Day 014 - 20 Jul 94 - Page 30


     
     1        fatty acids and serum cholesterol?
              A.  That is right.
     2
         Q.   Which I think you already explained to us this morning. If
     3        there is any part of this that I am going more quickly
              over than you think I should, please say so, but there is
     4        a feature of this case you may or may not know about which
              is the plaintiffs have accepted that there is a recognised
     5        association between excessive ingestion of saturated fats,
              particularly, and coronary heart disease, so we need not
     6        spend too much time on that?
              A.  Yes, I understand.
     7
         Q.   Then 3.4.10:  "Dietary cholesterol intake has a small
     8        effect on serum cholesterol levels. The effect of dietary
              cholesterol in raising serum cholesterol is minimised when
     9        SFA intake represents a small proportion of energy".
 
    10   MR. JUSTICE BELL:  I missed that reference.
 
    11   MR. RAMPTON:  3.4.10, my Lord, on page 46.  Does SFA stand for
              saturated fatty acids?
    12        A.  Yes, it does.
 
    13   Q.   Then 3.4.14 on page 47:  "Relationship of serum
              cholesterol to CHD risk.  The evidence relating to serum
    14        cholesterol to CHD risk does not suggest a threshold
              effect -- that is a particular level of serum cholesterol
    15        above which the risk is high, and below which the risk is
              low. Rather the risk appears to increase continuously with
    16        serum cholesterol".  Is that your reading of the
              literature?
    17        A.  Yes, it is.
 
    18   MR. JUSTICE BELL:  I would like to read those last two again,
              Mr. Rampton.
    19
         MR. RAMPTON:  My Lord, certainly. Your Lordship might care to
    20        read also 3.4.9?
 
    21   MR. JUSTICE BELL:  Yes.  Where they are talking about risk,
              that is a statistical risk?
    22        A.  Yes, I would say so.
 
    23   Q.   I think it is bound to be.
 
    24   MR. RAMPTON:  My Lord, yes, a statistical risk but, as
              I understand it, a conclusion as to which is supported or
    25        helped by what one might call different approaches,
              whether clinical or experimental, or whatever.  Am 
    26        I right, Professor Wheelock, one would not draw a 
              conclusion from merely statistical information? 
    27        A.  Oh, no.  I thought we were referring to the risk of an
              individual than risk of a population.  I mean, the reality
    28        is that in countries where the average cholesterol
              concentration is of the order of 6 millijules per hundred
    29        grammes, then the heart disease level tends to be quite
              high; whereas if the average is about 4.5, then the death
    30        rate in heart disease is quite low.  One can never be
              sure, as far as an individual is concerned, if you have a

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