Day 017 - 25 Jul 94 - Page 23


     
     1        in Norway during the war, 1940 to 1945?
              A.  Yes.
     2
         Q.   But that after the war they started eating better.  Can
     3        one draw -- this is an example perhaps of something you
              were saying earlier -- from that the certain conclusion
     4        that girls at the peripubertal stage of their lives ought
              to restrict their intake of calories or of fat?
     5        A.  I do not think one can draw that particular
              conclusion.  What this suggests to me is that this is an
     6        interesting finding and obviously requires further
              investigation.  They have made the hypothesis that the
     7        change in diet and the better feeding that occurred after
              the war led to the development of people with greater
     8        height, but that this change occurred at a sensitive time
              in their life-span.  In other words, when they were
     9        changing from pre-pubertal to a post-pubertal woman.  But
              again it is a theory, and it is something that -- my
    10        feeling would be it is an interesting one and it requires
              further investigation, without it being conclusive.
    11
         Q.   Can we go back, please, to Dr. Kinlen's study at page 587
    12        underneath the table: "Migrant studies.  Another series of
              observations which has encouraged the view that fat is a
    13        cause of breast cancer concerns the Japanese in the United
              States, whose fat intake is known to have increased. This
    14        group has shown an increasing incidence of the disease
              from the very low levels characteristic of Japan, although
    15        at older ages the levels are still appreciably below those
              in the USA generally. These observations, together with
    16        the geographic correlations, reasonably suggest the
              hypothesis that fat is a cause of breast cancer.  To
    17        become compelling, however, evidence from studies of
              individual women is needed.
    18
              Studies of individuals.  1.  Case-control studies.
    19
              At least six case-control studies relevant to fat and
    20        breast cancer have been reported, though some of these
              have concerned meat, a major source of saturated fat in
    21        most Western countries, rather than fat per se".
 
    22        If one turns over the page one can see table 1 and one can
              see what these case control studies mentioned actually
    23        produced.  Miller produced a positive association by only
              one of three methods, right?
    24        A.  Correct.
 
    25   Q.   Lubin did with a population study and the answer is "yes,
              but see text", so we will have to go back to that.  Graham 
    26        produced no positive association.  Hirohata did not either 
              in either of his studies, and Lubin in 1986, which was 
    27        five years after his first study, found it only in
              subgroups.
    28
              Going back to page 587:  "The first such study was carried
    29        out in four areas of Canada by Miller and his colleagues
              (1978), and its findings were reported as supporting the
    30        causal hypothesis.  The study involved a 24-hour recall
              and a four day record of diet about six months after

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