Day 254 - 22 May 96 - Page 65
1 appear from the vegetable and fruit side of things that the
2 evidence, the consensus of evidence, is that it is
3 protective. What I am saying to you is that we cannot say
4 that taking more fat than is recommended in this is
5 necessarily harmful.
6
7 MR. MORRIS: Apart from it is linked to obesity?
8 A. I think that is the argument that I would make, yes.
9
10 Q. Just one point, the last line of that recommendation, or
11 that conclusion, is that the point has probably already
12 been reached for groups of people at high risk of cancer
13 such as the first degree relatives of patients with cancer
14 of the breast, colorectum or endometrium, that it is his
15 view, is it not, that for people that are genetically at a
16 higher risk of getting cancer it is even more important for
17 them to take notice of these recommendations to improve
18 their dietary habits?
19 A. Well, that is what he is saying and, of course, one
20 ----
21
22 Q. Do you agree with that?
23 A. One would have to agree with him in that there
24 obviously is an increased risk which you know we believe
25 may be genetic.
26
27 Q. So the greater the genetic susceptibilities the greater the
28 importance of diet for those people?
29 A. Well, I do not know that we even know that, to be
30 honest with you.
31
32 MR. JUSTICE BELL: Is it more than this, that if you have a high
33 risk to start with, that is bad enough, so anything you can
34 do which avoids increasing the risk one iota becomes more
35 important to you than to the man beside you who does not
36 start with the high risk?
37 A. Yes, that is absolutely right. That is my philosophy,
38 yes.
39
40 Q. It is not meant to be an absurd analogy. If you are going
41 to get on a motor bike and ride it, it is only sensible to
42 put on a helmet. It is not a very good analogy, but you
43 put yourself at risk in the first place so it is more
44 important to do absolutely anything you can to avoid
45 increasing the risk at all?
46 A. Yes, I would say that is absolutely right.
47
48 Q. Is Hill saying more than that when he speaks of the people
49 at high risk, or is he saying there may be in there? If
50 they have a genetic propensity he is not saying that there
51 is some extra feature in fruit and vegetables?
52 A. I think what he is saying, the benefit is tilted --
53 sorry, the risk and benefit is tilted towards benefit.
54 I think he is saying no more than that. Again, as you
55 rightly point out, my Lord, if one is at increased genetic
56 susceptibility then one should be taking every opportunity,
57 or trying every measure, to reduce one's risk as much as
58 possible. Now, I obviously deal with patients who are
59 trying to do this all the time and many of the things which
60 people will try are unproven, but certainly I never
