Day 036 - 13 Oct 94 - Page 29


     
     1        indeed 33 and the other is 40.
     2
     3   MR. RAMPTON:  I am sorry about that.  We will try and get the
     4        original.
     5        A.  It is all right.  Secondly, when one looks at
     6        carbohydrate, frankly I cannot make out those figures, but
     7        it looks like 317 for the Finns, 283 for New York.  So, we
     8        are talking about a difference of 30, 34 grammes, or
     9        whatever it may be there, per day of carbohydrate.  In
    10        other words, if one holds calorie content constant and
    11        holds protein intake constant, if you are going to reduce
    12        carbohydrate and you have no choice but to increase fat,
    13        that is what is happening there.
    14
    15        I would not like that to be lost in interpreting this.
    16        I do agree with you that there is an important role for
    17        fibre.  Whether there is a role for calcium or something
    18        else in dairy products, I am not in a position to say
    19        based on what we have gone through.  However, the data on
    20        fat there might want to be entered into the discussion.
    21
    22   Q.   I am not suggesting that one can draw any firm conclusions
    23        from a report of this kind.  You see, as I think I said
    24        earlier, I am not presently concerned to prove any kind of
    25        positive case at all.  I am suggesting that material of
    26        this kind, and it has, I believe, this sort of phenomenon,
    27        been confirmed or reflected by others in later studies.  I
    28        might be wrong about that what.  What I am suggesting is
    29        that this sort of evidence is suggestive of a whole lot of
    30        possible reasons for what one might call ecologic
    31        correlations, is it not?
    32        A.  Yes.  That is why one responsibly -- well, suggestive
    33        of a whole lot.  What that would mean to me is that when
    34        one responsibly describes the situation, one would say
    35        there are links between a diet which is not simply
    36        high-in-fat but also high-in-salt and sugar, low-in-fibre
    37        and cancers of the colon and of the breast.  That would be
    38        quite reasonable.  That does seem to be what this study
    39        does suggest.
    40
    41        This study also talks about the mechanisms that relate to
    42        the bile acids and their carcinogenic effect, which I
    43        think is obviously important and something to which I made
    44        reference in my statements.
    45
    46   Q.   I know you do.  I was not going to take up the question of
    47        bile acids in any detail at this stage.  I think I will
    48        leave that there.  We have had evidence about that, and
    49        there may be some more.  What I was going to say was, or
    50        ask you to comment on, is this: From a study like that one 
    51        could hypothesize, I am not saying one should assert as a 
    52        fact, one could hypothesize that fat was in a sense 
    53        irrelevant, because so long as you ate enough fibre, the
    54        amount of fat in the diet, up to a certain level
    55        obviously, but the amount of fat in the diet was not
    56        really the important thing; it was the amount of the fibre
    57        that you ate?
    58        A.  Fibre seems to have a protective effect, perhaps
    59        regardless of fat intake, although this study does not
    60        establish that because as in nature, as in human diets, in

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