Day 252 - 20 May 96 - Page 12


     
     1        whole event is over before the event is recorded.
     2
     3   MR. RAMPTON:   May I see if I have understood that correctly?
     4        Does that mean to say because it has all gone, the event is
     5        over, you would not expect to find it that had any effect
     6        on the cardiovascular activity one way or the other?
     7        A.  No, we have not decided whether it had an effect or
     8        not.  I think the main point of this is, is this change in
     9        the ability of an artery wall to expand in response to a
    10        meal, eating any meal, or is it something in response to
    11        eating a high fat meal, and from this paper we cannot
    12        answer that question for the reasons I stated that the
    13        carbohydrate meal would have been digested and absorbed,
    14        the whole event over, before the first measurement was
    15        recorded.  Whether there were measurements made before that
    16        we do not know because the information is not given in the
    17        paper.  So, that is really the main criticism of this
    18        paper, and I took it to the Director of our Vascular
    19        Biology Unit.
    20
    21   Q.   We cannot have him in the witness box through you.
    22        A.   Yes.
    23
    24   Q.   Yes?
    25        A.   I see.  Well, my opinion of this paper is that it may
    26        be interesting but the data is totally inadequate to come
    27        to any conclusion at all about what is actually going on,
    28        and as for its physiological significance I have
    29        considerable doubt.  I think the main point here is that
    30        following a meal of any kind blood is drawn to the vascular
    31        bed around the intestinal tract in order to absorb the
    32        food.  Consequently, the idea of blood vessels in the
    33        extremities, like the arms and legs, expanding is extremely
    34        unlikely, the opposite is the case.  That is why one
    35        recommended if people are going take exercise they do not
    36        do it immediately after a meal because the blood supply is
    37        elsewhere at the time.
    38
    39   Q.   During the time that it takes to digest, whatever that be,
    40        would that apply as well to the cereal meal as it will to
    41        the high fat meal?
    42        A.   No, the point about the high fat meal, any high fat
    43        meals are tended to be described as having a high satiety
    44        value.  That means if you have a meal which is high in fat
    45        you feel satisfied for a long period of time, and the
    46        reason is it remains in the stomach for a much longer
    47        time.  That inhibits gastric emptying, so that we can find
    48        on high fat meals, and one of this size, that the process
    49        of releasing material from the stomach into the intestinal
    50        track and its digestion would go on for many hours 
    51        following the meal whereas if it is a high carbohydrate one 
    52        the whole thing would proceed very much more rapidly.  So 
    53        with that paper all I can say is that I am not really sure
    54        what possible significance it has.  I would need a great
    55        deal more information and it would have to be repeated at
    56        least by one other laboratory to confirm it.
    57
    58   Q.   Can we then turn to the other one, please, which is the
    59        same source but different author, Doctor Michael Miller
    60        assistant Professor of Medicine.   Again, with this there

Prev Next Index