Day 031 - 05 Oct 94 - Page 19
1 MS. STEEL: What would you say to respond to the suggestion
2 that there was no compelling evidence that cancer was
3 either caused or promoted by aspects of diet?
4 A. That statement is clearly wrong. The experimental
5 evidence is quite firm on the promotory effects of cancer,
6 particularly total fat, and also on the protective effects
7 of n-3 fatty acids.
8
9 I think I would argue that the epidemiological evidence,
10 and the parallels which we see with heart disease, provide
11 a compelling body of evidence that the diet, that the
12 modern western diet, as we perceive it, is, I think you
13 could use the word "causative" of the promotion of
14 cancer. It does not cause the cancer; I do not think we
15 could say it causes the cancer. But once the cancer is
16 established, and you have the genetic susceptibility to it
17 in place, then I think the diet that you eat matters a
18 very great deal.
19
20 I think that is the conclusion that most of the expert
21 bodies have derived in so far as they are consistently
22 recommending, in the interests of relieving the burden of
23 cancer, they are consistently recommending a reduction in
24 total fat, and the Scottish one (which is the most recent
25 one) adds a reduction in particularly saturated fats.
26 They make other recommendations as far as diet is
27 concerned which are complimentary to this particular
28 dietary recommendation.
29
30 So, I think it would not just be me who says the evidence
31 is compelling. I think these expert bodies who are making
32 recommendations to the public and in general to government
33 that it would be prudent and wise to reduce the total
34 amount of fat, particularly saturated fats. I think that
35 illustrates their conviction that the evidence is
36 sufficiently compelling to make those recommendations to
37 the public.
38
39 Q. Is that why on page 4 where you are talking about a test
40 to see if you could establish, if the incidence of heart
41 disease and cancer was greater in a group fed a high fat
42 diet for 20 years -- you have just gone into the reason
43 why you say that on the basis of present evidence it is
44 highly improbable that any ethical committee would allow
45 such a trial?
46 A. Yes, I am not sure that I would ----.
47
48 Q. I might be wording this wrongly. I am sorry.
49 A. - I would include that statement again if I rewrote
50 this document, but it was an attempt to try to highlight
51 the balance of evidence, that if you presented the case to
52 an ethical committee, as we all have to do before we
53 conduct a clinical trial, if you presented a case for a
54 study in which you were going to propose that a number of
55 children were fed the highest level of fat as we have it
56 today, particularly the highest level of saturated fat for
57 a period of 20 years compared with a "prudent diet", I do
58 not think that study would get through an ethical
59 committee. That is actually an opinion which -- I do not
60 know how much weight you put on it, but it is my opinion.
