Day 252 - 20 May 96 - Page 23
1 A. From its present level.
2
3 Q. And I think you said that it had decreased since
4 recommendations were initially made 20 years ago?
5 A. Yes, it has over the last ten years decreased because,
6 although the public became aware that in 1974 the
7 recommendation was to reduce cholesterol, and particularly
8 to reduce egg consumption, as I said, egg consumption has
9 now been halved and the result is that the average level of
10 blood cholesterol in the British population has fallen
11 significantly and now it has become responsive to an
12 increase in dietary cholesterol, which it did not do
13 before.
14
15 Q. Because it was--
16 A. Simply because it is not a dose related response that
17 above a certain level of increase further increases have no
18 effect on the cholesterol. So we have now achieved
19 something, we have lowered cholesterols significantly, and
20 the idea is to hold them at that level and not allow them
21 to increase again.
22
23 Q. Right. And you want to hold them at that level because of
24 the health risks?
25 A. Yes, yes. Well, because of a risk of the mean blood
26 cholesterol beginning to rise again and thereby increase
27 the risk of developing heart disease, yes.
28
29 MR. JUSTICE BELL: Just pause a moment, please. Yes.
30
31 MS. STEEL: When you talked earlier in your evidence about the
32 recommendations and reducing the incidence of
33 cardiovascular disease, do you know the figures for in
34 terms of how many people suffer from it and how many people
35 would be expected to be at less risk, or whatever, as a
36 result of the changes?
37 A. Not off the top of my head. Recommendations are based
38 on looking at all of the risk factors and the recognition
39 that some, if the advice is taken, that some are going to
40 be much more effective than others. For example, it is
41 believed that if people gave up smoking cigarettes this
42 would have more effect than a diet modification. If people
43 ate more fruit and vegetables this might have a more
44 beneficial effect than, say, reducing fat consumption and
45 people can make calculations but they are really guesses of
46 what could happen. The only way of seeing what can happen
47 is to carry out long term intervention studies and make
48 measurements.
49
50 Q. But the purpose of making these recommendations is to
51 reduce the numbers of deaths and the number of people
52 suffering from heart disease or heart related diseases?
53 A. Yes, it is to reduce mortality. It is also to reduce
54 morbidity, people ill, because it costs an awful lot of
55 money to look after people who are suffering from heart
56 disease.
57
58 Q. Right. Can I just briefly ask you about the study that you
59 commented on. You said something about one of them being a
60 piece of work done on 5 subjects which was a very small
