TITLE:
Plasma vitamin C levels in men and women from different ethnic backgrounds living in
England.
AUTHOR:
Ness AR, Cappuccio FP, Atkinson RW, Khaw KT, Cook DG
AFFILIATION:
Department of Social Medicine, University of Bristol, UK.
SOURCE:
Int J Epidemiol 1999 Jun;28(3):450-5
ABSTRACT:
BACKGROUND: People of South Asian origin living in the UK have higher death rates due to coronary heart disease
than whites. The reasons for these differences are not fully understood. Previous attempts to relate diet to cardiovascular
risk in South Asians have been inconclusive. METHODS: We compared the levels of plasma vitamin C in a
cross-sectional population-based study of 1018 men and women aged 40-59 (455 men, 563 women, 328 South Asians,
355 of African descent, 335 whites) co-resident in a geographically defined area of South London, when allowing for
potential confounders. RESULTS: Fasting plasma vitamin C levels were significantly higher in women, vegetarians,
supplement takers and non-smokers. After adjustment for age, body mass index, current smoking, supplement use and
vegetarianism the mean plasma vitamin C levels were 38.8 (SE 1.6) mumol/l in white men, 36.5 (1.6) mumol/l in men of
African descent and 32.9 (1.5) mumol/l in South Asian men (P = 0.033 by analysis of co-variance). In women the
adjusted mean plasma vitamin C levels were 52.4 (1.6) mumol/l in whites, 46.0 (1.4) mumol/l in women of African
descent and 37.3 (1.8) mumol/l in South Asians (P < 0.0001 by analysis of covariance). South Asians had lower levels
than whites in both men (difference 6.4 [95% CI: 1.5, 11.3] mumol/l) and women (16.8 [95% CI: 11.5, 22.1] mumol/l).
South Asian women, but not men, also had lower levels than those of African descent (8.8 [95% CI: 4.5, 13.1] mumol/l).
African women, but not men, had lower levels than white women (6.6 [95% CI: 2.3, 10.9] mumol/l). No significant
differences were seen between Caribbeans and West Africans or between South Asian Hindus and Muslims.
CONCLUSIONS: These data suggest that important dietary differences in vitamin C exist between different ethnic
groups living in England. The larger differences in South Asians may contribute to their increased coronary risk.
PMID: 10405847, UI: 99334319
TITLE:
Gender difference in cereal intake: possible impacts of social group affiliation and
season.
AUTHOR:
Chakrabarty M
AFFILIATION:
Anthropology Section, Indian Museum Calcutta, India.
SOURCE:
Anthropol Anz 1996 Dec;54(4):355-60
ABSTRACT:
Food may not be equitably distributed within the household. The distribution depends on some factors, one of which is
availability of food. The generalised proposition of gender bias against women in the distribution of food in South Asia has
been examined here in three culturally contrasting population groups in two seasons, viz. lean and peak. The result shows
that in all the three groups, in all household membership categories, the intake of cereal is higher than the recommended
intake, but the male-female differences in net intakes are higher in peak season than in lean season.
TITLE:
Psychopathology and personal agency: modernity, culture change and eating disorders
in south Asian societies.
AUTHOR:
Littlewood R
AFFILIATION:
Department of Psychiatry, University College London, UK.
SOURCE:
Br J Med Psychol 1995 Mar;68 ( Pt 1):45-63
ABSTRACT:
The cultural contribution to psychopathology may become more salient in situations of social change, but it remains
difficult to distinguish individual agency among wider social and economic transitions, such as 'modernization' or simply
'culture change', which carry the potential for recourse to new patterns. Eating disorders, a biosocial pattern once
identified exclusively with European societies, do occur among South Asian women including those living in the West.
This seems not just a simple appropriation of contemporary Western ideals of female morphology--the 'fear of
fatness'-but a reassertion of an instrumental strategy of self-renunciation in situations of experienced constraint.
TITLE:
Iron deficiency anaemia in women of South Asian descent: a qualitative study.
AUTHOR:
Chapple A
AFFILIATION:
National Primary Care Research and Development Centre, University of Manchester, UK.
SOURCE:
Ethn Health 1998 Aug;3(3):199-212
ABSTRACT:
OBJECTIVE: Menorrhagia is thought to be the commonest cause of iron deficiency anaemia in women of reproductive
age living in Britain. However, it has been suggested that the high prevalence of iron deficiency anaemia in women of
South Asian descent living in Britain is due to religious and cultural restrictions on certain foods. While lack of iron in the
diet, or poor iron absorption may well be reasons for this prevalence of iron deficiency anaemia, there may be other
complex reasons why South Asian women suffer particularly from this complaint. This study aimed to explore reasons
for the relatively high level of iron deficiency anaemia found in South Asian women living in Britain. METHOD: A
qualitative study using semi-structured interviews with women of Indian and Pakistani descent living in a town in North
West England. FINDINGS: It appears that some South Asian women value a relatively heavy menstrual blood flow
because such blood is thought to be 'dirty' and 'impure' and because a scanty period is thought to result in abdominal
weight gain and pain. When menstrual blood loss is thought to be 'excessive', women tend to avoid 'hot' foods such as
meat, fish and eggs, thus denying themselves a valuable source of iron. When South Asian women believe that they have
a serious problem of menorrhagia they may not seek medical help because of the shortage of female general
practitioners. Poor communication with doctors and other health care professionals may also affect illness behaviour.
CONCLUSION: This study suggests that attitudes to menstruation and menstrual blood may help to account for the
relatively high levels of iron deficiency anaemia found in women of South Asian descent living in Britain. Since most of
the women interviewed during this research had families who came from Gujarat in Western India, more research is
needed to explore the values and beliefs of women coming from other parts of Southern Asi
TITLE:
No evidence for an ethnic influence on basal metabolism: an examination of data from
India and Australia.
AUTHOR:
Soares MJ, Piers LS, O'Dea K, Shetty PS
AFFILIATION:
School of Nutrition and Public Health, Deakin University, Victoria, Australia. mjsoares@deakin.edu.au
SOURCE:
Br J Nutr 1998 Apr;79(4):333-41
ABSTRACT:
A lower BMR of Indians, when compared with Westerners matched for age, sex and either surface area or body weight,
has often been reported in the literature and has been interpreted to reflect an ethnic influence on BMR. To determine the
contribution of body composition to these observed differences in BMR, we analysed the data on ninety-six Indians and
eighty-one Caucasian Australians of both sexes, aged 18-30 years, studied in Bangalore, India and Melbourne,
Australia. Absolute BMR and BMR adjusted for body weight were significantly lower in Indians when compared with
Australians of the corresponding sex. However, BMR adjusted for fat-free mass (FFM) in men, and BMR adjusted for
FFM and fat mass (FM) in women, were not significantly different between the two groups. Stepwise regression of
FFM, FM, sex (0 = women; 1 = men) and ethnicity (0 = Indian; 1 = Australian) on BMR, resulted in the following
relationship for the combined data on all subjects: BMR = 88.7 x FFM (kg) + 1713 (n 177; r 0.92; r2 0.85; SEE 425 kJ).
The Indian equations of Hayter & Henry (1994), based on body weight, resulted in a significant bias
(measured-predicted BMR) of 318 (SE 54) kJ/d in Indian men and -409 (SE 70) kJ/d in Indian women. The equation of
Cunningham (1991), based on FFM, accurately predicted the BMR of Indian men, Indian women and Australian men.
The small but significant bias of 185 (SE 61) kJ/d in Australian women, may be explained by the significant contribution
of FM to BMR in this group. The present study does not provide any evidence for an ethnic influence on basal
metabolism. The results strongly support the use of FFM, rather than body weight, for the prediction of BMR in
population groups of varying body size and composition. This would allow an accurate estimation of BMR and hence
energy requirements in population groups worldwide.
TITLE:
Eating disorders in British Asians.
AUTHOR:
Ratan D, Gandhi D, Palmer R
AFFILIATION:
Leicestershire Mental Health Service NHS Trust, United Kingdom.
SOURCE:
nt J Eat Disord 1998 Jul;24(1):101-5
ABSTRACT:
OBJECTIVE: There has been a clinical impression that British Asians present with eating disorders less commonly than
expected. The study examines the numbers and characteristics of Asians presenting to the Leicestershire Eating
Disorders Service with a catchment area which includes a substantial proportion of people with a background in the
Indian subcontinent. METHOD: Case note review and comparison of rates of presentation of people with and without
such a background. RESULTS: Twenty-one eating-disordered Asians were seen in 10 years. Their clinical
characteristics resembled the rest of the referrals. However, the rate of presentation of people from the Asian population
was about one fourth of that of the white population. DISCUSSION: Asian women with eating disorders were referred
less often. This might be because of a lower prevalence in this population. However, it seems likely there are variable and
sometimes high threshold filters to secondary care for such women.
TITLE:
An ethnic comparison of eating attitudes and associated psychological problems in
young British women.
AUTHOR:
Button E, Reveley C, Palmer R
AFFILIATION:
Leicestershire Mental Health Service NHS Trust, University of Leicester, United Kingdom.
SOURCE:
nt J Eat Disord 1998 Apr;23(3):317-23
ABSTRACT:
OBJECTIVE: The study aimed to investigate possible differences in eating attitudes/problems and associated
psychological problems in young women of differing ethnic origin. METHOD: In a city with a relatively high Asian
population (with a background in the Indian subcontinent), 235 young women aged 18-27 registered with a general
practice responded to a postal questionnaire. The questionnaire examined eating and weight problems (including the
26-item Eating Attitudes Test), self-esteem (measured by the Rosenberg Self-Esteem Scale), and general
psychological well-being (measured by The Hospital Anxiety and Depression Scale). We also included three short
vignettes designed to assess illness perception and health seeking-behavior. RESULTS: We found relatively little
difference in eating attitudes and problems according to ethnicity, although self-induced vomiting for weight control was
more common among Caucasian women. Neither was there any difference in self-esteem, anxiety, depression, and
illness perception. DISCUSSION: The results suggest that one cannot generalize about eating problems across the
Asian population and a more sophisticated approach to the examination of sociocultural factors is recommended.
PMID: 9547666, UI: 98208882
TITLE:
Some aspects of dental health in young adult Indian vegetarians. A pilot study.
AUTHOR:
Sherfudhin H, Abdullah A, Shaik H, Johansson A
AFFILIATION:
Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
SOURCE:
Acta Odontol Scand 1996 Feb;54(1):44-8
ABSTRACT:
The effect of a vegetarian diet on oral health status could be manifold, but reports have so far mainly appeared from
within Western populations. This study reports the oral health status of southeast Indian vegetarians, obtained by means
of a questionnaire, clinical examination, and study cast evaluations. The material comprised 30 vegetarians and 25 sex-
and age-matched non-vegetarian controls. Comparison between the samples included dietary and oral hygiene habits,
health-related variables, caries prevalence, and dentoalveolar characteristics. The questionnaire showed significantly
less consumption of between-meal sweets and more widespread use of a soft toothbrush by the vegetarians. The
vegetarians had a significantly higher degree of tooth wear than the non-vegetarians, but no difference in the degree of
wear between women and men in either group was found. The vegetarians had a significantly higher tendency towards
crowding in the maxillary arch, numerically higher DMFT, and greater number of cervical buccal defects than the
controls. The results of this study suggest that the Indian vegetarian diet may produce certain effects on the oral health,
associations that need to be studied further.
TITLE:
Zinc status of Indian children.
AUTHOR:
Bhaskaram P, Hemalatha P
AFFILIATION:
National Institute of Nutrition, Hyderabad.
SOURCE:
Indian J Med Res 1995 Nov;102:210-5
ABSTRACT:
Zinc is a trace metal essential for human health and its deficiency is found to cRotuiause severe growth retardation in children.
Information on the zinc status of Indian children is meagre perhaps due to lack of a reliable parameter. However, in view
of the role of zinc in promoting growth, it has become common practice to prescribe zinc supplements to young children
and newborns, particularly preterm infants. It is now clearly established that zinc confers no additional benefits to an
individual with adequate zinc status while it can potentially lead to harmful effects by disturbing the milieu of other trace
metals in the body. Estimation of thymulin levels in circulation is found to be a sensitive indicator of zinc status and using
this parameter we found that apparently normal children have adequate zinc status. Children suffering from severe
protein energy malnutrition however had very low levels of the hormone besides low leukocyte and plasma zinc levels
indicating zinc deficiency. Such children showed improvement in their zinc status when zinc supplements were provided
along with rehabilitation diets. Pregnant women and term newborns showed no evidence of zinc deficiency. Preterm
infants had higher leukocyte zinc levels during early infancy and the breast milk of their mothers also had higher zinc
content which could cater to the higher requirements of the rapidly growing preterm infant. All breast-fed infants
showed decline in the zinc status gradually over the initial 4 months of life and regained adequate zinc status after
appropriate weaning. These studies thus do not support the view of routine zinc supplements to pregnant women or
children. However, Infants solely fed formula milk from birth had significantly impaired zinc status till the time of weaning.
The functional significance of severe zinc inadequacy in such infants needs to be established.
TITLE:
Supplementation with iron and folic acid enhances
growth in adolescent Indian girls
AUTHOR:
Kanani SJ; Poojara RH
AFFILIATION:
SOURCE:
JOURNAL OF NUTRITION 2000, Vol 130, Iss 2, pp
452S-455S
ABSTRACT:
The prevalence of anemia is high in adolescent
girls in India, with over 70% anemic. Iron-folic
acid (IFA) supplements have been shown to enhance
adolescent growth elsewhere in the world, To
confirm these results in India, a study was
conducted in urban areas of Vadodora, India to
investigate the effect of IFA supplements on
hemoglobin, hunger and growth in adolescent girls
10-18 y of age. Results show that there was a high
demand for IFA supplements and >90% of the girls
consumed 85 out of 90 tablets provided. There was
an increment of 17.3 g/L hemoglobin in the group
of girls receiving IFA supplements, whereas
hemoglobin decreased slightly in girls in the
control group. Girls and parents reported that
girls increased their food intake. A significant
weight gain of 0.83 kg was seen in the
intervention group, whereas girls in the control
group showed little weight gain. The growth
increment was greater in the 10- to 14-y-old age
group than in the 15- to 18-y-old group, as
expected, due to rapid growth during the
adolescent spurt. IFA supplementation is
recommended for growth promotion among adolescents
who are underweight.
TITLE:
Anaemia in pregnancy: possible causes and risk
factors in Nepali women
AUTHOR:
Bondevik GT; Eskeland B; Ulvik RJ; Ulstein M;
Lie RT; Schneede J; Kvale G
AFFILIATION:
SOURCE:
EUROPEAN JOURNAL OF CLINICAL NUTRITION 2000, Vol
54, Iss 1, pp 3-8
ABSTRACT:
Objective: The aim of this study was to
investigate the importance of nutritional
deficiencies and infections in the development of
anaemia in pregnant Nepali women.Design:
Case-control study.Setting: Patan Hospital,
Kathmandu, Nepal.Subjects: A sub-sample (n = 479)
of all pregnant women (n = 2856) coming for their
first antenatal visit in a 12 month period,
1994-1995. Women who had already received any
micronutrient supplementation (n = 82), and those
whose serum samples showed macroscopic haemolysis
(n = 7) were excluded. The remaining women (n =
390) were included in the statistical analysis.
They were divided into three groups; a non-anaemic
control group, haematocrit (Hct)>33% (n = 82), and
two case-groups: moderately anaemic, Hct 25-33% (n
= 254), and severely anaemic, Hct<25% (n =
54).Results: We found high prevalences of
nutritional deficiencies and intestinal
infections, both among cases and controls. The
prevalence of low s-ferritin was high, especially
among the severely anaemic women (55.6%). In a
multiple logistic regression model, the presence
of low s-vitamin A, elevated s-C-reactive protein
or hookworm infection was associated with a
significantly increased risk of severe anaemia.
The adjusted odds ratios (95% CI) were 8.38 (1.99,
35.30), 4.91 (1.22, 19.67) and 5.43 (1.20, 24.61),
respectively.Conclusions: In addition to the
present routine iron and folate supplementation to
pregnant Nepali women, vitamin A supplementation
needs to be considered. Prevention and treatment
of infections should, together with dietary
advice, be emphasized more strongly in the
antenatal care.