Day 030 - 03 Oct 94 - Page 24
1 that came out. Usually what happens, which I think is
2 really rather a matter of common sense, is that when
3 experts are invited to judge on an issue which is
4 relatively new -- diet and cancer is an example -- the
5 link between specific diet and specific cancers the point
6 at which, as I say, the evidence on that was regarded as a
7 good enough basis to make judgments was 1982. There were
8 many individual scientists who thought the same. In fact,
9 it goes back to Peri Celsus(?) I think, but this was the
10 first time an expert committee took the view.
11
12 In a case like that, what they did was to issue what they
13 termed "interim dietary guidelines". If you look for what
14 they mean by proof, actually reading the documents, if you
15 like, from a lawyer's point of view, I think it would be
16 fair to say that, on the whole, they felt that the
17 evidence fell somewhere between balance of probability and
18 proof beyond reasonable doubt. But as time goes on, and
19 as more reports come out on this or on other subjects --
20 diet and heart disease is another example -- generally
21 speaking, the judgment and the confidence of the committee
22 becomes -- the evidence becomes stronger, the judgment
23 becomes more confident.
24
25 Q. So, concentrating on US government recommendations and the
26 World Health Organisation recommendations, which we will
27 come to in detail a bit later, they are not interim
28 guidelines?
29 A. No.
30
31 Q. Are they both ----?
32 A. No. Let me comment on the interim guidelines. What
33 the National Academy of Sciences said is that these are
34 interim guidelines, although they were expressed quite
35 confidently, and we recommend that the issue is revisited
36 every five years or so. In effect, the issue was
37 revisited by the National Cancer Institute and the
38 American Cancer Society, whose job it is, among other
39 things, to issue recommendations to the public. In
40 successive statements, starting, I believe, in 1985, if
41 I am wrong it would be before then, but certainly in the
42 early or mid-1980s, after the NAS report, both the NCI and
43 the ACS produced recommendations not only for policy
44 makers and health professionals, but for the general
45 public. They, in effect, revisited the scientific
46 evidence up to that point, as they do every two or three
47 years in the States.
48
49 Q. The World Health Organisation, what is the status of their
50 general recommendations?
51 A. It is a little misleading to use the term World Health
52 Organisation. The way WHO works is rather like the way
53 the UK government works in that from time to time WHO
54 judges that an issue -- in this context an issue to do
55 with diet and public health -- is so important and so much
56 a matter of public interest that, like the COMA Committee
57 of this country, they fore gather a committee of experts
58 and ask those experts what is the latest state of
59 scientific knowledge on a specific subject. WHO have
60 never commissioned a report specifically on diet and
