Low-Fat Dietary Pattern and Risk of Colorectal Cancer

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Abstract
The Women's Health Initiative (WHI) Dietary Modification Trial is a randomized controlled trial designed in 1991-1992 to test whether a low-fat eating pattern with increased fruits, vegetables, and grains reduces the risk of breast cancer, colorectal cancer, or, secondarily, coronary heart disease in postmenopausal women. At that time, international comparisons suggested that countries with 50% lower fat intake than the US population had approximately one third the risk of colorectal cancer.1,2 Migration studies supported this hypothesis. Women migrating from countries with low fat consumption to countries with high fat consumption experienced the higher colorectal cancer rates of their new country.3,4 Fairly consistent evidence existed for an effect of dietary fat, vegetables and fruits, and grains on colorectal cancer risk from within-country observational studies,2,5-8 although the protective effect of lower fat intake was no longer clear after adjusting for energy intake.2,9 The WHI Dietary Modification Trial is the first randomized trial to directly address the health effects of a low-fat eating pattern in predominantly healthy postmenopausal women from diverse racial/ethnic, geographic, and socioeconomic backgrounds. This article reports the principal results for colorectal cancer.