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Three thousand breast cancer survivors were coached for years to eat far more vegetables, fruit and fibre. They did, and it made no difference to recurrence or survival.
WHEL randomised 3,088 women (1995-2000) and followed them for a mean 7.3 years. The intervention group substantially and durably changed their diet (vegetables +65%, fruit +25%, fibre +30%, fat -13% at four years, confirmed by plasma carotenoids). Invasive breast cancer events (16.7% vs 16.9%) and deaths (10.1% vs 10.3%) did not differ. Secondary analyses generated hypotheses later explored elsewhere: women with both high vegetable-fruit intake and high physical activity had lower mortality; a nightly fast under 13 hours was associated with recurrence. WHEL and WINS (low-fat diet, marginal effect confined to HR-negative disease) are the reason the field moved from diet alone to energy balance, weight loss and exercise, and they are a standing caution against assuming observational diet associations are causal.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
3,088 enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Invasive breast cancer event (recurrence or new primary)primary | Dietary intervention | 1,537 | 16.7% | 0.96 (0.8 to 1.14) | - | link |
| Comparison | 1,551 | 16.9% |
Shares Energy balance, Dietitian-led weight-loss programmes in HR-positive breast cancer, Diet, exercise and lifestyle roadmap: causes established → interventions that disappointed → exercise proven as treatment, Failures are hidden.
Shares Time-restricted eating in cancer prevention and survivorship, Energy balance, Mediterranean and plant-forward dietary patterns.
Shares Energy balance, Dietitian-led weight-loss programmes in HR-positive breast cancer, Survivorship and late effects are neglected, HR-positive / HER2-negative breast cancer.
Shares Time-restricted eating in cancer prevention and survivorship, Energy balance, Diet, exercise and lifestyle roadmap: causes established → interventions that disappointed → exercise proven as treatment.
Shares Dietary pattern scores (Mediterranean, HEI, AHEI, DASH, WCRF/AICR), Mediterranean and plant-forward dietary patterns, HR-positive / HER2-negative breast cancer.
Shares Dietary pattern scores (Mediterranean, HEI, AHEI, DASH, WCRF/AICR), Mediterranean and plant-forward dietary patterns, Diet, exercise and lifestyle roadmap: causes established → interventions that disappointed → exercise proven as treatment.
Shares Energy balance, Diet, exercise and lifestyle roadmap: causes established → interventions that disappointed → exercise proven as treatment, Triple-negative breast cancer (TNBC), HR-positive / HER2-negative breast cancer.
Shares Energy balance, Diet, exercise and lifestyle roadmap: causes established → interventions that disappointed → exercise proven as treatment, Survivorship and late effects are neglected, HR-positive / HER2-negative breast cancer.