Day 254 - 22 May 96 - Page 12
1 is not something which has happened this year or last year,
2 or over a 2-year period; it is something which has gathered
3 as time has gone past.
4
5 Q. So, basically, it has been going on ever since the very
6 first studies were done in the 1960s and 1970s?
7 A. I would say so.
8
9 Q. Right, but despite that, as we heard the last time you were
10 here, the World Health Organisation, the US Government, and
11 numerous other authoritative bodies on the issue of diet
12 and chronic diseases have felt that there is enough
13 evidence to make recommendations that people modify their
14 diet to prevent these diseases?
15 A. The relationship between diet and disease, in general,
16 is complex, and I have already said to you that one of the
17 things that we know, as far as cancer patients is
18 concerned, is that obesity appears to carry a bad omen as
19 far as the outlook following treatment, so it is only
20 reasonable to try to give people advice which will stop
21 them getting into the situation where they are rendering
22 themselves more prone to adverse circumstances, such as
23 trying to avoid becoming obese.
24
25 What you are doing, in some respects, I am afraid, is
26 taking that quotation out of context because this case, as
27 I understand it, is based on the relationship between diet
28 and breast cancer, and large bowel cancer, but we do know
29 that in relationships to other forms of cancer, like cancer
30 of the mouth and cancer of the oesophagus there are more
31 clear cut relationships between elements in our diet, such
32 as alcohol, for example.
33
34 This blanket recommendation that you suggested has been
35 made is to try to give people general advice about the way
36 they should lead their lives to try to reduce the
37 likelihood of them getting chronic disease. It is not
38 specifically related to cancer of the breast and cancer of
39 the bowel.
40
41 Q. The recommendations were to reduce fat consumption, in
42 particular saturated fat consumption, to increase fruit and
43 vegetables and fibre intake and so on?
44 A. Right. If you are a body trying to give
45 recommendations to people, I have already said this to you,
46 that I am faced with the problem of actually trying to give
47 patients recommendations about what they should or should
48 not do, I have already said that in the 1960s and 1970s, it
49 appeared there was a very clear cut relationship between
50 fat and breast and bowel cancer incidence.
51
52 Now, in the current situation there is no clear
53 relationship, but it has been stated in the past that fat
54 may be related to the development of these cancers. It
55 will be foolish of me to say to patients: "Eat a lots and
56 of fat" because, apart from the possibility that fat may
57 have some part to play, what I am saying is we do not know
58 the answer to that as far as these two particular cancers
59 is concerned, but that it does have a greater propensity to
60 make people obese because the amount of calories per gram
