Day 256 - 04 Jun 96 - Page 84
1 MR. JUSTICE BELL: This is, as you pointed out, the overall
2 diet?
3 A. Yes, of which fat is a part and a contributor.
4
5 MR. MORRIS: So, are you saying there is a direct relationship
6 which is a causal relationship between fat and breast
7 cancer?
8 A. Yes.
9
10 Q. And between fat and colon cancer?
11 A. Yes.
12
13 MS. STEEL: And the same for animal products?
14 A. Especially for animal products; more so, in fact.
15
16 MR. MORRIS: Right. Your comment about cohort studies and you
17 talk about the so-called confounding variables that are
18 diet related being removed, which you said obscures the
19 results -- if those confounding variables, so-called
20 confounding variables are not removed, do the cohort
21 studies then show a relationship, for example, between fat
22 consumption and breast cancer, when the other dietary
23 related variables are included and not adjusted?
24 A. The best example I think I can refer to in this
25 particular case is the paper we had before, Shanghai and
26 Tianjin -- comparisons. I cannot speak to the seven study
27 report of Hunter and Company,.
28
29 Q. But for that other paper that was put to you?
30 A. Yes. I mean, in general, this is the way it has always
31 tended to be, in promotion of these studies; you begin to
32 control and you adjust to these factors. They actually
33 are, themselves, the result of, let us say, the high fat
34 intake. One begins to remove the effect that is actually
35 seen.
36
37 Q. You say that would be shown in those tables that we looked
38 at?
39 A. Definitely in the Shanghai and Tianjin; it speaks
40 specifically to that one; it is a good illustration.
41
42 MR. JUSTICE BELL: Let me ask a question before Ms. Steel and
43 Mr. Morris conclude their re-examination. You said that
44 the chances of diet not being causal in cancer of the
45 breast and bowel was one in 1,000?
46 A. Roughly. I have actually done this kind of analysis
47 before.
48
49 Q. Yes. But you were not then restricting yourself -- you
50 were not saying fat in the diet; or were you?
51 A. No. I was speaking more comprehensively, in the total
52 diet. I was speaking of high fat diets that are high fat
53 because of the consumption of animal foods.
54
55 Q. So, you say with a high fat diet, including animal products
56 ---
57 A. Yes.
58
59 Q. -- the chances of a high fat diet, including animal
60 products, not being causal of cancer of the breast and
