Day 022 - 12 Sep 94 - Page 47


     
     1        you had for supper on Monday of last week, if you think
     2        quite hard, you might not be able to remember then?
     3        A.  That is right.  This applies particularly, for
     4        example, when you look at elderly populations.  Their
     5        recall of diet may be, you know, very imperfect.  This is
     6        true particularly of the studies looking at prostate
     7        cancer which is, essentially, a disease of elderly men.
     8
     9   MR. MORRIS:  Although you said there are problems with
    10        population studies in changes of diet over a period of
    11        time, in some ways the cohort studies are relying on the
    12        individual recalling their diet over a long period of time
    13        and that would be one disadvantage of the studies that are
    14        based upon questionnaires?
    15        A.  Yes, whereas with the cohort studies you are actually
    16        asking them up front:  "What did you have in the last 24
    17        hours?" for example.  Then they often go and repeat the
    18        questionnaires at intervals to find out what, you know, to
    19        try to get some idea of pattern of diet.
    20
    21   Q.   I think I have finished on that chunk.  Perhaps we could
    22        have a minute to collect our thoughts?
    23
    24   MR. JUSTICE BELL:  Yes.  (Pause).
    25
    26   MR. MORRIS:  Could we have a five-minute break now?  Is it
    27        possible?
    28
    29   MR. JUSTICE BELL:  Yes, if you want it now, I will come back in
    30        five minutes.
    31
    32                       (Short Adjournment)
    33
    34   MR. MORRIS:  I want to go through some specific studies from
    35        your references.  I actually have a number on this.  It is
    36        Environmental Dietary Factors in colorectal cancer; Some
    37        Unresolved Issues, Wynder and Others.  It is No. 21.
    38
    39   MR. JUSTICE BELL:  Which one is this?  What is the reference?
    40
    41   MR. MORRIS:  No. 21.
    42
    43   MR. RAMPTON:  It is orange IV, part 2, tab 21.
    44
    45   MR. MORRIS:  It is No. 3.
    46
    47   MR. JUSTICE BELL:  Yes.
    48
    49   MR. MORRIS:  Orange No. IV is the actual bundle.  This is
    50        published in 1991 and the main person behind that is Ernst 
    51        Wynder; is that correct? 
    52        A.  That is correct. 
    53
    54   Q.   I think you have described him as a notable
    55        epidemiologist  ---
    56        A.  That is correct.
    57
    58   Q.   -- the last time.  If we look at page the conclusions, his
    59        conclusion is, or their conclusion is:  "Dietary factors
    60        play a key role in causation and prevention of large bowel

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