Day 031 - 05 Oct 94 - Page 07

     
     1        country to country and, as a product of that difference in
     2        distribution, he suggested that the only reason he could
     3        see for this contrast in distribution was that some 30 to
     4        about 70 per cent of the cause of cancer was related to
     5        the diets of the different countries.
     6
     7        Now, nothing really was picked up on that issue because
     8        the smoking issue came to the front as a consequence of
     9        Sir Richard Doll's work, and it was left more or less in
    10        the libraries.  But it began to be rehearsed again in the
    11        1970s.  It was not really until the 1980s Caroll and
    12        others -- I presented some of the epidemiological graphs
    13        which Caroll has published -- took up the issue again.  So
    14        it was really the end of the 70s and the beginning of the
    15        80s that the relationship between diet and cancer began to
    16        become an issue.
    17
    18   Q.   Can you go into a bit more detail about the sorts of
    19        evidence that have come up since then?
    20        A.  The evidence again is largely epidemiological, and
         I think my enclosure 1 presents Caroll's initial
    22        publication of the country to country evidence, which is
    23        very striking.  It related, interestingly enough, in a
    24        very similar way to the evidence in heart disease in the
    25        sense that the same countries that had the high incidence
    26        of cancer of the breast, colon and prostate were the same
    27        countries that had the high mortalities from heart
    28        disease.  And you just need to glance at enclosure 1 to
    29        recognise this fact.
    30
    31   Q.   Do you want to take the court to enclosure 1?  If it
    32        helps, I will hold it up.  It is the chart.
    33        A.  If you -----
    34
    35   MR. JUSTICE BELL:  Where has that come from?
    36
    37   MS. STEEL:   I gave you a copy of it the other day, directly
    38        behind his statement.
    39
    40   MR. JUSTICE BELL:  It is the one immediately behind the
         supplemental statement.
    42
    43   MS. STEEL:   Yes.
    44
    45   THE WITNESS:  What it shows, if you look at breast cancer, is
    46        that countries like Netherlands, Denmark, New Zealand,
    47        United Kingdom, United States, Ireland, Australia and
    48        Belgium are right at the top of the league; whereas
    49        countries like Japan and Thailand are very much at the
    50        bottom of the league with the Mediterranean countries 
    51        somewhat in the middle. 
    52 
    53        Essentially, this is the same kind of data that came out
    54        of Ancell Keys' Seven Countries study, which was published
    55        in the early 1950s which looked at the incidence in seven
    56        different countries, including the Mediterranean, Finland,
    57        United States and Japan, and, from the evidence in
    58        relation to heart disease (it was mortality evidence they
    59        were looking at) the conclusion was that the relationship
    60        that existed between heart disease and dietary fat intake