Dietary fat, coronary heart disease, and cancer: A historical review

Objectives. This report describes the historical development of medical theories and research concerning the relationship between dietary fat intake and breast and colorectal cancer and coronary heart disease (CHD). Method. The historical and medical literature on this topic was analyzed with special reference to the Womanʹs Health Initiative (WHI) studies. Results. After 1900, changes in clothing fashions and life insurance mortality studies created strong preferences for slimness and emphasized reduced dietary fat intake as the preferred method of weight control. After midcentury, ecological correlations of countries found that national average dietary fat intake was related to national breast cancer and CHD rates. These relationships were not found in longitudinal studies of the same countries or in studies of dietary fat intake of individuals, including the WHI study. Dietary fat intake was found to affect colorectal cancer in some studies of individuals, although not the WHI. The WHI, like other intervention studies of dietary fat reduction, used unrepresentative samples and costly lifestyle change techniques that are not economically feasible in the community. Conclusion. The WHI concurred with many other studies in finding that dietary fat intake is not a significant risk factor for CHD or breast cancer.