Day 023 - 13 Sep 94 - Page 15
1
2 MR. JUSTICE BELL: Had we not better look at the article
3 again? Had we not better look at it and see whether they
4 did actually point to lack of adequate nutrition as
5 opposed to anything less direct?
6 A. It is reference No. 8. Certainly, looking at the
7 summary, they comment that they hypothesize that the
8 diversity in nourishment may be of importance to women in
9 their peri-menarchal development.
10
11 MR. JUSTICE BELL: In the summary they refer to nationally
12 increased nutritional variability with reduction in
13 dietary fat and restricted caloric intake.
14
15 THE WITNESS: They were measuring body height, of course.
16
17 MR. JUSTICE BELL: Sorry?
18 A. They were measuring body height.
19
20 Q. Yes. Is there a particular point you want to put on the
21 article, Ms. Steel?
22
23 MS. STEEL: No. I looked at it and I could not see anything
24 indicating that they actually thought they were
25 malnourished, or whatever, as opposed to just having
26 restrictions in terms of they could not eat cream cakes
27 every day of the week, or whatever.
28
29 MR. JUSTICE BELL: How do you interpret, because you are giving
30 the evidence, Dr. Arnott, the relevance, if at all, of
31 restricted caloric intake and less fat?
32 A. Basically, what this is suggesting, and it is, they
33 admit, a hypothesis, they are suggesting that one of the
34 aspects in the development of breast cancer which may be
35 important is not what one does in later life necessarily,
36 but what is actually happening at a time when there are
37 substantial hormonal changes taking place in the body; in
38 other words, when one is in the pubertal or prepubertal
39 period. The point about this is that that could explain
40 why breast cancer incidence is lower in countries where
41 they expend more energy on working in the fields, for
42 example, food is not so plentiful and the menarche occurs
43 at an older age because of that. It was just a
44 question -- the point that was being made was that this is
45 a factor possibly explaining differences in breast cancer
46 incidence between under developed countries and developed
47 countries. It is not necessarily what is happening to
48 subsequent diet; it is what happens around a particular
49 time in one's life.
50
51 MR. JUSTICE BELL: Does it come to more than this, that the
52 diet they would have naturally had was interfered with or
53 may have been interfered with in some way?
54 A. In some way, yes.
55
56 Q. At a time when they were subjected to significant hormonal
57 changes?
58 A. Yes.
59
60 Q. Does it mean more than that?
