Day 034 - 11 Oct 94 - Page 28


     
     1   Q.   This is the Toniolo study:  Calorie-Providing Nutrients
     2        and Risk of Breast Cancer?
     3        A.  That is correct.  There are just two things I would
     4        like to note regarding this study.  The first again is the
     5        date of the study.  It appeared in 1989, again in the
     6        Journal of the National Cancer Institute, a journal which
     7        is read by all cancer researchers, widely known, widely
     8        reported.  I will briefly read a portion of the abstract.
     9        If there are comments regarding the rest of the study,
    10        I would be glad to sort that out.  But the only part
    11        I would mention is nicely summarised in the abstract.
    12
    13        Dr. Toniolo states:  "A case-control study was conducted
    14        in Italy to investigate the role of diet in breast
    15        cancer.  Cases were 250 women with breast cancer, and
    16        controls were a stratified random sample of 499 women from
    17        the general population.  A dietary history questionnaire
    18        was used to measure the intake of total fat, saturated
    19        fat, animal proteins, and other macronutrients.  In
    20        multivariate analyses, the relative risks of breast cancer
    21        for women in the highest quintile of consumption of
    22        saturated fat and animal proteins were 3.0."
    23
    24        If I may pause there, what that is suggesting is that
    25        those women who are in the highest 1/5th of the group have
    26        three times the risk of breast cancer compared to other
    27        women.
    28
    29        He then states: "(95% confidence interval, 1.9-4.7)"
    30        meaning that chances are 95 out of a 100, that the true
    31        value is somewhere between 1.9 times higher risk and 4.7
    32        times risk.  He then describes the relative risk related
    33        to animal proteins which, he says, is again 2.9 in
    34        parenthesis (1.8-4.6); that being the confidence interval
    35        respectively. "A reduced risk was found for women who
    36        derived less than 28 per cent of calories from fat versus
    37        greater than 36 per cent."
    38
    39        So, again, showing that women on a lower fat diet had
    40        substantially less risk of breast cancer.
    41
    42        "A similarly reduced risk was found for women who derived
    43        less than 9.6 per cent of calories from saturated fat or
    44        less than 5.9 per cent from animal proteins.  These data
    45        suggest that during adult life, a reduction in dietary
    46        intake of fat and proteins of animal origin may contribute
    47        to a substantial reduction in the incidence of breast
    48        cancer in population subgroups with high intake of animal
    49        products."
    50 
    51        So simply, in summary, he is suggesting that if those 
    52        individuals who are on high fat diets reduced their fat 
    53        intake there is an expectation there may be a reduction in
    54        subsequent breast cancer risk.
    55
    56        Those are the only comments I wanted to bring to the
    57        court's attention on that study.  I bring these examples
    58        not to suggest that they are the only ones that have
    59        looked at this, but simply to say they are important and
    60        useful and representative examples.

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