Total fat: is the low-fat diet recommended?

Commentary

“Why are Low-Fat Diets Bad For You?”
Y
outube video (December 2015)
David S. Ludwig, MD, PhD, New Balance Foundation Obesity Prevention Center, Boston Children’s Hospital.

“Low-Fat Diet Not a Cure-All”
Harvard T.H. Chan School of Public Health (2015)

“Low-Fat Diet not Most Effective in Long-Term Weight Loss”
Harvard T.H. Chan School of Public Health (2015)

“The 2015 US Dietary Guidelines. Lifting the Ban on Total Dietary Fat”
JAMA (2015) and
“Why Is the Federal Government Afraid of Fat?”
The New York Times (2015)
Dariush Mozaffarian, MD, DrPH, Friedman School of Nutrition Science and Policy, Tufts University, David S. Ludwig, MD, PhD, New Balance Foundation Obesity Prevention Center, Boston Children’s Hospital.

The Last Anti-Fat Crusaders”
Wall Street Journal (October, 2014)
Nina Teicholz, journalist and author

Fear of Fat is Melting
CNN.com (September 2014)
Nina Teicholz, journalist and author

 

Studies that Have Failed to Confirm Superior Disease-Prevention Effects of the Low-fat Diet 

Primary prevention of cardiovascular disease with a Mediterranean diet
New England Journal of Medicine (2013)
Estruch R, Ros E, Salas-Salvadó J, Covas MI, Corella D, Arós F, Gómez-Gracia E, Ruiz-Gutiérrez V, Fiol M, Lapetra J, Lamuela-Raventos RM, Serra-Majem L, Pintó X, Basora J, Muñoz MA, Sorlí JV, Martínez JA, Martínez-González MA; PREDIMED Study Investigators.
Conclusions: In this study, the higher fat (41% of calories) Mediterranean diet had better cardiovascular outcomes than the low-fat control group.

Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet
New England Journal of Medicine (2008)
Shai, Iris, Ph.D . Visiting Scientist, Harvard School of Public Health, Department of Epidemiology, Harvard School of Public Health, Dan Schwarzfuchs, Yaakov Henkin, et al.
Conclusions: This was a NIH-funded study lasting two years. Compared to people on Mediterranean or Atkins-style diets, those on a low-fat diet had the least amount of weight loss and the poorest outcomes on markers for both heart disease and diabetes.

Low-Fat Dietary Pattern and Risk of Cardiovascular Disease: The Women’s Health Initiative Randomized Controlled Dietary Modification Trial
Journal of the American Medical Association (2006)
Howard BV, MedStar Research Institute/Howard University, et al.
Conclusions: “Over a mean of 8.1 years, a dietary intervention that reduced total fat intake and increased intakes of vegetables, fruits, and grains did not significantly reduce the risk of CHD, stroke, or CVD in postmenopausal women and achieved only modest effects on CVD risk factors, suggesting that more focused diet and lifestyle interventions may be needed to improve risk factors and reduce CVD risk.”

“Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes”
New England Journal of Medicine (2013)
Look AHEAD Research Group, Wing RR, Bolin P, Brancati FL, et al.
Conclusions: This large, NIH-funded study was stopped early after a “futility analysis” found it would not be worth continuing.  Nearly 10 years of intensive lifestyle intervention, including a low-fat diet, “did not reduce the rate of cardiovascular events in overweight or obese adults with type 2 diabetes.”

Low-Fat Dietary Pattern and Risk of Colorectal Cancer: The Women’s Health Initiative Randomized Controlled Dietary Modification Trial
Journal of the American Medical Association (2006)
Beresford, Shirley A. A., University of Washington, Karen C. Johnson, University of Tennessee Health Science Center et al.
Conclusions: “In this study, a low-fat dietary pattern intervention did not reduce the risk of colorectal cancer in postmenopausal women during 8.1 years of follow-up.”

Low-Fat Dietary Pattern and Weight Change Over 7 Years: The Women’s Health Initiative Dietary Modification Trial
Journal of the American Medical Association (2006)
Howard, Barbara V., PhD, MedStar Research Institute, et al.
Conclusions: This was the largest-ever test of the low-fat diet, on nearly 49,000 women for an average of 8 years. At the end of this time, the low-fat dieters weighed, on average, 1 lb less than the non-dieting control group.

Low-Fat Dietary Pattern and Risk of Cardiovascular Disease: The Women’s Health Initiative Randomized Controlled Dietary Modification Trial
Journal of the American Medical Association (2006)
Howard, Barbara V., MedStar Research Institute/Howard University et al.
Conclusions: “Over a mean of 8.1 years, a dietary intervention that reduced total fat intake and increased intakes of vegetables, fruits, and grains did not significantly reduce the risk of CHD, stroke, or CVD in postmenopausal women and achieved only modest effects on CVD risk factors, suggesting that more focused diet and lifestyle interventions may be needed to improve risk factors and reduce CVD risk.”

Low-Fat Dietary Pattern and Risk of Invasive Breast Cancer: The Women’s Health Initiative Randomized Controlled Dietary Modification Trial
Journal of the American Medical Association (2006)
Prentice, Ross L., Fred Hutchinson Cancer Research Center, Bette Caan, Rowan T. Chlebowski, et al.
Conclusions: “Among postmenopausal women, a low-fat dietary pattern did not result in a statistically significant reduction in invasive breast cancer risk over an 8.1-year average follow-up period.”

Low-Fat Dietary Pattern and Cancer Incidence in the Women’s Health Initiative Dietary Modification Randomized Controlled Trial
Journal of the National Cancer Institute (2007)
Prentice, Ross L., Fred Hutchinson Cancer Research Center, Cynthia A. Thomson, Bette Caan, et al.
Conclusions: A NIH-funded study on nearly 49,000 women. After adhering to a low-fat diet for an average of 8 years, the rates of cancer were not significantly lower in the intervention group, compared to controls.