Day 252 - 20 May 96 - Page 15


     
     1        a prediction about atherosclerosis or cardiovascular
     2        disease?
     3        A.   Well, apoprotein B is the one that carries most of the
     4        cholesterol, so you would expect it to be elevated if low
     5        density, like proteins are elevated, and the total
     6        cholesterol is elevated, but the point about this table is
     7        there are no significant differences between either of the
     8        dietary treatments which indicates that by modifying one's
     9        diet not a great deal happens as a result of it.
    10        Certainly, within the period of the study of one month.
    11
    12        Now, having prepared the subjects in this way they were
    13        given a meal of fat, and it is stated in the document here
    14        that this was 730 grammes of fat per square metre.  Now, I
    15        must say I found that the terminology that was used in this
    16        paper was pretty archaic.  I mean, one does not really talk
    17        now about hydroglycerides and one certainly does not talk
    18        about doses of anything in relation to square metre body
    19        surface area.  I had to go back to my students' physiology
    20        text book to find out what this meant in relation to body
    21        weight.
    22
    23   Q.   What does it mean?
    24        A.   I discovered that 730 grammes of body fat per metre
    25        amounted to an average 75 kilogramme person, because I
    26        calculated from data in the paper itself by the index.
    27        This amounted to something like 125 grammes of fat that was
    28        given in a slug.  You know, it was given what is referred
    29        to as a milkshake, a very strange milkshake, 120 grammes of
    30        fat.  Now, that is actually more than an average man would
    31        consume in his diet, in his normal food, in 24 hours.  So,
    32        this is a huge load of fat that is put on the subjects.
    33
    34   Q.   Can you tell me whether it tells us what kind of fat this
    35        splodge or lump was that they were given?
    36        A.   No, all that is said, not in the paper but in the
    37        accompanying letter, was that it was the milkshake.  In
    38        other words, it was the fat emulsion.  Very obviously it
    39        will not be animal fat because one could not really make an
    40        emulsion of dripping or lard or mutton fat.  It would have
    41        to be a vegetable oil that was emulsified.  That is my
    42        assumption, because we are simply not told, but if you are
    43        going to produce something that can be drunk it would have
    44        to be liquid.  So this huge load of fat was given and then
    45        measurements were made thereafter, and the conclusion was
    46        that if one consumed a diet high in fat this slows down,
    47        virtually slows down, the clearance of triglycerides from
    48        the blood.  Normally, when you eat a meal the fat is
    49        digested, it enters the blood circulation and is rapidly
    50        cleared by the animal's tissue which has drawn from the 
    51        blood and this normally takes 3 hours or so, depending on 
    52        the size of the meal.  This obviously went on a bit longer 
    53        here, but what they are suggesting is that if one is
    54        accustomed to eating a high fat diet the ability, the rate
    55        of clearance of the fat in the blood is slowed down whereas
    56        on the lower fat diet it is cleared more rapidly.
    57
    58   MR. JUSTICE BELL:   Can I just take you back to absolute
    59        basics?  In the process of digestion, various qualities
    60        -- call them what you will -- in what has gone into the

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