Day 252 - 20 May 96 - Page 16


     
     1        stomach are leeched out of the intestine into the
     2        bloodstream are they?
     3        A.   Yes.
     4
     5   Q.   And then distributed by the circulation?
     6        A.   Yes.
     7
     8   Q.   That is the sort of basic mechanics?
     9        A.   Yes.  Carbohydrate tends to be digested fairly
    10        rapidly.
    11
    12   Q.   Yes.
    13        A.  And very simple carbohydrates like sugar would pass
    14        into the circulation even more rapidly and be cleared more
    15        rapidly.  Fat digestion tends to be a fairly slow process,
    16        it takes several hours, and with a huge meal -- as in the
    17        previous paper -- it will take 4 hours.  What happens is if
    18        you take a blood sample from somebody an hour after a meal
    19        containing fat, it is cloudy.  All that means is that there
    20        are tiny blobs of fat floating around in the blood.  3
    21        hours later it is clear again, and all that means is that
    22        the animal's tissue has removed all this fat from the
    23        circulation and deposited it.  What this paper suggests is
    24        that habitually eating a high fat diet slows this process
    25        down.
    26
    27   MR. RAMPTON:   Does that matter?
    28        A.   Well, they suggest, and it is a suggestion, that this
    29        reduced ability to clear triglycerides from the blood may
    30        be associated with atherosclerosis.  On the other hand, it
    31        may not.
    32
    33   MR. JUSTICE BELL:   It may be?
    34        A.   Associated with the process of atherosclerosis, this
    35        persistent small elevation of blood lipids of a very large
    36        fat load.  I think it is interesting that in this document,
    37        'Nutritional Aspects of Cardiovascular Disease', there is
    38        no discussion at all of the role of triglycerides in the
    39        development of atherosclerosis and certainly any experts I
    40        have talked to about triglycerides as being a risk factor,
    41        fat being a risk factor, the matter is very contentious,
    42        there is no real clear-cut evidence that triglycerides are
    43        part of the atherosclerosis process, unlike cholesterol.
    44
    45   MR. RAMPTON:   Two questions only, Professor Naismith.  First,
    46        do you believe that what the abstract itself describes as
    47        limited data in this -- you see the first two words say
    48        'limited data is available', never mind the grammar, but
    49        'limited data is available, compare it', and so on?
    50        A.   Yes. 
    51 
    52   Q.   First question:  do you believe that the limited data 
    53        disclosed or revealed by this study supports the conclusion
    54        drawn in Professor Miller's letter?
    55        A.   No.  I think one of the problems with studies of this
    56        kind is that medical scientists, and I must admit to having
    57        been guilty of this myself at times, in order to
    58        demonstrate that something is happening tend to use very
    59        unphysiological or abnormal conditions.  If you want to
    60        demonstrate an effect of a deficiency or an excess one

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