Day 033 - 10 Oct 94 - Page 18


     
     1   MR. JUSTICE BELL:  Bottom of page 7.
     2
     3   MR. MORRIS:  Yes.  Very briefly on uterine and ovarian cancer,
     4        can you just indicate what the dietary implications are?
     5        A.  Like the breast, the uterus and ovary are hormone
     6        responsive organs, meaning that oestrogen plays a central
     7        role in their function, and it has been found that a high
     8        fat diet is associated with higher rates of cancer of both
     9        the uterus and the ovary, and it is believed that the
    10        mechanism by which a high fat diet operates or, at least,
    11        one of the mechanisms (because there may well be several)
    12        is through the effect of a high fat diet increasing
    13        hormone levels; I should, perhaps, say high fat, low
    14        fibre.
    15
    16        Since I wrote this statement an additional study has come
    17        out in the journal of the National Cancer Institute -- if
    18        memory serves it came out in September of this year --
    19        showing that saturated fat is tightly linked to,
    20        associated with a higher risk of ovarian cancer; saturated
    21        fat intake.
    22
    23   Q.   Cancer of the prostate -- can you say something briefly
    24        about that, on page 8?
    25        A.  Yes.  Many studies have shown associations between
    26        high fat/low fibre diets and cancer of the prostate in a
    27        variety of contexts.  If one looks, for example, for
    28        latent cancer cells -- I am speaking of a cell within the
    29        prostate that has undergone a genetic change so that it is
    30        a cancer cell -- one finds a higher incidence of latent
    31        cancers in countries that follow a high fat/low fibre
    32        diet.
    33
    34        If one tracks cancer mortality specifically for prostate
    35        cancer, one will find also that it varies in precisely the
    36        same way; a high fat diet is linked to a higher risk of
    37        cancer death.
    38
    39   MR. JUSTICE BELL:  I do not want to break your chain of
    40        thought, but sometimes you say high fat, sometimes you say
    41        high fat/low fibre; that may well be advisedly, the
    42        distinction between the two.  But on some occasions you
    43        have said "high fat", then you have corrected yourself by
    44        saying "by which I mean high fat/low fibre".  Am I to
    45        understand that wherever you said "high fat", even when
    46        you have talked, made your oestrogen point, you mean high
    47        fat/low fibre, because a diet low in fibre is often
    48        associated with a diet which happens to be high in fat, or
    49        do you make a distinction in relation to some cancers?
    50        A.  Yes.  In general, a high fat and low fibre diet, both 
    51        factors have been implicated in the studies that I have 
    52        mentioned.  There have been a number of cases where the 
    53        specific effects of fat or fibre are isolated.  But,
    54        overall, the two are linked.
    55
    56   Q.   In your own mind, do you take the two together in the
    57        cases of all the cancers you have mentioned?  I appreciate
    58        that studies might point in a specific direction, but
    59        looking at the investigations overall, what is your own
    60        position?

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