Fruit and vegetables WHEL study

There are people, like these "scientific" committee members, who believe that if "powerhouse" fruit and vegetables were eaten more often in the USA, there would be major health benefits. Don't bother getting the full text.

Here's a flavour of the outpourings of Nanney, Haire-Joshu, Hessler and Brownson:

"Epidemiological (yawn) data published from large longitudinal cohort studies such as the Women’s Health Study, Health Professionals Follow-Up Study, Physician’s Health Study, and National Health and Nutrition Examination Survey (NHANES) have helped to identify food constituents (dietary folate, vitamin C) 3, 4, 5 and 6, food patterns (cruciferous vegetables) 4, 7 and 8, and specific food outcomes (carrots, tomatoes) 6, 8, 9, 10, 11 and 12 as more directly linked to reduced risk for selected chronic diseases. For example, consumption in the highest quintiles of green leafy vegetables is associated with a risk reduced by 6% to 30% for cardiovascular disease and stroke 4, 7 and 8. High intakes of broccoli and spinach are associated with reduced risk for some cancers 11 and 12 and cataract formation 13, 14 and 15. The Netherlands Cohort Study on Diet and Cancer (1986–1992; n=62,573) further specified that women with the highest consumption of cooked cauliflower and cooked spinach were associated with 38% to 49% risk reduction in colon cancer (11)."

Oops, I fell asleep after the first word.

The first word is epidemiological. That is; only useful for generating speculation.

OK, let's speculate, I mean generate an hypothesis. I hypothesise that a massive, intensive and long duration intervention trial, to get women to eat "powerhouse" fruit and vegetables, will do nothing to prevent or reduce the recurrence of previously operated breast cancer. Someone else generated a very different hypothesis. They got mega funded to check it out.

They set up the WHEL (Women's Healthy Eating and Living) study. Nice catchy name.

How might one change women's eating habits? Let's try this:

"The Women’s Healthy Eating and Living Study’s principal strategy to promote dietary change involves a telephone-counseling protocol that facilitates one-on-one advice tailored to the needs of the individual participant. The highly-structured, computer-assisted protocol facilitates standardization of the intervention. Quality control is enhanced by providing this telephone service from a centralized location at the Study Coordinating Center, thus enabling weekly case management meetings and considerable flexibility in scheduling. Counselor performance is carefully monitored, and regular feedback comparing individual to group performance has led to considerable consistency across counselors. Additional intervention strategies include an orientation meeting, monthly cooking classes, and monthly newsletters. The intervention protocol recommends 28 to 36 intervention contacts during the first 12 months (Table 1), with the majority (54% to 64%) of these contacts made by telephone."

This will work. It did work. What did it achieve?

It achieved "5 vegetable servings plus 16 oz of vegetable juice; 3 fruit servings; 30 g of fiber; and 15% to 20% of energy intake from fat."

It worked for 7.3 years. This is hard core long term intervention stuff. No groups of 10 people for 8 weeks and measure a few lipid parameters. This is big research using big money to make a big point. To confirm all of the benefits of those mysterious micro-nutrients in the vegetable juice.

What did it achieve? I can't say anything. I just have to leave it to the WHEL study team 2007 report:

"CONCLUSION: Among survivors of early stage breast cancer, adoption of a diet that was very high in vegetables, fruit, and fiber and low in fat did not reduce additional breast cancer events or mortality during a 7.3-year follow-up period."

Pretty conclusive. No mincing of words.

You could say it didn't do any harm I guess.

Phew.

Peter