Day 023 - 13 Sep 94 - Page 12


     
     1        factors apart from diet?
     2
     3   MS. STEEL:  I lost the bit about alcohol actually.
     4        A.  Alcohol has been implicated.
     5
     6   Q.   In many studies?
     7        A.  Yes, in quite a few studies.
     8
     9   Q.   As many as diet overall?
    10        A.  Well, one of the problems is that a lot of the studies
    11        have looked at diet overall and, you know, they then
    12        said:  "Well, look, these people have fat, a high fat
    13        intake", but they also have other factors.  Fat is not
    14        just the single factor they have looked at.  So many of
    15        them have looked at alcohol at the same time they have
    16        looked at fat.
    17
    18   Q.   Is alcohol something that is proposed as a cause of colon
    19        cancer in particular?
    20        A.  The arguments surrounding alcohol and colon cancer are
    21        as controversial and contradictory as the articles
    22        surrounding fat and colon cancer.
    23
    24   MR. JUSTICE BELL:  Can I just -- then Ms. Steel will ask you
    25        further questions, but what we have come to at the moment
    26        is that with cancer of the colon there may be a genetic
    27        cause which is sufficient in itself?
    28        A.  Yes.
    29
    30   Q.   Whatever you drink or whatever your level of activity?
    31        A.  Yes.
    32
    33   Q.   Apart from diet, level of activity has attracted attention
    34        as a possible cause?
    35        A.  It has, yes.
    36
    37   Q.   Within the diet fat has attracted attention; alcohol has
    38        attracted attention; fruit and vegetables have attracted
    39        attention as having -----
    40        A.  Protective.
    41
    42   Q.   -- protective.  That is where we have got to?
    43        A.  And fibre.
    44
    45   Q.   And fibre.
    46
    47   MS. STEEL:   There is an odd question.  I do not know whether
    48        it actually fits in here, but when you were referring to
    49        limitations with population studies because they do not
    50        take account of wastage, do you think -- were you trying 
    51        to suggest that if wastage was taken into account then 
    52        western developed countries would have a lower intake 
    53        than, say, what we call Third World countries or whatever?
    54        A.  No, I am not suggesting that.  What I am suggesting is
    55        that the intake of fat is not necessarily constant.  There
    56        may well be changes in fat intake in western countries
    57        which are difficult to actually detect, because in the
    58        most developed countries there is a lot of food wastage.
    59        So that is one factor.  There is some evidence, for
    60        example, in the United States that fat intake has

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