Day 036 - 13 Oct 94 - Page 08


     
     1
     2   Q.   " - develop obesity with all its complications eg.
     3        diabetes and hypertension.  Studies on the control of
     4        energy balance in humans have not yet shown differences
     5        between saturated and unsaturated fatty acids, so the
     6        total amount of fat seems to be the important
     7        consideration in the prevention of obesity".  Do you agree
     8        or disagree with that?
     9        A.  I do agree.  If we are speaking of dietary fat intake,
    10        that is a very important consideration both in the cause
    11        and in the prevention of obesity.
    12
    13   Q.   I think, and I am not using tendentious words, the effect
    14        of your book is to incriminate excessive fat of all kinds,
    15        is it not?
    16        A.  Fat, all types of fat, have the same calorie intake
    17        and do have an effect on the growth of the adipose tissue.
    18
    19   Q.   The study group go on:  "There are no good systematic
    20        studies" -----?
    21        A.  Could you hold on for just a moment?  Pardon me.
    22
    23   Q.   "There are no good systematic studies on the prevalence of
    24        obesity in relation to the proportion of fat in the
    25        nation's diet, but crude analyses of the national food
    26        supply from FAO" -- that is the Food and Agriculture
    27        Organisation of the United Nations -- "FAO figures in
    28        relation to the average body mass index measured as part
    29        of the recent major Interstart study on adults, suggests
    30        that a mean body mass index of 22 to 23 is associated with
    31        a dietary fat content that provides 15 to 20 per cent of
    32        energy."
    33
    34        Dr. Barnard, pausing there, what is, in your view, so far
    35        as -- this is, I know, a very broad question and qualify
    36        the answer, by all means -- the general health of human
    37        beings, what is an ideal body mass index?
    38        A.  Well, there is no single body mass index that is
    39        ideal, because the body mass index, as you have aptly
    40        hinted at, does not take into account constitutional
    41        factors such as the size of the frame or the distribution
    42        of fat, as I am sure you are well aware.
    43
    44   Q.   Yes.
    45        A.  However, a body mass index that is below 25, most
    46        people would consider not to be obese and to be in the,
    47        broadly speaking, normal range.
    48
    49   Q.   "In Brazil the mean body mass index is about 22, the fat
    50        content of the diet amounts to about 18 per cent of energy 
    51        intake.  On average figure 3 on page 30 shows that in 
    52        Brazil the prevalence rate of obesity is low in children. 
    53        European figures suggest that for adults a mean body mass
    54        index of 25 to 26 is associated with a dietary fat
    55        content, but provides 35 to 40 per cent of energy."
    56        There is then a prevalence of grade 1 obesity.  Is that
    57        the same as what you earlier called frank obesity, do you
    58        think?
    59        A.  I am not sure what they are using as a definition of
    60        grade 1 obesity in this paragraph.

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