Day 036 - 13 Oct 94 - Page 10


     
     1        high-fat consumption and some cancers that needs looking
     2        at because that association may be causal, but that no
     3        respectable scientist, whether in 1990 or 1994, is going
     4        to assert that it is causal?
     5        A.  I interpreted that as a declarative sentence rather
     6        than a question, which is why I did not respond.
     7
     8   MR. JUSTICE BELL:  That is fair enough.
     9
    10   MR. RAMPTON:  That is perfectly fair, but it is a proposition.
    11
    12   MR. JUSTICE BELL:  Treat it as a question.
    13        A.  OK.
    14
    15   MR. RAMPTON:  Treat it as a proposition on which I invite you
    16        to comment.
    17        A.  Thank you.  Without question, I think all sides would
    18        agree that there is an association, a link, if you will,
    19        between fat as well as other components of the diet,
    20        fibre, a diet high-in-fat, high-in-sugar, high-in-salt,
    21        low-in-fibre; there is a link, an association, with cancer
    22        of the breast and colon.  I guess we would all agree on
    23        that.
    24
    25   Q.   We would all agree; I am not so sure about the sugar so
    26        far as obesity, and the salt too, but stick with fat and
    27        fibre; total fat and low fibre.
    28        A.  If we are all agreed that there is this link between a
    29        diet high-in-fat, high-in-salt, high-in-sugar and
    30        low-in-fibre with cancers of the breast and colon as well
    31        as heart disease, there certainly is ongoing discussion as
    32        to the evidence that that link is causal.
    33
    34   MR. JUSTICE BELL:  Can I put it another way, Mr. Rampton?
    35        Dr. Barnard, if what that paragraph meant to me was that
    36        there is evidence to support a suggestion that a high
    37        intake of total fat may also promote the development of a
    38        number of cancers, but that evidence cannot be considered
    39        sufficiently strong to say that it is a causative factor,
    40        nevertheless, in the light of the evidence we do have most
    41        expert groups now consider it prudent to reduce fat intake
    42        etc., if that is what the paragraph meant, if that is what
    43        it meant to me, would you agree with that or not?
    44        A.  My understanding of what they are saying is that when
    45        they say -----
    46
    47   Q.   No, I am sorry.  I have asked you to deal with my
    48        understanding and say, if that was my understanding, would
    49        you agree with what they are saying?
    50        A.  If by "is causal" means "definitively causal", then 
    51        I would agree.  What I am trying to say is that I agree 
    52        that definitive causality has not been established and 
    53        that most experts would not feel that it had been.
    54        However, the links and associations that we are all agreed
    55        on are believed to be causal which is suggested also in
    56        their first sentence in my reading, but I agree that
    57        definitive proof has not been adduced.
    58
    59   MR. RAMPTON:  One more short passage, Dr. Barnard, in this
    60        document and then we will move on to something else.

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