Day 034 - 11 Oct 94 - Page 17
1 I will restrict my attention to pages 205 and 206. Then
2 I will hand it back. I will obviously get a photocopy in
3 due course.
4
5 MR. RAMPTON: If your Lordship would, because I am going to use
6 it for cross-examination.
7
8 MR. JUSTICE BELL: I have it now. Do you not have a copy?
9
10 MR. MORRIS: I have not a copy, but I am sure the witness will
11 be able to take us through it.
12 A. All right. Yes. Let me do so briefly. I regret to
13 say I did not review this last night, so I am looking at
14 it for the first time as well in a long time. But again,
15 when the Surgeon General lays out these charts, he does it
16 in the same way where the studies are grouped according to
17 the way the study is conducted. A variety of studies are
18 listed down the left-hand column and the positive or
19 negative link with various dietary constituents is noted.
20
21 Q. Can I ask again, would the same apply that these would be
22 the most authoritative studies that were available?
23 A. Yes, these would be considered objective, well done
24 authoritative studies, but not chosen with any bias or to
25 support one or another viewpoint. This study -- this
26 table 4.9 the summary of epidemiologic studies examining
27 dietary fibre in colon cancer. The first thing one
28 notices when one glances at the chart on page 205 is that
29 there are a lot of minuses, no pluses, and there are a lot
30 of minuses on the next page as well, although there are a
31 couple of pluses.
32
33 The minus sign indicates an inverse relationship between
34 one or another type of dietary fibre and the incidence of
35 colon cancer. In looking at the international correlation
36 studies, in looking at the within country correlation
37 studies and other types of correlation studies, metabolic,
38 time-trend correlation studies on that page, putting these
39 all together one sees -- I have to count them up -- but
40 there are a good number, perhaps 15 or more studies that
41 have shown a negative relationship, an inverse
42 relationship, meaning the more fibre in the diet the lower
43 the risk of colon cancer, indicating a protective effect.
44
45 In the first category, international correlation studies,
46 there are seven studies; three of them looked simply at
47 total fibre not reporting a particular type; two of those
48 found an inverse or, if you will, protective effect of
49 dietary fibre. One did not find a significant
50 relationship.
51
52 Four studies looked specifically at cereal fibres and all
53 four found a protective relationship. Two of those looked
54 also at vegetables, vegetable fibre, and found that
55 vegetable fibre was protective. None of these studies
56 combined the effects of fibre and fat.
57
58 Much the same pattern holds true, again with the within
59 country correlation studies in the next column. Six
60 studies looked at total fibre. Of those six one did not
