Day 017 - 25 Jul 94 - Page 40


     
     1        saturated fat has an influence on the amount of serum
              cholesterol in the blood?
     2        A.  Yes, indeed.
 
     3   Q.   That, in turn, is a factor in the deposition of fat in the
              arteries or atherosclerosis?
     4        A.  It is a factor, yes, and also the presence of fats
              within the blood other than cholesterol lead to deposition
     5        of fats on blood vessels which is what we call
              atherosclerosis.
     6
         Q.   And atherosclerosis, in turn, is a factor at least in the
     7        incidence of coronary heart disease?
              A.  Oh, yes, undoubtedly.
     8
         Q.   Are there any such simple mechanical explanations
     9        available in relation to cancer of the colon, the rectum
              or the breast?
    10        A.  I am afraid there is nothing as straightforward as
              that.
    11
         Q.   I will just finish this conclusion by Dr. Kinlen.  "Much
    12        of the international data that suggests a relationship may
              simply reflect the effects of calorie restriction during
    13        growth in certain countries, or over-nutrition in others,
              respectively reducing or increasing breast cancer risk.
    14        The largely negative findings of prospective studies, the
              greater scope for bias in case-control studies, and the
    15        possible confusion between the effects of fat per se and
              those of excess calories all make a conservative position
    16        prudent in evaluating the findings to date about fat.
              There is a dearth of data about individuals with a very
    17        low fat intake and a need also for a combined analysis of
              all the prospective studies.  A stringent approach is
    18        required in designing future studies of the role of fat in
              this disease. A protective effect of green vegetables
    19        suggested by certain studies requires confirmation".
 
    20        Has that confirmation, so far as breast cancer is
              concerned, been obtained since 1991, Dr. Arnott?
    21        A.  No, it has not.
 
    22   Q.   Then, finally, on this topic, I would like you to look at
              the latest work of Dr. Willett and his colleagues which is
    23        at tab 5.  I am only going to ask you to read the
              abstract.  This is the American nurses study, is it not?
    24        It is a prospective study, is it not?
              A.  A prospective study.
    25
         Q.   In 1980, did it? 
    26        A.  It originated in 1980. 
  
    27   Q.   I think you said earlier one has to be a bit cautious
              because one needs a period of time?
    28        A.  Indeed, yes.
 
    29   Q.   To see what happens?
              A.  Yes.
    30
         Q.   You may get a better idea eight years on than you had four

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