Day 033 - 10 Oct 94 - Page 51
1 A. Yes.
2
3 Q. Do you have to wait until -----
4 A. Clearly, one does have to wait until one has some
5 basis for believing that the recommendations are likely to
6 be helpful or unlikely to be harmful and deal with the
7 subject which is important. Clearly, the evidence linking
8 a high fat diet with cancer, the evidence suggesting a
9 causal link has long -- it has been a rather long time
10 since that evidence has been there. In effect, Dr.
11 Wheelock earlier mentioned some of that. It is well known
12 that obesity, for example, increases the risk of breast
13 cancer and worsens the prognosis when cancer occurs. He
14 says in the first and second pages that obesity is linked
15 to high fat diets, if I have read him correctly,
16 suggesting that he agrees with at least some portions of
17 that causal link there, if not all of it.
18
19 So, I strongly agree with making recommendations known,
20 weighing the evidence and helping people to modify their
21 diets, even if there are some ambiguities about the
22 mechanisms that are operating.
23
24 As I say, we have been long past the point where the links
25 were identified, where those links were characterised
26 quite convincingly as causal in nature. Certainly, in the
27 United States the link between diet and cancer of a causal
28 nature has been accepted for quite a number of years. In
29 fact, the American government is committing quite a
30 substantial amount of money to dispersing information
31 about that to the American public.
32
33 Q. If we can move on in your supplementary statement, the age
34 of menarche regarding breast cancer, would you like to
35 make some comment about that?
36 A. Yes. It is well accepted (and I believe that the
37 Plaintiffs perhaps may accept this as well) that the age
38 of menarche plays a role in breast cancer; the earlier the
39 age of menarche, the higher the risk of breast cancer.
40 Dietary factors play a well known role in the age of
41 menarche. The World Health Organisation has noted the age
42 of menarche going back, at least, to 1850, perhaps
43 earlier, and reported on that in the literature.
44
45 As the fat content of the diet has increased and as the
46 fibre content of the diet has decreased, the age of
47 menarche has dropped in many western countries. That is
48 also true in Japan. Since 1950 the fat content of the
49 diet has doubled; the age of menarche has changed from an
50 average of 15 in 1950 to 12 and a half today.
51
52 Now, the reference that I made to de Ridders article --
53 I actually said "high fat diets" -- de Ridder in his
54 introduction talks about the role of diets that are high
55 in fat in menarche. In his own study he concentrates on
56 fibre intake, and he notes that those girls who grow up on
57 high fat diets hit menarche later.
58
59 The mechanisms for this are not mysterious. The body has
60 a means of ridding itself of excess oestrogen, the female
