Low fat diet works better with extra vegetables and whole grains

Avoiding fat, particularly saturated fat, is one way of improving your plasma lipid profile. A low fat diet works even better if it includes plenty of fruit, vegetables, and whole grains. A randomised trial in 120 healthy Americans found that a traditional low fat diet lasting four weeks reduced participants' serum concentration of total cholesterol by 0.24 mmol/l. Participants who ate the same diet with added extras reduced their serum concentration of total cholesterol by 0.46 mmol/l (P = 0.01). At the end of the four weeks, the group given extra fruit, vegetables, and whole grains had significantly lower serum concentrations of total cholesterol (0.22 (95% CI 0.05 to 0.39) mmol/l lower) and low density lipoprotein cholesterol (0.18 (0.04 to 0.32) mmol/l lower) (figure).

The trial diets were carefully matched to contain identical amounts of fat, saturated fat, protein, carbohydrate, and cholesterol, and the participants were carefully chosen: they were all healthy, aged between 30 and 65, and had a body mass index less than 31 kg/m²and serum concentrations of low density lipoprotein cholesterol between 3.3 and 4.8 mmol/l (moderately hypercholesterolaemic).

The researchers say the added impact of their “low fat plus” diet on serum lipid concentrations is probably due to the extra soy, fibre, garlic, and plant sterols in the diet, which was modelled on the latest revision of the American Heart Association's dietary guidelines.

Annals of Internal Medicine 2005;142: 725-33

Routine episiotomies should be abandoned

Despite 50 years of research it's still impossible to draw up a list of evidence based indications for episiotomy, say researchers from the United States. But one thing is fairly clear—episiotomies should not be done simply to prevent perineal injury in the mother. A thoughtful and systematic review of the best research available (only 26 studies in total) found no …