Day 014 - 20 Jul 94 - Page 30
1 fatty acids and serum cholesterol?
A. That is right.
2
Q. Which I think you already explained to us this morning. If
3 there is any part of this that I am going more quickly
over than you think I should, please say so, but there is
4 a feature of this case you may or may not know about which
is the plaintiffs have accepted that there is a recognised
5 association between excessive ingestion of saturated fats,
particularly, and coronary heart disease, so we need not
6 spend too much time on that?
A. Yes, I understand.
7
Q. Then 3.4.10: "Dietary cholesterol intake has a small
8 effect on serum cholesterol levels. The effect of dietary
cholesterol in raising serum cholesterol is minimised when
9 SFA intake represents a small proportion of energy".
10 MR. JUSTICE BELL: I missed that reference.
11 MR. RAMPTON: 3.4.10, my Lord, on page 46. Does SFA stand for
saturated fatty acids?
12 A. Yes, it does.
13 Q. Then 3.4.14 on page 47: "Relationship of serum
cholesterol to CHD risk. The evidence relating to serum
14 cholesterol to CHD risk does not suggest a threshold
effect -- that is a particular level of serum cholesterol
15 above which the risk is high, and below which the risk is
low. Rather the risk appears to increase continuously with
16 serum cholesterol". Is that your reading of the
literature?
17 A. Yes, it is.
18 MR. JUSTICE BELL: I would like to read those last two again,
Mr. Rampton.
19
MR. RAMPTON: My Lord, certainly. Your Lordship might care to
20 read also 3.4.9?
21 MR. JUSTICE BELL: Yes. Where they are talking about risk,
that is a statistical risk?
22 A. Yes, I would say so.
23 Q. I think it is bound to be.
24 MR. RAMPTON: My Lord, yes, a statistical risk but, as
I understand it, a conclusion as to which is supported or
25 helped by what one might call different approaches,
whether clinical or experimental, or whatever. Am
26 I right, Professor Wheelock, one would not draw a
conclusion from merely statistical information?
27 A. Oh, no. I thought we were referring to the risk of an
individual than risk of a population. I mean, the reality
28 is that in countries where the average cholesterol
concentration is of the order of 6 millijules per hundred
29 grammes, then the heart disease level tends to be quite
high; whereas if the average is about 4.5, then the death
30 rate in heart disease is quite low. One can never be
sure, as far as an individual is concerned, if you have a
