Day 036 - 13 Oct 94 - Page 48


     
     1        A.  Sorry. From that point going down to the seventh line
     2        of that paragraph is a summary statement that is worth
     3        taking note of; it says:  "With nutrients expressed as a
     4        percentage of total calorie intake, our data show quite
     5        clearly that a reduction in the consumption of total fat
     6        to less than 30 per cent, of saturated fat to less than 10
     7        per cent, or of animal proteins to less than 6 per cent
     8        may be strongly protective against breast cancer."
     9
    10        If I may finish with this by simply turning to the next
    11        page; the third full paragraph there is a paragraph that
    12        begins with the words "Our study was based".
    13
    14   MR. JUSTICE BELL:  Yes.
    15        A.  The third full paragraph says:  "Our study was based".
    16        I will read that paragraph, if I may:  "Our study was
    17        based on the assumption that a large variability in
    18        dietary intakes existed in the population under study.  An
    19        absence of sufficient variation in nutrient intakes could
    20        lead to a lack of evidence for association with breast
    21        cancer.  A comparison with the prospective data of Willett
    22        et al shows that our premises may have been correct.  With
    23        total fat expressed as a percentage of calories, American
    24        nurses" -- referring here to the Willett study -- "had a
    25        mean contribution to total calories from fat of 44 per
    26        cent in the highest quintile and of 32 per cent in the
    27        lowest quintile.  The corresponding figures for women in
    28        Vercelli" -- the current study -- "were 46 per cent and 26
    29        per cent respectively".
    30
    31        So, in summary in this study  (which followed on the heels
    32        of Willett's first report) they simply identified a
    33        population with a slightly wider fat intake, found a
    34        significant relationship with breast cancer, and even when
    35        controlling for the confounders that we have discussed
    36        today, that relationship remained -- that relationship
    37        persisted; and the language in which it is described it is
    38        not simply described on page 284, the second to last part
    39        I read, not simply described as an association but in
    40        somewhat stronger terms that their data, quite clearly,
    41        show, and they say may be -- not may be protective or
    42        could be protective, but may be strongly protective.
    43
    44        So, in my reading, they are trying to put additional
    45        emphasis there, even though they are in keeping with what
    46        many researchers would do and say that it may be strongly
    47        protective.  That was the only point I wanted to make
    48        about that study.
    49
    50   MS. STEEL:  You were asked about figures for the contribution 
    51        of diet to overall risk of cancer.  I do not know whether 
    52        you have a copy of the green Diet, Nutrition and Cancer 
    53        book up there?
    54        A.  I only have a couple of pages.
    55
    56   MR. JUSTICE BELL:  I want you to remind me where that is.
    57
    58   MS. STEEL:   Possibly behind Cannon.
    59
    60   MR. MORRIS:  Yes, I think it is in Mr. Cannon's list of

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