I am sure that we are all surprised by this.  But there are some
uncertainties here, scientifically, most obviously that the study did not
include men so far as it may without doubt apply to PCa.  Regarding heart
disease, I cannot help but be skeptible.  What kind of fat did these women
eat or not eat?  Or if they developed high cholesterol during the study, did
they go on meds to lower it?  How "low in fat"  was "low"?  How "normal" was
normal for whom?  Was it moderate or high?

But I want to believe it and there's the rub  I may be tempted to start
again to eat the way I really want to and that could accelerate the
progression of my PCa.  But I really hate the "moderate" fat diet I follow
(as I would call it).  Haven't had spareribs in months!  Or--well, you get
the idea.

As I noted in a letter I sent to the NY times (but probably won't get
published),  this study shows that if you are a woman, 50-79,  your
current diet contains about 35 percent fat, you only expect to live 8
additional years, and you are contemplating reducing your fat intake to
about 25 percent,  then you probably shouldn't bother.   If that doesn't
describe you, the study doesn't necessarily tell you anything.

The article mentions, for example, that women on the lower fat diet did
have a 9 percent lower breast cancer rate (in eight years), but it
wasn't statistically significant.   They will continue to follow those
women to see if it becomes significant after more time passes.  Wouldn't
it be ironic if lots of women start eating as much fat as they want and
10 years from now, the same researchers report that using a follow-up
period of 20 years, breast cancer incidence was reduced by a third?
People will cite this as yet another example of how scientists keep
changing what they say.   But in fact if you look carefully at what they
do say and don't generalize beyond the study population,  you are much
less likely to be misled.

In my case, I am a 72 year old man who started off in my middle 30s with
a cholesterol level of about 210, and it had been going up about 15
units each year.  I've been on first a low saturated fat diet and for at
least 20 years on a very low fat diet, probably 10 to 20 percent of my
diet.   My total cholesterol ranges from 130 to 150, depending on how
strictly I limit fats.  In addition, at my age, my mother and all three
of her siblings had cardiovascular disease on what might be described as
a normal American diet.  Actually, her brother had died of colon cancer
at about age 65, which my mother had survived in her 50s.  I have no
evidence yet of cardiovascular disease and no one has ever found a polyp
in my colon.   Of course, one case doesn't prove anything, and it is
possible that my cholesterol level may have come down anyway for some
other reason.  But I doubt it.   It is known, by the way, that a low LDL
decreases risk of heart attack and strokes.  It is hard to see how I
managed that except through diet.

Note that if you studied smokers and non-smokers for 8 years, you might
very well conclude that there was no significant difference in lung
cancer or cardiovascular disease.

I may die of a heart attack tomorrow, while someone who thrives on pizza
and steak may live to 100, but I'm convinced I've added a few years to
my life.  Until someone does a study comparing much larger differences
in fat intake,  I will stick with my present regimen.   My relatives
have all tended to die by 80, and I hope to get a bit beyond that.

"JK@work" <JKSinrod@verizon.net> wrote >
http://www.washingtonpost.com/wp-dyn/content/article/2006/02/07/AR2006020701681.
html?nav=rss_nation

Dr. Mirkin responded:
Dear Dr. Mirkin: Should we change our diets based on the news
that low-fat diets don't reduce cancers or heart attacks?

You should not be surprised by the latest three studies
showing that low-fat diets do not prevent breast and colon
cancers and heart attacks (Journal of the American Medical
Association, Feb 8, 2006).  These studies were designed several
years ago when a lot of people believed that all fats were bad.
They did not test the newer diets such as the Mediterranean diet,
which recommend eating good fats and avoiding the bad ones.
You should restrict the bad saturated and partially hydrogenated
fats, not the good omega-3 and monounsaturated fats.  Even if
you restrict the bad fats, your diet will be unhealthful unless you
also restrict the bad refined carbohydrates and eat lots of the
good carbohydrates found in fruits, vegetables, whole grains and
beans.
The main reason that these studies failed to show
protection from cancer and heart attacks was that the women on
the low-fat diets did not lose weight. That means that they did not
eat fewer calories, even though they were instructed to avoid the
most concentrated sources of calories. Heart attacks and
cancers are associated with excess weight, and many scientists
feel that inflammation explains the link.  When germs get into
your body, your immunity calls out cells and proteins to kill them.
However, if your immunity remains active, it attacks and
damages your own body to increase risk for heart attacks,
strokes and cancers.   We now know that full fat cells (as well as
lymph nodes) produce the proteins of immunity to cause
inflammation.  The diet I recommend to all my patients is at
http://www.drmirkin.com/heart/8614.html

I.P.