Day 035 - 12 Oct 94 - Page 42


     
     1        just have been in that Norwegian paper that what happened
     2        was they did not have as much food as they might have
     3        liked up until 1945, which was the time up to, including
     4        immediately after menarche, and then they got much more
     5        food and ended up taller than people who were a little
     6        older may have been?
     7
     8   MR. RAMPTON:  My Lord, I have a feeling but I will come back to
     9        it obviously at some stage that -----
    10
    11   MR. JUSTICE BELL:  Just bear it in mind rather than stop now.
    12        I will look at the paper again.  I was left with the
    13        feeling that the greater height may have been coincidental
    14        to the hormonal factors which I have touched on.
    15
    16   MR. RAMPTON:  My Lord, that may be right.
    17
    18   MR. JUSTICE BELL:  And the height may have had nothing to do
    19        with any causal factor at the end of the day.
    20
    21   MR. RAMPTON:  I did not suggest that.  I believe that I have
    22        seen a number of statements in these papers -- I cannot
    23        find the references now -- where height has been
    24        identified as one of the factors which is
    25        epidemiologically, not causal, associated with a higher
    26        incidence of breast cancer, not simply that Norwegian
    27        paper.
    28
    29   MR. JUSTICE BELL:  Yes.  I have a vague recollection of
    30        Dr. Arnott's answer to you on that, but I cannot remember
    31        in detail what it was.
    32
    33   MR. RAMPTON:  One can certainly go back to it.  (To the
    34        witness): Another factor which has been identified, has it
    35        not, Dr. Barnard, as being relevant to the incidence of
    36        breast cancer is the age at menopause; the later the
    37        menopause, the greater the risk?
    38        A.  There are any number of -- yes, individuals have
    39        talked about that.  However, all of these factors are far
    40        more controversial, if I may say so, than the ones that
    41        have been discussed so far.  The role of height, I think,
    42        is precisely as your Honour has described it.  The role of
    43        multiple births is an area that is fraught with
    44        controversy.  So, yes, people do speculate about such
    45        things.  What to make of them and what public health
    46        information may be useful is another matter.
    47
    48   Q.   Leaving height and age at menopause perhaps on one side
    49        for the moment, the age at which a person gets married and
    50        the number of children which that woman decides to have no 
    51        relationship with diet, do they?  They are social effects, 
    52        are they not? 
    53        A.  That is right.
    54
    55   Q.   It is right to say, is it not, that in Western societies
    56        -- this is a generalisation -- generally women are
    57        tending to get married later and have fewer children than
    58        people in what one might call the developing or
    59        under-developed countries?
    60        A.  In some cases that is true.

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