Day 253 - 21 May 96 - Page 12


     
     1        something.  They die less of coronary heart disease, and we
     2        think we may have an explanation for that.
     3
     4   Q.   What I am saying is, if, as I believe everyone has
     5        accepted, that coronary heart disease is a very substantial
     6        concern and health risk?
     7        A.  A major cause of death.
     8
     9   Q.   Major cause of death, and that Governments are attempting
    10        to influence dietary patterns in order to reduce?
    11        A.  Yes.
    12
    13   Q.   That risk, does the fact that whether it is 300 people per
    14        100,000 or 7 per 100,000, does that mean that, therefore,
    15        the French Government Authorities and health professionals
    16        can be complacent and say:  "We do not have a coronary
    17        heart disease problem in this country"?
    18        A.  I doubt very much if the French authorities think like
    19        that at all.  I have no doubt they would like to reduce the
    20        incidence of heart disease, stroke and other degenerative
    21        diseases within the population.  It certainly does not give
    22        me any satisfaction.  I mean, obviously, I would like to
    23        see values for all countries being reduced.
    24
    25   Q.   Right.  I note the stroke rate for France are -- they have
    26        been coming down actually, according to the list on page
    27        53:  125 per 100,000 in 1970 coming down to about 80 per
    28        100,000 in the middle of the year, whenever that last year
    29        would be.  I think we can move on from that.
    30
    31        I am just trying to understand this chart.
    32
    33   MR. JUSTICE BELL: Your question started with asking a proportion
    34        is more and it looks as if the rate in the United Kingdom
    35        is approximately 4 times that in France falling to about
    36        just over 3 times that, so far as coronary heart disease is
    37        concerned.  The difference between stroke mortality in
    38        France and the United Kingdom is very little, is quite
    39        small.
    40
    41   MR. MORRIS:  Yes.
    42
    43   MR. JUSTICE BELL: Did you have a question about that?  So it is
    44        the left hand page which is the French paradox?
    45
    46   MR. MORRIS:  I see what you mean, yes.  The so-called paradox,
    47        though, does not apply to stroke where the incidence is
    48        very similar in France and the United Kingdom?
    49        A.  Yes.
    50 
    51   Q.   Yes.  In fact, on page...  No, I will leave it at that, 
    52        I think.  I will move on from that point.  There is very 
    53        little else we have got.  Helen has a few questions as
    54        well.  Does obesity as a health problem take a period to
    55        develop; I mean, can it develop over a year, does it take
    56        ten, 15 years to develop?
    57        A.  I would say in my own report that it was an insidious
    58        thing, it is something that creeps up on you gradually, but
    59        it does not take all that long.  I think if one looks at
    60        heights and weights of people as reported by the Department

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