Health actions and disease patterns related to coronary heart disease in the coloured population of the Cape Peninsula

The health-related behaviour of the Cape Peninsula coloured population, which has been shown to have an adverse coronary heart disease (CHO) risk factor profile, is reported. Private medical services were used most often by participants: 54,1% and 51,6% of males and females respectively had made use of these services during the preceding year. Only 17,9% and 21,8% of males and females respectively had attended day hospitals during the year. Blood pressures were measured in 43,8% and 57,1% of male and female participants respectively during the year preceding the study. The results indicated the need for the measurement of blood pressure to determine the true prevalence of hypertension, since patient reporting of the condition was inaccurate. Attempts to give up smoking had been made by 44,4% of male and 47,1% of female smokers. About 75% of the participants were found to have hypercholesterolaemia, yet their knowledge of the prudent diet was poor and few reported appropriate dietary modifications to protect against CHO. Frequent reporting of hypercholesterolaemia, hypertension and constipation by the study population highlights the need for dietary education. Mortality rates (MRs) for CHO and cerebrovascular disease (CVO) for the coloured and the white populations were compared. In all age groups white males had higher MRs for CHO than coloured males, while coloured females older than 34 years had higher rates than their white counterparts. The coloured population had MRs for CVO that were higher than those of whites.S Afr Med J 1990; 78: 73-7

The relationship between dietary factors and serum cholesterol values in the coloured population of the Cape Peninsula

A cross-sectional study of 976 coloured subjects aged 15 -64 years identified a population consuming a typical Western diet. Nutrient intake, determined by the 24-hour dietary recall method, reflected a diet high in fat (37% of total energy intake) and animal protein and a polyunsaturated/saturated fatly acid ratio of 0,85. Only 32,2% of men and 27,5% of women consumed a prudent diet (Keys score < 28). The influence of this Western diet on serum total cholesterol (TC) levels was seen to be marked whe'n participants with a high risk of developing coronary heart disease (CHD) were compared with those with a TC level putting them at low risk; the former consumed significantly more saturated fat and had a higher mean Keys score. Multiple linear regression analysis on TC levels of men identified six variables that explained 26,9% of the variation of TC. These were body mass index, age, the inverse of the polyunsaturated fat intake, saturated fat intake, polyunsaturated/saturated fat ratio and cholesterol intake. For women only three variables (age, the inverse of the polyunsaturated/saturated fat ratio, and body mass index) explained 30,2% of the variation of TC. Promotion of the prudent diet to lower TC levels of the coloured population of the Cape Peninsula is an increasingly urgent priority.S Afr Med J 1990; 78: 63-67

Risk factors for coronary heart disease in the black population of the Cape Peninsula The BRISK study

A cross-sectional study of risk factors for ischaemic heart disease (IHO) in a random sample of 986 black people aged 15 - 64 years living in the Cape Peninsula revealed a population at lower risk for IHO than other South Africans. Blood pressures of 140/95 mmHg or above were found in 14,4% of males and 13,7% of females. Fifty-two per cent of males and 8,4% of females smoked, while 16,5% of males and 25,8% of females had a total cholesterol (TC) level imparting risk for developing IHO. In this population the TC level is not a good surrogate measure for low-density lipoprotein cholesterol because of the high level of high-density lipoprotein cholesterol (HOLC) found in this population. A protective HOLC/TC ratio of 20% was found in 96% of males and 96,1% of females. When considering the three major reversible IHO risk factors at a high level of risk, 30,8% of males and 12,5% of females had at least one such a risk factor. The population was frequently exposed to the media, with 80% listening to the radio every day and 55% watching television at least once a week. This suggests that a healthy lifestyle could be promoted successfully by means of these media. In addition, schools should promote a healthy lifestyle and the prevention of chronic degenerative diseases should be incorporated into the evolving primary health care services in South Africa

Growth and weight status in treatment-naïve 12-16 year old adolescents with Alcohol Use Disorders in Cape Town, South Africa

The original publication is available at http://www.nutritionj.com/Publication of this article was funded by the Stellenbosch University Open Access Fund.Abstract: Background Heavy alcohol consumption during adolescence has many known harmful health and social consequences and is strongly associated with numerous health risk behaviours. The consequences of heavy alcohol use during adolescence on nutritional status, specifically growth and weight status are largely unknown at this time. Methods Substance use, anthropometric indices of growth and weight, dietary energy intake and physical activity in heavy drinking adolescents (meeting DSM-IV criteria for alcohol use disorders) and matched light/non-drinking control adolescents were assessed. Results Lifetime alcohol dose, measured in standard drinks of alcohol, was orders of magnitude higher in adolescents with alcohol use disorders (AUDs) compared to controls. The AUDs group was selected to represent relatively 'pure' AUDs, with minimal other drug use and no psychiatric diagnoses. The growth and weight status of adolescents with AUDs were generally comparable to that of controls, and is in line with the growth and weight status of the South African adolescent population. A greater proportion of overweight/obese females was found in both groups, with this percentage tending to be greater, although not significantly so, in the AUDs group. Adolescent females with AUDs had increased odds of being overweight/obese compared to controls, after adjustment for smoking, physical activity and energy intake. Conclusion Anthropometric indices of growth and weight status of participants in the Control and AUD groups were generally comparable. Female adolescents with AUDs may have an increased risk of being overweight/obese compared to adolescent females without AUDs. The presence of an AUD in our adolescent sample was associated with higher energy intake. Longitudinal studies are needed to elucidate the effects of heavy alcohol use on energy balance, growth and weight status in adolescents as they age. Nonetheless, the current study contributes to our understanding of the impacts of heavy alcohol consumption on important aspects of adolescent development.Publishers' versio

Anthropometric profile of the coloured population of the Cape Peninsula

Study of a sample of 976 randomly selected coloured persons 15 - 64 years of age living in the Cape Peninsula included measurement of height, weight and mid-arm circumference and calculation of the body mass index (BMI). The mean height of the men was 167,6 cm and that of the women 156 cm. Mean weight, BMI and mid-arm circumference for men were 65,9 kg, 23,4 and 27,5 cm respectively and those for women 65,8 kg, 27,1 and 28,9 cm respectively. The prevalence of underweight for men (BMI < 20) was 23,6% and for women (BMI < 19) 9,8%; 17,7% of men were overweight (BMI ≥ 25) and 3,7% obese (BMI ≥ 30), while 35,2% of women were overweight (BMI ≥ 24) and 18,8% obese. Overweight and obesity were more common among the older coloured women than among a group of South African white women of the same age. Obese women in the age group 35 - 44 years were 4,8 times more likely to be hypertensive than women of normal weight in the same age group (odds ratio; 95% confidence interval 2,2 • 4). Older women did not show this association. There were too few obese men to analyse in this manner. Many of the obese participants did not see themselves as obese. Only 19,7% of men and 45,2% of women had attempted to lose weight during the year preceding the study, in many cases using methods known to be ineffective. The coloureds of the Cape Peninsula were found to be a population  with shorter stature than South African white and American populations. Some young participants of both sexes and some older men were underweight, while among older women there was a high prevalence of overweight and obesity. The findings may suggest previous undernutrition in both sexes, with a marked tendency to current overnutrition in adult females.S Afr Med J 1990; 78: 68-72