Day 266 - 20 Jun 96 - Page 21
1 Journal of the American Medical Association. I would have
2 given it to the defendants before Court but they were not
3 in the usual place and I did not search the building for
4 them, I am afraid. I would want to ask maybe one question
5 about this. I would be entitled to, given the evidence
6 in-chief that we have had, after the lunchtime
7 adjournment. So perhaps I could dish out copies. Miss
8 Brophy would, I expect, be very familiar with it. It has
9 just been published end of May '96.
10
11 MS STEEL: If I could just make a comment on that? When I
12 actually handed over the BMJ paper the other day I did say
13 Miss Brophy would be referring to it, and when we raised it
14 in Court yesterday we again said Miss Brophy would be
15 referring to it. We deliberately have not gone through the
16 parts that would be related to the admission, and I only
17 brought it in for the figures about what the degree of the
18 risk was. So, I do not think that, given their admission,
19 the Plaintiffs should be able to start casting doubt on
20 whether or not there is any evidence that there is a causal
21 link.
22
23 MR. RAMPTON: No.
24
25 MR. JUSTICE BELL: What I am interested in the salt element -- I
26 will explain and then I will suggest what we do and rise --
27 is because of the meaning as I have defined it, quite apart
28 from the dispute about the extent to which eating any or
29 such and such an amount of McDonald's food might affect
30 your diet, I may well have to grapple with -- well, I will
31 have to grapple with -- the extent of any risk.
32
33 MR. RAMPTON: My Lord, that is right.
34
35 MR. JUSTICE BELL: Should McDonald's food so affect diet by
36 making it high in fat and salt and lower in fibre or
37 helping sustain a diet which has those characteristics, and
38 what I may -- I am putting in it very neutral terms -- what
39 I may very well have to do is grapple with what the risk is
40 and it may be particularly important because it may be that
41 one's got to keep one's eye on the possible distinction
42 between, for instance, views that you can minimise risk by
43 following a certain diet on the one hand and any evidence
44 which I may have that if you do not follow such a "healthy"
45 diet you will actually create a very real risk of
46 suffering a particular degenerative disease, and I think I
47 must keep that distinction in mind.
48
49 If there is such a distinction then it is important to
50 know what the evidence is, not just that lowering salt
51 intake may lower blood pressure and may lower incidence of
52 ischemic heart disease, query whether stroke comes in, but
53 also know to what extent it does that.
54
55 This is not a point made against you. It is just
56 underlining what I particularly have in mind, and that is
57 partly why I asked the question, which report was it that
58 Mrs. Brophy found significant? Was it the one which says a
59 modest change, was it the part which showed, or purported
60 to show, that such and such a lowering of salt intake led
