Day 252 - 20 May 96 - Page 56
1 have increased nutrient products with little or not
2 nutritional value. These foods rich in fat and sugar have
3 become important socially, if not as yet in nutritional
4 terms, and are now beginning to be substituted for better
5 traditional foods."
6
7 This is talking about developing countries. Would you
8 accept that?
9 A. Well, I am not sure about "better traditional foods".
10 I accept that these changes are taking place. I would also
11 point out that one does not always eat food purely for its
12 nutritional content. That applies to things like snacks
13 and soft drinks and so on.
14
15 Q. Well we can put that away, that report away that you have.
16 I am sorry, on page 12 -- I did photocopy this at lunch
17 time -- if I could had one to the Judge. (Same handed)
18
19 On page 12, it talks about the various range of chronic
20 diseases in the previous paragraph etc. It then says:
21
22 "The causes of these chronic diseases are complex" --. It
23 is the top first paragraph on page 12-- "and dietary
24 factors are only part of the explanation. Individuals also
25 differ in their susceptibility to the adverse health
26 effects of specific dietary factors but within the public
27 health context the focus is to help the whole population.
28 Public health interventions aim to lower the average level
29 of risk to health of whole populations either because the
30 whole population is at risk, or because the strategy to
31 identify the minority of individuals at greatest risk, even
32 if available, would only contribute to a modest public
33 health improvement since much, if not most, of the disease
34 in the population occurs in the more numerous individuals
35 at moderate to low risk."
36
37 Could you accept that?
38 A. Yes, that is probably correct, yes.
39
40 Q. So the people who are what are defined as "moderate to low
41 risk" are the bulk of the people who contract these chronic
42 diseases?
43
44 MR. JUSTICE BELL: No. They are the bulk of the population,
45 what happens to them affects public health in a greater
46 degree generally.
47
48 MR. MORRIS: So the bulk of the population is at risk, what they
49 define as "low to moderate risk" and there are other people
50 that are high risk sections of the population?
51 A. Yes.
52
53 Q. But the high risk sections are substantial sections of the
54 population?
55 A. I think they tend to be a minority in the population.
56 I do not know if you have thought of people with something
57 like severely elevated blood cholesterol blood level, they
58 represent fortunately a comparatively small population, but
59 a large portion of the population have elevated blood
60 cholesterol.
