South Africa Study
Year Begun: 1954
Location: Capetown, South Africa
Principal Investigator: Bronte-Stewart, Brian
This is one of the earliest systematic cross-cultural comparisons of diet, blood lipids, and coronary disease and was carried out in a collaboration between the Minnesota and South African groups early in the modern history of diet-heart theory.
Large industries of Capetown were surveyed in which all three major ethnic groups, Bantu, Cape Colored, and European were simultaneously employed. Careful dietary surveys and chemical analyses were made, while differences in disease rates were based on other data elsewhere. Some 600 adult men were examined, their diets carefully characterized, their blood lipid determinations carried out centrally.
Analyses revealed striking differences in the total and beta cholesterol level in the serum between the three ethnic groups and large differences in average consumption of fat and animal fat. At the same income level, however, these ethnic differences were very small.
Both the sophistication of the thinking, the population strategy, the detailed metabolic, diet and social measurements, and the interpretations were advanced for that period. The authors concluded that the close parallelism between the incidence of coronary heart disease, the serum cholesterol level, and the percentage of fat in the diet supported by experimental and theoretical evidence for the cause of atherosclerosis offers the greatest hope for effective prevention and control of morbidity and mortality from coronary heart disease.This important early cultural comparison shares the limitations of cross-sectional, one-time surveys, plus the unsystematic evaluation made of coronary disease incidence. (HB)
Serum-cholesterol, diet, and coronary heart-disease; an inter-racial survey in the Cape Peninsula. B. Bronte-Stewart, Ancel Keys, J.F. Brock. Lancet, Nov 26 1955; 269 (6900):1103-1108.