Day 036 - 13 Oct 94 - Page 31


     
     1        1988.
     2
     3   MR. RAMPTON:  Though eight years may not be long enough in your
     4        view, Dr. Barnard, it is better than four, is it not?
     5        A.  It is longer than four.  It is hard to say if it is
     6        more relevant in terms of breast cancer risk, but eight
     7        years is longer than four ----
     8
     9   Q.   Do you know ----
    10        A. --- to state the obvious.
    11
    12   Q.   Do you know if this group is still under scrutiny by
    13        Dr. Willett and his team?
    14        A.  I believe they are continuing under scrutiny.  Whether
    15        there is going to be additional data adduced regarding
    16        breast cancer, I do not know.
    17
    18   Q.   I need not read the whole of the text of the abstract, we
    19        have all looked at it before.  As you said, it is very
    20        well known. I will just read the conclusions: "These data
    21        provide evidence against both an adverse influence of fat
    22        intake and (one must insert) against a protective effect
    23        of fibre consumption by middle-aged women on breast cancer
    24        incidence over eight years.  Nevertheless, the positive
    25        association between intake of animal fat and the risk of
    26        colon cancer observed in many studies provides ample
    27        reason to limit this source of energy".
    28
    29        Can I please ask you to turn to the Comment which is on
    30        page 2042 which is 388 stamped at the bottom in your
    31        copy?  "In this large prospective cohort study we found no
    32        evidence of any positive association between intake of
    33        total or specific types of fat and risk of breast cancer
    34        among either premenopausal or postmenopausal women.  Our
    35        inability to demonstrate the positive relation suggested
    36        by international correlations could not be explained by
    37        either imprecision in the measurement of fat intake or
    38        biased ascertainment of breast cancer.  These findings
    39        contrast with a clear positive association between total
    40        or animal fat intake and risk of colon cancer in the same
    41        cohort.    Our data, based on eight years of follow-up,
    42        cannot exclude a very weak association, an effect of fat
    43        intake earlier in life, or an influence of substantially
    44        lower levels of fat consumption, such as below 20 per cent
    45        of energy".
    46
    47        We have visited that point before, Dr. Barnard, but what
    48        I would like you to look at is this:  "However, this
    49        possibility would imply a non-linear relation, which is
    50        not suggested by the international correlations used to 
    51        formulate the hypothesis." 
    52 
    53        Dr. Barnard, do you understand that to mean this, that in
    54        Dr. Willett's view the international correlations suggest
    55        that the relationship between intake and incidence is
    56        directly proportional?
    57        A.  That is how he is interpreting it, yes.
    58
    59   Q.   If you were right about that, it would follow that you
    60        would expect to find, as he did in relation to colon

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