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Medical Forum / General / Nutrition / December 2006Low fat diets and breast cancer
The hardest of all diet intervention studies have to be dietary intervention studies to reduce cancer. The just published study in the Journal of the National Cancer Institute is a watershed. You are going to read a lot about it. If you scan the news headlines, it's so interesting how people view it. One headline read "Low fat diets fail to reduce breast cancer deaths." Another read "Low fat diets reduce breast cancer deaths." Others were in between. But here's the take home message, cutting through all the background noise. Women with estrogen receptor negative breast cancer cut their death rate by 66% if the stayed with a diet in which fewer than 20% of calories were from fat. Nothing but nothing has ever achieved results like that before. Not chemotherapy. Not radiotherapy. If results like this were obtained with a new drug, it would be the breast cancer treatment breakthrough of the decade. But it will get buried. Why? Firstly, people like their food. And people don't like being told how to eat. Secondly, there is no money to be made by anybody. No money for surgeons, radiotherapists, medical oncologists. And it costs the patient nothing. Probably low fat diets are cheaper than high fat diets. People can debate this all they want. We can wait another 20 years for the next dietary intervention trial to mature. But if you are diagnosed with breast cancer and it turns out to be estrogen receptor negative you can either wait 20 years for the proof beyond reasonable doubt which will never come, or you can go with the preponderance of evidence, which is that you can cut your chance of dying by 2/3rds if you cut the fat in your diet by 1/3. Has to be one of the biggest no brainers of our time. - Larry Weisenthal "runnswim@aol.com (Larry Weisenthal)" <runnswim@aol.com> wrote in part: >Nothing but nothing has ever achieved results like that before. Not >chemotherapy. Not radiotherapy. Have there been any tests of weight-loss diets? It's not clear to me if it is the % fat in the diet or the fact that the study ended up comparing people who lost weight with people who didn't. -- Jim Chinnis Warrenton, Virginia, USA jchinnis@alum.mit.edu >>It's not clear to me if it is the % fat in the diet or the fact that the study ended up comparing people who lost weight with people who didn't. << You are correct. This is one of those things that will take two decades to sort out. Here's what we know though: The best currently available evidence indicates that if an estrogen receptor negative breast cancer patient sticks to a 20% or less calories as fat diet, her risk of dying will by reduced by 2/3rds. This is what is known as a high class problem. We have a simple, free treatment of breast cnacer which works, but we don't know exactly why. Usually the case in cancer treatment is that we clearly understand that what we have doesn't work. - Larry Weisenthal "runnswim@aol.com (Larry Weisenthal)" <runnswim@aol.com> wrote in part: >>>It's not clear to me if it is the % fat in the diet or the fact that the >study ended up comparing people who lost weight with people who didn't. [quoted text clipped - 13 lines] >Usually the case in cancer treatment is that we clearly understand that >what we have doesn't work. Insightful as usual, Larry. I have to get a copy of the study. I know it was a randomized, prospective one. It looks like the subgroup with the significant result (estrogen- and progesterone-receptor-negative breast cancer) was analyzed post-hoc with no significant result in the overall group. That's always a bad sign, but the the effect is enormous and the significance level of the subgroup analysis is 0.0001! I see it as a major finding. At the same time, I hope we can get some studies that will clarify whether it was the weight loss, the fat-restriction, or what. For my wife and myself, the only way of eating that ever gave us a big weight loss that stayed off was one with increased fat and decreased glycemic load. No, I haven't sorted out which factor contributes how much to the weight loss. We're happy using olive oil, eating nuts, dark chocolate, some probiotic cheese and naturally raised meat, a good bit of sprouted, whole kernel, and other low-GI bread, and lots of veggies, berries and low-GI fruits. I'd hate to learn we have to ditch the oil, nuts, meat and cheese! But you are right that this is going to be the best way to go for non-hormone-responsive breast cancer victims for quite a while. I wish they had tried a South Beach diet along with the low fat one, but they didn't. -- Jim Chinnis Warrenton, Virginia, USA jchinnis@alum.mit.edu > For my wife and myself, the only way of eating that ever gave us a big > weight loss that stayed off was one with increased fat and decreased [quoted text clipped - 8 lines] > non-hormone-responsive breast cancer victims for quite a while. I wish they > had tried a South Beach diet along with the low fat one, but they didn't. IMO, unless studies control for the effect of highly inflammtory feedlot produced fats vs. grass/range fed sources, we cannot conclude a single thing about the role of fats. Studies showing risks of meat consumption also fail to account for cured vs. uncured meats, range fed vs. grain fed meat. Susan >>IMO, unless studies control for the effect of highly inflammtory feedlot produced fats vs. grass/range fed sources, we cannot conclude a single thing about the role of fats. << Hi Susan. I see that you are once again breaking your promise never to reply to my posts. No. You are wrong. We can conclude that women with estrogen receptor negative breast cancer (the worst prognosis group, by the way) can reduce their chance of dying by 2/3 if they reduce the percent of fat in their diets to 20% or less. About a week ago, what was being hailed as the breakthrough of the century in breast cancer was the finding the there was a reduced death rate in patients with Her2/neu positive breast cancer treated with Herceptin. Her2/neus are typically estrogen receptor negative, but constitute a smaller group of patients than all patients with estrogen receptor negative cancer. And the magnitude of death reduction with a low fat diet was greater than with Herceptin. Herceptin therapy will make billions of dollars for the pharmaceutical company and for the doctors who administer it. A low fat diet will save money for the women who adapt it but will make no money for anyone. Which study do you think will most influence the practice of medical oncologists? Best available evidence is that going on a 20% or less fat as calories diet will reduce breast cancer deaths by 2/3 in the most at risk subset of breast cancer patients. If you get diagnosed with breast cancer and it turns out to be estrogen receptor negative, you can go on a low fat diet or you can intellectualize your way to do something else. It's your choice. But the information should be available. Additionally, all studies are not created equally. An intervention study trumps an observational study. And then there is the following: 1: J Nutr. 2005 Jan;135(1):124-8. Dietary carbohydrate intake is not associated with the breast cancer incidence rate ratio in postmenopausal Danish women. Nielsen TG, Olsen A, Christensen J, Overvad K, Tjonneland A. Institute of Cancer Epidemiology, The Danish Cancer Society, Copenhagen, Denmark. Although many case-control studies have suggested positive associations between carbohydrate intake and breast cancer incidence rates in both pre- and postmenopausal women, there is limited information available from cohort studies. We examined the effect of the intake of different carbohydrates, the glycemic index, and the glycemic load on breast cancer incidence in postmenopausal women taking into consideration tumor estrogen receptor status. Postmenopausal women (n = 23,870; aged 50-65 y) participated in the "Diet, Cancer, and Health" study, and provided information about diet and established risk factors for breast cancer. During follow-up, we identified 634 incidents of breast cancer. Associations between carbohydrate intake and breast cancer incidence were analyzed using Cox's regression models. There was no association for intake of glucose, fructose, sucrose, maltose, lactose, or starch and breast cancer incidence rate, and no association for glycemic index or glycemic load after adjusting for confounding factors. Intake of different carbohydrates was not associated with breast cancer incidence rates for either estrogen receptor positive (ER+) or (ER-) breast cancer. Similarly, glycemic index and glycemic load were not associated with ER+ breast cancer after adjusting for confounding factors. A borderline significant positive association between glycemic index and (ER-) breast cancer was observed (P = 0.05). In conclusion, we found no clear associations between intake of different carbohydrates, total carbohydrate intake, glycemic index, or glycemic load and breast cancer incidence in postmenopausal women. Furthermore, when ER+ and ER- breast cancer cases were analyzed separately, no clear associations were observed. - Larry Weisenthal "runnswim@aol.com (Larry Weisenthal)" <runnswim@aol.com> wrote in part: >We can conclude that women with estrogen receptor >negative breast cancer (the worst prognosis group, by the way) can >reduce their chance of dying by 2/3 if they reduce the percent of fat >in their diets to 20% or less. Well, any randomized controlled study only applies to a *group* of people similar to the one in the study. I think Susan is perhaps making the point that the group of women in the study who reduced their fat intake were almost certainly getting a good bit of the fat from hormone-laden feedlot animals. The results may not apply to women who are eating grass-fed, free range, etc. meats. But, as I've said, we don't know. That's why I'm sorry the study didn't have some diet arms other than the low-fat one. But it didn't, and we are stuck with that for a while. -- Jim Chinnis Warrenton, Virginia, USA jchinnis@alum.mit.edu > Well, any randomized controlled study only applies to a *group* of people > similar to the one in the study. I think Susan is perhaps making the point > that the group of women in the study who reduced their fat intake were > almost certainly getting a good bit of the fat from hormone-laden feedlot > animals. The results may not apply to women who are eating grass-fed, free > range, etc. meats. It's even more complicated than that, though the inflammatory qualities of the inflammatory fats in agribusiness meat and dairy cannot/should not be ignored. What about the women who cut the carbs below 20% of calorie and get much higher % of calories from fat and protein? A high insulinogenic diet stimulates cancers, and feeds them, too. You cannot manipulate fat and conclude it's the culprit unless you control for the hormonal effects of what's eaten with it. Susan Susan <nevermind@nomail.com> wrote in part: >x-no-archive: yes > [quoted text clipped - 17 lines] >Studies showing risks of meat consumption also fail to account for cured >vs. uncured meats, range fed vs. grain fed meat. I agree that it is possible that the finding would not apply to a woman who was getting most fats from "natural" sources rather than agribusiness. We don't know. The result may apply and it may not. It may not apply to women who drink pomegranate juice each morning. It may not apply to women who are marathoners. We dunno. But what the subject study tells us looks very important to me. -- Jim Chinnis Warrenton, Virginia, USA jchinnis@alum.mit.edu > "runnswim@aol.com (Larry Weisenthal)" <runnswim@aol.com> wrote in part: > [quoted text clipped - 7 lines] > -- > Jim Chinnis Warrenton, Virginia, USA jchinnis@alum.mit.edu The Harvard nurses study showed that the highest starch eaters (like the study of Mexican women) had the most breast cancer and the highest fat consumers had the least. Susan Susan <nevermind@nomail.com> wrote in part: >x-no-archive: yes > [quoted text clipped - 15 lines] > >Susan Were those randomized controlled trials? -- Jim Chinnis Warrenton, Virginia, USA jchinnis@alum.mit.edu Larry, is this all fat including olive oil , fatty fish and nuts? Is it fat like Ornish counts fat (like the fat in lettuce) or is it added fat like oils and the fat in meat? Just when I added back some olive oil, fish, and nuts. Drat. Dolores > The hardest of all diet intervention studies have to be dietary > intervention studies to reduce cancer. [quoted text clipped - 40 lines] > > - Larry Weisenthal runnswim@aol.com wrote: : Women with estrogen receptor negative breast cancer cut their death : rate by 66% if the stayed with a diet in which fewer than 20% of : calories were from fat. Those are impressive results, but only one fifth of breast cancers are estrogen receptor negative type.  SignatureJuhana Wouldnt it be lovely if someone invented a device that we could pass over every morsel fo food we are about to put into our mouths which could tell us the fat content of it and keep track of the total amount of fat we have eaten all day and then start blasting a loud sound when the fat limit was reached? How am I supposed to know what percentage of fat is in my diet? On Dec 18, 8:39 am, "Juhana Harju" <spamshantigiriorama.removes...@gmail.com> wrote: > runns...@aol.com wrote:: Women with estrogen receptor negative breast cancer cut their death > : rate by 66% if the stayed with a diet in which fewer than 20% of [quoted text clipped - 5 lines] > -- > Juhana >Has to be one of the biggest no brainers of our time. Agree with that. Amy williamson@shaklee.net Puppies for sale http://tubedog.tripod.com Nature and Science in Harmony http://www.shaklee.net/williamson/ |
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