Day 022 - 12 Sep 94 - Page 62


     
     1   MR. JUSTICE BELL:  Where do I find that?
     2
     3   MR. MORRIS:  That is in Dr. Arnott's references, No. 2.
     4
     5   MR. JUSTICE BELL:  That is Howe and Others?
     6
     7   THE WITNESS:  Yes.
     8
     9   MR. MORRIS:  This survey is called Dietary Factors and Risk of
    10        Breast Cancer; Combined Analysis of 12 Case-Controlled
    11        Studies, Geoffrey Howe and others; published April
    12        4th 1990.  You have obviously seen this; it is your
    13        reference?
    14        A.  Yes.
    15
    16   Q.   On the next page from the first page under "Methods", this
    17        is file page 363, under the title Studies: "Studies
    18        originally considered for inclusion in the present
    19        analysis consisted of all case-controlled studies of diet
    20        and breast cancer that had been completed by the end of
    21        1986 that included specific estimates of fat intake.  We
    22        identified 14 studies and 12 agreed to take part",
    23        basically.  So, this really, is it not, is an analysis of
    24        all the relevant studies as far as they could identify?
    25        A.  That was up until 1986.
    26
    27   Q.   Up to 1986.  Their conclusion -- let us have a look -----
    28
    29   MR. JUSTICE BELL:  It is the bottom of page 369.
    30
    31   MR. MORRIS:  This would be quite important in terms of up to
    32        1986, would it not?
    33        A.  I may say that this has been subjected to a lot of
    34        criticism, this particular paper, and people have
    35        criticised the way in which statistically the results were
    36        analysed.  Many people have said that, in fact, if you
    37        analyse them in a different way, you do not get the
    38        conclusions that were found.
    39
    40   Q.   Shall we read out the conclusion -- do you know Geoffrey
    41        Howe?
    42        A.  I do not.
    43
    44   Q.   You have heard of him?
    45        A.  Oh, yes, I have heard of him.
    46
    47   Q.   Is he well-known in the field?
    48        A.  I would not say he was a leader in the field, but he
    49        is known, certainly.
    50 
    51   Q.   His conclusions are:  "With respect to the intake of 
    52        calories and major sources of calories during adult life, 
    53        our analysis supports an association between consumption
    54        of fat, particularly saturated and monounsaturated fat,
    55        and risk of postmenopausal breast cancer.  This finding
    56        from case-controlled studies appears to be inconsistent
    57        with the results from the largest cohort study in the
    58        United States reported to date."   Is that the nurses'
    59        one?
    60        A.  Yes.

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