Day 036 - 13 Oct 94 - Page 14
1 not be determined in these analyses".
2
3 I take it, Dr. Barnard, those are qualifications or
4 reservations expressed there which can often be made in
5 relation to prospective studies in homogenous populations?
6 A. Yes, particularly if it is short term.
7
8 Q. Yes, particularly if it is short term. Can one also say
9 this, do you think? The larger the cohort that is studied
10 the less powerful that those qualifications become?
11 A. A larger cohort can be helpful.
12
13 Q. Because you are likely to get, though, in one sense, the
14 population remains homogenous, you are likely to get a
15 wider range of intakes, are you not?
16 A. That would not necessarily follow, no.
17
18 Q. But you stand a better chance of doing so, do you think,
19 or not?
20 A. No, not necessarily. The range of diet may depend on
21 things quite apart from the size of the sample one has
22 recruited.
23
24 Q. I quite well accept that if you survey the members of the
25 American Meat Association, or something, you might not get
26 a very wide range. Now I would like you to turn over,
27 please, to page -- I have not a number for it, I am afraid
28 -- it is the next page; I imagine it is 470. I will just
29 read the conclusion, which is the last part of this
30 study. The last paragraph: "This study is an important
31 addition to the examination of diet and breast cancer
32 because of its prospective nature in which careful dietary
33 assessment was carried out prior to ascertainment of
34 breast cancer status. The NHANES I survey that provided
35 this cohort sampled from a large cross-section of the US
36 population, and thus these data do not focus primarily on
37 the upper-socioeconomic-class women at higher risk of
38 breast cancer who are usually the focus of breast cancer
39 studies."
40
41 Pause there, please, Dr. Barnard: Why is it that, at any
42 rate at this date in 1987, it was the
43 upper-socioeconomic-class women who in the United States
44 were at a higher risk of breast cancer, do you think?
45 A. They do not say whether that is in the United States
46 or elsewhere. This study was in the United States.
47 I believe the phrase you are referring to does not
48 particularly specify which population, but what they are
49 referring to is that the upper, I presume what they are
50 referring to, is the upper-socioeconomic-classes are well
51 known for consuming more animal products, more animal fat
52 in general.
53
54 Q. Would it not also be, Dr. Barnard, that they marry later
55 and have fewer children?
56 A. I could not say that that is the case, and one of the
57 situations that we have in the United States is that a
58 high-fat diet, regrettably, is pervasive through virtually
59 the entire population except those who have taken steps to
60 limit fat intake.
