Day 033 - 10 Oct 94 - Page 34


     
     1        calories and carbohydrate are expended simply in trying to
     2        make fat from it.
     3
     4        In addition to that, a high fat -- when fat is consumed it
     5        has no influence on body metabolism.  In other words, fat
     6        does not increase the speed with which the cells of the
     7        body consume calories, consume energy.  On the other hand,
     8        carbohydrates do.  When a diet is rich in carbohydrates --
     9        here I mean the complex carbohydrates that are in
    10        potatoes, rice, pasta, vegetables, beans and so forth --
    11        when individuals are on high carbohydrate diets their
    12        metabolism is measurably increased.
    13
    14        Without getting into great complexity about the mechanisms
    15        for that, certain hormonal changes, beneficial hormonal
    16        changes, have been identified that come from individuals
    17        consuming high carbohydrate diets.  More adrenaline levels
    18        are elevated, the levels of active thyroid hormone are
    19        elevated.
    20
    21        The reason I am giving this detailed discussion is to show
    22        that there is clearly a causal link between a high fat
    23        diet and obesity, and the causal link between obesity and
    24        hypertension is quite well accepted, and I cannot imagine
    25        anyone would challenge that.
    26
    27        In addition to that, however, when patients are
    28        hypertensive and put on any sort of weight reduction diet,
    29        very, very commonly their blood pressure drops.  So it is
    30        beyond any reasonable doubt that a high fat diet has a
    31        causal link with hypertension mediated by its effect on
    32        obesity.  That is by no means the only link, however, but
    33        that is one causal.
    34
    35   Q.   What about the sodium link?
    36        A.  Sodium, in general, has a tendency to hold water and
    37        when individuals are on high sodium diets the simple
    38        explanation is that it tends to draw water into the blood
    39        vessels raising the pressure of fluid within the blood.
    40        When individuals reduce their sodium intake their blood
    41        pressure falls and, contrarily, if an individual has
    42        hypertension, if you increase their sodium intake their
    43        blood pressure will be driven up.
    44
    45   Q.   So the link which you have identified between hypertension
    46        and salt or sodium, what kind of link is that?
    47        A.  Well, it is a causal link.
    48
    49   Q.   Is hypertension a serious disease?
    50        A.  Very much so.  When you have excessive pressure in 
    51        your arteries, that pressure accelerates atherosclerosis; 
    52        the formation of the plaques in the arteries that causes 
    53        heart disease, or that is what we call heart disease, when
    54        it occurs in the coronary arteries.  When the arteries
    55        that go up the neck into the head and reach the brain are
    56        under higher than normal pressures, the likelihood of a
    57        haemorrhagic stroke is increased.  Hypertension is a well
    58        known risk factor for stroke.  So, yes, hypertension is a
    59        very serious condition.
    60

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