Day 017 - 25 Jul 94 - Page 28


     
     1        meant on one to three days each week (64 deaths) or those
              who did so more often (41 deaths) (Phillips and Snowdon,
     2        1983). Recently Willett and his colleagues (1987) reported
              details of a prospective study of more than 89,000 US
     3        nurses who provided details of their consumption of fat,
              calories, saturated fat, linoleic acid and cholesterol.
     4        Of these, 60 developed breast cancer during a four-year
              follow-up period. Among those in the highest quintile of
     5        calorie-adjusted total fat intake (44% calories from fat),
              there was no increased incidence compared with women in
     6        the lowest quintile with 30% calories derived from fat
              (relative risk 0.82), the relative risk for saturated fat
     7        being 0.88".
 
     8        Can we turn over the page, please, Dr. Arnott, and look at
              table 2 where we see the results of these studies set out
     9        in tabular form.  The Hirayama results.  The important
              sections are the three right-hand columns, Breast cancers
    10        by consumption categories, this is consumption of fat or
              meat, is it not?
    11        A.  Yes.
 
    12   Q.   Hirayama's criterion was meat; the lowest meat eaters had
              125 and the highest had 14.  In the Hiroshima sample, the
    13        lowest had two; the intermediate had 17 and the highest
              11.  But when we come to the Adventists in California, we
    14        see 81 for the lowest; 64 intermediate and highest 41,
              which is a downward slope, is it not?
    15        A.  Yes.
 
    16   MR. JUSTICE BELL:  These are terribly small numbers, 60 out of
              89,000.  Would it be stupid to suggest you might quite
    17        easily get 60 out of 89,000 for any sort of reason
              whatsoever?  Is it statistically significant?
    18        A.  I do not think it is.  I think one of the problems at
              the time this particular paper was written was that the
    19        nurses had been followed up for a relatively short period
              of time.
    20
         Q.   Yes and that then ------
    21        A.  There are other publications which, in fact, followed
              them up for longer periods of time, we are seeing more
    22        numbers of breast cancer.
 
    23   MR. RAMPTON:  We will be looking at Willett's follow up study
              in a moment, Dr. Arnott.  That was published in 1992.  We
    24        see just looking at that table that there appears,
              although perhaps you would not draw any conclusion from
    25        it, in fact, to be an inverse relationship in that case
              between the consumption of a large amount of fat and the 
    26        incidence of cancer, does there not? 
              A.  It does. 
    27
         Q.   But you would tell me that is a nonsense looked at as a
    28        scientific -----
              A.  No, I would say that what this is showing is the lack
    29        of consistency in all of the findings in the published
              work.  It shows that one cannot say that there is a
    30        relationship between fat intake and breast cancer.  The
              nurses' study, for example, is a large study and, you

Prev Next Index