Culture and the Immune System: Cultural Consonance in Social Support and C-reactive Protein in Urban Brazil.

In this article, we examine the distribution of a marker of immune system stimulation-C-reactive protein-in urban Brazil. Social relationships are associated with immunostimulation, and we argue that cultural dimensions of social support, assessed by cultural consonance, are important in this process. Cultural consonance is the degree to which individuals, in their own beliefs and behaviors, approximate shared cultural models. A measure of cultural consonance in social support, based on a cultural consensus analysis regarding sources and patterns of social support in Brazil, was developed. In a survey of 258 persons, the association of cultural consonance in social support and C-reactive protein was examined, controlling for age, sex, body mass index, low-density lipoprotein cholesterol, depressive symptoms, and a social network index. Lower cultural consonance in social support was associated with higher C-reactive protein. Implications of these results for future research are discussed.

How culture shapes the body: cultural consonance and body mass in urban Brazil.

OBJECTIVES: The aim of this article is to develop a model of how culture shapes the body, based on two studies conducted in urban Brazil. METHODS: Research was conducted in 1991 and 2001 in four socioeconomically distinct neighborhoods. First, cultural domain analyses were conducted with samples of key informants. The cultural domains investigated included lifestyle, social support, family life, national identity, and food. Cultural consensus analysis was used to confirm shared knowledge in each domain and to derive measures of cultural consonance. Cultural consonance assesses how closely an individual matches the cultural consensus model for each domain. Second, body composition, cultural consonance, and related variables were assessed in community surveys. Multiple regression analysis was used to examine the association of cultural consonance and body composition, controlling for standard covariates and competing explanatory variables. RESULTS: In 1991, in a survey of 260 individuals, cultural consonance had a curvilinear association with the body mass index that differed for men and women, controlling for sociodemographic and dietary variables. In 2001, in a survey of 267 individuals, cultural consonance had a linear association with abdominal circumference that differed for men and women, controlling for sociodemographic and dietary variables. In general, as cultural consonance increases, body mass index and abdominal circumference decline, more strongly for women than men. CONCLUSIONS: As individuals, in their own beliefs and behaviors, more closely approximate shared cultural models in socially salient domains, body composition also more closely approximates the cultural prototype of the body.

Cultural consonance, a 5HT2A receptor polymorphism, and depressive symptoms: a longitudinal study of gene x culture interaction in urban Brazil.

In this study in urban Brazil we examine, as a predictor of depressive symptoms, the interaction between a single nucleotide polymorphism in the 2A receptor in the serotonin system (-1438G/A) and cultural consonance in family life, a measure of the degree to which an individual perceives her family as corresponding to a widely shared cultural model of the prototypical family. A community sample of 144 adults was followed over a 2-year-period. Cultural consonance in family life was assessed by linking individuals' perceptions of their own families with a shared cultural model of the family derived from cultural consensus analysis. The -1438G/A polymorphism in the 2A serotonin receptor was genotyped using a standard protocol for DNA extracted from leukocytes. Covariates included age, sex, socioeconomic status, and stressful life events. Cultural consonance in family life was prospectively associated with depressive symptoms. In addition, the interaction between genotype and cultural consonance in family life was significant. For individuals with the A/A variant of the -1438G/A polymorphism of the 2A receptor gene, the effect of cultural consonance in family life on depressive symptoms over a 2-year-period was larger (beta = -0.533, P < 0.01) than those effects for individuals with either the G/A (beta = -0.280, P < 0.10) or G/G (beta = -0.272, P < 0.05) variants. These results are consistent with a process in which genotype moderates the effects of culturally meaningful social experience on depressive symptoms.

Cultural consonance and adult body composition in urban Brazil.

In previous research in Brazil, we found socioeconomic and gender differences in body mass and percent body fat, consistent with a model in which individuals in higher socioeconomic strata, especially women, could achieve a cultural ideal of body size and shape. In this article, using new data, we examine these processes more precisely using measures of cultural consonance. Cultural consonance refers to the degree to which individuals approximate, in their own beliefs and behaviors, the shared prototypes for belief and behavior encoded in cultural models. We have found higher cultural consonance in several domains to be associated with health outcomes. Furthermore, there tends to be a general consistency in cultural consonance across domains. Here we suggest that measures of body composition can be considered indicators of individuals' success in achieving cultural ideals of the body, and that cultural consonance in several domains will be associated with body composition. Using waist circumference as an outcome, smaller waist size was associated with higher cultural consonance in lifestyle (beta = -0.311, P < 0.01) and higher cultural consonance in the consumption of high prestige foods (beta = -0.260, P < 0.01) for women (n = 161), but not for men (n = 106), controlling for age, family income, tobacco use, and dietary intake of protein and carbohydrates. Similar results were obtained using the body mass index and weight as outcomes, while there were no associations with height. These results help to illuminate the cultural mediation of body composition.

A prospective study of cultural consonance and depressive symptoms in urban Brazil.

Cultural consonance refers to the degree to which individuals, in their own beliefs and behaviors, approximate the prototypes for belief and behavior encoded in shared cultural models. In previous cross-sectional studies, lower cultural consonance in several cultural domains was associated with worse health outcomes, including greater psychological distress. The current paper extends these findings in three ways. First, the effect of cultural consonance on depressive symptoms is tested in a prospective study. Second, it is hypothesized that the effect of cultural consonance in a specific cultural domain will depend on the degree of cultural consensus within that domain: the higher the cultural consensus, the greater the effect of change in cultural consonance in that domain on depressive symptoms. Third, it is hypothesized that cultural consonance will have an inverse effect on depressive symptoms independent of the occurrence of stressful life events (a well-known risk factor for depression). We tested these hypotheses in a study conducted in urban Brazil, and found that change in cultural consonance (assessed as a general construct) was associated with depressive symptoms at a 2-year follow-up. Furthermore, cultural consonance in the domains in which there was highest cultural consensus--the domains of family life and lifestyle--was more strongly associated with depressive symptoms at follow-up than cultural consonance in domains with lower cultural consensus. Finally, all of these effects were independent of stressful life events. These results lend further support to the importance of cultural consonance in relation to human health.

Cultural consonance and psychological distress: examining the associations in multiple cultural domains.

Cultural consonance is the degree to which individuals, in their own beliefs and behaviors, approximate widely shared cultural models. In previous research in Brazil and the United States we found that higher cultural consonance in the cultural domains of lifestyle and social support was associated with lower psychological distress. The aim of this paper is to expand on these results in two ways. First, the measurement of cultural consonance has been improved through a closer link of cultural domain analyses and survey research. Second, the number of domains in which cultural consonance has been examined has been expanded to include-along with lifestyle and social support-family life, national identity, and food. We found that cultural consonance in these five domains can be conceptualized as two latent variables of generalized cultural consonance, and that this generalized cultural consonance is associated with lower psychological distress. These results continue to support the usefulness of cultural consonance as a theoretical construct in the explanation of human social suffering.

Absence of circadian salivary cortisol rhythm in women with anorexia nervosa.

STUDY OBJECTIVE: To compare the cortisol levels and 24 hour salivary cortisol rhythm in patients with anorexia nervosa (AN) and normal controls. DESIGN: Prospective transversal controlled study. SETTING: Tertiary-referral University Hospital. PARTICIPANTS: Twenty-five patients aged 15 to 35 years, 13 of them with regular ovulatory cycles, and 12 with diagnosis of AN. INTERVENTIONS: Salivary and blood collection for cortisol 24-hour rhythm determination. MAIN OUTCOME: Salivary cortisol was determined at 9 am, 5 pm, and 11 pm. Seric follicle-stimulating hormone, luteinizing hormone (LH), prolactin, estradiol (E2), progesterone, dehydroepiandrosterone-S (DHEA-S), and cortisol were sampled together with the 9 am salivary sample. RESULTS: LH, E2, and DHEA-S levels were reduced in patients with AN. A correlation between salivary and serum cortisol levels was observed in the 9 am sample only in controls (r = 0.67, P = 0.01; AN: r = 0.48, P = 0.12). Cortisol rhythm was present in all control subjects, whereas it was absent in one third of AN patients. The area under the curve for the AN group with preserved rhythm was significantly higher than for the control group (Me = 6811 ng/dl/24h vs 3708 ng/dl/24 h; P = 0.034). CONCLUSION: Patients with AN have higher salivary cortisol levels when compared to normal women and some of them do not present circadian rhythm.

Cultural consonance and arterial blood pressure in urban Brazil.

In previous research in Brazil, we tested the hypothesis that cultural consonance is associated with arterial blood pressure. Cultural consonance is the degree to which individuals are able to approximate in their own behaviors the prototypes for behavior encoded in shared cultural models. Individuals who had higher cultural consonance in the domains of lifestyle and social support had lower blood pressures. The aim of the current research was to replicate and extend these findings. First, a more extensive cultural domain analysis was carried out, improving the description of cultural models. Second, more sensitive measures of cultural consonance were developed. Third, data were collected in the same community studied previously. The following findings emerged: (a) cultural domain analysis (using a mix of quantitative and qualitative techniques) indicated that cultural models for these domains are widely shared within the community; (b) the associations of cultural consonance in these domains with arterial blood pressure were replicated; and, (c) the pattern of the associations differed slightly from that observed in earlier research. This pattern of associations can be understood in terms of macrosocial influences over the past ten years. The results support the importance of long-term fieldwork in anthropology.

Tradução e validação do Eating Attitudes Test em adolescentes do sexo feminino de Ribeirão Preto, São Paulo / Translation and validation of the Eating Attitudes Test in female adolescents in Ribeirão Preto, SP, Brazil

O objetivo desta pesquisa foi realizar a tradução e validação semântica do ating Attitudes test (EAT-26) para a língua portuguesa. Foram utilizadas a tradução e a retrotradução do instrumento e a análise estatística para avaliar a consistência interna dos itens do teste e sua confiabilidade. O EAT-26 foi aplicado em 365 adolescentes do sexo feminino com idades entre 12 e 18 anos. A idade média das meninas foi de 14,2 anos e a maioria era eutrófica. A pontuação média total do EAT-26 foi de 19,8 pontos. A consistência interna do teste representada pelo alfa de Cronbach foi de 0,82,considerado estatisticamente bastante satisfatório. Concluímos, assim, que o EAT-26 encontra-se em boas condições de ser utilizado nesse grupo de risco, possibilitando indicativos para o prognóstico de transtornos alimentares como a anorexia e a bulimia nervosas