Risk factors for cardiovascular disease and osteoporosis in adolescent Argentinian women with special reference to anorexia nervosa

• Main Author: Matzkin, Valeria
• Published: King's College London (University of London) 2004
• Subjects: 616.85262071
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.411038

This thesis examines: dietary and behavioural patterns in adolescents with reference to eating disorders and the risk for cardiovascular disease and osteoporosis; cardiovascular risk factors in patients with Anorexia Nervosa (AN); and whether these are considered during treatment. Little research in this field exists in Argentina, where there is an exaggerated desire for thinness. Four studies were performed: Dietary and behavioural patterns in adolescents were investigated in 15-17 year old schoolgirls (N=342) from three different socio-economic (SE) groups. 62% of the girls wanted to lose weight and 40% were dieting, especially in the upper SE girls (580/0). Body Mass Index was greater (22.4 kg/m2, SD 3.1) in dieters than in nondieters (20.3 kg/m2, SD 2.1). 37% of the low SE girls smoked tobacco and 39% consumed alcohol, compared with 19% and 28% of the upper SE girls. Mean fat and carbohydrate intakes were 390/0 and 46% of the total energy. Many of these patterns indicate an increased risk of AN, cardiovascular disease and osteoporosis in adolescents. Clinical Notes Review: documented cholesterol concentrations, on admission and at follow up, between patients with AN (N=308) and an age and sex-matched healthy Argentinean population (N=216) were compared. Patients had significantly higher cholesterol and LDL on admission, placing them at greater cardiovascular risk. Values had decreased to normal after nine months of treatment for AN. Follow up Patients with AN: biochemical risk factors for cardiovascular disease were compared in patients with AN on admission and after four months of treatment (N=30) and controls (N=30). Cholesterol, LDL and Apo B concentrations were significantly higher in patients on admission, while retinol and tocopherol were lower. At follow-up most elevated biochemical parameters had decreased, but not significantly. Treatment Assessment: institutions (N=13) were surveyed to assess treatment for AN. Cardiovascular disease was not recognised as a long-term problem and a high fat diet to achieve weight gain was prescribed by 61 %. Allowance of behavioural choices related to cardiovascular disease and osteoporosis (e.g. coffee, tobacco, alcohol and vegetarianism) differed by institution. These results suggest that preventive measures are needed to target the potential risk of AN, cardiovascular disease and osteoporosis in adolescents. As patients with AN are at greater risk of cardiovascular disease and osteoporosis, these need to be addressed in treatment.