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  #1   ^
Old Thu, May-16-19, 01:29
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Demi Demi is offline
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Default Breast cancer: Eating less fat cuts risk by a fifth, study shows

Quote:
From The Times
London, UK
16 May, 2019

Breast cancer: Eating less fat cuts risk by a fifth, study shows

Women aged over 50 can cut their risk of dying from breast cancer by a fifth by eating smaller portions of meat and having one extra serving of fruit and vegetables a day, the first trial of its kind has shown.

The two-decade study of 49,000 women found that even a slightly healthier diet could make a dramatic difference to a woman’s risk of suffering fatal breast cancer. Women have been urged to cut down on meat and dairy products or choose lower-fat options after the study found evidence that such changes could lengthen their lives.

About one in nine women will develop breast cancer and rates have increased by about a fifth since the 1990s, with obesity thought to be contributing. Better treatment has led to death rates falling by more than a third since the 1970s, but 12,000 people a year still die of the disease and the number is projected to rise again as the population ages.

Most diet studies find it hard to tease out the effect of what people eat from other aspects of their lifestyle, but the latest research is the first gold-standard trial of the issue. Thousands of women in the United States aged 50 to 79 were randomly told in the 1990s to carry on with their normal diet or were coached to adopt a healthier lower-fat diet.

On average those on the diet reduced fat from 32 per cent of their calories to 25 per cent and added an extra daily portion of fruit, vegetables and whole grains, and stuck with it for more than eight years.

During the 20 years of the study, there were 3,374 cases of breast cancer and women on the diet were 21 per cent less likely to die of the disease, according to results to be presented at the American Society of Clinical Oncology (Asco) annual meeting in Chicago. Rowan Chlebowski, of the University of California Los Angeles, lead author of the study, said: “Ours is the first randomised, controlled trial to prove that a healthy diet can reduce the risk of death from breast cancer. The balanced diet we designed is one of moderation, and after nearly 20 years of follow-up the health benefits are still accruing.”

Women made changes such as choosing lower-fat options, eating less butter and cheese, avoiding fried food and having smaller portions of meat, he said. “This is a change that is achievable by many because it represents moderation, achieved by 19,000 participants.” It remains unclear whether less fat, more vegetables or fewer calories contributed most to the reduced risk.

Excess weight has been shown to increase risk, but although women on the lower-fat diet lost about 3 per cent of their body weight, Professor Chlebowski’s team said the findings could not be explained by weight loss. Instead he suggested that healthy eating reduced harmful chronic inflammation.

Tony Howell, of Manchester University, cautioned that while it was impossible to ignore such an impressive trial, it did not show that eating fat was the key issue. “Women should try to maintain a healthy weight, exercise for at least 30 minutes a day and cut down on alcohol. Those are the three major risk factors,” Professor Howell said.

Susan Jebb, of the University of Oxford, said the findings were good news, with women in the trial reducing their fat intake by roughly the equivalent of a 4oz steak a day. “This is achievable and not some extreme low or no-fat diet,” Professor Jebb said.

Tips for a healthier diet

• Choose skimmed or semi-skimmed milk
• Have a smaller steak
• Grill meat instead of frying
• Cut down on cheese
• Avoid sausages and bacon
• Replace butter with olive oil spread



https://www.thetimes.co.uk/edition/...shows-cs8r2qr6p
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  #2   ^
Old Thu, May-16-19, 04:38
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DaisyDawn DaisyDawn is offline
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Breast cancer runs on my maternal side. All of the women are/were either overweight or obese and sedentary.

My mil is a survivor and she's thin and eats a fairly balanced diet. We spend a lot of time together, eat together frequently, and she eats veggies, locally raised meats, small amounts of dairy, they raise their own eggs etc. She's also active, doesn't drink at all, doesn't smoke etc. Her 'healthy' eating habits and lifestyle didn't mean anything, she still got cancer. There's also no family history for her, it was a total fluke.

I know the odds are stacked against me with my family history. But, they were stacked against me too for getting type 2 diabetes, and I'm the only one in my family who's reversed the progression of prediabetes. I'm also the only one in my family who's maintained a large weight loss long term, (my younger sister, a WW follower, is a couple years behind me in maintenance, is doing really well as well).

Cancer sucks. We can try and stack the odds in our favor to try to prevent it, but really there's only so much we can do. My husband's grandfather has lung cancer-he's never smoked. That's life

Last edited by DaisyDawn : Thu, May-16-19 at 04:50.
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  #3   ^
Old Thu, May-16-19, 07:30
Barbara20 Barbara20 is offline
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That one in nine women will get cancer in their lifetime is junk science. The fact is that they are counting women in their nineties who have some sort of cancer. Women who live into their nineties are few and far between and the fact that a few show cancer after a long long life (mostly eating junk diets) is not news - it's BULL/NEWS.

Scare tactics work very well. Many women I know in their 60s and 70s will not give up their high carb diets because they are afraid of cancer even though they are vastly overweight, and many are TII diabetics.
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  #4   ^
Old Thu, May-16-19, 08:43
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Calianna Calianna is online now
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Every one I've known who had breast cancer ate a low fat diet, with very little meat, high in fruits, veggies, and whole grains. Fluke? Perhaps.

I'm not going to subscribe just to read the entire article, so if someone has access to the actual data involved in this study, it'd be nice to know if the study actually shows a true 20% decrease, or if they used fuzzy-math to manipulate the numbers and make it look like a statistically insignificant difference is of such great significance.
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  #5   ^
Old Thu, May-16-19, 10:08
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Ms Arielle Ms Arielle is offline
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My grand mother AND her sister died of breast cancer. BOTH rail thin. TALL women and truely thin and trim. THink Dutch!

My mother developed breast cancer too. Only she was about ten years older than the age her mother died. Sorry I dont know the age of onset for my grandmother-- I was rather young. I do remember her younger sister--- dying 6 years later. Clearly the mechanism of cancer was not known and not beatable THEN.

Why did my mother develop it so late? SHe was fat-- some 30 pounds over weight, ate great foods including having a garden every year and eating good foods year around, and worshipping the sun thru the 60's and 70's, and lots of sun in the summer. BUT NOT in the MAINE winter. She has had breast cancer twice.

I hate reports like this-- my fear level soars, causing coritsols to race and that is detrimental.

Then I look at the info, and its rather NOT helpful. Where is fasting, where is the detail on actual amounts eaten, how was the data collected?

Eating more FRESH vegies is a good thing IMHO; and limiting foods that are charred ie BBQ is a good thing; avoiding nitrate added foods is a good thing IMHO. ( FInding no nitrated added bacon is very easy now.!!! )

Too many reports and doctors dont understand how cancer develops and works.

This report does more damage than good IMHO.

Last edited by Ms Arielle : Thu, May-16-19 at 10:40.
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  #6   ^
Old Thu, May-16-19, 10:30
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JEY100 JEY100 is online now
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Sigh.

WaPo: https://www.washingtonpost.com/heal...m=.ee38416e7017

Quote:
Experts on breast cancer generally praised the study but expressed some reservations.

For one thing, the study was designed to determine whether a low-fat diet could reduce the risk of developing breast cancer in the first place, not whether it provided a mortality benefit.

Previously released data has shown that a lower-fat diet did not result in a reduced risk for developing breast cancer.

The breast cancer experts also noted that the mortality benefit took almost 20 years to emerge, and some said that it was not clear which dietary component was responsible for the benefit — the reduced fat or the additional fruits, vegetables and grains.


NBC: https://www.nbcnews.com/health/wome...-study-n1005381

CBS: https://www.cbsnews.com/news/low-fa...er-study-finds/

Quote:
However, that risk was small to start with and diet's effect was not huge, so it took 20 years for the difference between the groups to appear. The diet change also did not lower the risk of developing breast cancer, which was the study's main goal.


However, don't let that stop mainstream media from creating scary headlines.
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  #7   ^
Old Thu, May-16-19, 11:59
tess9132 tess9132 is offline
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I'm with DaisyDawn - I think a lot of cancers are genetic. On the opposite end of the spectrum, my husband's aunt lived to be 98 and smoked at least a pack a day until she was 93 when she had to give it up because she just couldn't afford it anymore. All her possessions, including the clothes we buried her in, reeked of tobacco though she hadn't had a puff in 5 years.

Two remarkable things about her diet - she drank coffee from the minute she woke up until her head hit the pillow. And, she had meat at every single meal of the day. During her 90's when she lived with us, she'd usually have bacon for breakfast, but sometimes scrapple or sausage, and for lunch and dinner, she usually ate microwavable chicken nuggets (dinosaur shaped), sometimes with a side of "potatoes" (i.e. french fries).
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  #8   ^
Old Thu, May-16-19, 12:25
CityGirl8 CityGirl8 is offline
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Quote:
...lead author of the study, said: “Ours is the first randomised, controlled trial to prove that...
I think that study author needs some more education on what a "controlled" trial means in terms of diet studies. Did they randomized the women into two groups and then provide them with all the food they ate for 20 years? No. Did they even provide them with specific diets to follow with specifics foods? No.

They just told one group to lower their fat intake and then it's not clear. Maybe they collected some data via food recall questionnaires at some unstated frequency. They told the other group to just keep on doing whatever. Were data collected on what they were eating at the start? We're they required to keep eating exactly that way for the next 20 years? Or is it possible many in the "no change" group did gradually change their diets to follow popular low-fat eating styles, like the food pyramid.

Is it possible that by cutting fat overall that the "low fat" group also managed to reduce their intake of seed oils significantly and that's really the differential, not saturated fat?

I hate these studies. They really don't provide any solid information and seem like such a waste of money.
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  #9   ^
Old Thu, May-16-19, 14:36
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cotonpal cotonpal is online now
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Quote:
Originally Posted by CityGirl8
I think that study author needs some more education on what a "controlled" trial means in terms of diet studies. Did they randomized the women into two groups and then provide them with all the food they ate for 20 years? No. Did they even provide them with specific diets to follow with specifics foods? No.

They just told one group to lower their fat intake and then it's not clear. Maybe they collected some data via food recall questionnaires at some unstated frequency. They told the other group to just keep on doing whatever. Were data collected on what they were eating at the start? We're they required to keep eating exactly that way for the next 20 years? Or is it possible many in the "no change" group did gradually change their diets to follow popular low-fat eating styles, like the food pyramid.

Is it possible that by cutting fat overall that the "low fat" group also managed to reduce their intake of seed oils significantly and that's really the differential, not saturated fat?

I hate these studies. They really don't provide any solid information and seem like such a waste of money.


Right, exactly. This is not some gold standard randomized control study. It's just garbage masquerading as science with its minimal so-called results fluffed up to make them seem important when they really tell us nothing of value. We really need to see the whole study and then I am sure it could be torn to shreds.
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  #10   ^
Old Fri, May-17-19, 07:44
Barbara20 Barbara20 is offline
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I hate these scare tactics too. Here's what they do: create a crisis, then sell people something to solve it.

Scare gullible women enough and they will help pump up Weight Watchers stock again.
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  #11   ^
Old Fri, May-17-19, 09:19
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Bob-a-rama Bob-a-rama is offline
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Sounds like biased statistical reporting for an agenda to me.

Cancer feeds on sugar. What do they do to find out if you have cancer? Put some markers into sugar and find out where the sugar goes. It goes straight for the cancer.

Mark Twain said there are three kinds of lies: Lies, Damn Lies, and Statistics.

Unless everything those women ate, every bit of exercise the did, what they wore, what they drank, what they weighed, how much air pollution they breathed, what they put on their skin, what they put in their laundry, what material is in their clothes (especially bras I guess), what their genetic markers were, and everything else about their lives were included, you cannot be sure of your results. The statistics can be manipulated to say whatever you want them to say. Lies, Damn Lies, and Statistics.

Bob
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  #12   ^
Old Fri, May-17-19, 12:48
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Calianna Calianna is online now
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Quote:
Originally Posted by Bob-a-rama
Sounds like biased statistical reporting for an agenda to me.

Cancer feeds on sugar. What do they do to find out if you have cancer? Put some markers into sugar and find out where the sugar goes. It goes straight for the cancer.

Mark Twain said there are three kinds of lies: Lies, Damn Lies, and Statistics.

Unless everything those women ate, every bit of exercise the did, what they wore, what they drank, what they weighed, how much air pollution they breathed, what they put on their skin, what they put in their laundry, what material is in their clothes (especially bras I guess), what their genetic markers were, and everything else about their lives were included, you cannot be sure of your results. The statistics can be manipulated to say whatever you want them to say. Lies, Damn Lies, and Statistics.

Bob



Exactly.



Just look at the actual data for the holy-grail of all life-saving medications: STATINS. The ads make it sound like the effectiveness of these meds is so amazing that you'd be crazy not to beg to take them for the rest of your life. But here's what the actual data showed, as opposed to the claims that were made about the effectiveness of Lipitor and Crestor:


Quote:
What's amazing (and probably would never be included in the ads today, because it would be admitting that their product doesn't really do anything significant) is that the actual stats are alluded to in the Lipitor ad, where the small print says that 2% of patients taking Lipitor still had a heart attack, compared to only 3% NOT taking Lipitor. This of course resulted in a multi-billion dollar pharmaceutical boon, despite only having a 1% better outcome, and yet, because of the mathematical magic of multiplying the difference of 1.1% on Lipitor (The actual stat was 98.1% on Lipitor vs 97% on placebo) by the 3% on the placebo, the ad still claimed a 36% reduction in heart attacks.

Similar mathematical magic was worked on the Crestor study results - this time 98.4% did not have a first heart attack while on Crestor, vs 97.2% did not have a first heart attack while on the placebo - multiply the 1.2% difference between the two by the 2.8% who had heart attacks on the placebo, and you come up with the even more remarkable 44% better rate of not having a first heart attack.

There's no statistically significant differences between medicated and placebo results in any of these studies, because in every instance, there's still far less than 4% difference between the medicated and placebo groups.




My guess is that even IF they can somehow prove the two groups of women ate exactly as they were advised for the entirety of the 20 years of the study (as well as accounting for every other possible variable, as Bob mentioned), only managing to come up with a 20% better outcome for the more fruit group most likely means that the data will show the actual difference between the two groups was around 0.5%.
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  #13   ^
Old Fri, May-17-19, 18:33
Bonnie OFS Bonnie OFS is offline
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My own version of junk science is looking at my family. One aunt smoked heavily for years - perfect health until she died in her late 80s. In spite of many family members being overweight or obese (except the aunt who smoked), my dad & I were the only ones to end up with t2 diabetes. There have been different cancers: lung cancer in an uncle who didn't smoke, breast cancer in one aunt, mom had liver cancer tho she never drank & a couple of others I can't recall.

I've pretty much decided that cancer is random. So I'll just do the best I can to stay reasonably healthy & hope for the best.
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Old Sat, May-18-19, 04:33
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JEY100 JEY100 is online now
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Dr. Bret Scher wrote the analysis for DietDoctor:
https://www.dietdoctor.com/does-a-l...t-cancer-deaths

Does a low-fat diet reduce breast cancer deaths?

Quote:
Press briefings on an unpublished Women’s Health Initiative (WHI) report suggest that eating less fat improves a woman’s chance of surviving breast cancer. A more critical evaluation of the study, however, suggests we need to question the significance of the findings.

The Women’s Health Initiative (WHI) trial initially started in 1993, randomly assigning 48,000 women to a standard diet with at least 32% of calories coming from fat, or a “dietary intervention” group encouraged to reduce fat to 20% of calories (they actually reduced it to 25% on average) and to increase fruits and vegetables to at least 5 servings per day and whole grains to at least 6 servings per day.

The initial publication of this massive trial, in 2006, showed no difference in the primary outcome of breast cancer rates at 8.5 years.

The new report of the WHI study, which has yet to be published, is reported as showing a reduction in breast cancer deaths by 20%. Importantly, this is a relative risk reduction, and the absolute reduction is not provided. This details matters in how we interpret the data, yet we will have to wait to see the report, once issued.

As an example of the reason this matters, consider the results published from the same WHI study at 11.5 years of follow up; investigators reported a 22% reduction in mortality after breast cancer diagnosis. This equated to a mortality difference, in absolute terms of 1.1% vs. 0.9%.

That’s right. The 22% relative reduction was an absolute reduction of just 0.2% over 11.5 years. Furthermore, the risk of dying specifically from breast cancer was 0.4% vs 0.3%. As you can see, putting things into perspective with absolute risk reduction is crucial to understanding the true impact of an intervention, especially when the study leaves many other questions unanswered.

For instance, a crucial (and problematic) element of the WHI trial design was described in the 2006 publication.

The intervention group received an intensive behavioral modification program that consisted of 18 group sessions in the first year and quarterly maintenance sessions thereafter. Each group had 8 to 15 women and was led by a specially trained and certified nutritionist…Comparison group participants received a copy of Nutrition and Your Health: Dietary Guidelines for Americans

In other words, the intervention group had regular group support and coaching while the control group got a book. If that isn’t a set up for introducing an intervention bias, I don’t know what is. Unfortunately, this design flaw clouds any result from the trial as we can’t be sure whether any outcome difference was due to the dietary intervention or simply due to the increased personalized attention to health.

The authors promote the study as “the first randomized clinical trial evidence that a dietary change can reduce a postmenopausal woman’s risk of dying from breast cancer.” While on the surface that may be true, we are still left wondering, how did the two diets differ during the 20 years of follow up? Did the quality of fats and carbohydrates differ? For instance, did the higher fat group rely on industrial seed oils to add extra fat? Or were they eating more natural fats? Did the higher fat group eat more refined grains and carbohydrates since they were not encouraged to eat fruits and vegetables? Since the lower fat group had counselling sessions, did they also improve other healthy behaviors? Any of these examples could potentially explain a very small difference in cancer mortality.

In addition, the study group reportedly lost 3% more body weight than the control group. That small reduction may also explain the small difference in mortality. For instance, one report stated that the mortality benefit was more pronounced in those who were metabolically unhealthy to begin with. Thus, the difference in weight loss could potentially account for the difference in outcomes.

Some of the quotes in response to the report are “Patients are eager for things they can do” to improve their outcomes with breast cancer. And “What we eat matters.” While these quotes are true, it remains to be seen that this study adequately addresses them with a specific recommendation.

It should not be a surprise that reducing refined grains and sugars and focusing on whole foods should improve overall health, metabolic disease and probably even cancer outcomes. However, this report appears to have too many holes to impact our specific dietary recommendations. Once again, we have to be sure the strength of the recommendation is matched by the strength of the evidence. To learn more about what we know and what we don’t know about diet and its impact on cancer, see our detailed guide on this subject below.

Thanks for reading,
Bret Scher, MD, FACC
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