An inconvenient finding for the diet-heart hypothesis

[Ted_Hutchinson]

The Women�s Health Initiative Randomized Controlled Dietary Modifcation Trial: An inconvenient finding and the diet-heart hypothesis T D Noakes
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One goal of the US$700 million Women�s Health Initiative Randomized Controlled Dietary Modification Trial was to determine whether post-menopausal women who adopted what was regarded as a �heart healthy� low-fat diet, high in vegetables, fruits and grains, reduced their risk of developing cardiovascular disease.
The trial substantially favoured the outcome in the intervention group, who also received an intensive nutritional and behaviour education programme not offered to the control group.
These studies neatly disprove the diet-heart hypothesis since adoption of �heart healthy� eating not only failed to influence future cardiac events in the healthy but it increased such events in the unhealthy and worsened diabetic control in those with type 2 diabetes mellitus.

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In fact, there were a number of negative findings from the WHIRCDMT. The leanest women at the start of the trial gained weight on the low-fat diet[3]
and those with the least insulin resistance at the start of the trial were at greater risk of developing type 2 diabetes mellitus (DM) if assigned to the low-fat diet.[4]
The low-fat diet also worsened glucose control in women with diagnosed diabetes,[5] a finding that �agrees with some, but not all, previous studies evaluating the effects of high- and low-carbohydrate diets in persons with diabetes� (p. 83).
[1]
The authors concluded: �� caution should be exercised in recommending a reduction in overall dietary fat in women with diabetes unless accompanied by additional recommendations to guide carbohydrate intake� (p. 84). [1]