Day 034 - 11 Oct 94 - Page 03

     
     1   Q.   We will do it one by one.  It is pages 194 to 197, 198
     2        maybe, I do not know?
     3        A.  Yes, I have those pages.
     4
     5   Q.   Do you want to take us through the sections which you feel
     6        are important and read out anything you particularly think
     7        is important?
     8        A.  Yes, thank you.
     9
    10   Q.   It is No. 7 in the list.  I think I did copy the
    11        introductory section as well.
    12
    13   MR. JUSTICE BELL:  I come to 6, Cancer of the Colon and Rectum.
    14
    15   MR. RAMPTON:  My Lord, I do not know whether this would be
    16        helpful or not.  We have, in fact, made our own copy of
    17        this.  I have not got that section of the Defendants'
    18        discovery, but what we have done is to copy the whole (or
    19        most of the whole) of the early part of the work and the
    20        whole of the chapter on cancer, which is chapter 4.  That
         is in a file of its own, or should be.  I am sorry.
    22        I will sit down.  I thought there was more than one copy.
    23
    24   MR. JUSTICE BELL:  Let us see how we go. I have found it now.
    25
    26   MR. MORRIS:  We are referring to specifically the last pages
    27        194 to 198, Role of Dietary Fats in Cancer.
    28        (To the witness):  Dr. Barnard, would you like to take us
    29        through the relevant passages?
    30        A.  Yes.  The first thing that is, perhaps, worth taking
    31        note of is the date of the document, 1988.  It was issued
    32        by the Surgeon General of the United States, C. Everett
    33        Koop, and reflects -- it is an official US government
    34        document.
    35
    36        I would just like to go through two or three paragraphs on
    37        page 194 under the heading The Role of Dietary Fats in
    38        Cancer, where the Surgeon General takes note of the fact
    39        that data on dietary fat and cancer is not entirely
    40        perfect with regard to explanation of the mechanisms
         involved, but that the role is sufficiently solid that
    42        causation is very strongly suspected -- let me quote:
    43         "Despite some inconsistencies in the data relating
    44        dietary fat to cancer causation, animal studies show an
    45        effect on carcinogenesis" -- which means the origin of
    46        cancer or cause of cancer -- "and support a
    47        cancer-promoting role, and international epidemiologic
    48        studies have suggested that differences in dietary fat
    49        intake may provide a meaningful key to prevention of
    50        cancer.  For example, substantial epidemiologic and animal 
    51        evidence supports a relationship between dietary fat and 
    52        the incidence of both breast cancer".  He makes a 
    53        reference to K-A-K-A-R, I guess KAKAR, and Henderson
    54        1985.  Now quoting again:  "...  and colon" -- referring
    55        to work of Kolonel and Le Marchand.  "Indeed, a comparison
    56        of populations indicates that death rates for cancers of
    57        the breast, colon and prostate, are directly proportional
    58        to estimated dietary fat intakes".
    59
    60        Perhaps it would be easier if I do not read through the