A Syndrome of Osteoporosis in Africans and Its Relationship to Scurvy

Grusin, H.; Samuel, Eric

doi:10.1093/ajcn/5.6.644

Cited by 24 publications

(9 citation statements)

References 10 publications

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“…South Africa's continued issues with problem drinking can partially be attributed to the legacy of the “dop” system, in which farm laborers were regularly given alcohol as a condition or benefit of employment (London 1999, 2000). During the apartheid era, middle‐aged SAB males constituted a high proportion of clinical osteoporosis cases; researchers scapegoated the cultural practice of drinking sorghum beer brewed in iron drums (Grusin & Samuel, ; Lynch et al, , ; Schnitzler et al, ; Schnitzler, Schnaid, MacPhail, Mesquita, & Robson, ; Seftel et al, ; Wapnick et al, ). Heavy weekend binge drinking was reportedly highest among the SAC and SAB groups.…”

Section: Discussionmentioning

confidence: 99%

“…Territorial “homelands” of non‐white population groups received inferior governmental health expenditures and resource allocations, resulting in large health disparities, as well as differential dietary and substance abuse patterns, among the South African population groups (Harris et al, ; Nightingale et al, ; Price, ; van Rensburg & Benatar, ). Non‐white males were particularly vulnerable to malnutrition and drug use (Flisher, Ziervogel, Chalton, Leger, & Robertson, ; Harker Burnhams, Parry, Laubscher, & London, ; Parry et al, ; Peden, Spuy, Smith, & Bautz, ; Peltzer, Davids, & Njuho, ; Wechsberg et al, ), and constituted an unusually high proportion of clinical osteoporosis cases under the apartheid regime (Grusin & Samuel, ; Lynch et al, ; Lynch, Seftel, Wapnick, Charlton, & Bothwell, ; Seftel et al, ; Wapnick, Lynch, Seftel, Charlton, & Jowsey, ).…”

Section: Introductionmentioning

confidence: 99%

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Use of backscattered scanning electron microscopy to quantify the bone tissues of mid‐thoracic human ribs

Beresheim

Pfeiffer

Grynpas

et al. 2019

American J Phys Anthropol

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Objectives: Novel information on apartheid health conditions may be obtained through the study of recent skeletal collections. Using a backscattered scanning electron microscopy (BSE-SEM) approach, this study aims to produce bone quality and tissue mineralization data for an understudied South African population from the Western Cape province.Methods: Using BSE-SEM imaging, cortical porosity (Ct.Po), osteocyte lacunar density (Ot.Lc. Dn), and the degree of tissue mineralization were quantified in mid-thoracic ribs from the Kirsten Skeletal Collection. Individuals ( n female = 75, n male = 68, and mean age = 46.3 years)were predominantly from the South Africa Colored (SAC) population group ( n SAC = 103, 72%).Full cross-sectional images of each rib were manually stitched together in Adobe Photoshop.Photomontages were imported into MATALB (Mathworks, Natick, MA) for image processing and analysis. Age-related changes in histomorphometric parameters and sex differences were examined using correlation analysis, as well as linear and nonlinear regressions.Results: Young adult men have significantly less mineralized bone and fewer osteocyte lacunae, compared to women. Only men demonstrate a significant negative relationship between Ot.Lc.Dn and age. Average tissue mineralization decreases with age in women, while Ct.Po increases.Pore area (Po.Ar) does not vary with age, but pore density (Po.Dn) is highest in the perimenopause, when accelerated rates of bone turnover are first anticipated. Ct.Po is highest in the years following the predicted age of menopause, but levels off in the final decades of life.Conclusions: Men and women display disparate patterns of bone aging. Systemic disenfranchisement of non-white population groups affected bone health in South Africa, and may continue to do so today. Indicators of poor bone quality are evident in the full study sample, indicating that osteoporosis and fracture risk are not just of concern to the aged white female population. K E Y W O R D Sbone histomorphometry, BSE-SEM, osteoporosis, South African apartheid

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Use of backscattered scanning electron microscopy to quantify the bone tissues of mid‐thoracic human ribs

Beresheim

Pfeiffer

Grynpas

et al. 2019

American J Phys Anthropol

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“…These meals, however, also did consist of not much more than maize meal and sauce since they were not earning much and only certain foods could be purchased at the compound shop (Harries, 1994). The diet of these individuals is thus historically recorded to have been high in machine ground carbohydrates, low in animal proteins and low in fresh fruit and vegetables (Grusin & Samuel, 1957;Seftel et al, 1966). According to historical documents migrant labourers came from all over South Africa and its neighbouring countries to labour in the mines.…”

Section: Discussionmentioning

confidence: 99%

Dental health of 19th century migrant mineworkers from Kimberley, South Africa

Merwe

Steyn

Maat

2011

Intl J of Osteoarchaeology

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Dental health may deteriorate in populations exposed to economic growth as a result of easier access to refined carbohydrates and sugars. Such changes affected migrant labourers working in Kimberley, South Africa, during the late 19th century. A rescue excavation salvaged several skeletons from pauper's graves dating from this period, and the purpose of the study was to assess their dental health to determine whether it concurs with historical statements suggesting that the skeletal population sample being investigated was migrant labourers with limited access to a healthy diet. According to historic sources their diets mainly consisted of ground carbohydrates and occasional meat. The permanent dentition of 79 males and 13 females (majority between 20 and 49 years of age) were examined. Carious lesions were observed in 57% of males and 46.2% of females with an average of 2.7 and 3.8 carious teeth per mouth. The anterior teeth were significantly less affected than the posterior teeth. Periodontal granulomata ('abscesses') were observed in 17.7% of males and 15.4% of females, and periodontal disease affected 40% of those investigated. Antemortem tooth loss (AMTL) was recorded in 29% (N ¼ 27) of the sample with an average of 3.5 teeth lost per mouth.It was concluded that the prevalence of dental caries, periapical granulomata and periodontal disease as well as the pattern of AMTL observed concurs with dietary descriptions for paupers in historical documents. The relatively low prevalence of carious lesions can be ascribed to the limited time migrant labourers spent in Kimberley and the labour restrictions they had to comply with during their stay in the compounds.

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“…Any mechanical or physical strain on a defective blood vessel could result in haemorrhage. In a study conducted on the Johannesburg Bantu in 1962, Seftel et al (1966) noted that individuals suffering from scurvy often presented with haemorrhagic swellings of the gums as well as bleeding into the muscle of the calf or posterior thigh (Grusin & Samuel, 1957;Seftel et al, 1966). Steinbock (1976) also states that pathological features are common along the diaphyses of adults, rather than in the metaphyses as seen in infantile scurvy (Steinbock, 1976;Maat, 2004).…”

Section: Discussionmentioning

confidence: 99%

“…There were even times when no food was being supplied to compound workers and they were responsible for buying and preparing their own meals (Harries, 1994). These diets were therefore normally high in carbohydrates, low in animal proteins and low in fresh fruit and vegetables (Grusin & Samuel, 1957;Seftel et al, 1966). When considering the lack of fresh fruit and vegetables, Kimberley's climate should be kept in mind.…”

Section: Discussionmentioning

confidence: 99%

Adult scurvy in skeletal remains of late 19th century mineworkers in Kimberley, South Africa

Merwe

Steyn

Maat

2009

Intl J of Osteoarchaeology

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Throughout history, scurvy has been a well-known disease which develops due to restricted resources of fresh fruit and vegetables. The condition results from an extended limited intake of vitamin C. Although skeletal lesions associated with infantile scurvy have been well described by many authors, very little literature is available on adult scurvy and the resulting skeletal lesions. The purpose of this study was to investigate the skeletal remains of a 19th century mining population from Kimberley, South Africa, for any skeletal lesions that may be indicative of adult scurvy. Scurvy was well documented as being extremely prevalent in this population. The skeletal remains of 107 individuals, presumed to have died around 1898, were studied. The majority of these individuals were males between 19 and 45 years of age. It is likely that most individuals were migrant workers at the diamond mines. All bones were visually assessed for macroscopic indications of pathological bone alterations associated with healed scurvy. Bone samples were also taken from ambiguous lesions in order to perform histological investigations. Lesions indicative of possible healed adult scurvy were observed in 16 individuals. These lesions included bilateral ossified haematomas, osteoperiostitic bone changes and periodontal disease. Histological investigation confirmed the presence of ossified haematomas on the anterior tibiae of some individuals. Hospital records and historical documents describing the incidence of scurvy in the local hospitals and the daily diet of the black mine workers supported these findings.

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A Syndrome of Osteoporosis in Africans and Its Relationship to Scurvy

Cited by 24 publications

References 10 publications

Use of backscattered scanning electron microscopy to quantify the bone tissues of mid‐thoracic human ribs

Use of backscattered scanning electron microscopy to quantify the bone tissues of mid‐thoracic human ribs

Dental health of 19th century migrant mineworkers from Kimberley, South Africa

Adult scurvy in skeletal remains of late 19th century mineworkers in Kimberley, South Africa

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