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?

Prev Next Index