Public Health Nutrition

Invited Commentary

The Women's Health Initiative. What is on trial: nutrition and chronic disease? Or misinterpreted science, media havoc and the sound of silence from peers?

Lauren Lissnera1, Lluis Serra Majema2, Maria Daniel Vaz de Almeidaa3, Christina Berga4, Roger Hughesa5, Geoffrey Cannona6, Inga Thorsdottira7, John Kearneya8, Jan-Å Gustafssona9, Joseph Raftera9, Lbrahim Elmadfaa10 and Nick Kennedya11

a1 Department of Community Medicine and Public Health Sahlgrenska Academy at Göteborg University Göteborg, Sweden

a2 Department of Clinical Sciences, University of Las Palmas de Gran Canaria de Gran Canaria and Sociedad Espanñla de Nutrición Comunitária (Spanish Society of Public Health Nutrition), Spain

a3 Faculty of Nutrition and Food Sciences, University of Porto and Portuguese Society for Nutrition and Food Sciences Porto, Portugal

a4 Department of Home Economics, Göteborg University Göteborg, Sweden

a5 School of Public Health (Gold Coast), Griffith University Queensland, Australia

a6 World Health Policy Forum Juiz de Fora, Minas Gerais, Brazil

a7 Unit for Nutrition Research, Landspitali-University Hospital and University of Iceland, Reykjavik, Iceland

a8 Department of Biological Sciences, Dublin Institute of Technology Dublin, Ireland

a9 Department of Biosciences and Nutrition, Karolinska Institutet Novum, Huddinge, Sweden

a10 Department of Nutritional Sciences, University of Vienna, Austria

a11 Department of Clinical Medicine, Trinity College Dublin, Ireland


The first results of the Women's Health Initiative dietary intervention trial were published in the USA in February. This is a colossal intervention designed to see if diets lower in fat and higher in fruits, vegetables and grains than is usual in high-income countries reduce the incidence of breast cancer, colorectal cancer, heart disease and other chronic diseases, in women aged 50–79 years. As interpreted by US government media releases, the results were unimpressive. As interpreted by a global media blitz, the results indicate that food and nutrition has little or nothing to do with health and disease. But the trial was in key respects not reaching its aims, was methodologically controversial, and in any case has not produced the reported null results. What should the public health nutrition profession do about such messes?