Body Image: A Handbook of Theory, Research, and Clinical Practice

Estudo financiado pela Organizacao Pan-Americana da Saude atraves do Concurso Regional de Investigacion 1999 sobre “Genero y equidad en el acceso
a la atencion de la salud en las reformas de los sistemas de salud y seguridad social”. HDP/HDR/RGP/81/5.3.

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[Utilization of health care services in Brazil: gender, family characteristics, and social status].

Once concentrated among adolescent Caucasian females in high-income Western countries, today, eating disorders (EDs) are truly global. Building upon previous work describing the rise of EDs among cultures in transition, we contextualize the emergence of EDs in Asia by locating this development within the broader discourse about the processes of change that have radically transformed Asian societies over the last three decades. By identifying where EDs are emerging in the region, and by examining their particular expression, our aim is to explicate a fuller story of the relationship between culture and eating disorders. Much of the discussion of EDs in non-Western societies is predicated upon the assumption that an increase in EDs is the by-product of “Westernization”, the term used to describe the process by which increased cultural contact with the West results in the transmission of so-called ‘Western’ ideas and cultural norms to a non-Western culture. While the Westernization literature represents a historical anchor in our understanding of EDs in Asia, we propose that this analysis is incomplete in that societal change in the form of industrialization and urbanization occurring independently from, or in tandem with, “Western” influence are critical factors contributing to the rise of EDs in Asia. Further, our review of eating disorders in Asia suggests that an understanding of the diversity and distinctiveness of the individual countries and cultures that comprise ‘Asia’ is crucial to understanding the emergence and rise of EDs across this vast region, suggesting that eating disorders are not culture-bound or culture-specific, but rather culture-reactive. Taking into account both the historical influence of Western culture and the more contemporary effects of Asian industrialization and urbanization, key distinctions among respective Asian cultures expands our understanding of the development and expression of EDs globally.

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The rise of eating disorders in Asia: a review

わが国における"Care in normal birth : a practical guide" の実態 : 有床診療所の調査

Objective A number of studies have documented that acculturation to western society is related to an increase in blood pressure (BP). Although there is evidence that higher socioeconomic status appears related to better cardiovascular health, increasing acculturation to western society appears related to worse cardiovascular health. The purpose of this meta-analysis was to investigate the association between acculturation and BP. Methods Literature searches yielded 125 relevant research manuscripts, which were coded by teams of two independent raters. This study was conducted in 2003 and 2004, and research databases such as MEDLINE and PsychINFO were searched through 2004. Measures of association (effect sizes) were extracted for both systolic blood pressure (SBP) and diastolic blood pressure (DBP) readings. Random effects models were used to analyze the resulting data. Results The overall effect sizes associated with acculturation were 0.28 for SBP and 0.30 for DBP, with increasing acculturation to western society related to higher BP. More acculturated individuals had an average of 4 mm Hg higher BP than less acculturated individuals, which is similar to the effect sizes of known risk factors for high BP such as diet and physical activity. The effects of acculturation on BP appear to be universal, with similar effect sizes found across all regions of the world. Change in BP due to acculturation was not related to body mass index (BMI) or cholesterol but was related to length of residence in the new culture, with the largest effect sizes seen on initial entry and then decreasing rapidly within the first few years. Sudden cultural changes, such as migration from rural to urban settings, resulted in the largest effect sizes, which finding supports the hypothesis that the stress of cultural change is important role in the acculturation effect. Conclusions Acculturation to western society is associated with higher BP, and the distress associated with cultural change appears to be more influential than changes in diet or physical activity. Future studies would benefit from investigating how cultural change affects health and examining whether some non-Western cultural values and practices are health protective.

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Acculturation to Western Society as a Risk Factor for High Blood Pressure: A Meta-Analytic Review

This paper presents a global review of research done on adolescent eating behaviours and food choices and the probable factors underlying it. Worldwide adolescent girls tend to develop moderate to high level of disordered eating behaviour as a result of their excessive concern with body weight or obsession with thinness. The objective of the review is to understand the concerns over body weight and the current eating patterns of adolescent girls in the developed and developing countries.

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Eating Behaviours and Body Weight Concerns among Adolescent Girls

OBJECTIVES Growing concern about ideal body image among adolescent girls in developing countries has led them to follow dietary modifications In general, the ideal body image is perceived as a 'thin body' and now tagged with the concept of being physically fit The present study evaluates the prevalence of weight concerns, and subsequent eating behaviour modifications among a group of adolescent girls in Sikkim DESIGN Pre-tested FFQ and dietary behaviour questionnaire were canvassed through direct interviews Anthropometric measurements were taken following standard techniques In the present study, dieting stands for skipping meals or avoiding certain food items SETTING Sikkim, India SUBJECTS A total of 577 girls were selected from several blocks of all four districts of Sikkim RESULTS The results of the study show that concern with weight reduction is growing among adolescent girls, particularly among urban girls of affluent families Girls from families with a higher economic status are about two times more likely to report dissatisfaction with their body weight (OR = 1·96; P ≤ 0·05) and these girls are five times more likely to report the need for dieting CONCLUSIONS It is evident that weight concern and dissatisfaction over body weight are growing among adolescents It can be safely argued that eating disorder, once a problem of the Western world, is now slowly creeping in among adolescents of the developing world as a consequence of rapid lifestyle changes over the past few decades

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Eating and weight concerns among Sikkimese adolescent girls and their biocultural correlates: an exploratory study.

We evaluate the blood pressure profile in relation to selected biological, behavioral, and socioeconomic factors among the Lepchas, a tribal population of Asian origin inhabiting the Dzongu area of northern Sikkim. The results show that mean systolic and diastolic blood pressures of Lepcha adults (aged 19 years and older), engaged primarily in agricultural practices, are conspicuously high and that the prevalence of essential hypertension (defined in terms of WHO criteria) is remarkably high as well, irrespective of sex. Significant effects of age on blood pressure were found. None of the anthropometric variables considered was a significant correlate of blood pressure in males, whereas triceps skinfold thickness was the only significant correlate of blood pressure in females. Systolic blood pressure among males was significantly affected by alcohol intake. Mean systolic and diastolic blood pressures consistently increase with increasing intake of alcohol in both sexes.

Blood pressure profile of Lepchas of the Sikkim Himalayas: epidemiological study.

Objective Every society follows its own traditional health-care beliefs and practices during and after pregnancy, which is intimately linked to its socio-cultural environment. The objective of the present study was to document pregnancy-related food practices and the social-cultural factors linked with them. Design The present study was a cross-sectional one conducted among a group of women residing in five villages in east Sikkim, India. Mothers who had given birth to a child one year before the survey participated in the study. The mothers answered a pre-tested questionnaire on food habits and practices followed antepartum and for 6 weeks postpartum. Subjects The study group consisted of 199 women of Nepali caste groups with variations in economic condition. Results More than 86 % of mothers consumed special foods during the postpartum period. Taboos on different food categories during the postpartum were reported only by 65·3 % of mothers. Factors found to be significantly associated with special food consumption were literacy status during the antepartum and parity during the postpartum. Conclusions The change in consumption patterns reflects the success of a safe motherhood campaign propagated by the government. Detailed investigation in this area, involving per capita daily consumption during pregnancy and the postpartum period, is needed.

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Pregnancy-related food habits among women of rural Sikkim, India.

The present study investigates the prevalence of reproductive health morbidities, treatment-seeking behavior, and its association with sociodemographic correlates among unmarried and married adolescent girls of Sikkim. The study sample includes 1250 adolescent girls randomly selected from both urban and rural blocks of the State. Information on socioeconomic and demographic characteristics, prevalence of reproductive health morbidities, and treatment-seeking behavior was collected using standard pretested questionnaires. Results of the study indicate that the prevalence of reproductive health morbidities among both married and unmarried girls is quite high. Age, media exposure, and economic status emerged as significant correlates of treatment-seeking practices among both married and unmarried girls. High prevalence of reproductive health morbidity in this vulnerable group, particularly in rural settings, requires urgent intervention of health planners. This study reinforces an indirect and mediatory role...

Susmita Mukhopadhyay

Papers

Eating Behaviours and Body Weight Concerns among Adolescent Girls

Eating and weight concerns among Sikkimese adolescent girls and their biocultural correlates: an exploratory study.

Blood pressure profile of Lepchas of the Sikkim Himalayas: epidemiological study.

Pregnancy-related food habits among women of rural Sikkim, India.

Socioeconomic Correlates of Reproductive Morbidity Among Adolescent Girls in Sikkim, India: