Day 017 - 25 Jul 94 - Page 38


     
     1        increased.  However, all such evidence is crude and
              indirect and for causation to be invoked persuasively,
     2        individual women must be shown to have a higher than
              average fat intake.  Moreover, since this may simply
     3        reflect high energy requirements as determined by body
              size, physical activity or individual metabolism, affected
     4        women should ideally be shown to obtain a higher
              proportion of calories from total fat than do controls."
     5
              Then Dr. Kinlen reviews the existing evidence as at 1991,
     6        first of all, Case-control studies.  Then he comes back to
              re-examine International correlations.  Dr. Arnott, notice
     7        table 2, these are cohort studies as we pass.  We find
              that the population samples, the studies in Japan based on
     8        population of samples, that there was a positive
              relationship, but in the other four studies, the
     9        Adventists, the nuns in this country, the nurses in
              America and the population sample in America, there was no
    10        positive correlation found.  Those are cohort studies.
 
    11        On the right hand, page 465, Dr. Kinlen mentions all the
              things that you have mentioned, high menarche, other
    12        fertility factors, obesity and then the page, food
              wastage, obesity and survival.  Then he mention animal
    13        studies and other aspects of diet.  I will read that, if I
              may:  "A protective effect of green vegetables has been
    14        found in several case-control studies.  The possibility
              that this reflects an effect of Beta carotene was
    15        supported by a prospective study of plasma carotene levels
              in relation   to breast cancer.  However, later findings
    16        from this as well as from two other similar studies have
              cast doubt on this relationship.  An intriguing greater
    17        caloric intake from a variety of foods by cases than
              controls has been reported which persisted after
    18        adjustment for body weight.
 
    19        Conclusion:  There are well founded reasons concerning
              obesity and coronary heart disease for reducing
    20        consumption of animal fat."   Dr. Arnott, I know you are
              not a cardiologist, but I assume you have some general
    21        medical knowledge passing beyond a study of cancer ---
              A.  A little, yes.
    22
         Q.   -- do you regard the evidence associating a high intake of
    23        fat, particularly saturated fat, with coronary heart
              disease as convincing?
    24        A.  I am convinced by it, yes.
 
    25   Q.   Might one reason for that be that we understand the
              pathogenis of coronary heart disease rather better than we 
    26        do that of cancer? 
              A.  I think that is a fair comment, yes. 
    27
         Q.   Dr. Kinlen goes on:  "As a cause of breast cancer,
    28        however, the contradictory nature of the evidence prevents
              any definitive conclusion.  Much of the international data
    29        that suggests a relationship may simply reflect the
              effects of calorie restriction during growth in certain
    30        countries"  -----
 

Prev Next Index