Cross-cultural differences in the macronutrient intakes of women with anorexia nervosa in Australia and Singapore

Aim: To compare the macronutrient intakes of women with and without anorexia nervosa (AN) across cultures. Method: Participants were women with AN (n=39) and without AN (n=89) of North European and East Asian backgrounds recruited in Australia and Singapore. Energy and the percentage energy contributed by protein (%protein), fat (%fat) and carbohydrate (%CHO) were assessed from participant's diet histories and analysed in terms of cultural group, acculturation, socioeconomic status (SES) and education level. Results: AN status was associated with lower energy and higher %CHO. Greater % protein was associated with greater acculturation to Western culture and lower SES, but not AN. Greater % fat was associated with lower SES and lower acculturation in women with AN, but with higher acculturation in controls. Greater % CHO was also associated with higher SES. Conclusion: The findings may represent Western diets' higher protein and fat contents, 'Western' knowledge of weight-loss diets, and affordability of low fat foods.