Day 036 - 13 Oct 94 - Page 46
1 perhaps, have been consuming a high-fat diet.
2
3 Q. So, in other words, if all obese people were taken out of
4 the final figures?
5 A. Yes.
6
7 Q. That would be an unfair bias of the results?
8 A. That is an important point that has been shown in many
9 lines of research. We see it with diabetes as well. When
10 one removes the factor of obesity, it can mute the
11 apparent effect of dietary factors; yes, that is correct.
12
13 Q. In your opinion is this one of the things which may
14 explain why some of these studies -- you have said many
15 things but you did not say that -- it is just another
16 thing which may explain why some of these case-control or
17 these kind of things that we are referring to, the Yvonne
18 Jones, may not be showing up associations?
19 A. In some cases that could be true and that would add to
20 the difficulties that are really quite pronounced, say, in
21 that study of the rather narrow range of nutrient intake.
22 There are some studies, perhaps, for example, the Toniolo
23 study which I referred to, I believe, on Tuesday, in which
24 they specifically responded to the very issue that you
25 have raised in which, say, the age at early menarche was
26 taken into account and yet an influence of fat intake was
27 still shown. Perhaps I could come back to that?
28
29 Q. Did you want to take us through some of the studies or
30 something?
31 A. Well, I would be prepared to describe in just a little
32 bit more detail the Toniolo study, which I mentioned on
33 Tuesday, but there is a bit of that that is responsive to
34 your question. Why do I not take two minutes and do
35 this?
36
37 Q. Yes. We were not prepared for that. Your own study
38 No. 24, your own reference No. 24?
39 A. The first thing that is, perhaps, noteworthy about
40 this document, which I will not go over in any detail
41 because I already raised it, but it appeared in the
42 Journal of the National Cancer Institute in 1989, February
43 15th of that year, so early 1989.
44
45 The second thing that is perhaps noteworthy regarding the
46 Toniolo study is its summary finding in the abstract,
47 which I read before, but just briefly to describe again:
48 In the abstract about eight or, well, starting at the end
49 of the sixth line, it says -----
50
51 MR. JUSTICE BELL: Yes, I am sorry. I was making a note on
52 another matter. Where do I find the Toniolo?
53
54 MS. STEEL: No. 24 in Dr. Barnard's references.
55
56 MR. JUSTICE BELL: Thank you, yes.
57
58 THE WITNESS: Again, from the Journal of the National Cancer
59 Institute, February 15th 1989, starting at the sixth line
60 down in the Abstract it says: "In multivariate analyses,
