Day 034 - 11 Oct 94 - Page 24


     
     1        of sentences.  When the fat content of the diet is
     2        increased, or when the diet contains more meat, in either
     3        case one will find two effects.  The average individual
     4        consuming that diet will be heavier, although not
     5        necessarily obese.  Secondly, the proportion of
     6        individuals who are obese will also rise.
     7
     8        So, you have put your finger on two factors.  The
     9        prevalence of obesity will increase with an increase in
    10        fat or an increase in meat consumption, and the average
    11        body size will increase as well, independent of the
    12        prevalence of obesity.
    13
    14   MR. MORRIS:  If we move on to Gregorio.
    15
    16   MS. STEEL:  Before we do, if that is of any assistance that is
    17        No. 22 of Dr. Barnard's references.
    18
    19   MR. JUSTICE BELL:  Thank you.
    20
    21   MR. MORRIS:  No. 45 of Dr. Barnard's references?
    22        A.  Yes.
    23
    24   Q.   Is:  "Dietary Fat Consumption and Survival Among Women
    25        with Breast Cancer", Gregorio and Others.  Would you like
    26        to point us to the parts you find significant?
    27        A.  Yes.  It is an interesting and important study, but
    28        I would like briefly to draw attention to two things.  The
    29        first again is the date.  This was published in the
    30        Journal of the National Cancer Institute in 1985.  I would
    31        like to simply read the abstract and the first two or
    32        three paragraphs because they provide an interesting
    33        summary of what was already known and established at that
    34        time and may shed some light on the nature of the
    35        relationships between fat and breast cancer.  First of
    36        all, the abstract highlights the findings of the current
    37        study.  Then I will read the introduction which highlights
    38        what was already known prior to this study beginning.
    39
    40        The abstract states:  "An historical prospective study was
    41        conducted to examine the relationship of dietary fat
    42        intake to disease progression and length of survival of
    43        953 women with breast cancer.  Estimates of monthly fat
    44        intake were based on patient responses about usual
    45        frequency of consuming 33 foods and beverages prior to
    46        symptom onset.  Average estimated monthly fat intake did
    47        not vary by stage of disease at diagnosis.  When
    48        controlling for disease stage and patient age at
    49        diagnosis, the estimated risk of death at any time
    50        increased 1.4 fold for each 1,000 g in monthly fat 
    51        intake." 
    52 
    53        If I may stop reading at that point and provide an
    54        interpretation of that; that means a 40 per cent increased
    55        risk at any future point in time per 1000 grammes of fat
    56        in the diet consumed per month.
    57
    58        "Separate analysis by disease stage showed this
    59        association to be most pronounced for subjects with
    60        advanced disease.  The need for future studies to

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