Day 036 - 13 Oct 94 - Page 31
1 1988.
2
3 MR. RAMPTON: Though eight years may not be long enough in your
4 view, Dr. Barnard, it is better than four, is it not?
5 A. It is longer than four. It is hard to say if it is
6 more relevant in terms of breast cancer risk, but eight
7 years is longer than four ----
8
9 Q. Do you know ----
10 A. --- to state the obvious.
11
12 Q. Do you know if this group is still under scrutiny by
13 Dr. Willett and his team?
14 A. I believe they are continuing under scrutiny. Whether
15 there is going to be additional data adduced regarding
16 breast cancer, I do not know.
17
18 Q. I need not read the whole of the text of the abstract, we
19 have all looked at it before. As you said, it is very
20 well known. I will just read the conclusions: "These data
21 provide evidence against both an adverse influence of fat
22 intake and (one must insert) against a protective effect
23 of fibre consumption by middle-aged women on breast cancer
24 incidence over eight years. Nevertheless, the positive
25 association between intake of animal fat and the risk of
26 colon cancer observed in many studies provides ample
27 reason to limit this source of energy".
28
29 Can I please ask you to turn to the Comment which is on
30 page 2042 which is 388 stamped at the bottom in your
31 copy? "In this large prospective cohort study we found no
32 evidence of any positive association between intake of
33 total or specific types of fat and risk of breast cancer
34 among either premenopausal or postmenopausal women. Our
35 inability to demonstrate the positive relation suggested
36 by international correlations could not be explained by
37 either imprecision in the measurement of fat intake or
38 biased ascertainment of breast cancer. These findings
39 contrast with a clear positive association between total
40 or animal fat intake and risk of colon cancer in the same
41 cohort. Our data, based on eight years of follow-up,
42 cannot exclude a very weak association, an effect of fat
43 intake earlier in life, or an influence of substantially
44 lower levels of fat consumption, such as below 20 per cent
45 of energy".
46
47 We have visited that point before, Dr. Barnard, but what
48 I would like you to look at is this: "However, this
49 possibility would imply a non-linear relation, which is
50 not suggested by the international correlations used to
51 formulate the hypothesis."
52
53 Dr. Barnard, do you understand that to mean this, that in
54 Dr. Willett's view the international correlations suggest
55 that the relationship between intake and incidence is
56 directly proportional?
57 A. That is how he is interpreting it, yes.
58
59 Q. If you were right about that, it would follow that you
60 would expect to find, as he did in relation to colon
