Day 254 - 22 May 96 - Page 21


     
     1
     2   Q.   Right.
     3        A.  What is almost certainly true about all this is that it
     4        is a multi-factorial situation we are dealing with and no
     5        one factor is entirely responsible for all forms of cancer.
     6
     7   Q.   But that diet is one of them?
     8        A.  Diet may be one of them.
     9
    10   MR. MORRIS:  Is diet a causal factor in obesity?
    11        A.  Not entirely.  Obviously, diet is important but there
    12        is a relationship between the number of calories that you
    13        expend in terms of exercise and the number of calories that
    14        you take in your diet.  It is a balance.  So you cannot
    15        just say that diet is the sole cause of obesity.
    16
    17   Q.   I did not say it was the sole cause.  I said, is diet
    18        causally related to obesity?
    19        A.  It may be, certain aspects of it.
    20
    21   Q.   You are not sure?
    22
    23   MR. JUSTICE BELL:  No.  It may be in a particular case, as
    24        I understand that answer to be.
    25
    26   MR. MORRIS:  May be in a particular case?
    27        A.  Well, if you ----
    28
    29   Q.   Of the people that are obese what percentage are obese
    30        because part of the reason is it is diet related?
    31        A.  Probably the majority of people who eat too much are
    32        obese because of that factor.  But it is not just eating,
    33        of course.  Remember.  Alcohol is a great source of
    34        calories.
    35
    36   Q.   The vast majority of obesity is caused by dietary factors
    37        and there may be other factors as well?
    38        A.  Including alcohol, yes.
    39
    40   Q.   Right.
    41
    42   MS. STEEL:   In the third paragraph, the final sentence when you
    43        say 'there is a growing feeling that any effect may well be
    44        due to total energy intake rather than fat per se', that is
    45        the general medical view is it?
    46        A.  Well, it is certainly a growing feeling that it has not
    47        been easy to explain why fat itself may have any effect,
    48        because, if you remember, on the previous evidence I gave
    49        it was suggested that energy death risks at certain points
    50        in one's lifetime can affect things like growth and 
    51        development, and it may therefore be the total energy that 
    52        people take which is responsible for some of these 
    53        changes.  It is very easy to blame fat because, as I have
    54        said already, there are more calories per gram of fat than
    55        any other nutrients and what people are beginning to
    56        question now is it has been easy to say it is related to
    57        fat but is that really the answer, is it not more that the
    58        total energy intake from all sources rather than fat per se
    59        which can give rise to some of the effects that we are
    60        seeing.

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