Day 254 - 22 May 96 - Page 50


     
     1        through a whole range of fats, it mentions proteins,
     2        sucrose, vitamins, beta carotene, calcium, selenium, sodium
     3        and then it goes to overall conclusions. It is absolutely
     4        clear, is it not Dr. Arnott, that when they talk about
     5        "diet", they are not talking about alcohol or smoking or
     6        lifestyle?
     7
     8   MR. JUSTICE BELL:  Cut out "smoking" because I would not have
     9        thought smoking was part of your diet.
    10
    11   MR. MORRIS:  I would not have thought alcohol was either.
    12
    13   MR. JUSTICE BELL:  And I would not have thought "lifestyle" was.
    14          It might directly affect your diet, but you are
    15        suggesting that drinks are not part of diet, are you?
    16
    17   MS. STEEL:  I think the point is that they are not specifically
    18        looking at alcohol as one of the factors in this study, so
    19        when the summary is that the general consensus is "that
    20        diet is an important etiological component in
    21        carcinogenesis", they are not referring to alcohol in that
    22        statement.
    23
    24   MR. JUSTICE BELL:  What do you make of that?
    25        A.  I am sorry, I disagree.  I think alcohol is a component
    26        and that is why I said at the beginning one needs to look
    27        very carefully at the sorts of cancers one is talking
    28        about.
    29
    30        I think that the reason he has not discussed alcohol is, as
    31        I have said before, the situation regarding alcohol is
    32        fairly clear cut, that there is clear association between
    33        cancers of the mouth, the pharynx and the oesophagus with
    34        alcohol intake.
    35
    36        What he has spent most of his time discussing are the
    37        controversial areas, such as fat, and where in the studies
    38        that he quotes, interventional studies, where people have
    39        actually tried to add substances into the diet, such as
    40        beta, carotene, vitamins and so on, that these are the
    41        areas where the greatest degree of uncertainly lies and
    42        therefore he has spent most time discussing those points.
    43
    44   MS. STEEL:   Is there conclusive proof about alcohol then?
    45        A.  Yes, I would say there is.
    46
    47   Q.   So what is this conclusive proof?
    48        A.  Well, there are a number of studies which have looked
    49        at the variations in, for example, oesophageal cancer,
    50        cancer of the mouth, and cancer of the pharynx, and these 
    51        have consistently been shown to be related to alcohol 
    52        intake as well as cigarette smoking.  What most of the 
    53        studies have shown is that cigarette smoking seems to be an
    54        additive factor in all of these people.
    55
    56   Q.   So "consistent studies" means that there is conclusive
    57        proof?
    58        A.  Yes.
    59
    60   Q.   Right.  Were they cohort studies or what type of studies?

Prev Next Index