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
