Day 036 - 13 Oct 94 - Page 07


     
     1        cancers in women are attributable to diet".  I can tell
     2        you that reference 46 there is the work of Doll and Peto
     3        in 1981 as it so frequently is given for that estimate, is
     4        it not?
     5        A.  Yes.
     6
     7   Q.   "The evidence for the influence of diet on cancer is
     8        derived from several sources.  Correlations between
     9        national and regional food consumption data and cancer
    10        rates and studies of the changing rates of cancer in
    11        populations as they migrate from a region or country of
    12        one dietary culture to another have led to many important
    13        hypotheses" -- I ask you to note the word "hypotheses" --
    14        "case-control studies of the dietary habits of cancer
    15        patients in comparison subjects and prospective studies of
    16        populations with known dietary habits provide stronger
    17        evidence for the effects of diet in relation to major
    18        cancers".  Pausing there, do you agree or disagree with
    19        that sentence in this report?
    20        A.  The only change that I would make is, before the word
    21        "provide", I might add the word "may" because in some
    22        cases case-control studies and prospective studies do not
    23        provide additional evidence and in some cases they do.
    24
    25   Q.   I am going to come later on today to one of the supposed
    26        defects in cohort studies, but we will leave that for the
    27        moment.  It goes on:  "Many of these observations for
    28        human populations have been supported by animal
    29        experimental data.  Studies of diet in relation to some
    30        cancers have been confined to relatively homogeneous
    31        populations and have not been replicated across a range of
    32        cultural and dietary settings.  For other cancers the
    33        research has been pursued over a wider range of dietary
    34        intakes.  Included among the cancers that have been linked
    35        repeatedly to dietary factors and in different populations
    36        cancers of the oral cavity, pharynx, larynx, oesophagus,
    37        stomach, large bowel, liver, pancreas, lung, breast,
    38        endometrium and prostate".  Is there anything in that
    39        paragraph with which you would disagree?
    40        A.  No.
    41
    42   Q.   No.  I would like you to turn, please, to page 91 where
    43        elements in the diet are considered.  The first one which
    44        was considered was dietary energy on page 89.  I do not
    45        require any reference to that, but I would like you to
    46        look at paragraph headed 4.1.2. Fat Consumption on page
    47        91.  May I read it to you?
    48        A.  Please.
    49
    50   Q.   "As the total fat content of the diet increases, an 
    51        increasing proportion of persons within the population, 
    52        including particularly the most susceptible individuals 
    53        within that population".  Pausing there, Dr. Barnard, do
    54        you agree that (this is dealing with obesity), so far as
    55        obesity is concerned, there are individuals within
    56        societies who are more naturally susceptible to obesity
    57        than others?
    58        A.  Well, everyone has the potential to gain substantial
    59        amounts of weight.  Certain people are particularly
    60        susceptible to that; yes, correct.

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