Citation: Journal of Nutrition. 2019 Jun 08.Journal: The Journal of nutrition.Published: ; 2019ISSN: 0022-3166.Full author list: Prentice RL; Aragaki AK; Howard BV; Chlebowski RT; Thomson CA; Van Horn L; Tinker LF; Manson JE; Anderson GL; Kuller LE; Neuhouser ML; Johnson KC; Snetselaar L; Rossouw JE.UI/PMID: 31175807.Subject(s): IN PROCESS -- NOT YET INDEXEDInstitution(s): MedStar Health Research InstituteActivity type: Journal Article.Medline article type(s): Journal ArticleDigital Object Identifier: https://dx.doi.org/10.1093/jn/nxz107 (Click here)Abbreviated citation: J Nutr. 2019 Jun 08.Local Holdings: Available online from MWHC library: Sept 1928 - present (after 1 year).Abstract: BACKGROUND: The preferred macronutrient dietary composition, and the health consequences of dietary fat reduction specifically, have been debated for decades. Here we provide a comprehensive overview of long-term health outcomes in the Women's Health Initiative Dietary Modification (DM) trial.Abstract: OBJECTIVE: The DM trial aimed to examine whether a low-fat dietary pattern would reduce the risk of invasive breast cancer, colorectal cancer, and, secondarily, coronary heart disease (CHD), with various other health outcomes also considered.Abstract: METHODS: The DM trial is a randomized controlled trial conducted at 40 centers in the US, among 48,835 postmenopausal women aged 50-79 y with baseline intake of >=32% energy from fat. Participants were randomly assigned to a low-fat dietary pattern intervention group or to a usual-diet comparison group, during 1993-1998. Intervention goals were to reduce fat intake from ~35% to 20% of total energy, in conjunction with increasing vegetables and fruit to 5 servings/d and grains to 6 servings/d.Abstract: RESULTS: Over an 8.5-y (median) intervention period, intervention and comparison group differences included lower fat by 8-10%, and higher carbohydrate by 8-10%, of total energy, in conjunction with higher consumption of vegetables, fruit, and grains. Time-to-outcome analyses did not show significant differences between intervention and comparison groups for invasive breast cancer, colorectal cancer, or CHD, either over the intervention period or over longer-term cumulative follow-up. Additional analyses showed significant intervention group benefits related to breast cancer, CHD, and diabetes, without adverse effects. Over a 19.6-y (median) follow-up period, HRs (95% CIs) were 0.84 (0.74, 0.96) for breast cancer followed by death, and 0.87 (0.77, 0.98) for diabetes requiring insulin.Abstract: CONCLUSIONS: Reduction in dietary fat with corresponding increase in vegetables, fruit, and grains led to benefits related to breast cancer, CHD, and diabetes, without adverse effects, among healthy postmenopausal US women.Abstract: This trial was registered at clinicaltrials.gov as NCT00000611.Abstract: Copyright (c) American Society for Nutrition 2019.