Day 297 - 08 Nov 96 - Page 30


     
     1   MR. RAMPTON:   T-O-N-I-O-L-O.
     2
     3   MR. JUSTICE BELL:   Yes.
     4
     5   MS. STEEL:   The next one was Kinlan, 'Fat and Breast Cancer',
     6        which, although it was submitted as evidence by the
     7        Plaintiffs, Dr. Barnard believed that it supported our case
     8        and he offered a cogent explanation as to the
     9        inconsistencies in that study, and he believed that Kinlan
    10        was supporting the causal link between dietary fat and
    11        breast cancer; that is the study, this study, not
    12        necessarily Kinlan himself.  That was day 34, page 30.
    13
    14        Kinlan, in a 1991 study, also supported the contention that
    15        age at menarche is a well established risk factor for
    16        breast cancer.  That was day 34, page 31.  To summarise
    17        Dr. Barnard's views, he considered that Kinlan's
    18        conclusions were as follows: that a causal link is accepted
    19        and the preponderance of evidence indicates that fat is
    20        linked to cancer by lowering the age at menarche and
    21        aggravating obesity.  That was day 34, page 32.
    22
    23        Dr. Barnard also commented on the Ridder paper produced in
    24        1991, which concluded that a high fibre diet delays
    25        menarche and reduces the risk of breast cancer.  That was
    26        day 34, page 34.  He referred to a publication by the
    27        National Institute of Health which indicated that increased
    28        research during the '80s refined and strengthened evidence
    29        of the connection between diet, nutrition and cancer, and
    30        Dr. Barnard commented that the report suggests that it is
    31        clearly established, it is a clearly established fact, that
    32        by avoiding high fat foods such as that sold at McDonald's
    33        oestrogen levels will be significantly reduced.  That was
    34        day 34, page 36.
    35
    36        There is a useful summary of the state of the evidence
    37        which appears on page 37 of day 34.  He said about the
    38        Surgeon General's report, and noting there is an overall
    39        association between fat and breast cancer reported in many,
    40        many studies, although not all, that the Surgeon General
    41        took that evidence, along with other evidence, to suggest
    42        that there was substantial evidence that dietary fat did
    43        indeed play a causative role in cancer.
    44
    45        He says, the references that I have just been going
    46        through, what they have attempted to show was the
    47        mechanisms by which they operate are already established;
    48        for example, the earlier age at menarche increases the risk
    49        of breast cancer, a higher fat diet increases oestrogen
    50        levels, that a high fibre diet reduces oestrogen levels and
    51        can increase the age at menarche by protecting against
    52        breast cancer, and obviously high oestrogen levels are
    53        connected to an increased risk of breast cancer, and the
    54        second mechanism is that high fat diet increased body
    55        weight and also increased the risk of obesity, both of
    56        which were an established risk for breast cancer.  He says
    57        the mechanisms are clearly established and well accepted,
    58        and were somewhere in the '80s.
    59
    60        He referred to a report by Maria Gerhardson in 1988, which

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