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The largest study of its type suggests that popular notions about a low-fat diet require more scrutiny.
According to three JAMA papers reporting results from the Women's Health Initiative (WHI), a low-fat eating pattern does not have a significant effect on reducing the risk of cardiovascular disease or cancer in postmenopausal women.1–3 However, even the modest effects observed call for longer follow-up and more focused diet and lifestyle intervention studies to see if modified fat intake could indeed show improvements in risk factors, researchers conclude.
Nearly 49,000 postmenopausal women enrolled in the WHI dietary modification trial. About 19,500 women were assigned to an intervention diet intended to reduce total fat to 20% of energy intake and to increase fruit, vegetable, and grain intake.
After 8 years, researchers found no significant difference in rates of coronary heart disease, stroke, breast cancer, or colorectal cancer between women on the low-fat diet and those who continued to eat as usual.
An accompanying editorial points out that most women in the low-fat group were overweight and did not employ dietary strategies to lose weight or reduce high blood pressure.4
Further, the women who reduced total fat intake lowered intake of cardioprotective unsaturated fats as well as unhealthful saturated fat and trans fatty acids.
"It's the type of fat that counts," says Michael D. Parkinson,
MD, president-elect of the American College of Preventive Medicine. "The
essential message for doctors and patients remains unchanged: We're eating too
many calories, we're eating the wrong types of fats, and we're not physically
active enough." 
References
2. Beresford SAA, Johnson KC, Ritenbaugh C, et al.: Low-fat dietary
pattern and risk of colorectal cancer: The Women's Health Initiative
randomized controlled dietary modification trial. JAMA 295: 643–654, 2006.
3. Howard BV, Van Horn L, Hsia J, et al.: Low-fat dietary pattern and
risk of cardiovascular disease: The Women's Health Initiative randomized
controlled dietary modification trial. JAMA 295: 655–666, 2006.
4. Anderson CAM, Appel LJ: Dietary modification and CVD prevention: A
matter of fat. JAMA 295:693–695, 2006.
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