PUBLISHED: 11:26 AM on Wednesday, May 17, 2006
Diet for a healthy heart can be a trifle
It's the pain that keeps Beth Broome reaching for the salt substitute and the turkey bacon.

Just three weeks removed from her heart attack and the massive crushing pain in her chest, the 52-year-old high school teacher is vowing to change her diet and eat less fat.

"That is a pain I never ever want to experience again," Broome said.

But a surprising long-term study found few benefits for older post-menopausal women who followed a low-fat diet, although some physicians have problems with the study and the findings.

The Women's Health Initiative, which had previously reported some controversial findings about hormone-replacement therapy increasing the risk of stroke, followed 19,000 women who were assigned to a low-fat diet and 29,000 women who were not.

After about eight years, there were no significant differences in coronary heart disease, cardiovascular disease or stroke, although some of the risk factors were improved for those on the low-fat diet.

The diet achieved only a 9 percent reduction in the number of breast cancers in the low-fat group, and it had no significant effect on the risk for colorectal cancer.

The findings were published Wednesday in a series of reports in the Journal of the American Medical Association.

"We're all disappointed that the theory of benefit from low-fat diets was not borne out clearly by this study," said Lawrence Phillips of Emory University School of Medicine, principal investigator for one of the 40 study sites.

"(However) the trends within the data offer room for some encouragement." For instance, women in the study who followed the diet faithfully had a 15 percent reduction in breast cancer, Dr. Phillips said. And those who took an aspirin as well appeared to have less risk of colorectal cancer, he said. Some of that may be borne out in follow-up studies, Dr. Phillips said.

However, there were a number of problems with the current efforts, particularly with the fact that the diet resulted in only an 8 percent reduction in total fat and a slight decrease in the LDL or bad cholesterol, some physicians pointed out. The amount of vegetables and fruits added amounted to little more than an extra serving a day.

While the primary goal was to reduce cancer risk, the aim was also to see whether the moderate diet changes could have a heart benefit.

"But, like most things in life, seldom is it that easy," said cardiologist Mac Bowman.

"I think you really have to have that greater reduction, whatever you do it dietarily, whether it's more stringent diet, more vigorous exercise, medication, you really have to get a more aggressive reduction in LDL cholesterol to get those benefits."

Likewise, women who had the highest fat reduction also had the lowest risk of breast cancer, said Thomas Samuel, a hematologist/oncologist at the Medical College of Georgia.

"I still believe that decreasing dietary fat intake does impact upon breast cancer risk. And it can be an important part of decreasing that risk," Dr. Samuel said.

When the intervention was started, the postmenopausal women had a mean age of 62, said general surgeon Randy Cooper, who specializes in breast cancer.

"I believe you have to look at women years before they're post-menopausal to know if it has any impact," he said.

Now that she is aiming to get healthy and help her heart, Broome said she is reading all she can and doing what she feels will keep her healthy, no matter what one study or another may say. And she is reading everything she can to make up her own mind.

"I need to be my own medical advocate," she said.