A woman who went on an intense grapefruit-based diet developed a blood clot in her leg and risked losing the limb, US doctors have reported.



The unusual case, written up in the Lancet medical journal, occurred in Washington state in November last year.

Medics concluded grapefruit had affected the way the 42-year-old's body processed her contraceptive pill.

A UK expert stressed this was an unusual case, but said extreme diets may have "unpredictable consequences".


Three days of grapefruit for breakfast may well have tipped the balance
Dr Lucinda Grande, Providence St Peter Hospital

In November 2008, the woman came to the casualty department of the Providence St Peter Hospital in Olympia, Washington state.

The day before, she had gone on a long car journey, after which she felt pain radiating from her lower back down to her left ankle.

When she arrived at the hospital she was experiencing difficulty walking, shortness of breath, and light-headedness.

By the next day her left leg had turned purple.

The woman was generally in good health but was slightly overweight and had decided to diet.

Three days before falling ill, she had begun a crash diet which included eating 225g of grapefruit each morning, after rarely eating the fruit in the past.

When doctors examined her, an ultrasound scan confirmed the woman had a large blood clot within the veins of her left leg, which stretched from her hip down to her calf and she was deemed to be at risk of losing her leg because of gangrene.

The woman was given clot-busting treatment and had a stent, a kind of tube, fitted in order to widen her vein.

Fruit block

The doctors treating her said a number of risk factors had contributed to the woman developing the clot.

She had an inherited disorder which increased her risk, as did being on the combined Pill. Being immobile in a car probably also contributed to the clot forming.

Writing in the Lancet, the authors led by Dr Lucinda Grande, called it a "constellation of potential risk factors".

But they added: "The increased [oestrogen] serum concentration due to her three days of grapefruit for breakfast may well have tipped the balance."

They suggest the fruit blocked the action of a key enzyme that normally breaks down the form of oestrogen in her contraceptive.

Dr Trevor Baglin, a consultant haematologist at Addenbrooke's NHS Trust in Cambridge, said: "From this case study it appears as if the grapefruit enhanced the thrombotic effect of the contraceptive pill in the presence of a genetic predisposition.

"However, it is worth pointing out that this is a single case study and a very unusual case at that.

"I would suggest that any extreme diets should be avoided because they can have unpredictable consequences."

The US dollar rose briefly above 100 yen in Asian trading on Friday, the first time it had done so since early November 2008.


The news boosted shares in Japanese exporters, with the likes of Sony and Toyota Motor closing higher.

The dollar later fell to 99.50 yen amid nervousness ahead of the US jobless figures due later on Friday.

In the first three months of 2009, the dollar had its best quarterly performance against the yen since 2001.

"The yen selling was not sustainable before the US jobs data release," said a dealer at a Japanese brokerage.

"Opinion may be tilted towards the yen weakening in the longer term, but the market would first like to see this major event through."

The yen has been falling in value as a result of weak Japanese economic data and speculation that Japanese investors are planning to move funds overseas in the new financial year.

China's unprecedented economic growth over the past 30 years has come at a huge cost to the environment.


The damage has not only been to the air the Chinese breath or the water in their rivers, but also to its reputation across the world.

But there are signs that China may now be serious about tackling pollution to prove to the world that it can develop while causing less damage to the environment.

BBC Brasil travelled to China, which recently overtook the United States as the world's biggest emitter of carbon dioxide, as part of its series looking at where the BRIC economies - Brazil, Russia, India and China - will be in 2020.

China is today the world's biggest consumer of coal, the cheapest yet most polluting source of energy.

The country uses a quarter of the world's coal reserves and depends on it to provide more than two thirds of its energy needs.

The rapid growth has also altered old Chinese habits that used to be environmentally friendly.

As soon as you walk out from your hotel onto the street of Beijing you realise that the typical image of Chinese city streets being packed with bicycle-riding commuters is becoming a thing of the past.
Bumper to bumper, the people of Beijing crawl to work in their cars. Each car belching out fumes into the atmosphere.

In Beijing alone, the number of cars has tripled over the past decade, with more than 1,000 new vehicles arriving on the streets of the capital every day.

In discussions for the post-Kyoto global climate treaty, China now accepts the need for mandatory targets to reduce greenhouse gasses, but with the condition that stricter rules should be applied to developed countries.

"China is no longer a closed country," says Tom Wang, spokesman for Greenpeace in Beijing.

"To keep its economic growth and its place as an important player on the international scene, it needs to acknowledge what other countries are saying about it."

According to Mr Want, environmental damage costs the country up to 5% of its economic output each year.

Chinese victims

The biggest victims of the pollution are the Chinese themselves.

Beijing worker
I have a constant inexplicable cough
Beijing resident

One woman in Beijing complained about the low cloud that floats above the city centre.

A man complained about a "constant inexplicable cough".

According to the World Bank, of the 30 most polluted cities in the world, 20 are in China.

Each year more than 400,000 people die of pollution-related illnesses.

But when BBC Brasil visited Wang Xiaoming of Beijing's Environmental Protection Bureau, the mood was upbeat.

To get to the main office you walk over a glass floor under which is a model of the city showing where its monitoring points are.

Mr Wang's office is full of computer screens being studied by technicians.

He points proudly at one of the screens, which shows that pollution in the city is better than the level considered to be safe by the World Health Organisation.

And that's not all. Mr Wang says the trend for pollution has been down in the city for some time.
Miniature Beijing
You walk over a model of Beijing at the Environmental Protection Bureau

According to Mr Wang, last year Beijing had 274 of what are called "blue sky days", which is when the pollution level is under the maximum level considered acceptable by the WHO. In 2007, they had 246 days of blue sky days while in 1998 they only had 100.

Acid rain

But it is not only air quality that is a matter of concern.

Many of the country's rivers are polluted with heavy metals, spoiling the water used for irrigation and contaminating the food chain.

Around a third of the Chinese territory is affected by the acid rain caused by pollution. The rain has a direct impact on the country's food production.

The Chinese government has started to act on these issues, mainly because environmental damage poses a threat to the economic growth of the country.

Last year the Beijing Olympics served as a platform for the Chinese government to show the world that it cares about the environment.

All of the buildings designed for the Games had 'green' features such as solar power and systems for collecting rain water.

In addition, restrictions were set to limit emissions from polluting industries, and a rota-based system was put in place to reduce by half the amount of cars on the streets of Beijing.

These measures achieved what had seemed impossible: blue skies during the two weeks of the Games.

The measures adopted during the Olympics, although limited in their reach, proved the country is capable of fighting against its environmental problems if there is political will.

China is one of a few countries in the world that have been rapidly increasing their forest cover
David Dollar

For David Dollar, director of the World Bank in China, the country has achieved some progress in this area, although it still faces serious problems.

"If we had had this conversation a year ago, I would have said that environmental issues were the greatest challenge faced by China and the biggest threat to the country's growth in the long term," says Dollar.

"However, what is little known is that there has been a great deal of progress on the environmental front in the last ten years. China is one of a few countries in the world that have been rapidly increasing their forest cover. It is managing to reduce air and water pollution," says Dollar.

If China can develop alternative energy sources and reduce emissions, the country might in 2020 be an example of how economic development and environmental protection can work together.

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Barack Obama has hailed the G20 summit as a historic turning point in the pursuit of world economic recovery.

Leaders pledged new spending and tougher financial regulations, in what the US leader called an unprecedented set of actions to ease the crisis.

He now heads to Strasbourg for talks with the French and German leaders, before a Nato summit begins.

Security is extremely tight in the city, with tens of thousands of troops and police deployed.

On Thursday police clashed with protesters, firing tear gas and rubber bullets to stop a crowd getting to the city centre.

Masked protesters smashed bus shelters and set fire to rubbish bins. French news agency AFP reported around 100 arrests.

Nato talks

Speaking at a news conference in London late on Thursday, Mr Obama said that the G20 leaders had agreed "unprecedented steps to restore growth and prevent a crisis like this from happening again".
They pledged a total of $1.1 trillion (£681bn) in funding to tackle the crisis, including $750bn to the International Monetary Fund, $250bn to boost global trade and $100bn for international development banks to lend to the poorest countries.

Leaders also agreed to introduce tougher financial regulations and sanctions against secretive tax havens.

Representatives from the developing world welcomed the outcome.

Brazilian President Luiz Inacio Lula da Silva told the BBC's Newsnight programme that rich countries had engaged with emerging nations on "equal terms" to achieve a good result.

French President Nicolas Sarkozy - who had threatened to walk out of the meeting if it did not yield concrete gains - said that the conclusions were "more than we could have hoped for".

He will meet Mr Obama for one-to-one talks on Friday, after which the US leader will cross into Germany for a meeting with Chancellor Angela Merkel.

Then the focus will turn to Nato and the 60th anniversary summit that is being hosted jointly by France and Germany.

Leaders will gather for a working dinner in the German city of Baden Baden on Friday night before the main talks on Saturday.

The US president is expected to use the opportunity to build support for his new strategy for Afghanistan.

More troops are needed certainly, says the BBC's diplomatic correspondent Jonathan Marcus, but above all the Americans want to see their allies stumping up a good deal more money and more training teams to build Afghanistan's own security forces.

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Julia Perez, atau sering disingkat Jupe (lahir 15 Juni 1980; umur 28 tahun; terlahir dengan nama Yuli Rachmawati) adalah penyanyi dangdut, model, pemain sinetron dan presenter Indonesia. Ia seringkali berpenampilan dan berfoto seksi dan dijuluki "bom seks".Ia memulai karirnya di Perancis. Perkenalannya dengan model pria Damien Perez (Yusuf Perez) yang kemudian menjadi suaminya membuka kesempatan awal dirinya tampil sebagai model majalah FHM dan Maxim di Perancis. Dengan penampilannya dalam FHM dan Maxim, Jupe mendapat nominasi 100 wanita terseksi versi majalah FHM dan Maxim.

Namanya mulai dikenal setelah ia memerankan beberapa sinetron dan film layar lebar. Pada bulan April 2008, Julia Perez menyatakan terjun ke dunia dangdut. Ia lalu merilis album perdananya yang berjudul Kamasutra. Dalam album tersebut Jupe juga menyertakan kondom yang diselipkan dalam sampul albumnya. Meski Jupe menyatakan Keluarga Berencana (KB), namun banyak pihak yang menilai tindakannya tersebut adalah bentuk dukungan terhadap seks bebas. Bahkan Menteri Pemberdayaan Perempuan, Meutia Hatta menyatakan bahwa tindakan tersebut bisa diinterpretasikan sebagai dukungan terhadap seks bebas. Akibat dari penampilannya yang seksi serta album Kamasutra yang berbonus kondom, ia banyak dicekal di Indonesia, seperti di Nusa Tenggara Barat, Riau, Palembang, Balikpapan dan Bengkulu

Jakarta Keretakan rumah tangga Jupe dengan Damian Perez dicurigai karena faktor adanya PIL atau Pria Idaman Lain. Pesepakbola asal Argentina, Gaston Castano disebut-sebut sebagai pemicunya. Bahkan Jupe dan Gaston memiliki foto mesra di pantai. Ditanyai soal ini Jupe memilih no comment.

"Aku belum tahu, aku belum bisa jawab karena aku belum lihat fotonya. Tapi memang aku jalan-jalan ke pantai sama teman-teman," ujar Jupe saat ditemui di Plaza FX, Jl Jenderal Sudirman, Jakarta Selatan, Rabu (11/3/2009).

Selebihnya Jupe tak ingin lagi berkomentar soal hubungannya dengan Gaston. Ia kini memang tengah pusing akibat pernikahannya dengan Damian Perez makin tak jelas mau dibawa ke mana.

Jupe memang pernah memuji sosok Gaston saat menyaksikan pertandingan Persib Bandung melawan Persiba Balikpapan beberapa waktu lalu di Stadion Jalak Harupat, Bandung. Pemain film 'Hantu Jeruk Purut' itu menyukai permainan Gaston dan rela menemani kemanapun penyerang Persiba itu bermain sepakbola.