Reply to P Strazzullo et al Bernstein, Adam M; Willett, Walter C
The American journal of clinical nutrition,
03/2011, Letnik:
93, Številka:
3
Journal Article
Objective
To evaluate the influence of ethnicity on self‐reported health‐related quality of life (HRQOL) in the Canadian childhood‐onset systemic lupus erythematosus (cSLE) population.
Methods
...Patients with cSLE at 4 pediatric centers were consecutively enrolled. Sociodemographics and multiple disease activity measures were collected. The Child Health Questionnaire (CHQ) was administered and analyzed by ethnicity.
Results
We enrolled 213 cSLE patients, and complete data from 196 patients with the following ethnicities were analyzed: white (33%), Asian (32%), South Asian (16%), African American (11%), Latino/Hispanic (5%), and Aboriginal (4%). Compared to healthy children, cSLE patients rated their HRQOL significantly more poorly in 9 of 10 individual domains, and in 4 of 10 domains when compared to a cohort of juvenile arthritis patients. Within the cSLE cohort, CHQ scores were lower in 5 of 10 domains in white patients versus nonwhite ethnicities (P < 0.05 for each). Physical summary scores were lower for white patients compared to the other ethnicities aggregated together (mean ± SD 46.0 ± 11.9 versus 50.4 ± 10.1; P = 0.009); however, psychosocial summary scores were similar among the groups (mean ± SD 40.5 ± 14.6 versus 42.8 ± 12.7; P = 0.26). Disease activity measures, including the Systemic Lupus Erythematosus Disease Activity Index 2000, the Systemic Lupus Activity Measure, Revised, and physician global visual analog scale, were similar across ethnicities. However, patient‐reported Systemic Lupus Erythematosus Activity Questionnaire symptom scores were greater in patients of white ethnicity compared to those of Asian ethnicity (mean ± SD 8.2 ± 5.8 versus 4.5 ± 4.7; P = 0.004).
Conclusion
The self‐ and parent‐reported health status of Canadian cSLE patients differed across ethnicities, with white patients reporting lower HRQOL despite similar and overall low disease activity.
Reply to E Frazão et al Bernstein, Adam M; Bloom, David E; Willett, Walter C
The American journal of clinical nutrition,
04/2011, Letnik:
93, Številka:
4
Journal Article
Focus groups were held to better understand conceptions of disease prevention among low-income African American women at risk for diabetes. Mental calm was associated with health more than nutrition, ...exercise, or social connection. This finding suggests that prioritizing stress reduction will help with successful implementation of community holistic diabetes prevention programs.
Consistent with the compression-of-morbidity hypothesis, several studies have reported that a significant proportion of centenarians delay or escape age-related diseases. Of those who live with such ...diseases for a long time, many appear to do so with better functional status than do younger persons who do not achieve extreme old age. The authors describe the first autopsy in an Okinawan-Japanese centenarian who escaped many age-related illnesses and delayed frailty toward the end of her very long life. Her late-life morbidity pattern is contrasted with that of white centenarians.
Despite a wealth of research on cholesterol and saturated fat and cardiovascular disease (CVD), few studies have examined the association between red meat and CVD. We review the epidemiologic data on ...the relation between red meat intake and CVD. From observational studies over the past 25 years, we conclude that both unprocessed and processed red meat increase the risk of coronary heart disease and that processed red meat likely confers a greater risk. Data on the relation of red meat with stroke is limited, but also suggests an increased risk. As dietary iron, added sodium, and compounds created during cooking may contribute to these associations, simply choosing lean red meats may not reduce the risk of CVD. Clinicians may consider recommending that patients decrease or eliminate red meat from their diet and replace it with healthier protein sources such as nuts, fish, poultry, or low-fat dairy products.
In individuals with chronic kidney disease, high-protein diets have been shown to accelerate renal deterioration, whereas low-protein diets increase the risk of protein malnutrition. Vegetarian diets ...have been promoted as a way to halt progression of kidney disease while maintaining adequate nutrition. We review the literature to date comparing the effects of animal and vegetable protein on kidney function in health and disease. Diets with conventional amounts of protein, as well as high-protein diets, are reviewed. The literature shows that in short-term clinical trials, animal protein causes dynamic effects on renal function, whereas egg white, dairy, and soy do not. These differences are seen both in diets with conventional amounts of protein and those with high amounts of protein. The long-term effects of animal protein on normal kidney function are not known. Although data on persons with chronic kidney disease are limited, it appears that high intake of animal and vegetable proteins accelerates the underlying disease process not only in physiologic studies but also in short-term interventional trials. The long-term effects of high protein intake on chronic kidney disease are still poorly understood. Several mechanisms have been suggested to explain the different effects of animal and vegetable proteins on normal kidney function, including differences in postprandial circulating hormones, sites of protein metabolism, and interaction with accompanying micronutrients.
PDF
