34 Discussion 



animals were caught by this young man, Dr. U. de V. Pienaar, and then 

 brought to the laboratory for study. A reptilarium was started in Johan- 

 nesburg, and a number of lizards have now been studied for several years. 

 This high incidence of parasitic infection in these animals was regularly 

 associated with very profound anaemias which apparently contributed 

 to their deaths. Frequently, too, Dr. Pienaar found, during his excur- 

 sions into the wilds, a number of animals that had apparently just died 

 and in blood smears from these lizards he also found anaemias which were 

 very profound. Full postmortem examinations (macroscopic, histo- 

 logical and haematological) of these animals also revealed evidence of 

 gross anaemia. So Prof. Bourliere's statement certainly does not seem 

 to hold true for our country. 



Another point arises from the discussion relating to nutrition. There 

 is a tendency in the nutritional literature to emphasize the caloric values 

 of diets, and in the light of recent work emphasis is now being placed on 

 the fat content of the diet. I think, however, that other features of the 

 qualitative aspects of the contents of natural human diets, combined 

 with quantitative defects in the diet cannot be overlooked. The need 

 for studying nutrition in disease or for doing nutrition surveys has, of 

 course, been mentioned. However, one realizes more and more, by being 

 in contact with populations in Southern Africa — not just Johannesburg 

 or Durban, but in field work as well — that unless thorough studies are 

 made, not only of the nutritional state of the people at any particular 

 time, but especially of the nutritional habits of the people from birth, 

 one tends to get a completely distorted picture. The fact is, at least in 

 the Union of South Africa, that the African people are frequently 

 malnourished, virtually before birth, and they are malnourished, qualita- 

 tively and quantitatively, certainly from birth until their premature 

 deaths. In my opinion, based on some 14 years of study of these people, 

 it seems that the long-term effects of the overall pattern of chronic 

 malnutrition among these people on the disease incidence among them, 

 cannot be overlooked. One of the characteristic findings in adults 

 (fairly young adults in terms of Western concepts — aged 30-40) is the 

 evidence of lowered basal metabolic rate and clinical signs of a myxoe- 

 dema-like picture. Also of interest are the changes in blood pressures 

 observed in cases that we have now followed through repeated admissions 

 to hospital with episodes of acute nutritional failure (pellagra) super- 

 imposed upon chronic nutritional failure. At one stage they manifest high 

 blood pressures, both systolic and diastolic, and then, with the progress 

 of the underlying chronic nutritional failure— frequently accompanied 

 by the onset of severe liver disease — the blood pressure drops progress- 

 ively and they are admitted to the hospital with blood pressures of 

 about 90 or 100 systolic, and diastolic pressures well within the range of 

 so-called "normal" young people. 



Bearing all these things in mind, I think that Dr. Olbrich's remarks 

 are very pertinent. Ageing in an African population cannot be effec- 

 tively studied, in my opinion, without a thorough appreciation of the 

 overall life pattern of the population being investigated. 



Bourne: The comments that have been made about nutrition in human 



