Day 017 - 25 Jul 94 - Page 35


     
     1        by Yvonne Jones and others, also in 1987, do you have it?
              A.  Yes, I do.
     2
         Q.   Dietary Fat and Breast Cancer in the National Health and
     3        Nutrition Examination Survey 1.  Epidemiologic Follow-up
              Survey -- this is an American paper, is it not?
     4        A.  Yes.
 
     5   Q.   I do not know what JNCI -- Journal of the National Cancer
              Institute?
     6        A.  Journal of the National Cancer Institute.
 
     7   Q.   I am only going to read the abstract and then a short
              passage further on for balance.  Abstract:  "The
     8        relationship between dietary fat intake and breast cancer
              incidence was examined in the National Health and
     9        Nutrition Examination Survey 1 Epidemiologic Follow-up
              Study cohort.  This cohort is derived from adults", what
    10        do those signs mean?
              A.  It means either equal to or greater than 25 years of
    11        age.
 
    12   Q.   I realised the greater, I did not realise it meant equal
              to. That is a very useful sign.  Either equal to or
    13        greater than, so nobody under 25?
              A.  Nobody under 25.
    14
         Q.   "Examples in the cross-sectional survey of the US
    15        population and provides a mean follow-up time of 10 years.
                An analytic sample of 5,485 women, including 99 breast
    16        cancer cases (34 premenopausal and 65 postmenopausal at
              NHANES 1 base-line), was examined for associations with
    17        dietary intake of fat, percent energy from fat, total
              energy, saturated fat, polyunsaturated fat,
    18        monounsaturated fat, and cholesterol on the basis of a
              24-hour recall administered at the baseline NHANES 1
    19        examination.  No significant differences in dietary fat
              intake between cases and non-cases were evident when mean
    20        intakes for each group were compared.  For total fat (in
              grams) and saturated fat (in grams) a significant inverse
    21        association was indicated in proportional hazards
              analyses."   Do we need to know what proportional hazards
    22        analyses are?
              A.  I do not think so.  Basically, they are just looking
    23        at the relative risks of different factors, and this is
              analysed statistically to give you some sort rank order of
    24        the risks.
 
    25   Q.   Then Dr. James, if that is what it should be, goes on:
              "Adjustment of fat for total energy intake resulted in a 
    26        smaller effect that was no longer statistically 
              significant.  Adjustment for accepted breast cancer risk 
    27        factors did not change these findings.  This prospective
              study of a sample from the US population does not support
    28        the hypothesis that high dietary fat intake increases
              breast cancer risk.  Indeed, some lower risk associated
    29        high fat intake may be indicated, although this result may
              be influenced by methodologic problems with the dietary
    30        assessment".
 

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