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
