Day 034 - 11 Oct 94 - Page 34
1 oestrogen.
2
3 In summary the abstract states that -- and, in fact, the
4 rest of the study shows that girls who had high fibre
5 diets had elevated levels of estradiol and reached
6 menarche -- sorry, reached -- I stated that incorrectly --
7 girls on higher fibre diets had lower levels of estradiol
8 and reached menarche later, meaning that their risk of
9 breast cancer would be lower. Those girls who had less
10 fibre in their diet had higher levels of estradiol and
11 reached menarche significantly earlier, indicating that
12 their risk of breast cancer would be higher.
13
14 Just drawing attention, perhaps, to the first couple of
15 sentences under Introduction. He states: "An adequate
16 intake of nutrients together with good health is probably
17 responsible for the shift in the onset of puberty and
18 menarche to an earlier age", meaning elevated calories,
19 one might say, or removal of restriction. Then he states
20 very significantly: "The high-caloric Western diet
21 increases body fat mass". Again, body fat produces
22 oestrogen. "Most notably intraabdominal fat. In turn,
23 the amount of body fat modulates the timing of the growth
24 spurt and menarche as postulated by Frisch et al. about 20
25 years ago".
26
27 I would like to emphasise a couple of brief points here.
28 He states that body fat not "may modulate" or "may
29 affect", but "does modulate", does influence the timing of
30 the growth spurt and menarche; so that the higher the
31 degree of body fat, the earlier the menarche and the link
32 then between menarche and breast cancer is already well
33 established.
34
35 So, what de Ridder is bringing to our attention in his
36 introduction, or rather her introduction -- excuse me --
37 is that the links between adiposity and earlier menarche
38 are already established. The links between -- the causal
39 links between a high fat diet and obesity, even not
40 necessarily frank obesity, but increased body weight is
41 also well established, and that when girls are on higher
42 fibre diets menarche occurs later reducing the risk of
43 cancer.
44
45 I might mention that if one looks at the differences in
46 fibre intake that were used in this study and that were
47 shown to have a significant difference, they vary between
48 about 17.5 grammes per day and about 19.5 grammes per day,
49 suggesting that small differences in fibre of the range
50 that are commonly consumed in western countries do have a
51 pronounced and significant effect on the age of menarche
52 and hence would have an effect on breast cancer risk.
53
54 I have no more comments on that paper.
55
56 Q. If we can put that file away now, not completely away, but
57 the next one is the Measures of Progress Against Cancer,
58 which is on the miscellaneous supplementary list of the
59 Defendants regarding cancer and its number is 5. Do you
60 have a copy of that?
