Day 252 - 20 May 96 - Page 29
1 MS. STEEL: I am sorry, I did not realise you did not have the
2 letter.
3 A. I know have seen the letter. I know what is in it.
4
5 MR. JUSTICE BELL: Read the letter through to yourself first.
6 A. I have actually seen the letter. I know what is in it.
7
8
9 MR. JUSTICE BELL: Just make any check you want to in order to
10 answer Miss Steel's question.
11 A. I find it difficult, your Lordship, referring to this
12 letter because this is not a scientific paper. This is a
13 letter. If it were a scientific paper I would have a great
14 deal more to argue with it. I mean, this would not be
15 submitted to a scientific community as a cited paper.
16 There are things in it which are quite wrong, in fact.
17
18 MR. JUSTICE BELL: The way I read it, although it is at fasting
19 level, although the levels there are fasting levels, which
20 means they are not immediately after a meal, and if I just
21 take the abstract itself, I would not have thought they
22 were immediately after the oral fat load either. The
23 letter appears to say that they are after having the
24 milkshake and therefore (f) for fasting must mean not after
25 immediately after the meal but after drinking the
26 milkshake.
27
28 MR. MORRIS: Yes.
29
30 MR. JUSTICE BELL: Although I must say the milkshake would seem
31 to be a decent meal for a lot of people on its own, to have
32 that much fat in it?
33 A. These are, in fact, fasting blood levels. In a
34 procedure in a test of this kind the subject would come in
35 first thing in the morning in a fasting state and you
36 measure baseline values. These are the values on which all
37 the data in the COMA report is based. They are on fasting
38 level, that is are measured first thing in the morning, and
39 they indicate what the persistent value is in response to a
40 particularly dietary treatment. The dietary treatment was
41 either a high fat diet, 40 per cent, or a low fat diet, 30
42 per cent.
43
44 MR. JUSTICE BELL: I appreciate that, but there would not seem
45 to be much point in introducing the oral fat load,
46 administering the oral fat load, unless it was going to be
47 after that that one took the blood samples; do you see? We
48 might just as well miss that out altogether?
49 A. I agree, your Lordship, it would have been much better
50 if the table had referred to the response to the fat load
51 rather than the baseline values. The information about the
52 response to the fat load is underneath where it tells us
53 that one fraction of the triglycerides remains at a
54 persistently higher level following the high fat meal than
55 it did after following the low fat meal, and that is the
56 basis of the significant difference that they quote. So,
57 the meat of the matter is confined to statements with
58 numbers that come underneath the table rather than the
59 table itself.
60
