Day 253 - 21 May 96 - Page 23
1 MR. JUSTICE BELL: I have found it, thank you.
2
3 MR. RAMPTON: "Table 5 shows that obesity in adults is not
4 confined to industrialised countries. Obesity is already
5 prevalent to the developing world, particularly in women,
6 with very high rates in some places, eg in Trinidad. The
7 prevalence of obesity is surprisingly variable but in some
8 developing countries high rates are already evident in
9 children as well as in adults" and there is a reference to
10 figure.
11
12 "As life expectancy" -- and here I would ask you to read it
13 carefully, Professor, please -- "increases in many
14 developing countries, new problems of cardio-vascular
15 disorders and cancers are emerging. These reflect the
16 co-existing effects of the demographic ageing of the
17 population and of newly acquired risks relating to the
18 diets and lifestyles that have accompanied economic
19 development. On current trends, such diseases will present
20 a huge health care burden for less affluent communities in
21 the near future.
22
23 The stage at which cardio-vascular disease emerges as a
24 significant cause of death corresponds to a life expectancy
25 level between 50 and 60 years and at this level
26 cardio-vascular disease mortality accounts for 15 to 25 per
27 cent of all deaths."
28
29 That reflects, in large parts, something which you told us
30 yesterday I think?
31 A. Yes, one is to live long enough to develop heart
32 disease.
33
34 Q. Can you tell us, please, what, in your view, are the
35 factors which lead to increasing life expectancy in
36 developing countries?
37 A. I think the first factor is living to the age of 5 and
38 the major problem by far in most developing countries is
39 the protein energy malnutrition. This is a shortage of
40 both calories and protein in the diet. In other words, it
41 is a lack of food. This is by far the major problem in the
42 world, it is not heart disease or stroke, and it affects
43 millions and millions of people.
44
45 Now, if one can start off with changing the very high
46 levels of infant mortality, particularly in under 1 year
47 from thyroid diseases, then people have a chance of living
48 to the age of 50, but in between there are many stages of
49 infection, environmental conditions and so on, which are
50 going to affect it and all of these have to be tackled
51 before one can start thinking about increasing life
52 expectancy. These are all non-nutritional factors we are
53 talking about.
54
55 Q. Then I think you went on yesterday as part of the same
56 answer and I can see why. You said:
57
58 "In other words, since heart disease is something that on
59 average, certainly in this country, the average man has his
60 heart attack at the age of around 70. This may surprise
