Day 269 - 25 Jun 96 - Page 33
1
2 Q. -- to play?
3 A. Yes.
4
5 Q. That leaves only 30%, does it not, for things like physical
6 inactivity, smoking, alcohol, overweight, higher tension
7 and so on and so forth?
8 A. Well, higher tension is, in fact, induced by the same
9 kind of diet that induces heart disease, but I think one of
10 the pieces of evidence which may be helpful in this respect
11 is the studies in children which we contributed to in the
12 1970's and which have now been extensively documented in
13 the USA.
14
15 The interesting thing is that if you compare children who
16 are born into a low risk society, and we compared African
17 children in Africa with European children in Africa, if you
18 compare the children the question we asked was were they
19 born different, the African children having virtually no
20 risk of growing up to have heart disease, the European
21 children with a high risk, the question we asked at that
22 time was are they born differently or do they acquire the
23 difference.
24
25 And it clear that in the first year of life the blood
26 cholesterol levels which were used as the only relevant
27 marker at that stage in the proceedings that we could deal
28 with, was the same in the African versus the European
29 children, but by six to eight years of age you could
30 differentiate statistically the European children based on
31 cholesterol levels.
32
33 Now, this kind of evidence is well ingrained in the
34 literature. What I would put to you, and I think it is
35 helpful in discussing that, is that really basically
36 children the world over are not smoking. They are doing
37 the same kind of exercise. They are doing the same kind of
38 things. And really it is the environmental impact and
39 almost certainly the nutritional impact which is creating
40 this difference at this young age. And I think the other
41 factors that you talk about, namely the smoking, the lack
42 of exercise and hypertension, are not influencing these
43 differences at that stage in the proceedings.
44
45 Q. Did you follow the groups of children through to the age at
46 which they might have been expected to have a heart attack,
47 a premature heart attack?
48 A. That is being done by Verbussem in the United States
49 at this precise moment and what is interesting from that
50 study is that the rise in childhood is predictive of a high
51 risk, both in relation to raised blood cholesterol levels
52 and raised blood pressure by the time they reach 20 years
53 of age, which is the last time I saw the published data.
54
55 Q. I was going to ask you where we might find those data. Are
56 they published in the New England Journal of Medicine?
57 A. They will be published in the American literature. I
58 would be happy to look them up for you, if you wish.
59
60 Q. Also, I suppose it is possible at least that your African
