Day 034 - 11 Oct 94 - Page 20
1 my presumption is he is talking about a protective effect
2 of fibre, since that is what he is saying in the words
3 immediately preceding that sentence: "Various
4 investigators observed a protective effect of fibre
5 containing foods, especially vegetables". So, I presume
6 he is saying a protective effect has also been found in
7 two case-control studies that examined the relative risk
8 of high fat/low fibre diets. But my presumption is that
9 the Surgeon General is not intending to say that a high
10 fat/low fibre diet is protective.
11
12 Q. He may not be intending to show that. I just wonder what
13 we would have if we had that extra column.
14 A. My assumption of what he is -----
15
16 Q. He goes on to say: "Overall case-control studies present
17 mixed results; some show fibre and fibre-containing foods
18 to be protective; others do not". You may or may not
19 agree with his comments, but that is what he is saying, is
20 it not?
21 A. No, I do agree with that comment. If he had said
22 after that sentence that, in fact, some studies show that
23 a high fat/low fibre diet is protective, then I would
24 suggest that he might be saying that Dales' and Manousos'
25 studies had shown that a high fat/low fibre diet was
26 somewhat protective. I do not think that is what that is
27 showing.
28
29 Q. Are Dales and Manousos amongst our documentation?
30 A. Not to my knowledge.
31
32 MR. MORRIS: I do not have the book in front of me so I am at a
33 bit of a disadvantage.
34
35 MR. JUSTICE BELL: I think you should ----
36
37 MR. MORRIS: Is it possible that it refers to the fact that if
38 you have a high fat/low fibre diet, the fibre you do have
39 in your diet is still protective?
40 A. I would presume that is what he is saying, because
41 when we look at how Dales' study is characterised,
42 increasing fibre and going lower in fat was protective
43 indicated by the negative in the fourth column there.
44 Manousos' study was also protective for vegetables.
45 I would be very surprised if he was trying to suggest that
46 going high fat and low fibre exerted some protective
47 effect, particularly since it was not in his summary
48 statement.
49
50 MR. JUSTICE BELL: I have to say I find that construction
51 difficult on the wording which is on that page; whether
52 the wording which is on that page actually reflects what
53 the papers say, of course, is another matter.
54 A. Yes. If it would be helpful, I would be more than
55 happy to get my hands on those studies.
56
57 MR. JUSTICE BELL: Leave that on one side.
58
59 MR. MORRIS: Are we finished with that chapter? Mr. Rampton
60 might want to come back on it.
