ou bet! If you've been reading my newsletter at all over the past few years, you know that I have not been recommending a low-fat diet for quite some time. Now you've probably been hearing about the large-scale Women's Health Initiative (WHI) journal articles published recently in the Journal of the American Medical Association that conclude that a low-fat diet does nothing to help protect against breast cancer, prostate cancer or heart disease in women. But before you dive into that double cheeseburger with French fries on the side, let me give you a little bit more information about these study results.

First, I think that headlines such as "Low Fat Diet Does Not Cut Health Risks" can be misleading. Although the researchers intended to study low-fat diets in which only 20% of total calories came from fat, they only ended up studying lower fat diets, in which the women in the study group ate 24% of their total calories from fat in the first year and 29% of their calories from fat in years two through eight of the study. This is a lower percentage of fat than they were originally eating and lower than the control group, but it is not considered "low fat." The group of women who did reduce their fat the most, close to 20% for an extended period of time, did have a 22% lower rate of breast cancer and a 9% lower rate of colon polyps. Furthermore, those women who lowered their intakes of saturated and trans fat the most had lower coronary heart disease risk.

Second, the women enrolled in this large-scale study were between the ages of 50 and 79 at the start of the eight-year study. Cancers and heart disease do not develop over a matter of weeks or months, they develop over a lifetime. Therefore, making small dietary changes at an advanced age for just eight years may not have been enough to reverse what had already been set into motion. Furthermore, it takes at least 10 years for colon cancer to develop and this study has so far only lasted eight. Before we make any strong conclusions, we should wait several more years to see if the health outcomes for the study group are any different.

Third, we have known for quite some time that the types of fat you eat are more important factors in disease risk than the total amount of fat you eat. The women in the study group were instructed to lower all fats, which meant eliminating high-fat foods such as nuts, olive oil for cooking, olive oil-based salad dressings, avocado, and possibly even fatty fish. Those are the high-fat foods that we should be trying to eat, not avoid. The women actually reduced their monounsaturated fat and omega-3 fat intake on the diet. Research has confirmed that these fats help prevent heart disease, decrease risks of breast, ovarian, and stomach cancers, and quell inflammation, all benefits that these women probably missed out on.

Fourth, the average body mass index (BMI) of all the women in the study was 29, which is considered very overweight (BMI of 30 or more is considered obese) and, on average, there was no significant weight loss. Since most of the participants were either overweight or obese, they were already at increased risk for poor health. Being overweight, especially at midlife and beyond, increases the risks of developing heart disease, diabetes, and certain cancers. Unfortunately, weight loss was not addressed in the study.

Fifth, it is overall food choices, not one component in particular, that makes a diet healthful. Fruits, vegetables, and whole grains are other important parts of a beneficial eating plan. The participants only ate one more serving of fruits and vegetables (which were lumped together into one food group) than the comparison group, bringing the average daily fruit and vegetable intake to five servings from four. Aside from not being a very significant increase, the current recommendations for daily fruit and vegetable intake is seven to ten. Those in the study who at more fruits and vegetables did have a lower risk of coronary heart disease, though. The women also went from eating zero servings of whole grains to a half serving per day-again, not enough to really provide any health benefits.

Finally, regular physical activity was not addressed in the studies. Exercise is part of a healthy lifestyle, helps to control weight and improve cardiovascular health.

Still, there are several messages that we can take away from these studies:

• If you are a woman between the ages of 50 and 79, lowering total fat a little bit will probably not lower your risk of heart disease, breast, or colon cancer.

• Fat does matter, but the quantity and type of fats are what you need to watch. Lower saturated and trans fats as much as you can, mainly by eliminating processed foods and switching to leaner and nonfat versions of animal products (with the exception of fatty fish). Emphasize sources of monounsaturated fats (olive oil, avocado and nuts) and omega-3 fats (fatty fish, walnuts and flax seeds). Remember that fat has more than twice as many calories per gram as protein and carbohydrates, so if you are trying to lose weight, controlling fat calories can help.

• Eat as many fruits and vegetables as you can so you may reap their antioxidant, fiber, and low-calorie benefits. This study and other studies have confirmed that they work to help prevent heart disease.

• Good health and poor health develop over a lifetime, so making healthy lifestyle changes earlier in life may help lower health risks later in life. However, if you are a post-menopausal woman or a man over 50, don't think that making changes now will not help. If you smoke, are overweight, sedentary, or eat a diet high in unhealthy fats, removing unhealthful practices and replacing them with healthier habits will go a long way towards helping to prevent future diseases.