Day 034 - 11 Oct 94 - Page 37
1 I have no other comments to make.
2
3 MR. JUSTICE BELL: Let me have a look at the ----
4 A. The tabs indicate the pages that I was reading.
5
6 MR. JUSTICE BELL: Thank you.
7
8 MR. MORRIS: Could I have a quick look before I hand that to
9 Mr. Rampton? (Handed) Then we come on to ----
10 A. May I make one brief summary sentence about this since
11 we are moving on to a different topic with a final
12 reference -- it will be very brief. When we started this
13 morning, looking at the Surgeon General's report, we noted
14 that there is an overall association between fat and
15 breast cancer reported in many, many studies, although not
16 all.
17
18 We noted that the Surgeon General took this combined
19 evidence along with animal studies to suggest that there
20 is substantial evidence that dietary fat indeed may play a
21 causative role. What these other references have
22 attempted to show is that the mechanisms by which they
23 operate are already established and, in fact, are
24 established in the Plaintiffs' documents (which I found
25 very helpful), that an earlier age of menarche increases
26 the risk of breast cancer; a higher fat diet increases
27 oestrogen levels; a high fibre diet reduces oestrogen
28 levels and can increase the age of menarche by protecting
29 against breast cancer. The second mechanism is that high
30 fat diets increase body weight and also increase the risk
31 of obesity, both of which are established risk factors for
32 breast cancer. So the mechanisms are clearly established,
33 well accepted, and were somewhere in the 1980s. Anyway,
34 forgive me for being long winded with that.
35
36 Q. If we move on to No. 42 in the Barnard references, which
37 is entitled: Meat, Cooking Methods and Colorectal Cancer:
38 A Case-reference Study in Stockholm, Maria Gerhardsson.
39 Would you like to -----
40 A. Yes. The point I would like to refer to here is on
41 page 524 which, I believe, is the fifth page of that
42 document. Midway down the left-hand column is a paragraph
43 that starts with the words, "Fat tends to increase".
44 I would like to read those two paragraphs which go to the
45 question of heating meat and causing carcinogens to form
46 on its surface and when that was known:
47
48 "Fat tends to increase frying temperature and results in
49 increased production of mutagens during cooking".
50 Mutagens are chemical substances -- M-U-T-A-G-E-N-S --
51 which can damage DNA and can lead in some cases to
52 cancer: "Therefore, even though adjusting for fat intake
53 reduced the associations between a heavily browned meat
54 surface and colorectal cancer, it could be argued that it
55 is inappropriate to adjust these associations for fat
56 since this may adjust for the formation of the very
57 mutagens that are the exposure of interest."
58
59 These comments are mainly suggesting that he is talking
60 about statistics that he has adjusted in reporting his
