Day 021 - 29 Jul 94 - Page 16
1 details of specific SFAs that have the most effect. It
concludes: "However, despite these differences, it is
2 usual to consider total saturated fatty acids as a class
for practical purposes".
3
MR. JUSTICE BELL: That is really the only way you can approach
4 it?
A. Exactly. You cannot be advising people to reduce their
5 levels of myristic acid, for example.
6 MR. MORRIS: Is it true, based upon the reading of that and in
your experience and opinion, that the health risks of
7 cholesterol in general are not absolute in terms of, if we
have this much cholesterol it will have this much effect,
8 but are linked to your total saturated fatty acid intake?
A. That is right. Again I would emphasise that most of
9 this data is based on a study of the population because,
of course, in individuals there are some other factors,
10 particularly genetics, which will affect the concentration
of cholesterol in the blood.
11
MR. JUSTICE BELL: But unless we want to subject ourselves to
12 very refined tests to find out how it might affect us, we
have to go by the averages?
13 A. Yes, absolutely.
14 MR. MORRIS: If we just turn the page -- I will skip a couple
of paragraphs I was going to refer to -- if you go to page
15 47 at the bottom of the page -- just one second -----
16 MR. JUSTICE BELL: 3.4.14.
17 MR. MORRIS: If we look at 3.4.11 very briefly on page
46 -- no, just leave that one. I cannot understand it
18 straightaway. If we go to 3.4.14 at the bottom of page
47: "Relationship of serum cholesterol to CHD risk. The
19 evidence relating serum cholesterol to CHD risk does not
suggest a threshold effect - that is a particular level of
20 serum cholesterol above which the risk is high, and below
which the risk is low. Rather the risk appears to
21 increase continuously with serum cholesterol."
22 So, that is another factor, is it not? Does that suggest
to you that serum cholesterol at any amount is going to
23 increase the risk?
A. Well, again we have to be a little bit careful about
24 this because there is some suggestion (and I would not put
it any stronger than that) that if the cholesterol is too
25 low there may be an association with cancer, but this is
very debatable and people are not sure whether, when that
26 actually occurs, it is a cause or an effect.
27 But, I mean, I think as I mentioned before, looking at
populations, basically what you find is that if the
28 average is above about 6.5, I would say, milligrams,
millimoles per hundred mils, then the level of -- the
29 death rate from coronary heart disease is regarded as
actually pretty high. If you can get it down below about
30 5 for the population as a whole, then the incidence of
death from heart disease in those countries is pretty
