Day 254 - 22 May 96 - Page 06


     
     1        A.  Well, if anything, I would have said that there is more
     2        of a trend now than suggesting that there is not a trend.
     3
     4   Q.   You are talking about consistent trends?
     5        A.  I would have said, yes.  Certainly what you say is
     6        correct in a sense in that the trend has been to say that
     7        one does not know, but I think that on the whole, the more
     8        recent trend has been to suggest that if you look
     9        objectively in the way that the studies have been
    10        organised, that these studies have been unable to relate
    11        diet to cancer, certainly as far as breast and bowel cancer
    12        is concerned.
    13
    14   Q.   So, do you read all the scientific literature on this
    15        subject or just read selectively the ones that suit your
    16        view?
    17        A.  No.  I think any scientist tries to read a broad
    18        spectrum of articles to try to get a balanced view about
    19        what is exactly going on.  I would not able to live with
    20        myself if I only looked at one set piece of evidence to
    21        support a prejudiced view.
    22
    23        I have an open mind on this topic, which I hope I have
    24        tried to put across to the court, and I have tried to look
    25        dispassionately at the evidence which has been available to
    26        me as a scientist, because I do not have to just stand here
    27        in court today; I have actually got to deal with patients.
    28        I am a practising doctor looking after patients with cancer
    29        all the time.  A frequent question that I am faced with
    30        from patients is: "What do I do about my diet? What
    31        modifications can I make?  So I try to read the evidence
    32        that is published to give patients a reasonable judgment
    33        about what they may do to improve their chances of having
    34        successful treatment, and obviously being cured of their
    35        disease.
    36
    37   Q.   What advice is that in relation to diet?
    38        A.  Well, I say that, I try to be honest with them, that,
    39        at the moment, the evidence is not known.  I say that the
    40        thing which appears to come across most strongly is that a
    41        good intake of fruit and vegetables is important and that
    42        the other factor which seems to be important is that they
    43        should try to take some exercise.
    44
    45        I say that question marks regarding fat in the diet have
    46        been raised, and certainly we do know that people who are
    47        obese do seem to have a worse outlook following the
    48        treatment of their cancers than people who are thin.  One
    49        of the easiest ways to become obese is to eat too much fat,
    50        because of the relative amount of calories that fat 
    51        contains relative to the size of the meal you take.  So 
    52        I say that it is only reasonable, if you are trying to 
    53        avoid becoming obese, to try to cut down on your fat
    54        intake.
    55
    56        You remember, these are people who are not nutritionists or
    57        specialists in the field but one has to try and give advice
    58        which is easily followed for patients.
    59
    60   Q.   Right.

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