Diet-Related Disease Patterns in South African Interethnic Populations

Epidemiological Perplexities and Future Prospects
  • Alexander R. P. Walker
  • Demetre Labadarios
  • Ingrid I. Glatthaar


In South Africa there are four ethnic populations:
  1. 1.

    Blacks (30 million);

  2. 2.

    Coloreds (Euro-African-Malay) (3 million);

  3. 3.

    Indians (1 million); and

  4. 4.

    Whites (5 million).



Colon Cancer Dental Caries Acute Appendicitis Western Population White Population 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Herrick JB. Clinical features of sudden obstruction of the coronary arteries.JAMA 1912; 59:2015–2020.CrossRefGoogle Scholar
  2. 2.
    McCrae T. Osier’s Principles and Practice of Medicine. London: Appleton, 1912; 836.Google Scholar
  3. 3.
    Morris JM. Primary prevention of heart attack. Bull NY Acad Med 1975; 51:62–74.Google Scholar
  4. 4.
    Sytkowski PA, Kannel WB, D’Agostino RBD. Changes in risk factors and the decline in mortality from cardiovascular disease. N Engl J Med 1990; 322:1635–1641.CrossRefGoogle Scholar
  5. 5.
    Walker ARP, Adam A, Küstner HGV. Changes in total death rate and ischaemic heart disease death rate from 1978 to 1989 in South African interethnic populations. S Afr Med J 1993; 83:602–605.Google Scholar
  6. 6.
    Steyn K, Rossouw JE, Joubert G. The coexistence of major coronary heart disease risk factors in the coloured population of the Cape Peninsula (CRISIC study). S Afr Med J 1990; 78:61–63.Google Scholar
  7. 7.
    Rossouw JE, Jooste PL, Steenkamp HJ, Thompson ML, Jordaan PC J, Swanepoel ASP. Socio-economic status, risk factors and coronary heart disease: The CORIS baseline study. S Afr Med J 1990; 78:82–85.Google Scholar
  8. 8.
    Seedat YK, Mayet FGH, Khan S, Somers SR, Joubert G. Risk factors for coronary heart disease in the Indians of Durban. S Afr Med J 1990; 78:447–454.Google Scholar
  9. 9.
    Tunstall-Pedoe H, Smith WCS. Cholesterol as a risk factor for coronary heart disease. Br Med Bull 1990; 46:1975–1987.Google Scholar
  10. 10.
    Walker ARP. Diet and atherosclerosis.Lancet 1955; i: 565, 566.Google Scholar
  11. 11.
    Pisa Z, Uemura K. International differences in developing improvements in cardiovascular health.Ann Med 1989; 21:193–197.CrossRefGoogle Scholar
  12. 12.
    Mukerjee AB. Heart diseases in India. J Indian Med Assoc 1975; 65:156–158.Google Scholar
  13. 13.
    Ornish D, Brown SE, Scherwitz LW, Billings JH, Armstrong WT, Portis TA, McLanahan SM, Kirkeeide RL, Brand RJ, Gould KL. Lifestyle changes and heart disease. Lancet 1990; 336:741,742.Google Scholar
  14. 14.
    Muldoon MF, Manuck SB, Matthews KA. Mortality experience in cholesterol-reduction trials. N Engl J Med 1991; 324:922,923.Google Scholar
  15. 15.
    Hulley SB, Walsh JMB, Newman TB. Health policy on blood cholesterol: time to change directions. Circulation 1992; 86:1026–1029.Google Scholar
  16. 16.
    Anderson M, Walker ARP, Lutz W, Higginson J. Chemical and pathological studies on aortic atherosclerosis. AMA Arch Path 1959; 68:380–391.Google Scholar
  17. 17.
    Pokorny WJ. Appendicitis Principles and Practice. Oski FA, De Angelis CD, Feigin RD, Warshaw JB, eds. Philadelphia: JB Lippincott Co., 1990; 1737–1739.Google Scholar
  18. 18.
    Addiss DG, Shaffer N, Fowler BS, Tauxe RV. The epidemiology of appendicitis and appendectomy in the United States. Am JEpidemiol 1990; 132:910–925.Google Scholar
  19. 19.
    Walker ARP, Walker BF. Appendectomy in South African interethnic school pupils. Am J Gastroenterol 1987; 82:219–222.Google Scholar
  20. 20.
    Short AR. The Causation of Appendicitis. Bristol: Wright, 1946.Google Scholar
  21. 21.
    Trowell HC. Non-Infective Diseases in Africa. London: Edward Arnold, 1960.Google Scholar
  22. 22.
    Burkitt DP. The aetiology of appendicitis. Br J Surg 1971; 58:695–699.CrossRefGoogle Scholar
  23. 23.
    Cleave TL. The Saccharine Disease. Bristol: John Wright, 1974.Google Scholar
  24. 24.
    Barker DJP, Osmond C, Golding J, Watsworth, MEJ. Acute appendicitis and bathrooms in three samples of British children. Br Med J 1988; 296:956–958.CrossRefGoogle Scholar
  25. 25.
    Banks AL, Magee HE. Effects of enemy occupation on the state of health and nutrition in the Channel Islands. Mon Bull Min Health Pub Health Lab Serv 1945; 4:184–187.Google Scholar
  26. 26.
    Black J. Vegetable consumption and acute appendicitis. Br Med J 1986; 293:52.CrossRefGoogle Scholar
  27. 27.
    Young M, Russell WT. Appendicitis. A Statistical Study. Med Res Council Spec Rep Ser No 133, London: HMSO, 1939.Google Scholar
  28. 28.
    Segal I, Walker ARP. Low-fat intake with falling fiber intake commensurate with rarity of noninfective bowel diseases in blacks in Soweto, Johannesburg, South Africa. Nutr Cancer 1986; 8:185–191.CrossRefGoogle Scholar
  29. 29.
    Doll R. Prospects for Prevention. Harveian Oration of 1982. London: Royal College of Physicians, 1982.Google Scholar
  30. 30.
    Jolliffe N, Rinzler SH, Archer M, Maslansky E, Rudensey F, Simon M, Faulkner A. Effect of a prudent reducing diet on the serum cholesterol of overweight middle aged men. Am J ClinNutr 1962; 10:200–211.Google Scholar
  31. 31.
    Stewart MJ. Precancerous lesions of the alimentary tract. Lancet 1931; ii:669–675.CrossRefGoogle Scholar
  32. 32.
    Muir C, Waterhouse J, Mack T, Powell J, Whelan S. Cancer Incidence in Five Continents, Vol V. (IARC Scientific Publication No 88) Lyons: International Agency for Research on Cancer, 1987.Google Scholar
  33. 33.
    Phillips RL. Role of life-style and dietary habits in risk of cancer among Seventh-Day Adventists. Cancer Res 1975; 35:3513–3522.Google Scholar
  34. 34.
    Cancer Registry of South Africa, 1986. Johannesburg: South African Institute for Medical Research, 1988.Google Scholar
  35. 35.
    Potter JF, Dawkins DM, Pandha HS, Beevers DG. Cancer in Blacks, Whites and Asians in a British Hospital. J Roy Coll Phys (London) 1984; 18:231–235.Google Scholar
  36. 36.
    Shimizu H, Mack TM, Ross RK, Henderson BE. Cancer of the gastro-intestinal tract among Japanese and white immigrants in Los Angeles County. J Natl CancerInst 1987; 78:223–228.Google Scholar
  37. 37.
    Young TB, WolfD A. Case-control study of proximal and distal colon cancer and diet in Wisconsin. Int J Cancer 1988; 42:167–175.CrossRefGoogle Scholar
  38. 38.
    Slattery ML, Sorenson AW, Mahoney AW, French TK, Kritchevsky D, Street JC. Diet and colon cancer: assessment of risk by fiber type and food source. J Nat Cancer Inst 1988; 80:1474–1480.CrossRefGoogle Scholar
  39. 39.
    Iscovich JM, L’Abbe KA, Castelleto R, Calzona A, Bernedo A., Chopita NA, Jmelnitzsky AC, Kaldor J. Colon cancer in Argentina. I. Risk from intake of dietary items. Int J Cancer 1992; 51:851–857.CrossRefGoogle Scholar
  40. 40.
    Iscovich JM, L’Abbe KA, Castelleto R, Calzona A, Bernedo A., Chopita NA, Jmelnitzsky AC, Kaldor J, Howe GR. Colon cancer in Argentina. II. Risk from fibre, fat and nutrients. Int J Cancer 1992; 51:858–861.CrossRefGoogle Scholar
  41. 41.
    Heilbrun LK, Nomura A, Hankin JH, Stemmermann GN. Diet and colorectal cancer with special reference to fiber intake. Int J Cancer 1989; 44:1–6.CrossRefGoogle Scholar
  42. 42.
    Lee HP, Gourley L, Duffy SW, Esteve J, Lee J, Day NE. Colorectal cancer and diet in an Asian population—a case-control study among Singapore Chinese. Int J Cancer 1989; 43:1007–1016.CrossRefGoogle Scholar
  43. 43.
    DeCosse JJ, Miller HH, Lesser ML. Effect of wheat fiber and vitamins C and E on rectal polyps in patients with familial adenomatous polyposis. J Natl Cancer Inst 1989; 81:1290–1297.CrossRefGoogle Scholar
  44. 44.
    Tomlin I. A survey of normal bowel habit. Br J Clin Pract 1975; 29:289–291.Google Scholar
  45. 45.
    Thornton JR. High colonic pH promotes colorectal cancer. Lancet 1981; i:1081, 1082.Google Scholar
  46. 46.
    Segal I, Cooke SA, Hamilton DG, Ou Tim L. Polyps and colorectal cancer in South African blacks. Gut 1981; 22: 653–657.CrossRefGoogle Scholar
  47. 47.
    Thun MJ, Namboodiri MM, Heath CW. Aspirin use and reduced risk of fatal colon cancer. N Engl J Med 1991; 325:1593–1596.CrossRefGoogle Scholar
  48. 48.
    Baron JA, Greenberg ER. Could aspirin really prevent colon cancer? N Engl J Med 1991; 323:1644–1646.CrossRefGoogle Scholar
  49. 49.
    Willett WC, Stampfer MJ, Colditz GA, Rosner BA, Speizer FE. Relation of meat, fat, and fiber intake to the risk of colon cancer in a prospective study among women. N Engl J Med 1990; 323:1664–1672.CrossRefGoogle Scholar
  50. 50.
    Higginson J. In: Maltoni C, ed. Advances in Tumour Prevention. Detection and Characterization. Part II. Amsterdam: Excerpta Medica, 1974; 3.Google Scholar
  51. 51.
    Burkitt DP. In: Reilly RW, Kirsner JB, eds. Fiber Deficiency and Colonic Disorders. New York: Plenum, 1975, p. 156.Google Scholar
  52. 52.
    Block G, Lanza E. Dietary fiber sources in the United States by demographic group. J Natl Cancer Inst 1987; 79:83–91.Google Scholar
  53. 53.
    Mandel D. Caries through the ages: a worm’s eye view. J Dent Res 1983; 62:926–929.CrossRefGoogle Scholar
  54. 54.
    King JD. Dental Disease in the Island of Lewis. Med Res Coun Spec Rep Ser No 241. London: HMSO, 1940.Google Scholar
  55. 55.
    Bransby ER, Knowles EM. A comparison of the effects of enemy occupation and post-war conditions on the incidence of dental caries in children in the Channel Islands in relation to diet and food supplies. Br Dental J 1949; 87:236–243.Google Scholar
  56. 56.
    Burton VJ, Rob MI, Craig GG, Lawson JS. Changes in the caries experience of 12-year-old Sydney schoolchildren between 1963 and 1982. Med J Aust 1984; 140:405–407.Google Scholar
  57. 57.
    Walker ARP, Dison E, Walker BF, Segal AF. Contrasting patterns of caries profile and dental treatment in pupils of 16–18 years in South African ethnic groups. Comm Dent Oral Epidemiol 1982; 10:69–73.CrossRefGoogle Scholar
  58. 58.
    Steyn NP, Albertse EC. Sucrose consumption and dental caries in twelve-year-old children residing in Cape Town. J Dent Assoc S Afr 1987; 42:43–49.Google Scholar
  59. 59.
    Mintz SW. Sweetness and Power: The Place of Sugar in Modern History. Viking: Elizabeth Sifton Books, 1985; 67.Google Scholar
  60. 60.
    COMA Report. Dietary Sugars and Human Disease: Conclusions. Department of Health and Social Subjects. No 37. London: HMSO, 1990.Google Scholar
  61. 61.
    Walker ARP, Cleaton-Jones PE. Sugar intake and dental caries: where do we stand? J Dent Child 1989; Jan/Feb:30–35.Google Scholar
  62. 62.
    Rugg-Gunn AJ, Murray JJ. The role of sugar in the aetiology of dental caries. I. Sugar and the antiquity of caries. J Dent 1983; 11:190–199.CrossRefGoogle Scholar
  63. 63.
    Dietch R. Commentary from Westminster: Another ferocious but unavailing stand against fluoridation. Lancet 1985; I: 231.CrossRefGoogle Scholar
  64. 64.
    Rugg-Gunn AJ, Hackett AF, Appleton DR, Jenkins GN, Eastoe JE. Relationship between dietary habits and caries increment assessed over two years in 405 English adolescent school children. Arch Oral Biol 1984; 29:983–992.CrossRefGoogle Scholar
  65. 65.
    Dummer PMH, Oliver SJ, Hicks R, Kingdon A, Addy M, Shaw WC. Factors influencing the initiation of carious lesions in specific tooth surfaces over a 4-year period in children between the ages of 11–12 years and 15–16 years. J Dent 1990; 18: 190–197.CrossRefGoogle Scholar
  66. 66.
    Seedat YK, Seedat MA, Hackland DBT. Biosocial factors and hypertension in urban and rural Zulus. S Afr Med J 1982; 61:999–1002.Google Scholar
  67. 67.
    Solomon L. Bone density in ageing Caucasian and African populations. Lancet 1979; ii:1326–1330.CrossRefGoogle Scholar
  68. 68.
    Muir CS, Sasco AJ. Prospects for cancer control in the 1990’s. Ann Rev Public Health 1990; 11:143–163.CrossRefGoogle Scholar

Copyright information

© Humana Press, Totowa, NJ 1994

Authors and Affiliations

  • Alexander R. P. Walker
  • Demetre Labadarios
  • Ingrid I. Glatthaar

There are no affiliations available

Personalised recommendations