Day 266 - 20 Jun 96 - Page 34
1 Q. So, you see, it is something of a randomised trial?
2 A. Yes.
3
4 Q. You will see that the criteria which they used for the
5 selection of those trials which are 46 -- sorry, 56 -- in
6 all were quite strict?
7 A. Yes.
8
9 Q. And you see the conclusion. I will read it, at the bottom
10 of the first column on the first page:
11
12 "Dietary sodium restriction for older, hypotensive
13 individuals might be considered but the evidence in the
14 normotensive population does not support current
15 recommendations for universal dietary sodium
16 restriction."
17
18 You see that. I am not asking you to express an
19 opinion about the methods or the data described in the
20 articles. That would not be fair. What I do ask you is
21 this: suppose that to be right, would you agree with me
22 that one must, because of pieces of research like this, be
23 very cautious about being over dogmatic about the role of
24 salt in diet and in relation to health?
25 A. I think if you look at the paper in the context of the
26 way papers are produced, that there is an overwhelming
27 consensus on salt and the benefits of salt reduction, even
28 from this Government, although Governments do tend to be
29 very cautious when making recommendations like that. Even
30 this Government would recommend that -- I think, they do
31 not want us to increase the amount of salt and ways should
32 be found, if you look at the actual Government literature
33 that is produced, ways should be found to reduce salt.
34 That is very cautious there. In any sort of health debate
35 you are always going to find a mixture of papers, because
36 it is a very complex thing, trying to isolate a particular
37 dietary factor and say, you know, because you cannot
38 experiment on groups of populations, you have to put them
39 in unnatural situations. So it is very hard to get that
40 result.
41
42 This particular paper that was presented to me seems
43 to be against all the, if you like, consensus opinion of
44 people who have been reading these papers for a living. It
45 seems to be, if you like, a rather road paper in the sense
46 that the conclusions it comes to are quite different from
47 the conclusions of many other papers which suggest a
48 reduction in salt. Also, I mean, it is looking at lots and
49 lots of different trials and there are all sorts of ways of
50 coming up with, you know, different ways of analysing
51 things, and I would be very cautious about looking at this
52 particular paper as sort of like the be all and end all in
53 terms of advice.
54
55 Q. No, again, I am afraid I am, perhaps, not on the same wave
56 length as you. You come to a point in your professional
57 career where a state of affairs, so far as you can see,
58 appears to represent a consensus. Yes? Something appears,
59 and this is a meta analysis which I think you mentioned
60 earlier as being a particularly valuable source of
