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The Dietary Fat—Breast Cancer Hypothesis: Is It Really Alive?-Reply

Arthur Schatzkin, MD, DrPH; Carolyn K. Clifford, PhD; David P. Byar, MD; Peter Greenwald, MD, DrPH; Lawrence S. Freedman, MA
JAMA. 1990;263(2):238. doi:10.1001/jama.1990.03440020071032.
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In Reply.—  Dr Evans suggests that estrogenic contaminants of fat in certain meat products may be involved in the etiology of breast cancer. While this notion is biologically plausible, it by no means rules out a role for dietary fat per se. We cited both animal and ecological (international correlation, time trend, and migration) data in support of the dietary fat—breast cancer hypothesis. Residual estrogens in US meat products cannot satisfactorily account for these data.We agree with Drs Klurfeld and Kritchevsky that animal experiments clearly show that energy restriction reduces breast tumorigenesis in rodent models. However, it is not the case, as Drs Klurfeld and Kritchevsky imply, that the tumor-reducing effect of low fat in animal experiments is wholly attributable to reduced total energy intake. Animal studies of mammary carcinogenesis, carefully considered in toto, do demonstrate a fat effect independent of total energy intake.1, It is interesting that


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