Day 036 - 13 Oct 94 - Page 33
1 MR. JUSTICE BELL: Sorry to interrupt you. I have the point
2 you have made in relation to that. I would like to know
3 if Mr. Rampton is right in what he is putting or not
4 right. You have expressed your view very clearly and, if
5 I may say so, your various reasons for it. Now
6 Mr. Rampton is looking at the whole body of other
7 reputable scientific opinions. If you put the question
8 again, Mr. Rampton: You have not succeeded in showing us
9 -- this is a question -- Mr. Rampton does not know of any
10 authority certainly in the last 8 or 10 years that has
11 felt able to assert, whether a public authority or a
12 professional scientist, with any confidence that these
13 assertions we have been discussing are, indeed, causal?
14 A. Forgive me for trying to be very specific in my
15 response. The links we are discussing are causal in
16 nature. What is in doubt is how much confidence, how much
17 definitiveness can be given to them. No one is
18 suggesting, for example, that breast cancer causes a
19 high-fat intake. What has been investigated over and over
20 again is the causal link that a high-fat diet may cause
21 breast cancer. That is what is being discussed. But you
22 are quite right, that no one has been able to say with any
23 confidence that, indeed, the link is quite certain to be
24 causal except in so far as those links are under
25 investigation, presumed to be causal or quite probably are
26 causal.
27
28 MR. RAMPTON: Can we put away Dr. Willett? My Lord, there is a
29 lot more in there but I can leave it until the end of the
30 case.
31 A. May I also add one other comment? In that discussion
32 we were simply talking about the rather bald epidemiologic
33 studies. We were not talking about any mechanistic
34 studies whatsoever, because I think it would be a mistake
35 to overlook the fact that a high-fat diet, as we have
36 described but seems to get forgotten when we talk about
37 epidemiology alone, is the fact that a high-fat/low-fibre
38 diet or a diet that is high-in-fat and sugar and
39 low-in-fibre does increase the risk of obesity. If may
40 say so, that is clearly a causal relationship, in that
41 there are many, many experts who would, in fact, support
42 that with a great deal of confidence.
43
44 In addition, there are many experts, perhaps an
45 overwhelming number of experts, who would also hold that
46 the links between obesity and breast cancer are clear and
47 are causal. So, when one is talking about which experts
48 can assert what with confidence we have to be very, very
49 careful. It is dangerous to focus simply on overall
50 epidemiologic studies, particularly those on very
51 restrictive populations.
52
53 MR. JUSTICE BELL: I do not think Mr. Rampton was doing that.
54 He was asking you for any respectable expression of
55 scientific opinion or government body committee which says
56 not "may" not "hypothesis", not "suggest", which says that
57 a diet high-in-fat, saturated fat, etc. ----
58 A. Yes. In so far as -- forgive me, I did not mean to
59 interrupt.
60
