Day 017 - 25 Jul 94 - Page 29
1 know, it is not showing a relationship and it is a
prospective study too which, of course, is a more reliable
2 study.
3 So I think what Dr. Kinlen is saying basically is that if
you actually look beyond the earlier literature, look at
4 some of the more up-to-date literature, studies that have
been simulated to be conducted by the findings of earlier
5 studies, that there is no consistent relationship between
fat and the development of breast cancer.
6
Q. Just turn to page 591. I will not read the rest of 589 at
7 the moment at least. The last paragraph above the
"Discussion". "In most studies the reliance on recalled
8 diet has obvious limitations and any objective measure of
fat intake would be valuable. Serum cholesterol is
9 influenced (among other factors) by fat intake, and so has
relevance here; however, a prospective study of over
10 90,000 women in California found no relation between serum
cholesterol level and subsequent breast cancer". That is
11 Hiatt and others in 1982.
12 "Discussion. Among the studies of breast cancer based on
individual women, whether of the case-control or
13 prospective type, little support for the fat hypothesis
has emerged. In spite of this, the hypothesis finds
14 widespread favour. Indeed, in 1982 the Nutrition
Committee of the United States National Research Council
15 judged the evidence to be sufficiently strong to recommend
that Americans reduce their consumption of fat on grounds
16 of cancer alone. More recently, the National Cancer
Institute has embarked on an intervention trial among a
17 large group of American women to determine if breast
cancer incidence can be reduced by lowering their intake
18 of fat.
19 So many reasons are offered to defend the hypothesis in
the face of the negative findings of individual-based
20 studies, it would almost seem that the basis for the
hypothesis was so secure that only confirmatory evidence
21 is of interest."
22 It may be, I do not know, Dr. Arnott, that that is a
somewhat ironic or sarcastic -- what do you feel?
23 A. I would say it is an ironical remark.
24 Q. "International correlations re-examined. In view of the
largely negative nature of studies of individuals, it
25 seems reasonable to re-examine the international
correlational studies, since only these provide striking
26 support for, and indeed largely suggested, the
hypothesis. In the most often quoted study, these
27 correlations implied that about 80% of the worldwide
variation can be accounted for by variations in fat
28 consumption (Armstrong and Doll). Several observations
appear to have relevance: First, the basic quality of the
29 nutritional data used in these analyses is far from high,
for they relate to crude 'food disappearance' within
30 countries: Production plus imports for human consumption,
minus exports, divided by the total population figure,
