Day 017 - 25 Jul 94 - Page 41


     
     1        years on?
              A.  Indeed, yes.
     2
         Q.   It is called Dietary Fat and Fibre in Relation to Risk of
     3        Breast Cancer.  An eight year Follow-up."  Walter Willett
              and many others, some of whose names one will recognise
     4        from other papers. "Objective - To address the hypotheses"
               -- I should say it comes from, what is JAMA?
     5        A.  It is the Journal of the American Medical Association.
 
     6   Q.   October 21st 1992.  "Objective - To address the hypotheses
              that dietary fat increases and fibre decreases the risk of
     7        breast cancer".  This is in October 1992."   Are those
              postulations any more than hypotheses as at 25th July
     8        1984?
              A.  They are purely hypotheses.
     9
         Q.   "Design - prospective cohort study with dietary assessment
    10        at baseline, using a validated, self-administered food
              frequency questionnaire.
    11
              Setting/Participants - 89,494 women in the Nurses' Health
    12        Study who were 34 through 59 years of age in 1980 and who
              were followed up for eight years (not less than 95 per
    13        cent complete).
 
    14        Results - 1,439 incident cases of breast cancer were
              diagnosed including 774 among postmenopausal women.  After
    15        adjustment for age, established risk factors, and total
              energy intake, we observed no evidence of any positive
    16        association between total fat intake and breast cancer
              incidence", and then the relative risks are set out in
    17        parenthesis".  "Among postmenopausal women alone,
              corresponding RRs were", it is given first for the whole
    18        group, is it not, and then he gives the figures for
              menopausal women, does he not?
    19        A.  Yes.
 
    20   Q.   Then he says -----
              A.  These figures are for actually increasing amounts of
    21        fat.  They divided them up into five groups.
 
    22   Q.   Yes, which they call quintiles?
              A.  Quintiles, yes.  So the figures relate to increasing
    23        quantities of fat eaten in the individual groups.  So the
              first one is those taking the lowest intake and the last
    24        figure is the those taking the highest intake of fat.
 
    25   Q.   I see.  Following the second parentheses:  "A similar
              absence of any positive association was observed without 
    26        adjustment for energy intake; for tumours less than 2 
              centimetres as well as 2 centimetres or greater in 
    27        diameter; for saturated, monounsaturated, and
              polyunsaturated fat; and after excluding the first 4 years
    28        of the follow-up.  Also, we found no suggestion of any
              positive association when using a more detailed and
    29        precise dietary questionnaire completed in 1984 (666
              subsequent cases), even when women consuming less than 25
    30        per cent per cent of energy for fat were used as the
              comparison group.  No suggestion of a protective effect of

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