Day 014 - 20 Jul 94 - Page 17

     
     1   MR. JUSTICE BELL:  Any substance.  This is just one to 10?
              A.  Again one cannot take it in isolation because in
     2        making a judgment like that you also have to be conscious
              that if you recommend to people, shall we say, to reduce
     3        fat or to increase the amount of polyunsaturated fat in
              the diet, that there may well be a negative effect that
     4        has to be taken into account.  So, one has to weigh up
              these factors and do a cost benefit analysis.
     5
              The other important factor to take into account is the
     6        benefit that would be achieved and, clearly, if the
              benefit that can be obtained as a result is a significant
     7        reduction in the incidence of heart disease -- you can
              count up 10, 20,000 lives saved per year -- then obviously
     8        that is an important factor that has to be taken into
              account in the judgment.  It is a matter of weighing up
     9        all these factors and then governments, companies,
              individuals decide for themselves what they would do.
    10
         MR. RAMPTON:  We can look at that in a bit more detail and
         perhaps make our own scales, as it were, when we look at
              what the government actually does advise in this booklet.
    12
         MR. JUSTICE BELL:  Mr. Rampton, the only reason I asked the
    13        question is that all the figures between one and 10 may
              mean something to the witness and something different to
    14        me or anyone else.  What I would just want to know, what
              I am feeling for, is where on Professor Wheelock's 1-10
    15        scale would he put the ordinary intelligent concerned
              person thinking: "Well, I really ought to watch that",
    16        just to give a feel of it.  Would that be 2 or 7?
              A.  If I was forced into a corner and had to give a value
    17        I would probably say 5 or 6.
 
    18   MR. JUSTICE BELL:  Somewhere in the middle.
 
    19   MR. RAMPTON:  Somewhere in the middle you would start to wonder
              whether you should not and above the middle, round 8 or 9,
    20        you would probably say to yourself: "I certainly should
              not".  Is that right?
         A.  Yes.
 
    22   Q.   It cannot be pressed too far, the scale, I know, but if we
              may just quickly run through it.  Where would you put on
    23        the scale with that gloss that his Lordship has
              introduced, where would you put on the scale the
    24        relationship between intake of saturated fat and
              cardiovascular disease?
    25        A.  I would put it at about 8.
  
    26   Q.   Where would you put the intake of dietary, that is to say 
              extraneous or exogenous cholesterol and the creation of 
    27        health problems?
              A.  Well, with our current knowledge that can vary with
    28        individuals, but if we look at it from a population point
              of view, I would say about 3.
    29
         Q.   Yes.  Am I right in thinking that the Americans are or
    30        have been rather more concerned about the consumption of
              dietary cholesterol than we have been in this country?