Day 035 - 12 Oct 94 - Page 47
1 Q. If you had volunteers you might be able to arrange
2 something, but not otherwise. Then it goes on: "Key and
3 Pike concluded in a recent review that the data overall
4 suggest a promoting effect of oestrogens and possibly also
5 of progestagins". So far, Dr. Barnard, no problem.
6
7 As I understand it, your proposition is that the fairly
8 well accepted idea that oestrogen, particularly in
9 post-menopausal women who are overweight, have a promoting
10 effect on established tumours, but that process is in some
11 sense facilitated by a high-fat diet; is that right? Have
12 I understood it or not?
13 A. A high-fat diet does -- I believe you have understood
14 it, yes.
15
16 Q. You say it again to make sure.
17 A. The reason I am having difficulty is the sentence was
18 a bit long. By the time you got to the end I wanted to
19 make sure I remembered the beginning accurately.
20
21 Q. Tell us, please -- not prompted by me because I do not
22 want to put words into your mouth -- what your thesis is
23 in relation to the incidence of breast cancer and the
24 consumption of a high-fat diet in postmenopausal women who
25 are too fat?
26 A. The incidence of post-menopausal cancer does not begin
27 with post-menopausal diet. It begins premenopausally and
28 may -- and very likely occurs prepubertally. However,
29 there does not seem to be a time, so far as we know, in
30 which diet fail to have an effect because, as we have seen
31 with studies of Gregorio and Verreault (and many others
32 that I did not bring in but would be glad to and are
33 cited), there is no time when or no age when dietary fat
34 levels seem not to have an effect on cancer progression.
35
36 However, the mechanisms that have been discussed in the
37 literature (and again I am not attempting to say that they
38 have all been conclusively proven and that everyone is in
39 agreement) but simply that the links are there, that the
40 links are established while on-going research would be
41 useful, these have certainly gotten a lot of attention.
42
43 The first is that a high diet fat encourages obesity and
44 increases body weight. Adipose tissue, fat tissue,
45 encourages the production of oestrogens and as was
46 described by Dr. Kinlen in his study increased body weight
47 is associated with increased risk of breast cancer.
48
49 Q. That, as I understand it, Dr. Barnard ------
50 A. That is half the response.
51
52 Q. That is half the response, but can I deal with that and
53 make sure I really do understand it?
54 A. Please.
55
56 Q. That is because in post-menopausal women the ovaries and
57 the adrenal glands no longer produce oestrogen themselves?
58 A. That is not -- well, go ahead, sorry.
59
60 Q. There is a production post-menopause of something called
