Day 256 - 04 Jun 96 - Page 65


     
     1        A.  Only vaguely.
     2
     3   Q.   They are periodical reviews done by panels of experts, on
     4        behalf of our Department of Health in this country, of
     5        different aspects of diet; and for each topic there is a
     6        different review group, as it were.
     7
     8        Can I ask you to turn, please, to page -- I will start at
     9        the beginning -- page 39.  That is a chapter on -----
    10
    11   MR. JUSTICE BELL:  Is this 41 or 46?
    12
    13   MR. RAMPTON:  41, my Lord, sorry -- Dietary Reference Values for
    14        Food Energy and Nutrients for the United Kingdom.  It is in
    15        this book, Professor Campbell, that one finds the panel's
    16        recommendations for different aspects of diet, and this
    17        chapter is on fat in the diet, and it deals with various
    18        topics, including, as you see at page 49, fat and cancer,
    19        at 3.5.  I tell you that this was first published in 1991
    20        and reprinted in 1994.
    21
    22        I am not going to ask you, unless you would like to do so,
    23        to read all the review of fat and cancer, reviewing the
    24        evidence to date under the headings Geographical
    25        Variations, Animal Studies, Epidemiology, Colon Cancer,
    26        Cancer and Serum Cholesterol, Prostatic Cancer; and then,
    27        on page 52, Dietary Fat and aetiology of cancer.
    28
    29        May I read this, because you may not be familiar with
    30        this.
    31
    32        "A number of mechanisms whereby fat could be involved in
    33        cancer promotion has been suggested.  Hormones,
    34        particularly oestrogens, are known to be important
    35        promoters of both animal and breast cancer but there are
    36        conflicting reports on the effect of fat on circulating
    37        levels of oestrogen, other female sex hormone levels and
    38        sex hormone binding globulin.  Other suggested mechanisms
    39        include modulation of immune function and prostanoid
    40        synthetic pathways, and membrane lipid peroxidation.   In
    41        bowel cancer, it has been proposed that the concentration
    42        of faecal bile acids is increased by high fat diets and
    43        that secondary bile acids act as tumour promoters.
    44        However, individuals living in areas with a high risk of
    45        colon cancer do not have a higher faecal bile acid
    46        concentration or total faecal bile acid output compared
    47        with those living in areas with a low risk, neither do
    48        cases of large bowel cancer have higher faecal bile acid
    49        outputs or concentrations compared with controls.  Other
    50        factors modulating the solubility of free bile acids may be 
    51        involved. 
    52 
    53        "Conclusions.  The Panel concluded that there is currently
    54        insufficient evidence on which to base a recommendation for
    55        a decrease in fat intakes to prevent cancer, although an
    56        increase in consumption of any fatty acid should not be
    57        encouraged.  The Panel agreed that the Dietary Reference
    58        Values based on other considerations and presented in
    59        paragraph 3.8 were consistent with a prudent view of the
    60        current data relating dietary fat and the occurrence of

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