut diet on serum lipids and colonic function. Metabolism 2001 Apr;50(4):494-503.
Hu FB, Willett WC. Optimal diets for prevention of coronary heart disease. JAMA 2002 Nov 27;288(20):2569-2578.
Campbell TC, Parpia B, Chen J. Diet, lifestyle, and the etiology of coronary artery disease: the Cornell China study. Am J Cardiol 1998 Nov 26;82(10B):18T-21T
Esselstyn CB. Resolving the Coronary Artery Disease Epidemic Through Plant-Based Nutrition. 2001 Autumn;4(4):171-177