Day 252 - 20 May 96 - Page 06
1 Disease" to the report of the Cardiovascular Review Group
2 of the Committee on Medical Aspects of Food Policy
3 published by the Department of Health in 1994. I know you
4 have your own copy but I do not believe it is here. There
5 is a copy for the Judge and one for the witness. (Same
6 handed).
7
8 MR. JUSTICE BELL: I have kindly been handed one with the
9 report, if it is same one.
10
11 MR. RAMPTON: Is that, Professor Naismith, the work to which
12 you have referred?
13 A. This is the work, yes.
14
15 Q. May we regard the contents of that report as authoritative?
16 A. Yes, I would agree with that.
17
18 Q. Can I ask you, they make various recommendations during the
19 body of the report, particularly in relation to the
20 consumption of saturated fat, do they not?
21 A. They do, indeed.
22
23 Q. In this court, not being medical men or scientists, how
24 should we approach those recommendations; what significance
25 do they have?
26 A. I think the recommendations are made by a body of
27 scientists who have looked very carefully at a great deal
28 of evidence and they are making recommendations in the
29 interests of public health. They are not saying we have
30 conclusive evidence here that eating a diet which is high
31 in fatty saturated acids is going to cause heart disease,
32 what they are saying is that the evidence seems to be
33 pointing in this direction and if we make recommendations
34 about alterations in diet in general, provided the public
35 can actually understand these recommendations, then there
36 is a reasonable chance that the instances of cardiovascular
37 disease will be reduced. On the other hand, in ten years'
38 time these reports, these particular panels are set up at
39 ten-yearly intervals and I would not like to predict what
40 the panel will be saying in ten years' time. I think the
41 important thing about recommendations made by these panels
42 is that everybody on the panel knows that the
43 recommendations are sensible at this stage of our
44 knowledge, and that they are extremely unlikely to do
45 anybody any harm, but they may well be revised at a future
46 date.
47
48 MR. RAMPTON: We should not regard them as being, as it were,
49 maxima which are written in stone?
50 A. Not at all. I can think back over 3 successive
51 documents produced by COMA on diet and heart disease in
52 which recommendations have indeed changed. For example, in
53 the 1974 recommendations dietary cholesterol was identified
54 as a risk factor in heart disease. Consequently, people
55 were encouraged to reduce their intake of diets of that
56 sort and this had the effect of reducing egg consumption,
57 which is by far the richest source of cholesterol, and egg
58 consumption dropped by 50 percent. Now, this had quite a
59 devastating effect on people who rear poultry but ten years
60 later the decision was, in the light of another ten years
