Day 035 - 12 Oct 94 - Page 33


     
     1        put on all copies of those documents supplied to the
     2        Defendants.
     3
     4   MS. STEEL:  I do not think he actually gave direction or leave,
     5        but we are not specifically complaining about that anyway.
     6
     7   MR. JUSTICE BELL:  What I suggest is, if when we refer to a
     8        page you are really having difficulty with it, you will
     9        hear it read through, put a PostIt on it, or something.
    10        Without necessarily giving you a completely new bundle you
    11        can replace the particular pages, if you end up with so
    12        many PostIts you need a replacement, then do that.  Do you
    13        have some?
    14
    15   MS. STEEL:  Yes.  It is the whole way through the bundle.  It
    16        is partly because the text is so small that it actually
    17        blocks out whole words.
    18
    19   MR. RAMPTON:  This is not the important part.  If there is a
    20        difficulty when I come to the important part I will read
    21        it very slowly.  May I just finish this introductory
    22        paragraph:  "Once such change in thinking occurred about
    23        20 years ago, when the cumulative effect of a series of
    24        epidemiological observations made it clear that all types
    25        of cancer that were at all common anywhere varied greatly
    26        in incidence, always 5 times, often 50 times, and
    27        occasionally 500 times, and that most of this variation
    28        could be explained only by differences in the environment
    29        or in the way people behaved.  It followed that a large
    30        proportion of all cancers were, at least in principle,
    31        avoidable".
    32
    33        Then turn over the page to page 448 of the document and
    34        there is a passage headed Dietary Factors:  "Dietary
    35        Factors.  That dietary factors are important, particularly
    36        perhaps in producing cancers of the stomach, large bowel
    37        and breast (3 of the 4 most common types throughout the
    38        world) is suggested by many laboratory experiments and
    39        hinted at by such epidemiological observations as the
    40        positive correlation in different populations between the
    41        incidence of cancers of the breast and large bowel and the
    42        consumption of fat, the negative correlation between the
    43        incidence of cancer of the large bowel and the consumption
    44        of fibre and resistant starch, and the negative
    45        association between the incidence of gastric cancer and
    46        the consumption of fresh fruit and green vegetables.  The
    47        evidence is, however, inconclusive.  Insofar as it varies
    48        in strength, the strongest is that obtained from studies
    49        of individuals, which has suggested that the consumption
    50        of fruit and green vegetables diminishes the risk of 
    51        cancer of stomach and that the consumption of large 
    52        amounts of beta-carotene similarly protects against a wide 
    53        range of cancers, and the weakest is that relating to the
    54        role of fat in the causation of cancer of the breast and
    55        to a broadly protective effect of selenium and vitamin E.
    56        Fortunately, action based on this evidence will certainly
    57        help to reduce the risk of a variety of other diseases,
    58        from coronary thrombosis to constipation, and it may,
    59        therefore, be justifiable to recommend changes in diet
    60        based on these associations, as well as changes in smoking

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