Day 035 - 12 Oct 94 - Page 47


     
     1   Q.   If you had volunteers you might be able to arrange
     2        something, but not otherwise.  Then it goes on:  "Key and
     3        Pike concluded in a recent review that the data overall
     4        suggest a promoting effect of oestrogens and possibly also
     5        of progestagins".  So far, Dr. Barnard, no problem.
     6
     7        As I understand it, your proposition is that the fairly
     8        well accepted idea that oestrogen, particularly in
     9        post-menopausal women who are overweight, have a promoting
    10        effect on established tumours, but that process is in some
    11        sense facilitated by a high-fat diet; is that right?  Have
    12        I understood it or not?
    13        A.  A high-fat diet does -- I believe you have understood
    14        it, yes.
    15
    16   Q.   You say it again to make sure.
    17        A.  The reason I am having difficulty is the sentence was
    18        a bit long.  By the time you got to the end I wanted to
    19        make sure I remembered the beginning accurately.
    20
    21   Q.   Tell us, please -- not prompted by me because I do not
    22        want to put words into your mouth -- what your thesis is
    23        in relation to the incidence of breast cancer and the
    24        consumption of a high-fat diet in postmenopausal women who
    25        are too fat?
    26        A.  The incidence of post-menopausal cancer does not begin
    27        with post-menopausal diet.  It begins premenopausally and
    28        may -- and very likely occurs prepubertally.  However,
    29        there does not seem to be a time, so far as we know, in
    30        which diet fail to have an effect because, as we have seen
    31        with studies of Gregorio and Verreault (and many others
    32        that I did not bring in but would be glad to and are
    33        cited), there is no time when or no age when dietary fat
    34        levels seem not to have an effect on cancer progression.
    35
    36        However, the mechanisms that have been discussed in the
    37        literature (and again I am not attempting to say that they
    38        have all been conclusively proven and that everyone is in
    39        agreement) but simply that the links are there, that the
    40        links are established while on-going research would be
    41        useful, these have certainly gotten a lot of attention.
    42
    43        The first is that a high diet fat encourages obesity and
    44        increases body weight.  Adipose tissue, fat tissue,
    45        encourages the production of oestrogens and as was
    46        described by Dr. Kinlen in his study increased body weight
    47        is associated with increased risk of breast cancer.
    48
    49   Q.   That, as I understand it, Dr. Barnard ------
    50        A.  That is half the response. 
    51 
    52   Q.   That is half the response, but can I deal with that and 
    53        make sure I really do understand it?
    54        A.  Please.
    55
    56   Q.   That is because in post-menopausal women the ovaries and
    57        the adrenal glands no longer produce oestrogen themselves?
    58        A.  That is not -- well, go ahead, sorry.
    59
    60   Q.   There is a production post-menopause of something called

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