Day 252 - 20 May 96 - Page 11


     
     1   Q.   It is 9.3 percent plus or minus 7.5 percent?
     2        A.   In other words, the ability of a vessel to expand in
     3        relation to this constriction is reduced from 11 per cent
     4        to 9.3 and it goes down even further to 8.2 after 4 hours.
     5          So, really, it is saying that consuming this meal, which
     6        is very high in fat, has reduced the ability of the blood
     7        vessel to make this huge expansion, 20 percent, in response
     8        for having total occlusion of blood through the vessel
     9        which, as I said at the beginning, is a fairly
    10        unphysiological measurement to make and its relevance to
    11        what happens in normal everyday life is very obscure.
    12        One's blood vessels simply do not expand in relation to
    13        eating a meal.  In fact, the point I make later is that
    14        they are more likely to contract rather than expand.
    15
    16        The point about drawing attention to this huge standard
    17        area is that it means we had a huge variation in response
    18        to this treatment.  Now, if we go down a bit further it is
    19        simply stated that when the fat free breakfast was consumed
    20        there were no significant differences.  Now, bearing in
    21        mind that the level of significance that was achieved with
    22        these 5 individuals was 0.05, that is the absolute rock
    23        bottom level of significance that is accepted for
    24        scientific investigation.  So, a one in 20 chance of the
    25        results being arrived at totally by chance.
    26
    27   MR. JUSTICE BELL:   Can you keep your voice up?
    28        A.   Yes, I will try to do that.   In the case of the
    29        feeding of the fat free meal they state that there were no
    30        significant changes, no significant decrease in activity.
    31        I do not really know what that means.  Does it mean that
    32        the values were similar to the ones that were reported for
    33        the high fat meal but the variants were even greater and
    34        consequently it did not reach statistical significance?  We
    35        do not know.  I would have been very much happier as a
    36        referee on the full paper, I would have wanted to see the
    37        values for the other meal so that I would make that
    38        judgment myself, but none of this information is given.
    39
    40        The final point I would like to make about it, because I do
    41        not think it is worth spending too much time on this, is
    42        that this was work done by a cardiologist.  Had he been a
    43        gastroenterologist we would have realised that comparing a
    44        huge meal which is high in fat with another huge, perhaps
    45        even huger meal which is fat free because in order to eat a
    46        breakfast of 900 calories based on dry cereal, fat free
    47        milk and fat free orange juice, this must have been an
    48        enormous breakfast, something equivalent to about 4 bowls
    49        of a dry cereal.
    50 
    51   MR. JUSTICE BELL:   Bowls of what? 
    52        A.  Of a dry cereal, something like cornflakes.  They do 
    53        not say what the meal is, but it is be cereal and extremely
    54        low in fat.  So this huge meal of essentially carbohydrate
    55        and protein is offered.  As I say, had he been a
    56        gastroenterologist he would have realised that a meal
    57        composed almost entirely of carbohydrate and protein would
    58        be digested and absorbed within that 3 hour period.  The
    59        first measurement here is of the 3 hours, so in the case of
    60        the breakfast which is composed of the fat free element the

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