Day 022 - 12 Sep 94 - Page 64


     
     1
     2   MR. JUSTICE BELL:  Do you want to add something?
     3        A.  No.  One of the things that does seem to be coming out
     4        from a lot of studies is that the strongest relationship
     5        may be with fruits and vegetables and a protective effect,
     6        but that is mainly in colorectal cancer because, equally,
     7        other studies that have looked at breast cancer have not
     8        found a benefit for these foods in breast cancer, so it is
     9        a controversial issue.
    10
    11   MR. MORRIS:  One last thing I have to look at is your reference
    12        No. 6, which is the epidemiology of breast cancer with
    13        special reference to the role of diet, Takeshi Hirayama,
    14        published in Preventative Medicine, 1978.  I am not sure
    15        if this is an actual study or just a look at the ----
    16        A.  They were looking at statistics.
    17
    18   Q.   The first paragraph is an abstract, is it not?
    19        A.  Yes.
    20
    21   Q.   "Breast cancer is still relatively infrequent in Japan.
    22        However, both mortality and morbidity rates have sharply
    23        increased in recent years, especially in ages 45 to 59.
    24        The risk was noted to be to 8.5 times higher in women of
    25        high socioeconomic strata eating meat daily, compared with
    26        women of low socioeconomic strata who do not eat meat
    27        daily, when 142,857 women aged 40 years were followed for
    28        10 years".  This is quite a substantial survey, yes.  I am
    29        just reading the abstract.
    30        A.  Yes.
    31
    32   Q.   "A high positive correlation was found between per capita
    33        fat intake and adjusted death rates of breast cancer in
    34        different districts of Japan.  It was estimated that the
    35        breast cancer death rate will rise to the U.S. level when
    36        Japanese dietary fat intake approaches present day U.S.
    37        levels.  The close correlation with fat intake was noted
    38        to come mainly from the consumption of pork and animal
    39        fat.  The ratio of recent increase in breast cancer death
    40        rates was also found to be under the combined influence of
    41        animal fat and AF2, a highly mutagenic food additive
    42        widely used in Japan from 1965 to 1975 and shown to
    43        produce mammary carcinoma in rats.  A series of
    44        case-control studies reveals the higher risk of breast
    45        cancer with the increase in body size especially in
    46        postmenopausal women.  The recent breast cancer increase
    47        could therefore be a reflection of the fact that women in
    48        Japan are becoming heavier, especially after age 30."
    49
    50        If we just go to the conclusions on page 402 of the file, 
    51        Discussion and Summary:  "Breast cancer frequency is still 
    52        quite low in Japanese women.  However, breast cancer 
    53        mortality and morbidity rates are on a steady increase in
    54        Japan in recent years.  Most probably this increase in
    55        breast cancer mortality and morbidity rates is the
    56        reflection of the increase in the amount of dietary fat
    57        intake, especially in the form of pork, in recent years in
    58        Japan."
    59
    60        There cannot be any genetic reason for these dramatic

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