Day 036 - 13 Oct 94 - Page 22


     
     1        A.  I think it is a reasonable thing for Willett to say,
     2        certainly.
     3
     4   Q.   Here is Kushi's possible answer to that:  "However, the
     5        presence of a strong association of fat intake with colon
     6        cancer does not negate the possibilities of either a
     7        moderate dietary fat-breast cancer association in the
     8        range of fat intake under study or a more striking
     9        protective effect on breast cancer risk of substantially
    10        lower fat intakes".
    11
    12        Dr. Barnard, leaving aside what conclusions might be drawn
    13        from what are here called ecologic studies, or sometimes
    14        called correlational or international studies, is there
    15        any epidemiologic evidence to your knowledge that has
    16        studied populations with greater extremes of fat intake
    17        than the sort of thing we see here?
    18        A.  I am pausing because that is a detailed question of
    19        research design.
    20
    21   MR. JUSTICE BELL:  Shall we take the five minutes there and
    22        then you can think about that.  What I would also like, it
    23        may help me to get the matter in proportion because we
    24        have had various percentages of energy referred to in this
    25        paper.  If you think you can give me a percentage figure
    26        for a typical vegan diet, on the one hand, and a typical
    27        ovo-lacto-vegetarian diet on the other -- you may say,
    28         "No, there is no such thing" -- but, if you can do, it
    29        will help me, perhaps, get these percentages in
    30        proportion?
    31        A.  Thank you, yes.
    32
    33   Q.   I will come back in five minutes time.
    34
    35                            (Short Adjournment)
    36
    37   MR. RAMPTON:  Dr. Barnard, we left you with a question, whether
    38        you were conscious of any prospective studies that
    39        succeeded in studying a wider range of fat intakes than we
    40        have identified in the ones we have got?
    41        A.  Yes, I am afraid that in the short break that we had,
    42        I am not able to pull out an adequate response to your
    43        question.  I was looking at Dr. Toniolo's study to see his
    44        range.  His lower range was somewhere below 28 per cent,
    45        but I could not find the median to say what actually it
    46        was.
    47
    48   Q.   We are going to come to that in due course.  He says -- it
    49        looks as though it is 28 to 36; if one looks at the ----
    50        A.  He says less than 28 and more than 36. 
    51 
    52   Q.   Yes.  He says "less than". 
    53        A.  That is the problem, to see what the actual median or
    54        mean might be.
    55
    56   MR. JUSTICE BELL:  You might think about that during the
    57        mid-day adjournment as well.
    58
    59   MR. RAMPTON:  Yes.  I will not get to Toniolo until after the
    60        mid-day adjournment anyway.  Can we pass over to the final

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