Day 252 - 20 May 96 - Page 07
1 of research, that dietary cholesterol really had no
2 appreciable affect at all in people who are consuming a
3 normal diet, and consequently the recommendation was
4 revised. They recommended that the cholesterol consumption
5 should not be changed. In fact, that report had no
6 specific recommendation about dietary cholesterol at all.
7 In the most recent report, dietary cholesterol has come
8 back into the picture because as a result of the public's
9 response, and I am surprised because the public does not
10 respond, certainly as I would like, to nutritional
11 information, the public had reduced its dietary cholesterol
12 to such an extent that the average blood cholesterol in
13 people in the UK had been lowered, and it then became
14 tentative to an increase in dietary cholesterol. So the
15 current recommendation is that dietary cholesterol should
16 not be increased. So, that is an example where a
17 recommendation about a particular factor has been changed
18 considerably with the success of COMA publications, and I
19 think the next issue of COMA publication on heart disease
20 well have different things to say.
21
22 Q. That was the only thing I was going to ask you about this
23 written report of yours. You write at the bottom of page 6
24 in the last line but one: "The cause of vascular
25 disease..." Do you have it?
26 A. Yes.
27
28 Q. The last two lines: "The cause of vascular disease is
29 multifactorial. Diet is only one factor."
30 A. Yes.
31
32 Q. Professor Naismith, without going into any detail at all
33 can you just summarise for us what, according to modern
34 scientific thinking, which is what you just explained may
35 change, are the other factors which may contribute to
36 cardiovascular disease?
37 A. Well, there are a great many factors which are
38 believed to contribute to cardiovascular disease. I think,
39 in fact, two new ones have come into play in the last
40 months or so. There is obviously a general ethical
41 factor. People are predisposed to having cardiovascular
42 disease. Smoking is a factor. It is an important factor.
43 It probably has a greater effect in the development of
44 cardiovascular disease than does diet. I am very pleased
45 to see that in this report of cardiovascular disease the
46 question of physical activity has been addressed. I think
47 personally this is an important factor, given that the
48 instance of obesity has increased in men in the last ten
49 years with no change in the composition of the diet.
50 Clearly, overweight is a very important factor, and at last
51 it is being addressed by the Government in its report.
52 There are other factors, such as fibre content of the diet,
53 which may have an effect. There is a great deal of
54 interest in antioxidants and nutrients which promote the
55 degenerative aspects of atherosclerosis and, more recently,
56 folic acid which is one of the B vitamins has come into the
57 picture as a factor involved in the metabolism of a
58 particular folic acid where, if the metabolism is
59 defective, there is an accumulation more consistent with
60 levels in people with atherosclerosis. So, the picture
