Day 023 - 13 Sep 94 - Page 11


     
     1        A.  Well, as far as colon cancer is concerned, people are
     2        not sure about other factors, but obesity may be a factor
     3        involved.  But one of the problems with colon cancer is
     4        that we are stuck with knowing exactly why people develop
     5        colon cancer.
     6
     7   Q.   So you are not aware of any studies regarding lifestyle
     8        that do not relate to diet in this context?
     9        A.  Well, it may not -- diet undoubtedly may change, that
    10        may be one factor; the level of activity of the people may
    11        change.
    12
    13   Q.   Are you aware of any studies putting that forward?  Can
    14        you name any studies?
    15        A.  People, well, epidemiologists have actually looked at
    16        the data that have come from the population studies and
    17        said:  "Just hang on a minute; it is not necessarily only
    18        diet that is changing or one aspect of the diet which is
    19        changing; it is a substantial change in lots of different
    20        things, such as the level of activity they undertake
    21        perhaps.  There may be some changes in diet, but it is not
    22        necessarily only, for example, fat that changes in the
    23        diet.  There are other factors which may change".  It is
    24        not just a straightforward simple correlation, for
    25        example, with fat.  There may be other factors.
    26
    27   MR. JUSTICE BELL:  What other factors are there?  Level of
    28        activity you have mentioned.
    29        A.  For example, they may drink more.  Alcohol has been
    30        implicated as a possible cause in colon cancer.  If
    31        somebody moves from a country where either alcohol is
    32        difficult to come by or very expensive and then moves to a
    33        country where it is relatively cheap and easily
    34        accessible, that will undoubtedly change.
    35
    36   Q.   I suppose alcohol could be considered to be part of diet,
    37        could it not?
    38        A.  Oh, yes.  What I am saying, though, is that if one
    39        looks at changes in diet that may occur -----
    40
    41   Q.   As I understand it, we are not necessarily on fat at the
    42        moment, we are just on diet.  That is what Ms. Steel has
    43        asked you about.  She may go on to be more specific, but
    44        at the moment she has just asked you about diet.  So you
    45        have mentioned activity.  Is there anything apart from
    46        diet and activity that has been promulgated as a possible
    47        cause or risk factor?
    48        A.  Well, other aspects in the diet are things such as the
    49        amount of fibre  -----
    50 
    51   Q.   No, other than activity and diet -- forget specific 
    52        factors of diet. 
    53        A.  No.
    54
    55   MR. JUSTICE BELL:  Does that answer the question you put
    56        originally, Ms. Steel?
    57
    58   MS. STEEL:   Sort of, yes.
    59
    60   MR. JUSTICE BELL:  You were asking whether there were other

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