Serum cholesterol in vitamin C deficiency in man

Although Cape Town was founded in 1652 to combat the ravages of scurvy in ships at sea, goo years later scurvy was still rife there.Some 10-15 years ago there was a continuous migration into this urban area of rural Bantu males, whose aim was to make sufficient money as unskilled labourers, in as short a time as possible, so that they might return to their homelands with the requisite marriage fee.This purpose was achieved by restricting variety in food intake, and scurvy resulted.Indeed this situation prompted a study of the anaemia in scurvy, in one report on which the dietary circumstances were fully explained (Bronte-Stewart, 1953).Now scurvy is rapidly becoming a rare disease.Between 1948 and 1953 there were twelve to fifteen admissions annually to this hospital, but over the last 4 years there have been only three admissions.This rapid decrease in incidence has prompted the publication at this stage of the following findings on serum cholesterol before, during and after recovery from scurvy. E X P E R I M E N T A LClinical material.Of fourteen adult Bantu males with scurvy, nine (subjects nos.6-14) were studied in the Metabolism Unit of Groote Schuur Hospital.T h e clinical features were follicular hyperkeratosis, gingival hyperplasia, ecchymoses, intramuscular haematomas, mild pyrexia and varying degrees of anaemia.For example, the haemoglobin levels on admission of subjects 7 and 9 were 6.0 g/Ioo ml; of subjects 8, 12 and 1 3 between 8 and 10 g; of subjects 10 and 14 between 10 and 1 2 g; and of subjects 6 and 1 1 above 1 2 g.As before (Bronte-Stewart, 1953), other forms of avitaminosis were not found, but two further subjects had to be excluded as one was found to have pulmonary tuberculosis, and another had tapeworm infestation.The ages of the subjects ranged from 30 to 60 years. Method of study.Initial observations were made while the patients ate a diet similar to that on which the disease had developed, except that the maize meal and white bread were supplemented by 50 g casein daily, together with adequate minerals and vitamins, and no unprescribed ascorbic acid was given.The dietary calories were varied between 2300 and 2500 kcal daily to ensure that no marked weight gain or loss occurred throughout the period of study.T h e daily fat intake was in the region of 3 g and the daily cholesterol intake was 20 mg.T h e initial period of observation, before treatment with ascorbic acid, was kept to a minimum as scurvy is an unpleasant +