Day 017 - 25 Jul 94 - Page 43
1 twenty or thirty years, the incidence of breast cancer has
increased by some forty per cent over the same period?
2 A. Yes, that is quite correct.
3 Q. Can we pass then, please, to cancers of the colon and the
rectum? Can we start, please, with a relatively old piece
4 of work, which is at tab 25 of your orange bundle, which
is a piece of population study I believe it to be,
5 conducted by Reddy and others, including Wynder, and on
this occasion we see that Reddy comes before Wynder. It
6 was published in 1978. I will read the abstract at the
beginning:
7
"Dietary pattern feed and constituents of two populations
8 with distinct risk in the development of colon cancer. A
high risk population in New York Metropolitan area and a
9 low risk population in rural Kuopio were studied. The
average daily intake of dietary fat and protein was the
10 same in the two groups, but the sources of fat were
different, a greater proportion coming from dairy products
11 in rural Kuopio and meat from the New York Metropolitan
area".
12
Pausing there, has at this time (July 1994) any
13 distinction been made between fats derived from dairy
products such as butter, milk and cream, and fats derived
14 from meat, so far as your field is concerned?
A. People have looked at various components of fat
15 intake, but I would say again that the evidence for one
fat or another being particularly important is
16 controversial. I think that they looked at these two
groups of people because they felt they could consider the
17 fat essentially to be the same.
18 Q. The abstract goes on: "Not only the frequency of bowel
movements was higher but also the daily total stool output
19 ... (reading to the words)... fibre excretion was greater
in Kuopio compared with New York due to high dietary
20 intake in rural Kuopio ... (reading to the words) ....
was lower in rural Kuopio but the total daily excretion of
21 these constituents was the same in two populations. The
daily fecal excretion of bacterial nuclear dehydrogenised
22 activity and of neutrol sterols was higher in rural Kuopio
and the concentration of these constituents was the same
23 in the two groups.
24 The high daily excretion of cholesterol metabolites in
Kuopio might be due to high dietary intake of dairy
25 products. The data suggests that one of the factors
contributing to the low risk of large bowel cancer in
26 Finland, in spite of high dietary intake, appears to be
the fact that a high dietary fibre leads to an increase in
27 stool bulk, thus diluting bile acids which have promoting
activity".
28
A preliminary question, Dr. Arnott, then another
29 question. Looked at at the present day, how do you react
to the proposition that bile acids have a cancer promoting
30 activity?
A. There is experimental evidence from animals ----
