Eating disorders risk and its relation to self-esteem and body image in Iranian university students of medical sciences.
Eat Weight Disord. 2016 Dec;21(4):597-605
Authors: Naeimi AF, Haghighian HK, Gargari BP, Alizadeh M, Rouzitalab T
INTRODUCTION AND OBJECTIVES: Eating disorders are rapidly increasing in young adults. But, a few studies have examined the risk of eating disorders and body image in university students of non-Western societies. The current study aimed to assess eating disorders risk in relation to body image and self-esteem among Iranian university students.
METHOD: The participants were 430 students from Tabriz, between April and May 2015. The 26-item Eating Attitude Test (EAT-26), Multidimensional Body-Self Relations Questionnaire (MBSRQ) and Rosenberg's Self-Esteem Questionnaires were used. EAT-26 score of 20 or more was considered as eating disorders risk cutoff.
RESULTS: Majority of the students (68 %) were females. The overall eating disorders risk was 9.5 % (7.5 and 10.5 % in men and women, respectively). Further, the prevalence of poor body image and low self-esteem was 34.2 and 16 %, respectively. Neither of the gender differences was statistically significant (p > 0.05). In simple logistic regression, there were significant associations between self-esteem, body image, parental education and eating disorders risk (p < 0.025). But, after adjustments for gender, age, Body Mass Index (BMI) and marital status, only self-esteem (OR = 0.37, 95 % = 0.16-0.87) and mother's education level (OR = 2.78, 95 % = 1.30-5.93) were predictors of eating disorders risk.
CONCLUSIONS: The findings revealed that low self-esteem and mother's higher education may increase eating disorders risk and the predictive role of body image possibly is by other mediators such as self-esteem. This warrants awareness improvement and developing appropriate interventions targeting self-esteem and self-respect of students.
PMID: 27107872 [PubMed - indexed for MEDLINE]
Impact of ethnicity on progress of glycaemic control in 131,935 newly diagnosed patients with type 2 diabetes: a nationwide observational study from the Swedish National Diabetes Register.
BMJ Open. 2015 Jun 05;5(6):e007599
Authors: Rawshani A, Svensson AM, Rosengren A, Zethelius B, Eliasson B, Gudbjörnsdottir S
OBJECTIVES: Studies on ethnic disparities in glycaemic control have been contradictory, and compromised by excessively broad categories of ethnicity and inadequate adjustment for socioeconomic differences. We aimed to study the effect of ethnicity on glycaemic control in a large cohort of patients with type 2 diabetes.
SETTING: We used nationwide data (mainly from primary care) from the Swedish National Diabetes Register (2002-2011) to identify patients with newly diagnosed (within 12 months) type 2 diabetes.
PARTICIPANTS: We included 131,935 patients (with 713,495 appointments), representing 10 ethnic groups, who were followed up to 10 years.
PRIMARY AND SECONDARY OUTCOME MEASURES: Progress of glycated haemoglobin (HbA1c) for up to 10 years was examined. Mixed models were used to correlate ethnicity with HbA1c (mmol/mol). The effect of glycaemic disparities was examined by assessing the risk of developing albuminuria. The impact of ethnicity was compared to that of income, education and physical activity.
RESULTS: Immigrants, particularly those of non-Western origin, received glucose-lowering therapy earlier, had 30% more appointments but displayed poorer glycaemic control (2-5 mmol/mol higher HbA1c than native Swedes). Probability of therapy failure was 28-111% higher for non-Western groups than for native Swedes. High-income Western groups remained below the target-level of HbA1c for 4-5 years, whereas non-Western populations never reached the target level. These disparities translated into 51-92% higher risk of developing albuminuria. The impact of ethnicity was greater than the effect of income and education, and equal to the effect of physical activity.
CONCLUSIONS: Despite earlier pharmacological treatment and more frequent appointments, immigrants of non-Western origin display poorer glycaemic control and this is mirrored in a higher risk of developing albuminuria.
PMID: 26048210 [PubMed - indexed for MEDLINE]
J Allergy Clin Immunol. 2015 May;135(5):1099-106; quiz 1107
Authors: Green PH, Lebwohl B, Greywoode R
This review will focus on the pathogenesis, clinical manifestations, diagnosis, and management of celiac disease (CD). Given an increasing awareness of gluten-related disorders, medical professionals of all varieties are encountering patients with a diagnosis of CD or who are thought to have food intolerance to gluten. The prevalence of CD among the general population is estimated to be 1% in Western nations, and there is growing evidence for underdiagnosis of the disease, especially in non-Western nations that were traditionally believed to be unaffected. The development of serologic markers specific to CD has revolutionized the ability both to diagnose and monitor patients with the disease. Additionally, understanding of the clinical presentations of CD has undergone a major shift over the past half century. Although it is well understood that CD develops in genetically predisposed subjects exposed to gluten, the extent of other environmental factors in the pathogenesis of the disease is an area of continued research. Currently, the main therapeutic intervention for CD is a gluten-free diet; however, novel nondietary agents are under active investigation. Future areas of research should also help us understand the relationship of CD to other gluten-related disorders.
PMID: 25956012 [PubMed - indexed for MEDLINE]
Vitamin D deficiency in school-age children is associated with sociodemographic and lifestyle factors.
J Nutr. 2015 Apr;145(4):791-8
Authors: Voortman T, van den Hooven EH, Heijboer AC, Hofman A, Jaddoe VW, Franco OH
BACKGROUND: There is concern about a reemergence of vitamin D deficiency in children in developed countries.
OBJECTIVES: The aims of this study were to describe vitamin D status in the Generation R study, a large multiethnic cohort of 6-y-old children in The Netherlands, and to examine sociodemographic, lifestyle, and dietary determinants of vitamin D deficiency.
METHODS: We measured serum 25-hydroxyvitamin D [25(OH)D] concentrations in 4167 children aged 6 y and defined deficiency following recommended cutoffs. We examined the associations between subject characteristics and vitamin D deficiency with the use of multivariable logistic regression analyses.
RESULTS: Serum 25(OH)D concentrations ranged from 4 to 211 nmol/L (median: 64 nmol/L), with 6.2% of the children having severely deficient (<25 nmol/L), 23.6% deficient (25 to <50 nmol/L), 36.5% sufficient (50 to <75 nmol/L), and 33.7% optimal (≥75 nmol/L) 25(OH)D concentrations. The prevalence of vitamin D deficiency [25(OH)D <50 nmol/L] was higher in winter (51.3%) than in summer (10.3%); and higher in African, Asian, Turkish, and Moroccan children (54.5%) than in those with a Dutch or other Western ethnic background (17.6%). In multivariable models, several factors were associated with vitamin D deficiency, including household income (OR: 1.74; 95% CI: 1.34, 2.27 for low vs. high income), child age (OR: 1.39; 95% CI: 1.20, 1.62 per year), child television watching (OR: 1.32; 95% CI: 1.06, 1.64 for ≥2 vs. <2 h/d), and playing outside (OR: 0.71; 95% CI: 0.57, 0.89 for ≥1 vs. <1 h/d). In a subgroup with dietary data (n = 1915), vitamin D deficiency was associated with a lower diet quality, but not with vitamin D intake or supplement use in early childhood.
CONCLUSIONS: Suboptimal vitamin D status is common among 6-y-old children in The Netherlands, especially among non-Western children and in winter and spring. Important modifiable factors associated with vitamin D deficiency were overall diet quality, sedentary behavior, and playing outside.
PMID: 25833782 [PubMed - indexed for MEDLINE]
Complementary and alternative medicine use in infertility: cultural and religious influences in a multicultural Canadian setting.
J Altern Complement Med. 2014 Sep;20(9):686-92
Authors: Read SC, Carrier ME, Whitley R, Gold I, Tulandi T, Zelkowitz P
OBJECTIVES: To explore the use of complementary and alternative medicine (CAM) for infertility in a multicultural healthcare setting and to compare Western and non-Western infertility patients' reasons for using CAM and the meanings they attribute to CAM use.
DESIGN: Qualitative semi-structured interviews using thematic analysis.
SETTINGS/LOCATION: Two infertility clinics in Montreal, Quebec, Canada.
PARTICIPANTS: An ethnoculturally varied sample of 32 heterosexual infertile couples.
RESULTS: CAM used included lifestyle changes (e.g., changing diet, exercise), alternative medicine (e.g., acupuncture, herbal medicines), and religious methods (e.g., prayers, religious talismans). Patients expressed three attitudes toward CAM: desperate hope, casual optimism, and amused skepticism. PARTICIPANTS' CAM use was consistent with cultural traditions of health and fertility: Westerners relied primarily on biomedicine and used CAM mainly for relaxation, whereas non-Westerners' CAM use was often influenced by culture-specific knowledge of health, illness and fertility.
CONCLUSIONS: Understanding patients' CAM use may help clinicians provide culturally sensitive, patient-centered care.
PMID: 25127071 [PubMed - indexed for MEDLINE]
Acne and diet: facts and controversies.
Acta Dermatovenerol Croat. 2012;20(3):170-4
Authors: Rezaković S, Bukvić Mokos Z, Basta-Juzbašić A
Acne is a common skin disorder characterized by follicular hyperkeratinization and obstruction of the pilosebaceous follicles, androgen stimulated sebum production, colonization of the follicles by Propionibacterium acne, and inflammation. A large number of epidemiological studies have shown a low incidence of acne in non-Western societies, suggesting that diet might be an important factor in acne pathogenesis, particularly in mediating inflammation, oxidative stress and androgen stimulation in the acne process. Consequently, it has been hypothesized that diet might have a preventive or therapeutic effect in this skin disorder. Since the majority of recent data have not been consistent, the aim of this article is to present current knowledge and scientific assumptions on the relationship between diet and acne.
PMID: 23069302 [PubMed - indexed for MEDLINE]
Managing treatment for end-stage renal disease--a qualitative study exploring cultural perspectives on facilitators and barriers to treatment adherence.
Psychol Health. 2013;28(1):13-29
Authors: Griva K, Ng HJ, Loei J, Mooppil N, McBain H, Newman SP
Although adherence to hemodialysis (HD) regimes is important to maximise good clinical outcomes, it remains suboptimal and not well understood, particularly for those in non-Western settings and patients from Asian cultures. This qualitative study sought to explore cultural perspectives on facilitators and barriers to treatment adherence in HD patients. A descriptive exploratory design was used for the study, incorporating individual semi-structured interviews (n = 17) and three focus groups (n = 20). Each interview/focus group was audio-taped and transcribed verbatim, and coding was conducted by two coders using an iterative process. Study participants identified personal and social/contextual factors as major barriers or facilitators of treatment adherence. Barriers include time consumption, forgetfulness, concerns about safety, poor knowledge/understanding, poor communication and lack of control/social pressure. Participants also identified facilitators, both internal (self-initiated) and external (initiated by family, health care professional and peers) to ensure treatment adherence. These included support from family members and social obligation towards others, risk perception, establishment of routines and peer support. Internal and external factors can hinder or facilitate adherence to diet, fluid and medications in the context of dialysis. Several of these barriers/facilitators can be effectively addressed in the context of interventions and psycho-educational programmes.
PMID: 22780853 [PubMed - indexed for MEDLINE]
Dietary shifts and human health: cancer and cardiovascular disease in a sustainable world.
J Gastrointest Cancer. 2012 Mar;43(1):8-12
Authors: Lindeberg S
INTRODUCTION: Increasing evidence suggests that optimal food choice is critical for sizable prevention of western diseases such as cardiovascular disease and cancer. The Mediterranean diet is an important step in this direction. Moreover, substantially lower rates of Western disease, even compared to Mediterranean countries, have been observed among hunter-gatherers and other non-western populations (Lindeberg 2010). Observational studies and controlled trials support the notion that an evolutionary perspective is helpful when designing food models for optimal human health.
DISCUSSION: However, sustainable health for the individual patient is not enough: environmental sustainability must also be considered. Are fish and fruit sustainable for everyone? Are starchy root vegetables a better option than cereal grains? Is locally produced meat an underestimated wholesome food? These and other questions need to be addressed in order to cut greenhouse gases and the consumption of (blue) water and nonrenewable energy.
PMID: 22081408 [PubMed - indexed for MEDLINE]
Vegetarianism. A blossoming field of study.
Appetite. 2012 Feb;58(1):141-50
Authors: Ruby MB
Vegetarianism, the practice of abstaining from eating meat, has a recorded history dating back to ancient Greece. Despite this, it is only in recent years that researchers have begun conducting empirical investigations of the practices and beliefs associated with vegetarianism. The present article reviews the extant literature, exploring variants of and motivations for vegetarianism, differences in attitudes, values and worldviews between omnivores and vegetarians, as well as the pronounced gender differences in meat consumption and vegetarianism. Furthermore, the review highlights the extremely limited cultural scope of the present data, and calls for a broader investigation across non-Western cultures.
PMID: 22001025 [PubMed - indexed for MEDLINE]
Effect modification of meat intake by genetic polymorphisms on colorectal neoplasia susceptibility.
Asian Pac J Cancer Prev. 2010;11(2):281-7
Authors: Shin A, Kim J
Colorectal cancer incidences differ considerably between Western and non-Western countries. In recent years, a dramatic increase in colorectal cancer incidence has been reported in several Asian countries. Immigration studies have suggested that environmental rather than genetic factors are primarily responsible for the international variability and secular trends of colorectal cancer incidence rates. Therefore, not only the main effect of a gene but also the influence of gene-environment interactions on cancer risk are important from the public health perspective. This review encompasses the literature on gene-diet interactions, particularly focusing on meat intake and its association with the risk of colorectal carcinoma or adenomas. It is generally accepted that genotypes which are associated with the higher enzyme activity for metabolic activation or lower activity for detoxification would affect individual's susceptibility to meat carcinogens. The most intensively studied genes were those involved in xenobiotic metabolism, including N-acetyltransferase (NAT), cytochrome P450 (CYP) families, glutathione S-transferase (GST), and sulfotransferase (SULT). However, the associations were not consistent across studies. The role of genetic polymorphisms and their role in effect modification of environmental carcinogens should be assessed in well-designed large-scale epidemiological studies with comprehensive information for risk factors for better understanding the etiologic role of dietary factors and in developing a personalized cancer prevention strategy in the genome-wide association study era.
PMID: 20843102 [PubMed - indexed for MEDLINE]
Tendency toward deliberate food restriction, fear of fatness and somatic attribution in cross-cultural samples.
Eat Behav. 2007 Aug;8(3):407-17
Authors: Viernes N, Zaidan ZA, Dorvlo AS, Kayano M, Yoishiuchi K, Kumano H, Kuboki T, Al-Adawi S
OBJECTIVE: To compare Omani and western teenagers attending schools in Muscat, Sultanate of Oman and Filipino teenagers residing in Manila, Philippines on indices of deliberate food restriction and dieting behavior.
METHODS: The sample consisted of 444 students who were assessed using the cross-culturally valid measure, Eating Attitude Test-26, a subscale of Eating Disorder Inventory to gauge the presence of the drive for thinness or 'fat phobia' and the Bradford Somatic Inventory to elicit the presence of somatization.
RESULT: Significant differences in attitudes to eating, body image and somatization between the western and non-western teenagers were found.
CONCLUSION: This paper suggests that trajectories of eating disorder, such as body image disturbances as expressed in fat phobia and somatization, tend to vary from culture to culture and underscore the view that some of the health related behavior among adolescents need to be examined within socio-cultural contexts.
PMID: 17606239 [PubMed - indexed for MEDLINE]
Health effects of vegetarian and vegan diets.
Proc Nutr Soc. 2006 Feb;65(1):35-41
Authors: Key TJ, Appleby PN, Rosell MS
Vegetarian diets do not contain meat, poultry or fish; vegan diets further exclude dairy products and eggs. Vegetarian and vegan diets can vary widely, but the empirical evidence largely relates to the nutritional content and health effects of the average diet of well-educated vegetarians living in Western countries, together with some information on vegetarians in non-Western countries. In general, vegetarian diets provide relatively large amounts of cereals, pulses, nuts, fruits and vegetables. In terms of nutrients, vegetarian diets are usually rich in carbohydrates, n-6 fatty acids, dietary fibre, carotenoids, folic acid, vitamin C, vitamin E and Mg, and relatively low in protein, saturated fat, long-chain n-3 fatty acids, retinol, vitamin B(12) and Zn; vegans may have particularly low intakes of vitamin B(12) and low intakes of Ca. Cross-sectional studies of vegetarians and vegans have shown that on average they have a relatively low BMI and a low plasma cholesterol concentration; recent studies have also shown higher plasma homocysteine concentrations than in non-vegetarians. Cohort studies of vegetarians have shown a moderate reduction in mortality from IHD but little difference in other major causes of death or all-cause mortality in comparison with health-conscious non-vegetarians from the same population. Studies of cancer have not shown clear differences in cancer rates between vegetarians and non-vegetarians. More data are needed, particularly on the health of vegans and on the possible impacts on health of low intakes of long-chain n-3 fatty acids and vitamin B(12). Overall, the data suggest that the health of Western vegetarians is good and similar to that of comparable non-vegetarians.
PMID: 16441942 [PubMed - indexed for MEDLINE]
Prospective study on usual dietary phytoestrogen intake and cardiovascular disease risk in Western women.
Circulation. 2005 Feb 01;111(4):465-71
Authors: van der Schouw YT, Kreijkamp-Kaspers S, Peeters PH, Keinan-Boker L, Rimm EB, Grobbee DE
BACKGROUND: Phytoestrogens have been suggested to lower cardiovascular disease risk, but existing research focused on non-Western high intake levels and on risk factors. We investigated whether habitual low phytoestrogen intake is associated with manifest cardiovascular disease risk.
METHODS AND RESULTS: Between 1993 and 1997, 16,165 women 49 to 70 years old and free from cardiovascular disease were enrolled in the Dutch Prospect-EPIC cohort (European Prospective study Into Cancer and nutrition) and followed up for a median period of 75 months. At enrollment, women filled in questionnaires on chronic disease risk factors and nutrition. Intake of phytoestrogens was estimated using the food frequency questionnaire covering regular dietary intake of 178 food items in the year before enrollment. Cox regression analysis was used to estimate hazard ratios of cardiovascular disease for quartiles of phytoestrogen intake adjusted for age at intake, body mass index, smoking, physical activity, hypertension, hypercholesterolemia, use of hormone replacement therapy, menopausal status, and intake of total energy, total fiber, vegetables, fruit, and alcohol. In total, 372 women experienced a coronary event (CHD) (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9], 410 to 414, 427.5) and 147 women a cerebrovascular event (CVD) (ICD-9, 430 to 438) during follow-up. Overall, neither isoflavones nor lignans were associated with decreased cardiovascular disease risk. When stratifying for ever versus never smokers, CHD risk decreased with increasing lignan intake for ever smokers.
CONCLUSIONS: Our results do not support the presence of a protective effect of higher intake of phytoestrogens in low doses on cardiovascular disease risk, although a small risk reduction with higher lignan intake cannot be excluded for smokers.
PMID: 15687135 [PubMed - indexed for MEDLINE]
[Cardiovascular risk factors. I. Review of possible causes of heart and vascular diseases].
Ned Tijdschr Geneeskd. 2002 Jun 22;146(25):1169-74
Authors: van der Bom JG, Bots ML, Grobbee DE
Despite the decline in the past 30 years in age-adjusted mortality, cardiovascular disease is still the most important cause of morbidity and mortality in the Western world and increasingly so in the non-Western world. The decreased mortality rate is attributed to increased knowledge of the risk factors, a concomitant healthier life style and improved treatment for the risk factors. It has been clearly demonstrated that increased serum levels of cholesterol, increased blood pressure, the presence of diabetes, physical inactivity and smoking increase the risk of cardiovascular disease. The role of estrogens, homocysteine, thrombotic and inflammatory factors is currently the subject of considerable research. It seems likely that a certain genetic constitution enhances the susceptibility to the effects of other risk factors. New candidate genes are being suggested daily. Until now, no clearly decisive results have been achieved in determining the relations between the investigated genetic polymorphisms and the occurrence of cardiovascular disease. The consumption of foodstuffs that are rich in anti-oxidants seems to reduce the risk of cardiovascular disease, but randomised research into the effects of anti-oxidants as food supplements suggests that this does not affect the development of cardiovascular disease.
PMID: 12109306 [PubMed - indexed for MEDLINE]
Body dissatisfaction and its interrelations with other risk factors for bulimia nervosa in 12 countries.
Psychother Psychosom. 2002 Jan-Feb;71(1):54-61
Authors: Jaeger B, Ruggiero GM, Edlund B, Gomez-Perretta C, Lang F, Mohammadkhani P, Sahleen-Veasey C, Schomer H, Lamprecht F
BACKGROUND: It is widely accepted that risk factors for bulimia nervosa, mainly body dissatisfaction, are dependent on cultural factors. However, to date few studies have compared data from different cultures with an appropriate methodology. Therefore we aimed to gather reliable information on body dissatisfaction and other risk factors for bulimia from different nations and to reveal their functional interrelations.
METHODS: A series of 10 silhouettes, designed to be as far as possible free from cultural and other detailed aspects, was shown to 1,751 medical and nursing students in 12 nations. A functional model was applied to each sample and tested by structural equation methodology.
RESULTS: The most extreme body dissatisfaction was found in northern Mediterranean countries, followed by northern European countries. Countries currently undergoing a process of westernization show an intermediate amount of body dissatisfaction, and non-western countries demonstrate rather low values. Body dissatisfaction is the most important influence on dieting behaviour in most countries.
CONCLUSIONS: Despite ongoing adoption of western values worldwide, we observe remarkable differences in body dissatisfaction between different cultures. That body dissatisfaction seems disturbingly partly detached from the actual BMI, i.e. possible overweight, as well as from feelings of low self-esteem in some western countries, raises new questions about the possible origin of the pressure to be thin.
PMID: 11740169 [PubMed - indexed for MEDLINE]
Weight loss and delayed gastric emptying following a South American herbal preparation in overweight patients.
J Hum Nutr Diet. 2001 Jun;14(3):243-50
Authors: Andersen T, Fogh J
BACKGROUND: Obesity and overweight may soon affect more than half of the population in some regions of the world and are associated with diabetes, hypertension and other diseases that cause morbidity, mortality and high health-care expenditure. No one approach, whether dietetic management, medication, or commercial weight loss programme, can alone solve the problem--all potential treatments need to be investigated and exploited. Among the herbal preparations known to non-western cultures are materials which may have applications in modulating physiological processes which influence gut motility, food intake and energy balance. One such mixed herbal preparation is 'YGD' containing Yerbe Maté (leaves of Ilex paraguayenis), Guarana (seeds of Paullinia cupana) and Damiana (leaves of Turnera diffusa var. aphrodisiaca).
AIMS: This study had two distinct aims: to determine the effect of a herbal preparation 'YGD' containing Yerbe Maté, Guarana and Damiana on gastric emptying; to determine the effect of the same preparation on weight loss over 10 days and 45 days and weight maintenance over 12 months.
METHODS: Gastric emptying was observed using ultrasound scanning in seven healthy volunteers following YGD and placebo capsules taken with 420 mL apple juice. Body weight was observed before and after 10 days of treatment with three YGD capsules or three placebo capsules before each meal for 10 days in 44 healthy overweight patients attending a primary health care centre. Forty-seven healthy overweight patients entered a double-blind placebo-controlled parallel trial of three capsules of YGD capsules before each main meal for 45 days compared with three placebo capsules on body weight. Body weight was monitored in 22 patients who continued active (YGD capsules) treatment for 12 months.
RESULTS: The herb preparation YGD was followed by a prolonged gastric emptying time of 58 +/- 15 min compared to 38 +/- 7.6 min after placebo (P = 0.025). Body weight reductions were 0.8 +/- 0.05 kg after YGD capsules compared to 0.3 +/- 0.03 kg after placebo capsules over 10 days, and 5.1 +/- 0.5 kg after PGD capsules compared to 0.3 +/- 0.08 kg after placebo over 45 days. Active treatment with YGD capsules resulted in weight maintenance of the group (73 kg at the beginning and 72.5 kg at the end of 12 months).
CONCLUSIONS: The herbal preparation, YGD capsules, significantly delayed gastric emptying, reduced the time to perceived gastric fullness and induced significant weight loss over 45 days in overweight patients treated in a primary health care context. Maintenance treatment given in an uncontrolled context resulted in no further weight loss, nor weight regain in the group as a whole. The herbal preparation is thus shown to be one that significantly modulates gastric emptying. Further clinical studies with dietetic monitoring of energy intake, dietary quality, satiety ratings, body weight and body composition are now indicated, and examination of the active principles contained in the three herbal components may prove rewarding.
PMID: 11424516 [PubMed - indexed for MEDLINE]
Eating disorders: an Indian perspective.
Int J Soc Psychiatry. 1995;41(2):132-46
Authors: Khandelwal SK, Sharan P, Saxena S
Anorexia nervosa and related eating disorders are rare in non-western cultures. In India the information regarding these disorders is very limited. The authors describe five cases of young women who chiefly presented with refusal to eat, persistent vomiting, marked weight loss, amenorrhea and other somatic symptoms. They did not show overactivity or disturbances in body image seen characteristically in anorexia nervosa. Though finally diagnosed and treated as cases of eating disorder, they presented considerable difficulty in diagnosis. The paper discusses the reasons for the seeming rarity of anorexia nervosa in India and sociocultural reasons for its atypical presentation.
PMID: 7558678 [PubMed - indexed for MEDLINE]
Effects of doxazosin and hydrochlorothiazide on lipid levels in Korean patients with essential hypertension.
J Cardiovasc Pharmacol. 1993 Sep;22(3):431-7
Authors: Jones DW, Sands CD
Because none of the major studies used to document adverse or beneficial metabolic effects of antihypertensive drugs were made of non-Western patients with a non-Western diet, we compared doxazosin and hydrochlorothiazide in Korean patients receiving a Korean diet to determine if one regimen is superior to the other in terms of efficacy, adverse metabolic effects, or both. The randomized, double-blind, parallel study of Korean hypertensive patients compared the effects of oral doxazosin (mean +/- SD dose, 10.3 +/- 6.3 mg/day) and oral hydrochlorothiazide (44.0 + 11.0 mg/day) on blood pressure (BP) and lipid metabolism. The results of 48 patients treated for 20 weeks are reported here. Systolic (p < 0.001) and diastolic (p < 0.001) BP (SBP, DBP) were significantly lower in both groups at the end of the treatment period. Doxazosin significantly increased high-density-lipoprotein (HDL) cholesterol from a baseline of 1.10 +/- 0.31 to 1.27 +/- 0.30 mM (p < 0.05) and HDL/total cholesterol from 0.25 +/- 0.1 to 0.28 +/- 0.1 mM (p < 0.01). Hydrochlorothiazide significantly increased triglyceride from a baseline of 1.63 +/- 0.71 to 2.02 +/- 0.87 mM (p < 0.05). In contrast to Western studies, hydrochlorothiazide demonstrated no adverse effect on total, low-density-lipoprotein (LDL), or HDL cholesterol, or on HDL/total cholesterol. Indeed, HDL cholesterol was increased by 0.16 mM (p < 0.01). As in Western patients, doxazosin is effective for treatment of essential hypertension in Koreans and has no adverse effects but some beneficial effects on lipids.(ABSTRACT TRUNCATED AT 250 WORDS)
PMID: 7504134 [PubMed - indexed for MEDLINE]