A doctor’s personal reflections on the “diet-heart” hypothesis
In a short reflection piece Dr. AG Shaper shares a history of his involvement in research on cardiovascular disease and diet in south and east Africa. This reflection describes an early interest in the links between one’s diet and one’s heart health despite continued debate on this very relationship today, over 50 years later.
His research on the topic began when he noticed that coronary heart disease disproportionately affected the White population in South Africa. Working with other doctors and researchers Dr. Shaper’s interest in the comparative burden of heart disease across populations was fostered by this work environment. Here he could better develop research studies to verify hypothesized links between diet and heart disease in different south and east African hospitals.
At that time it had been shown that coronary heart disease was close to non-existent in the African population of Uganda whereas the Asian population of the country was considerably affected by this disease burden. Dr. Shaper further developed this research with a comparative study of cholesterol levels between a sample of the two populations in Kampala from 1956 to 1958. The diet of African subjects consisted of mostly staple foods such as green plantains, sweet potatoes and green leafy vegetables with a low daily fat intake (10-20% of total calories) while the Asian subjects ate a diet with a fat intake of 30-45% total calories consumed. The study results indicated that Asian subjects had significantly higher total cholesterol levels across age groups.
These results were in line with the diet-heart hypothesis and led Dr. Shaper and his research team to conclude that blood cholesterol levels in Western societies was abnormal and would cause coronary heart disease to become endemic.