Day 034 - 11 Oct 94 - Page 17


     
     1        I will restrict my attention to pages 205 and 206.  Then
     2        I will hand it back.  I will obviously get a photocopy in
     3        due course.
     4
     5   MR. RAMPTON:  If your Lordship would, because I am going to use
     6        it for cross-examination.
     7
     8   MR. JUSTICE BELL:  I have it now.  Do you not have a copy?
     9
    10   MR. MORRIS:  I have not a copy, but I am sure the witness will
    11        be able to take us through it.
    12        A.  All right.  Yes.  Let me do so briefly.  I regret to
    13        say I did not review this last night, so I am looking at
    14        it for the first time as well in a long time.  But again,
    15        when the Surgeon General lays out these charts, he does it
    16        in the same way where the studies are grouped according to
    17        the way the study is conducted.  A variety of studies are
    18        listed down the left-hand column and the positive or
    19        negative link with various dietary constituents is noted.
    20
    21   Q.   Can I ask again, would the same apply that these would be
    22        the most authoritative studies that were available?
    23        A.  Yes, these would be considered objective, well done
    24        authoritative studies, but not chosen with any bias or to
    25        support one or another viewpoint.  This study -- this
    26        table 4.9 the summary of epidemiologic studies examining
    27        dietary fibre in colon cancer.  The first thing one
    28        notices when one glances at the chart on page 205 is that
    29        there are a lot of minuses, no pluses, and there are a lot
    30        of minuses on the next page as well, although there are a
    31        couple of pluses.
    32
    33        The minus sign indicates an inverse relationship between
    34        one or another type of dietary fibre and the incidence of
    35        colon cancer.  In looking at the international correlation
    36        studies, in looking at the within country correlation
    37        studies and other types of correlation studies, metabolic,
    38        time-trend correlation studies on that page, putting these
    39        all together one sees -- I have to count them up -- but
    40        there are a good number, perhaps 15 or more studies that
    41        have shown a negative relationship, an inverse
    42        relationship, meaning the more fibre in the diet the lower
    43        the risk of colon cancer, indicating a protective effect.
    44
    45        In the first category, international correlation studies,
    46        there are seven studies; three of them looked simply at
    47        total fibre not reporting a particular type; two of those
    48        found an inverse or, if you will, protective effect of
    49        dietary fibre.  One did not find a significant
    50        relationship. 
    51 
    52        Four studies looked specifically at cereal fibres and all 
    53        four found a protective relationship.  Two of those looked
    54        also at vegetables, vegetable fibre, and found that
    55        vegetable fibre was protective.  None of these studies
    56        combined the effects of fibre and fat.
    57
    58        Much the same pattern holds true, again with the within
    59        country correlation studies in the next column.  Six
    60        studies looked at total fibre.  Of those six one did not

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