Day 036 - 13 Oct 94 - Page 09


     
     1
     2   Q.   "There is then a prevalence of grade 1 obesity of about 40
     3        per cent in middle aged men and women".  It may be that it
     4        is a lower grade for the height, I do not know. "The
     5        grounds of obesity are low.  Therefore, any increase in
     6        fat intake beyond perhaps 20 per cent of energy should be
     7        avoided."
     8
     9        Do you believe, again drawing a very crude picture, a
    10        broad brush, do you believe that a reduction from, say, 35
    11        to 40 per cent of energy as fat is likely overall to
    12        produce a reduction in the body mass index of, say, the
    13        American population?
    14        A.  Yes.
    15
    16   Q.   "Table 11 on page 67", say the authors of this report,
    17         "which summarises the links between diet and cancer,
    18        suggests that a high intake of total fat may also promote
    19        the development of a number of cancers.  The evidence
    20        cannot be considered sufficiently strong to be termed
    21        causal.  But most expert groups now consider it prudent to
    22        reduce fat intakes in western society from the prevailing
    23        figure of about 40 per cent energy towards the 20 to 30
    24        per cent figure."
    25
    26        Dr. Barnard, as an expression of the state of medical and
    27        scientific knowledge in 1990, how do you react to that
    28        paragraph?
    29        A.  The second sentence in my reading is contradicted by
    30        the first sentence; the first sentence implies that for
    31        those cancers listed in table 11 on page 67 for which
    32        there is a link with dietary fat, those being breast,
    33        colon, prostate and rectum, that, "a high intake of total
    34        fat may also promote the development of a number of
    35        cancers", presumably those.  "Promote", "may promote", to
    36        me is a causal link as opposed to "may coincide with"
    37        which would not be causal.  The second sentence then says,
    38        "the evidence cannot be considered sufficiently strong to
    39        be termed causal".  It is difficult for me to resolve
    40        those two.
    41
    42   Q.   May I suggest a simple resolution, it is one I put to you
    43        at the end of yesterday's hearing.  It is this:  The
    44        evidence at this stage and, so far as we on this side of
    45        the court are concerned at the present day, is suggestive
    46        of this proposition, that there is an association between
    47        high-fat consumption and some cancers; that it needs
    48        looking at because that association may be causal but that
    49        no respectable scientist, whether in 1990 or 1994, is
    50        going to assert that it is causal. 
    51 
    52   MR. JUSTICE BELL:  What do you say about that? 
    53        A.  I am sorry, was there a question?
    54
    55   MR. RAMPTON:  I will repeat it.  I put it to you that there was
    56        a simple resolution of what you see as a contradiction
    57        between those two sentences which is this:  The evidence
    58        at this stage in 1990 and, so far as we are concerned on
    59        this side of the court at the present day, is suggestive
    60        of this proposition:  That there is an association between

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