Day 254 - 22 May 96 - Page 50
1 through a whole range of fats, it mentions proteins,
2 sucrose, vitamins, beta carotene, calcium, selenium, sodium
3 and then it goes to overall conclusions. It is absolutely
4 clear, is it not Dr. Arnott, that when they talk about
5 "diet", they are not talking about alcohol or smoking or
6 lifestyle?
7
8 MR. JUSTICE BELL: Cut out "smoking" because I would not have
9 thought smoking was part of your diet.
10
11 MR. MORRIS: I would not have thought alcohol was either.
12
13 MR. JUSTICE BELL: And I would not have thought "lifestyle" was.
14 It might directly affect your diet, but you are
15 suggesting that drinks are not part of diet, are you?
16
17 MS. STEEL: I think the point is that they are not specifically
18 looking at alcohol as one of the factors in this study, so
19 when the summary is that the general consensus is "that
20 diet is an important etiological component in
21 carcinogenesis", they are not referring to alcohol in that
22 statement.
23
24 MR. JUSTICE BELL: What do you make of that?
25 A. I am sorry, I disagree. I think alcohol is a component
26 and that is why I said at the beginning one needs to look
27 very carefully at the sorts of cancers one is talking
28 about.
29
30 I think that the reason he has not discussed alcohol is, as
31 I have said before, the situation regarding alcohol is
32 fairly clear cut, that there is clear association between
33 cancers of the mouth, the pharynx and the oesophagus with
34 alcohol intake.
35
36 What he has spent most of his time discussing are the
37 controversial areas, such as fat, and where in the studies
38 that he quotes, interventional studies, where people have
39 actually tried to add substances into the diet, such as
40 beta, carotene, vitamins and so on, that these are the
41 areas where the greatest degree of uncertainly lies and
42 therefore he has spent most time discussing those points.
43
44 MS. STEEL: Is there conclusive proof about alcohol then?
45 A. Yes, I would say there is.
46
47 Q. So what is this conclusive proof?
48 A. Well, there are a number of studies which have looked
49 at the variations in, for example, oesophageal cancer,
50 cancer of the mouth, and cancer of the pharynx, and these
51 have consistently been shown to be related to alcohol
52 intake as well as cigarette smoking. What most of the
53 studies have shown is that cigarette smoking seems to be an
54 additive factor in all of these people.
55
56 Q. So "consistent studies" means that there is conclusive
57 proof?
58 A. Yes.
59
60 Q. Right. Were they cohort studies or what type of studies?
