Day 254 - 22 May 96 - Page 27


     
     1        in energy adjusted nutrients intake.
     2        A.  They actually do not.  What they say is, look at the
     3        bottom of page 358, overall relative risks, in table 2 we
     4        show the pooled quintile specific relative risk of breast
     5        cancer as compared with the lowest quintile.  So quintile
     6        No. 1, which is the reference, is the lowest quintile of
     7        intake.
     8
     9   Q.   Yes, but we do not know what the intake was.
    10        A.  No, obviously they divided the intake according to a
    11        range, and quintile No 5 is the quintile with the highest
    12        fat intake, quintile No. 1 is the quintile with the lowest
    13        fat intake.
    14
    15   Q.   Yes, but we do not know what the range is or the -- or what
    16        the range within the quintiles either.
    17        A.  What they have said is, quintile No. 1 is where the
    18        energy is less than 20 per cent of total intake.
    19
    20   Q.   Where do you get that?
    21        A.  That is in the summary.  I am just trying to find the
    22        data for you.
    23
    24   MR. JUSTICE BELL:   What I suggest is we take the 5-minute break
    25        there.  It occurs to me that there might be an explanation
    26        in that the figures might vary quite considerably, not
    27        necessarily within the United States but between the
    28        different countries, or might vary to some extent.  They
    29        must have had that information, it is a question of how
    30        much you actually put into your paper at the end of the
    31        day, I suppose.  But if you do not mind, while everyone
    32        else has a 5-minute break, having a look through and see if
    33        we can find the answer, Dr. Arnott.
    34
    35                          (Short adjournment)
    36
    37   MR. JUSTICE BELL:  Can you find an answer to it?
    38        A.  Yes, my Lord.  Basically, what they appear to have done
    39        they have not specified exactly what these quintiles
    40        represent, except that quintile 1 is the quintile with the
    41        lowest intake and they have taken that as the reference
    42        level.  But they have used a variable energy intake
    43        relating the intake to 1,600 calories, and I think this is
    44        obviously a statistical analysis which they have not fully
    45        explained in how they have divided the quintiles up.  But
    46        they have essentially based it on a number of factors, like
    47        nutrients density they quote, which is the ratio of energy
    48        from fat, to obtain the total intake since this is often
    49        used, they quote, to make dietary recommendations.
    50 
    51        That is as much information as they actually give in the 
    52        paper regarding how they have divided the groups of 
    53        patients up into these five categories.
    54
    55   Q.   Might I suggest that you put to Dr. Arnott the conclusion
    56        you are aiming at because he may agree with me if it is
    57        related to whether, for instance, there might have been a
    58        very great or a very small difference or we just cannot
    59        tell from the report itself.
    60

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