Day 256 - 04 Jun 96 - Page 59
1 A. Yes, I say that there is a general consensus of
2 opinion. The strength of the association has been debated
3 quite vigorously.
4
5 Q. Yes. Association is one thing. As we noticed before,
6 there is an association between telegraph poles and heart
7 disease, whatever it was. Causation of is quite another
8 thing; do you agree?
9 A. Yes.
10
11 MR. JUSTICE BELL: I would like to ask a question, Mr. Rampton,
12 while it is on my mind.
13
14 Are you saying that that is actually the intake of fat
15 itself, or might it be, even for someone who holds your
16 general view of the topic, that if you get less of your
17 energy from fat, and particularly if you get less of your
18 total energy from animal fat, you are likely, if you are
19 not to be short of calories altogether, to eat far more
20 vegetable matter and complicated carbohydrates, and so on,
21 which you would say (and others would say) may very well
22 have a protective element in them, and in China, in
23 particular, may have an extra protective effect because of
24 the particular kinds of vegetables, fibre, whatever, which
25 they have in their diet and which we would not, even if we
26 were vegetarian or vegan in this country, have in ours,
27 because we would be eating different vegetables? It is a
28 rather long question, but do you understand what I am
29 putting to you? In other words, do you say it is actual
30 fat which has the causative effect, or is it a remove from
31 that: if you eat less fat, particularly if you eat less
32 animal fat, you eat more vegetables, you get more of your
33 energy from complicated carbohydrates, and that has a
34 protective effect?
35 A. Yes, I agree with everything you said. I think you put
36 it quite well.
37
38 Q. Is that what you are -- I will say it again, because
39 I thought I was putting an alternative view for you to
40 choose. Are you saying that ingestion of fat, and
41 particularly ingestion of animal fat, has a causative
42 effect on its own, or are you saying that it has an
43 indirect causative effect, in that if you eat a lot of
44 animal fat you are going to eat less vegetable matter and
45 fibre and, therefore, there is a less protective effect?
46 A. Both. I have used the term "aggregate" on a number of
47 occasions, and that is what I mean by that term; that, in
48 addition to the enhancement of cancer risk by dietary fat
49 alone, we also see all of these other things tended to
50 operate at the same time. So, as we look across, let us
51 say, many cultures, with widely varying fat intakes, and we
52 see this very strong and impressive association between
53 dietary fat intake and breast cancer, for example, or colon
54 cancer, we have to take into consideration what you just
55 said, namely, that there is a contribution of fat itself;
56 in some cases it is purely modest, if you will, and in some
57 kind of cases it may be more substantial, but it is also a
58 contribution to an increase in cancer risk in any case; and
59 at the same time, in all these other things that are being
60 displaced by the consumption of fat, are surely
