Relationship between nutritional status, dietary intake patterns and plasma lipoprotein concentrations in rural black...

Coronary artery disease remains rare in rural Africans. The survey reported here was conducted in order to investigate nutritional factors that might be responsible for this. The nutritional status, dietary intake and plasma lipoprotein concentrations of a representative sample (42 men, 60 women) of the inhabitants of a rural district in Zululand, South Africa, were measured. Results demonstrated that whilst men were generally underweight (ie, 20 per cent below 80 per cent of ideal body weight), women were commonly obese (20 per cent were over 140 per cent of ideal). The major dietary component was refined commercial maize-meal with infrequent intakes of animal and dairy products. Dietary fibre intake was consequently low (approximately 10 g/d). Low plasma cholesterol concentrations were found in 67 per cent of men and 42 per cent of women. High density lipoprotein (HDL) concentrations were generally lower than quoted 'desirable' levels. The results of our survey suggest that the low incidence of ischaemic heart disease (IHD) in rural Africans is associated with a diet low in cholesterol but often excessive in carbohydrate, resulting in obesity. HDL concentration and dietary fibre intake were low and therefore could not be invoked as 'protective'. The possibility of genetic resistance to IHD remains.