Day 036 - 13 Oct 94 - Page 20


     
     1        polyunsaturated fat."  That is what you have just drawn
     2        our attention to, is it not, in the table?
     3        A.  Yes.
     4
     5   Q.   "Other well-established breast cancer risk factors were
     6        evident in this cohort of postmenopausal women and have
     7        been reported previously; thus, this cohort was not
     8        otherwise atypical with regard to breast cancer risk.
     9
    10        One perplexing finding concerns the effects of different
    11        methods of adjustment for total energy intake.
    12        Specifically, different procedures for energy adjustment
    13        gave different impressions of the dietary fat-breast
    14        cancer association, not so much in the strength of the
    15        association, which was relatively weak in all analyses,
    16        but in the shape of the exposure-outcome relationship."
    17        I read that, Dr. Barnard, because I did not understand it
    18        and I wondered if you could help us to explain it?
    19        A.  Let me take a look at that sentence and I would be
    20        pleased to.
    21
    22   MR. JUSTICE BELL:  I have a theory myself, but I am sure yours
    23        is more valuable, Dr. Barnard.  What occurred to me is it
    24        is not so much the strength of the association which was
    25        relatively weak in all analyses, but in the feature which
    26        Mr. Rampton was putting to you, "the shape of the
    27        exposure", that is, the intake, which quartile of intake
    28        of fat you are in, as against the outcome, the
    29        relationship between those two?
    30        A.  Yes, I am sure you are right.
    31
    32   MR. RAMPTON:  That is what I hoped you would say; it is the
    33        curious bumps and wobbles in the graph, if one drew it,
    34        that they find puzzling; is that right?
    35        A.  Yes.
    36
    37   Q.   Never mind which kind of analysis one used.  Can I jump
    38        on, because I am conscious of the need to save as much
    39        time as can I.
    40
    41   MR. JUSTICE BELL:  Are you going to another paper?
    42
    43   MR. RAMPTON:  No, I am going to deal with this paper a little
    44        bit further, if I may.  I think it is in fairness to the
    45        witness.
    46
    47   MR. JUSTICE BELL:  We will have our break when we have finished
    48        with this paper.
    49
    50   MR. RAMPTON:  Very well, my Lord.  Can you go to the top of 
    51        page -- it is the one after the tables -- 513. 
    52        A.  Yes. 
    53
    54   Q.   513 stamped at the bottom of the page.  Again, I am doing
    55        this because I think it fair to you that I should and
    56        because it may help his Lordship in the end.  It starts
    57        right at the top of the left-hand column, "Two limitations
    58        in the ability"; have you got that?
    59        A.  Yes.
    60

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