Day 023 - 13 Sep 94 - Page 07


     
     1        When they go out for a meal or preparing or buying food,
     2        that is something which is a conscious act not to buy
     3        meat.   What I am getting at in some of the studies we
     4        have been discussing is that the relationships of diet are
     5        more subtle than that.  This is one of the things that is
     6        a problem in some of the control, you know, the control
     7        groups in the case-control studies, that the people who
     8        are willing to take part as controls are often people who
     9        are interested in diet and what they eat, much more so
    10        than perhaps the cases.
    11
    12        There is, therefore, this question mark about whether they
    13        are truly comparable.  It is the same with the cream
    14        cakes, that people usually have to give up gorging on
    15        cream cakes because they have been told to go on a diet or
    16        want to lose weight.  I think these are much more obvious
    17        conscious things.  Many aspects of diet are very subtle.
    18
    19   Q.   Yes.  But that would be similar to like giving up smoking,
    20        things like giving up meat?
    21        A.  It may be.
    22
    23   Q.   You agreed yesterday there was some evidence from some
    24        reports giving a conflicting opinion on lung cancer and
    25        smoking?
    26        A.  I think most of those reports have now -----
    27
    28   Q.   You said it was a long time?
    29        A.  A long time ago.  I think nowadays there is no doubt
    30        amongst thinking -----
    31
    32   MR. JUSTICE BELL:  A phrase which is used in another kind of
    33        case is a responsible body of competent medical opinion.
    34        Is there any responsible body of competent medical opinion
    35        which disputes a link between smoking and lung cancer
    36        today?
    37        A.  No, none at all.
    38
    39   MS. STEEL:   It has been stated by some researchers that we are
    40        at the stage now in terms of the relationship between diet
    41        and cancer that we were at 20 or so years ago in terms of
    42        smoking and lung cancer.  Is that something you think
    43        would be a fair statement?
    44        A.  I actually am not sure about that.  You see, I think
    45        if we go back to the 1970s and the 1980s, I think when
    46        people looked at population studies and saw these
    47        tremendous geographical variations of the incidence of
    48        cancer, such as breast and colon, and also looked at
    49        dietary habits, it seemed as though we had found a similar
    50        sort of relationship between, say, fat and cancer, like 
    51        breast and bowel cancer, that we had with cigarette 
    52        smoking and lung cancer. 
    53
    54        What has happened since then is that as the experiments
    55        have been done to try to confirm this evidence, the
    56        picture has become less clear.  What I think people are
    57        beginning to realise now is that there may be an influence
    58        of diet on the development of these cancers, and it would
    59        seem reasonable to think there might be.  But the
    60        influence of diet is much more subtle than had originally

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