Abstract:Introduction: Geophagia is very common among pregnant women, particularly in Africa. There are many reasons given for geophagia such as cultural, medicinal and religious, making it an acceptable norm regardless of health risks involved. Objectives: The study explored prevalence and factors influencing geophagia among women visiting an antenatal clinic in Pretoria. Methods: A quantitative survey was done on a convenience sample of 597 pregnant women and structured interviews conducted. Statistical analysis was done using simple percentage and interview data analyzed using Epi Info statistical software. Results: Geophagia was reported by 54.0% of the women (n=323) and of these, 75.2% (n=243) ate at least 3 teaspoons per day. Reasons for the practice ranged from simple unexplained craving to belief that soil acts as an iron supplement. The study revealed that education levels did not act as a contributing factor as both literate and illiterate women were consumers. Partners of consumers played a key role in influencing the practice as most consumers were not married. Conclusion: Geophagia is practiced by a considerable proportion of pregnant women in this area. Greater vigilance may be needed as part of the antenatal classes to avoid potentially harmful effects of the habit.

The American Heart Association predicted the rise in the prevalence of cardiovascular disease as 38.7% by 2020, where the coronary heart disease would rise for 8.6% and stroke for 3.6%. [1] In South Africa (SA), Liberty Life Insurance group has forecast the premature deaths due to heart and blood vessel diseases in people of working age (35-64 years) to increase by 41% between 2007 and 2030, with a warning of enormous negative economic impact. [2] Locally, an increased awareness of cardiovascular disease at the Dr George Mukhari referral hospital has led to more requests for plasma lipid profiles comprising fasting triglyceride (TG), total cholesterol (TC), high-density lipoprotein (HDL) cholesterol (HDLC) and low-density lipoprotein (LDL) cholesterol (LDLC). In 2013, 18 234 lipid profiles from 7 255 patients were analysed compared with 24 656 requests for 6 348 patients in 2014. The 35% increase occurred despite opening a new antiretroviral (ARV) clinic in the neighbourhood, which reduced patient flow at the tertiary hospital, and the introduction of electronic gatekeeping. Requests were in response to patients' history of early death among first-degree relatives due to heart disease and stroke, [3] and cardiovascular risk suggested by obesity, metabolic syndrome, smoking, sedentary lifestyle, lack of exercise and stressful living. Genetic disorders in lipoprotein metabolic pathways generally have a greater impact on risk and typically display more severe and/ or persistent lipid abnormalities after treating the secondary factors. [4,5] Cascade testing of the family is advised. [6] Admixture of primary and secondary causes is especially evident in Fredrickson hyperlipidaemia types III, IV and V, where predisposing variant genes are stressed by diet, obesity with insulin resistance, hormonal derangements and alcohol intake. In SA, at least three low-density lipoprotein receptor (LDLR) mutations are known in Afrikaans-speaking whites, one in Jewish people from Eastern Europe and one in Indians of Gujerati descent. [7,8] Familial hypercholesterolaemia (FH) is mostly due to a pathogenic mutation in one of three genes (LDLR, apolipoprotein B (apoB) or proprotein convertase subtilisin/kexin type 9). FH is relatively common (prevalence 1:200-1:500) and is therefore the most important monogenic disorder of lipoprotein metabolism. It exists as either heterozygous, where only one allele of the gene involved is mutated and the other allele is normal, or homozygous, where both alleles are abnormal. Persons with untreated

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