Day 036 - 13 Oct 94 - Page 52
1 elucidating the causative role of fat being the causative
2 agent along with other dietary factors and cancer being
3 the result.
4
5 MR. MORRIS: What does Willett say in that, in your
6 understanding or interpretation, that that seemed to be
7 the general view and he was somehow questioning the
8 general view? Is that the context in which his study
9 takes place or his review takes place?
10 A. Willett seems to be acknowledging in this statement
11 (and certainly in his other writings) that there is a
12 substantial amount of evidence that indicates that a diet
13 high-in-fat and low-in-fibre does contribute to the cause
14 of cancer of the breast and colon, and he then elaborates
15 on that from there.
16
17 Q. The Surgeon General's report -- it was mentioned but
18 I want to ask you again -- on page 194 of the Surgeon
19 General's report; I think it may be useful to the court to
20 go to that page. 194 in the Surgeon General's report,
21 that is from chapter 4 on cancer. I do not know again
22 where that was put.
23
24 MR. JUSTICE BELL: No, it is No. 7.
25
26 MR. MORRIS: I think, though, Mr. Rampton had copied the whole
27 chapter and it was not necessarily put in the same place.
28
29 MR. JUSTICE BELL: It is behind Mr. Barnard's supplementary
30 statement as No. 7.
31
32 MR. MORRIS: The first line on the Role of Dietary Fats in
33 Cancer, and this is in 1989, the Surgeon General's Report?
34 A. 1988 actually.
35
36 Q. Sorry, 1988, it starts off: "Despite some
37 inconsistencies", my emphasis, "in the data relating
38 dietary fat to cancer causation, animal studies show an
39 effect on carcinogenesis and support a cancer-promoting
40 role, and international epidemiologic studies have
41 suggested that differences in dietary fat intake may
42 provide a meaningful key to prevention of cancer".
43
44 It goes on but I just I want to go back to the first
45 phrase, "Despite some inconsistencies in the data relating
46 dietary fat to cancer causation", how do you interpret
47 that sentence?
48 A. A few things, perhaps, call for some attention; the
49 first is that in any area of medicine when one reviews the
50 research, there will always be inconsistencies in the
51 data. That has been true for things, as clearly accepted
52 now, that we talked about, cigarettes and lung cancer.
53 So, there are inconsistencies; those have to be expected.
54
55 But Dr. Koop does use language that speaks of causation
56 I guess in three parts of that sentence; the first is in
57 the second line, "animal studies show an effect on
58 carcinogenesis" which has to do with the beginnings of
59 cancer causal. The second line, "and support a
60 cancer-promoting role", again related to causation as we
