Day 023 - 13 Sep 94 - Page 15


     
     1
     2   MR. JUSTICE BELL:  Had we not better look at the article
     3        again?  Had we not better look at it and see whether they
     4        did actually point to lack of adequate nutrition as
     5        opposed to anything less direct?
     6        A.  It is reference No. 8. Certainly, looking at the
     7        summary, they comment that they hypothesize that the
     8        diversity in nourishment may be of importance to women in
     9        their peri-menarchal development.
    10
    11   MR. JUSTICE BELL:  In the summary they refer to nationally
    12        increased nutritional variability with reduction in
    13        dietary fat and restricted caloric intake.
    14
    15   THE WITNESS:  They were measuring body height, of course.
    16
    17   MR. JUSTICE BELL:  Sorry?
    18        A.  They were measuring body height.
    19
    20   Q.   Yes. Is there a particular point you want to put on the
    21        article, Ms. Steel?
    22
    23   MS. STEEL:   No.  I looked at it and I could not see anything
    24        indicating that they actually thought they were
    25        malnourished, or whatever, as opposed to just having
    26        restrictions in terms of they could not eat cream cakes
    27        every day of the week, or whatever.
    28
    29   MR. JUSTICE BELL:  How do you interpret, because you are giving
    30        the evidence, Dr. Arnott, the relevance, if at all, of
    31        restricted caloric intake and less fat?
    32        A.  Basically, what this is suggesting, and it is, they
    33        admit, a hypothesis, they are suggesting that one of the
    34        aspects in the development of breast cancer which may be
    35        important is not what one does in later life necessarily,
    36        but what is actually happening at a time when there are
    37        substantial hormonal changes taking place in the body; in
    38        other words, when one is in the pubertal or prepubertal
    39        period. The point about this is that that could explain
    40        why breast cancer incidence is lower in countries where
    41        they expend more energy on working in the fields, for
    42        example, food is not so plentiful and the menarche occurs
    43        at an older age because of that.  It was just a
    44        question -- the point that was being made was that this is
    45        a factor possibly explaining differences in breast cancer
    46        incidence between under developed countries and developed
    47        countries.  It is not necessarily what is happening to
    48        subsequent diet; it is what happens around a particular
    49        time in one's life.
    50 
    51   MR. JUSTICE BELL:  Does it come to more than this, that the 
    52        diet they would have naturally had was interfered with or 
    53        may have been interfered with in some way?
    54        A.  In some way, yes.
    55
    56   Q.   At a time when they were subjected to significant hormonal
    57        changes?
    58        A.  Yes.
    59
    60   Q.   Does it mean more than that?

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