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
