Rothstein William G
Department of Sociology and Anthropology, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, USA.
Prev Med. 2006 Nov;43(5):356-60. doi: 10.1016/j.ypmed.2006.07.013. Epub 2006 Sep 1.
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).
The historical and medical literature on this topic was analyzed with special reference to the Woman's Health Initiative (WHI) studies.
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.
The WHI concurred with many other studies in finding that dietary fat intake is not a significant risk factor for CHD or breast cancer.
本报告描述了关于膳食脂肪摄入与乳腺癌、结直肠癌及冠心病（CHD）之间关系的医学理论及研究的历史发展。
对该主题的历史和医学文献进行了分析，特别参考了妇女健康倡议（WHI）研究。
1900年后，服装时尚的变化和人寿保险死亡率研究使得人们强烈倾向于苗条身材，并强调减少膳食脂肪摄入是控制体重的首选方法。世纪中叶之后，对各国的生态相关性研究发现，国家平均膳食脂肪摄入量与国家乳腺癌及冠心病发病率相关。但在对相同国家的纵向研究或对个体膳食脂肪摄入的研究（包括WHI研究）中未发现这些关系。在一些个体研究中发现膳食脂肪摄入会影响结直肠癌，不过WHI研究未发现此关联。与其他减少膳食脂肪的干预研究一样，WHI使用的样本缺乏代表性，且采用了成本高昂的生活方式改变技术，这些技术在社区中不具有经济可行性。
WHI与许多其他研究一致，发现膳食脂肪摄入并非冠心病或乳腺癌的重要风险因素。
