Changing patterns of dietary iron overload in black South Africans
1979
MacPhail, A.P. | Simon, M.O. | Torrance, J.D. | Charlton, R.W. | Bothwell, T.H. | Isaacson, C.
Over the last 17 years the prevalence and severity of dietary iron overload in the urban blacks of Johannesburg have decreased significantly, due probably to the decrease in consumption of traditionally brewed beer of high iron content. In recent years the purchase of wine and spirits was legalized so their ingestion has increased. Furthermore, beer is now brewed in stainless steel containers rather than iron pots. A 40% reduction was found in hepatic iron measured in necropsy specimens from 248 male patients who died in 1976, compared with 220 males who died in 1959-1960. The iron concentrations rose with age in both groups. Hepatic iron concentrations measured in 345 female subjects were much lower than the male group and did not vary between 1959 and 1976. Iron overload was greater in males with carcinoma of the esophagus and with idiopathic heart failure, suggesting excessive exposure of these subjects to traditionally brewed beverages and the adulterants in them. An increase in portal fibrosis and cirrhosis was noted due perhaps to the effects of recently increased ingestion of spirits and fortified wine.
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