Overconsumption

Letters to the Editor

39

What the Faculty has to decide iS whether to treat other .Organizations as friends or foes. Arrogance, elitism and rejection never win friendship. Courtesy, consideration and hospitality do ,not generate ,enmity, If the Faculty maintains a dog-in-the-manger attitude and seeks tO enclude other bodies from consultation, it will arouse their antagonism and generate the hostility which .Professor Smith so deplores. Dear Sir, Overeonsumpfion It is good of you to say that I have enlivened your correspondence 'but my intention was also serious. Quite rightly you hav e' given Captain Cleave a chance to reply and have pointed out that opinions and theories soon become obsolete but ,factual observations do not. (George Bernard Shaw did much the same in the "Doctor's Dilemma, over 70years ago, in particular connection with Sir Colenso R.igdeon's opinion). My purpose was to make,sure that discussion was not closed by Surgeon-Captain Cleave's article. ] amnot going to follow Cap~tain Cleave i,n detail On honey or the African tribes. He is, however, perhapsthinking of the Masai who subsist, it seems, on a mixture'ofmiik and cow's blood, absorbed While standing on one leg. Foi" this or'other :reasons;, their age expectation is less than 50, so the fact that few 'of them die of CHD is pe'rhaps explicable. Olher tribes have at least a comparably low~life-expectation, but the matter is surely not a question ofdlet only. When Captain Cleave turns i'o dental matters, I think he errs by omission. Dental caries i s a multifactorial complaint. Of course the consumption of sucrose :is one of the factors but there are others. The reis, naturally, the presence' 'Of teeth, ihe existence 0f.0ral micro flora, the ,presence-orabsence---of fluoride in the water supply, and .the efficiency of oral hygiene. Some modern authorities would also add a genetic factor. Butto say 'that "'.the consumption of sugar can render .large sections o f the ,pbpulation ~toothless by the' age Of 30" is. an ovel:-simplification which is rtoto'aly misleading but'irresp6nsible. (IS this discourteous? If so; I am sorry). Finally I Would like to draw your attention to a'paper to which I failed tO refer in my previous letter, simply because/it was.not publishe d until I9 November 197.7 in the British Medical JournaL 1 Morris , M a r t & Clayton then mad8 public.the results of a 20-yearl study of 337 men begun in 1955,-6, whose jobs included those Of bus-driver; bus-conductor and bank staff. 'The authors.themSelves comment that the results of this long term and meticulously organized study were ~unexpeeted.(They were,clearly aware of Louis Pasteuffs recommendation: "Be reD' careful when you m-e lookingfor.s0mething, or you are sure to find i[".) Briefly, the study by Morris" and .his colleagues Shows that .there was an inyerse association between energy intake, Whether :in the form Of fat or carboh~'drate, and CHD. The important deduction from this paperis thatwhat matters is fibre--:-orwhat grandfather Used to~:a]l "roughage". It is not, alas for Captain Cleave, anyoldvegetable or fruit fibre---exceUent as that may .be-which counts; but cereal fibre. Ineidentally,with specific reference to Captain Cleave and Professor Yudkin, Morris et al. say: "~There was no sign o f a relation between the consumPti0nof sticrose'and CHD": Now elearly this is not the last Word on the subject, No word ever is. Perhaps one of the authors 0f.the paper "Diet and HearZ---A Postseript,might like to comment ? British Sugar Bureau, !40 Park Lane, London W1 Y 3AA

GP,ARAM C. SOMERVaLLE { D ~ P ~ DIREcror,-G~NERAL)

Reference I. Morris, J. N., Mart, Jean W. & Clayton, D. G, (1977). '?Diet and Heart--=A Postscript"~ British Medical Jo~irnal it, ~1307-14,