Day 023 - 13 Sep 94 - Page 13
1 decreased over the last 20 years or so. Also -----
2
3 Q. Right. You agreed yesterday that cancer can take ---
4 A. Yes.
5
6 Q. -- is likely to take a long time to develop?
7 A. The other thing is that the differences in fat intake
8 may be less marked than obviously appear to be the case
9 from just looking at crude food balance tables where
10 wastage is not taken into account.
11
12 Q. But is it not fairly obvious to anybody working in the
13 field, you know, from organisations such as the World
14 Health Organisation or similar, that the type of diet
15 eaten by people in, say, the USA or other western
16 developed countries is far richer, they eat far more fat
17 and sugar and things like that than, for example, the
18 population of Africa, or something like that. Is that not
19 something that is pretty obvious?
20
21 MR. MORRIS: Accepted?
22 A. Yes, there are differences in the diet, obviously,
23 that is why people have tried to say that it is these
24 differences in diet which can account for the different
25 levels of cancer we see in these countries. That is why
26 people have then gone on to try to carry out these
27 studies, either case-control studies or cohort studies,
28 prospective studies, to try to see whether this apparent
29 relationship is, in fact, a real relationship. That is
30 where the problem has begun.
31
32 MR. JUSTICE BELL: Sit down and look at your notes. (Pause).
33
34 MS. STEEL: When you were talking about menarche, you
35 mentioned something about nutritional deprivation, but
36 would you agree that rather than saying people who are
37 nutritionally deprived delay the start of menstruation, it
38 might be more accurate to say that over nutrition gives
39 rise to earlier menarche?
40 A. No, I do not think you can say that.
41
42 Q. You do not think so?
43 A. No, most of the studies which have tried to look at
44 this have looked at populations where there is energy
45 restriction, you know, in South East Asia before it
46 started to become developed Africa and so on, and it is
47 from that point that the hypothesis has developed that
48 people being better nourished may lead to the menarche
49 occurring at an earlier age.
50
51 Q. But are they necessarily better nourished or is it that we
52 are over nourished? I understand that over-nutrition in
53 western society is one of the main concerns in diet rather
54 than malnutrition.
55 A. I think it is a question of what you mean by
56 "over-nutrition". Certainly, if you get to the point of
57 obesity, we do know that obesity is harmful. Whatever may
58 be the cause of obesity, it is not just, for example, fat
59 intake that is related to obesity. It is all aspects of
60 our diet, and there is also a relationship with activity,
