Day 034 - 11 Oct 94 - Page 44


     
     1        of serious illness.
     2
     3   MR. JUSTICE BELL:  Just pause there, please.  Why do you draw
     4        that conclusion?  Somewhere else when I was looking at
     5        various papers overnight, I saw a quote about people's
     6        reluctance to change their diet which may just be a fact
     7        of life, even if there is a risk, and it explained to you
     8        that people will shrug and say:  "I am prepared to carry
     9        on eating what I want to eat"?
    10        A.  Yes.  I think there are two different factors.  The
    11        first is:  Does a person even have awareness of the links
    12        between what they eat and their subsequent health risk?
    13        The second question is:  Are they motivated to actually
    14        take advantage of that information?  This series of
    15        questions that I described simply went to the first of
    16        those points, that in this sample of American women, which
    17        we believed was a representative sample, taken at that
    18        time showed that American women were not even aware that
    19        there would be any benefit or even a potential benefit
    20        from reducing their fat intake with regards to their
    21        subsequent risk of breast cancer.  So, they did not even
    22        have the luxury of deciding to take advantage of it or to
    23        ignore that information.
    24
    25   MR. JUSTICE BELL:  What I asked was directed at your follow-up
    26        question, the answers to it and the conclusion you drew
    27        from that.  Can you remember what you said?
    28        A.  What I was intending to say was that, according to our
    29        survey results, this group of women did not have the
    30        information that they might need to even make an informed
    31        decision regarding diet.  So, they were unable -- so the
    32        question of motivation could not even be addressed.
    33
    34   MR. MORRIS:  Sorry, the second question you asked.   I just
    35        want to outline that again?
    36
    37   MR. JUSTICE BELL:  Let me read back what we have.  "We also
    38        then asked a follow-up question prompting the women who
    39        were telephoned in a randomly generated list:  Were they
    40        aware that reducing fat in the diet might reduce the risk
    41        of breast cancer?  And even with that degree of prompting,
    42        simply asking them to say 'yes' or 'no', still only about
    43        half were able to respond positively to that statement."
    44        A.  Yes.  Let me make sure that I am clear.  We were not
    45        asking them if they wanted to change their diets or if
    46        they thought that their children should change their
    47        diets, or if they thought it was advisable.  We were
    48        simply asking them if they were aware that reducing the
    49        fat intake of the diet might reduce breast cancer risk.
    50 
    51        But you are quite right, my Lord, that there can be or 
    52        there is, quite often, natural reluctance to modify the 
    53        diet even if there may be health benefits.  Much of the
    54        research I have been conducting has identified specific
    55        factors that facilitate that sort of change.  We have
    56        identified specific factors that make dietary change
    57        something that people are much more likely to take
    58        advantage of.  In fact, the article I mentioned which is
    59        going to be published in a November publication of the
    60        American Medical Association called The Archives of Family

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