Methods	RCT
Participants	Healthy women, BMI >25 (UK) CVD risk: low Control: randomised 53, analysed 40 Intervention: randomised 57, analysed 42 Mean years in trial: control 0.42, intervention 0.43 % male: 0 Age: mean control 50, intervention 51
Interventions	Reduced fat vs usual diet Control aims: advice - total fat 35%E, CHO 34.5%E, 1200kcal per day encouraged but not prescribed Intervention aims: total fat 20%E, CHO 58%E, 1200kcal/day encouraged but not prescribed Control methods: dietary advice supported by exchanges and recipes Intervention methods: dietary advice supported by exchanges and recipes Total fat intake: unclear Saturated fat intake: unclear Style: diet advice Setting: community
Outcomes	Stated trial outcomes: weight loss and cardiovascular risk factors Data available on total mortality? yes (no events) Cardiovascular mortality? yes (no events) Events available for combined cardiovascular events: cardiovascular deaths, non fatal MI, stroke (no events) Secondary outcomes: total and non-fatal MI, stroke, cancer deaths (no events) Tertiary outcomes: BMI, total, LDL and HDL cholesterol, TG, BP
Notes
Risk of bias
Bias	Authors’ judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	“medical officer drew coloured straws from a box”
Allocation concealment (selection bias)	Unclear risk	Randomisation method not clearly described
Blinding (performance bias and detection bias) All outcomes	High risk	Participants were not blinded, unclear about researchers
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Deaths, cancer and CV events are drop-outs, trialists asked for data
Selective reporting (reporting bias)	Low risk	Not relevant for primary and secondary outcomes as all trialists asked for data
Other bias	Low risk
Free of systematic difference in care?	Low risk	Similar intervention in both groups. See Control and Intervention Methods in Interventions section of the Table of Characteristics of Included Studies
Free of dietary differences other than fat?	Low risk	See Control and Intervention Aims in Interventions section of the Table of Characteristics of Included Studies