Day 254 - 22 May 96 - Page 18


     
     1   MR. JUSTICE BELL:  Do your best.  I did not have this argument
     2        with Mr. Morris.  When I explained it to him, he understood
     3        how the confusion could arise and he did his best, not
     4        always with success because he made himself laugh on one or
     5        two occasions when he did it, but he did his best to avoid
     6        using the word "so", which makes it look as if the question
     7        logically follows upon the answer which has just gone
     8        before.
     9
    10   MS. STEEL:  (To the witness): When you give this advice to your
    11        patients about keeping their diet low in fat, what
    12        percentage of fat do you refer to then?
    13        A.  I do not refer to a specific percentage of fat.
    14
    15   Q.   But if they asked you, you would just say "60 per cent";
    16        would you?
    17        A.  No.  I say to patients that it is important that they
    18        eat a good balanced diet with plenty of fruit and
    19        vegetables and suggest that when they are eating meat, they
    20        would cut off excess fat and use simple measures like that.
    21
    22        I think the average person -- have you any idea, you may do
    23        because you are very much involved with this case, I do not
    24        think has any idea what proportion of the calories in their
    25        diet comes from fat.  Therefore, to try to say to
    26        somebody,"Keep  your calorie, your energy intake from fat
    27        below 40 or 60 per cent" is actually meaningless.  You
    28        actually have to give them some practical advice about what
    29        they should or should not do.
    30
    31   Q.   Do you view 35 per cent of calories from fat in a person's
    32        diet as excessive?
    33        A.  For what purpose? For the purpose of cancer, or the
    34        purpose of becoming obese or what?  As I have already said
    35        to you, I think one of the things that one should try and
    36        do is give advice to patients or to people in general,
    37        which is practical which will avoid them becoming obese
    38        since that is one aspect that we clearly know appears to
    39        carry a poor outlook in terms of the response to treatment
    40        and outcome following treatment for cancers.
    41
    42        One of the easiest ways of becoming obese, because of the
    43        number of calories per gram of fat, is to eat fat.  So, one
    44        tries to give patients practical advice about measures to
    45        cut down on fat, such as cutting off excess fat from meat.
    46
    47   Q.   Do you view 35 per cent of calories from fat in a person's
    48        diet as excessive with regard to prevention of cancer?
    49        A.  I do not know the answer to that.  I am not sure
    50        anybody knows the answer to that, to be frank with you. 
    51 
    52   Q.   Do you regard 35 per cent of calories from fat in a 
    53        person's diet as excessive with regard to prevention of
    54        obesity?
    55        A.  Again, there is no straightforward answer to that.  It
    56        may be for some people, but it may not be for other people.
    57
    58   Q.   Is there a figure that would you put as an excessive amount
    59        of fat in the diet?
    60        A.  No.

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