Day 252 - 20 May 96 - Page 35


     
     1        in the 55-64 age group in 1990.  8 percent of all male
     2        deaths and 2 percent of all female deaths are due to
     3        premature death from CHD."
     4
     5        Are those statistics that you are familiar with?
     6        A.   Well, I have certainly looked at them before but, yes,
     7        I accept these statistics.
     8
     9   Q.   Right.    If we go to page 123, in the summary it says:
    10
    11        "The likelihood of death from coronary heart disease
    12        increases with the plasma level of total cholesterol and
    13        particularly of low density lipid (LDL) cholesterol.
    14
    15        Genetic factors play a part in determining a risk of CHD
    16        independently of plasma lipid patterns, and may affect
    17        individual responsiveness to dietary fat.  However, for the
    18        vast majority of the population, the quality and quantity
    19        of dietary fat are fundamental and modifiable determinants
    20        of plasma lipid levels."
    21
    22        You would with that?
    23        A.   Yes, I think I quoted that in my own report.
    24
    25   Q.   OK.  Just the point about cholesterol, the last but one
    26        paragraph says:
    27
    28        "Dietary cholesterol can raise blood total cholesterol but
    29        this effect is less important than that of saturated fatty
    30        acids."
    31
    32        That is confirmation that it is still the case that dietary
    33        cholesterol is seen as a determining factor or one of them?
    34        A.   Well, yes, it very much depends on one's baseline
    35        blood cholesterol level. If you take somebody who has a
    36        very low intake of saturated fat and cholesterol, because
    37        saturated fat, animal fat contains cholesterol, vegetable
    38        fat does not.  Such people tend to have very low blood
    39        cholesterol levels and they respond to dietary cholesterol,
    40        whereas somebody who habitually has a high intake of
    41        saturated fat and dietary cholesterol, the two going
    42        together, tends to be very much less responsive to dietary
    43        cholesterol.
    44
    45   MR. JUSTICE BELL:  Just pause a moment, please..
    46
    47   MS. STEEL:  That is basically because the saturated fat is
    48        causing enough of a problem in itself?
    49        A.   Well, it is more complicated than that.  The fact is
    50        the body manufactures cholesterol for itself and if the 
    51        dietary cholesterol input is low, the body manufactures 
    52        more, and if the input from the diet is high, then the body 
    53        manufactures less, so there is a balance between the two.
    54
    55        I think this is actually stated in the paragraph that you
    56        read out, that the response to dietary cholesterol depends
    57        on the level in the diet; it depends whether there is a lot
    58        there or a little, obviously, and on the accompanying
    59        lipids.  What that means is that somebody with a low blood
    60        cholesterol level, because of the nature of their diet,

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