Day 014 - 20 Jul 94 - Page 29
1 A. Well, these are fatty acids for which there is a
different requirement. In other words, if they are not
2 present, then the body will show specific deficiency
symptoms, in the same way as if there was absence or
3 insufficiency of a vitamin or a mineral.
4 Q. If you turn over to page 44, there is a discussion on
cardiovascular disease. It starts, as one might expect,
5 with atherosclerosis, at 3.4.2?
A. Yes.
6
Q. It says, this is halfway down the paragraph: "The
7 pathogenesis" -- is that what we mean by the mechanism?
A. I would think so, yes.
8
Q. "Pathogenesis of this condition is not clear, but it
9 appears to involve cholesterol in low density lipoproteins
(LDL)". The HDL's are not stigmatized in the same way as
10 LDL's?
A. That is right. There are several types, but the most
11 important ones are the LDL's because they are the ones
that, as it says here, are taken up by the arterial wall
12 and the HDL's which tend to remove cholesterol.
13 Q. Then at 3.4.4 there is a passage which says perhaps what
is obvious, that thrombosis "... is usually the final
14 event in coronary occlusion". Then it says at 3.4.4.:
"Risk factors for atherosclerosis. The development of
15 atherosclerosis depends on numerous risk factors both
genetic and environmental. Smoking, high blood pressure
16 and raised serum cholesterol are the major ones, while
before the menopause women are relatively protected.
17 Familial CHD risk is often unassociated with the major
risk factors. " Does that mean that even in the absence
18 of a genetic disposition or pre-disposition you may
nonetheless, if you eat or smoke the wrong things, expect
19 to get or expect to increase your risk of heart disease?
A. I am not quite clear.
20
Q. It says: "Familial CHD risk is often unassociated with the
21 major risk factors"?
A. Yes. There are people who suffer from hyper
22 cholesterolemia, where there is an inbuilt or hereditary
tendency to have a high cholesterol.
23
Q. Then it says: "Smoking is associated with a dose related
24 increase in risk of death from CHD, independently of other
risk factors. Risk of death from CHD is strongly
25 correlated with blood pressure. About 50% of the
variations CHD risk can be attributed to these known
26 environmental risk factors. Other modulators of risk may
include dietary components such as antioxidant vitamins,
27 which influence macrophage uptake of LDL, and long chain
fatty acids which may affect blood clotting". Then there
28 is a passage explaining serum cholesterol is a significant
factor in the assessment of risk?
29 A. Yes.
30 Q. But in 3.4.6 that dietary saturated fatty acids and --
sorry, there is a relationship between dietary saturated
