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

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