Day 017 - 25 Jul 94 - Page 27


     
     1        A.  Yes, that is right.  I think, undoubtedly, diet is
              difficult to recall, I think, at the best of times.  I
     2        mean, if one tries to think of one's own diet, even what
              did you eat last week, I mean, it is not necessarily that
     3        straightforward.  People who develop cancer undoubtedly do
              modify their diet either subconsciously or consciously.
     4        That, in itself, can actually influence their recall about
              what they ate before.  It can, for example, have an
     5        adverse effect; they may thought that their diet was
              terribly bad beforehand because there are all sorts of
     6        emotions engendered by the development of cancer and the
              knowledge that you have cancer.  It may be that they have,
     7        for example, said:  "Oh, the diet I had before was
              terrible" and it can, therefore, influence the way in
     8        which they respond to these questions.
 
     9   MR. RAMPTON: "Hirayama (1978) provided the first relevant data
              of this type from two studies in Japan, both started in
    10        the mid-1960s.  In a large mortality study covering
              different parts of Japan, women who ate meat daily had a
    11        60% greater mortality from breast cancer (based on 14
              deaths) than those who seldom ate meat (no details were
    12        presented about women in intermediate categories of meat
              consumption).  The other Japanese study concerned breast
    13        cancer incidence in Hiroshima, in which an increased
              relative risk of 3.8 was found for 'almost daily' meat
    14        consumption, though the confidence limits were wide.
 
    15        I do not know if you have explained confidence limits, but
              there again perhaps we ought to know precisely what that
    16        phrase means?
              A.  Well, it basically in, sort of, simple language it
    17        means that when you are measuring a result there is always
              the possibility that it may have arisen by chance, and if
    18        you have wide confidence limits, that means that there is
              a very wide range of possibility that the finding that you
    19        have arose purely by chance.
 
    20        When the confidence limits are narrow, that means your
              data are much harder; that there is only a relatively
    21        small risk of that event that you are measuring having
              arisen by chance.  It is a sort of concise way of just
    22        defining whether the thing could have arisen by chance or
              whether it is more likely or not to have arisen by chance.
    23
         Q.   Thank you.  Dr. Kinlen goes on:  "Since then three other
    24        studies have been reported - one from Britain and two from
              the USA - and in contrast, their findings have all been
    25        negative".   We will look at table 2 which is over the
              page in a moment, Dr. Arnott.  " A study of members of 
    26        religious orders who ate no meat and relatively little fat 
              from other sources yielded 31 deaths from breast cancer, 
    27        compared with an expected number of 35.8 based on the
              mortality of single women in the general population of
    28        Britain".  That is a piece of work apparently done by
              Dr. Kinlen himself in 1982.
    29
              "Similarly, in California, no significant differences
    30        were found in breast cancer mortality among Adventists who
              seldom ate meat (81 deaths) compared with those who ate

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