Day 256 - 04 Jun 96 - Page 84


     
     1   MR. JUSTICE BELL:  This is, as you pointed out, the overall
     2        diet?
     3        A.  Yes, of which fat is a part and a contributor.
     4
     5   MR. MORRIS:  So, are you saying there is a direct relationship
     6        which is a causal relationship between fat and breast
     7        cancer?
     8        A.  Yes.
     9
    10   Q.   And between fat and colon cancer?
    11        A.  Yes.
    12
    13   MS. STEEL:   And the same for animal products?
    14        A.  Especially for animal products; more so, in fact.
    15
    16   MR. MORRIS:  Right.  Your comment about cohort studies and you
    17        talk about the so-called confounding variables that are
    18        diet related being removed, which you said obscures the
    19        results -- if those confounding variables, so-called
    20        confounding variables are not removed, do the cohort
    21        studies then show a relationship, for example, between fat
    22        consumption and breast cancer, when the other dietary
    23        related variables are included and not adjusted?
    24        A.  The best example I think I can refer to in this
    25        particular case is the paper we had before, Shanghai and
    26        Tianjin -- comparisons.  I cannot speak to the seven study
    27        report of Hunter and Company,.
    28
    29   Q.   But for that other paper that was put to you?
    30        A.  Yes.  I mean, in general, this is the way it has always
    31        tended to be, in promotion of these studies; you begin to
    32        control and you adjust to these factors.  They actually
    33        are, themselves, the result of, let us say, the high fat
    34        intake.  One begins to remove the effect that is actually
    35        seen.
    36
    37   Q.   You say that would be shown in those tables that we looked
    38        at?
    39        A.  Definitely in the Shanghai and Tianjin; it speaks
    40        specifically to that one; it is a good illustration.
    41
    42   MR. JUSTICE BELL:  Let me ask a question before Ms. Steel and
    43        Mr. Morris conclude their re-examination.  You said that
    44        the chances of diet not being causal in cancer of the
    45        breast and bowel was one in 1,000?
    46        A.  Roughly.  I have actually done this kind of analysis
    47        before.
    48
    49   Q.   Yes.  But you were not then restricting yourself -- you
    50        were not saying fat in the diet; or were you? 
    51        A.  No.  I was speaking more comprehensively, in the total 
    52        diet.  I was speaking of high fat diets that are high fat 
    53        because of the consumption of animal foods.
    54
    55   Q.   So, you say with a high fat diet, including animal products
    56        ---
    57        A.  Yes.
    58
    59   Q.   -- the chances of a high fat diet, including animal
    60        products, not being causal of cancer of the breast and

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