Changes in dietary habits after migration and consequences for health: a focus on South Asians in Europe
ABSTRACT Immigrants from low-income countries comprise an increasing proportion of the population in Europe. Higher prevalence of obesity and nutrition related diseases, such as type 2 diabetes (T2D) and cardiovascular disease (CVD) is found in some immigrant groups, especially in South Asians.
To review dietary changes after migration and discuss the implication for health and prevention among immigrants from low-income countries to Europe, with a special focus on South Asians.
Systematic searches in PubMed were performed to identify relevant high quality review articles and primary research papers. The searches were limited to major immigrant groups in Europe, including those from South Asia (India, Pakistan, Bangladesh, Sri Lanka). Articles in English from 1990 and onwards from Europe were included. For health implications, recent review articles and studies of particular relevance to dietary changes among South Asian migrants in Europe were chosen.
Most studies report on dietary changes and health consequences in South Asians. The picture of dietary change is complex, depending on a variety of factors related to country of origin, urban/rural residence, socio-economic and cultural factors and situation in host country. However, the main dietary trend after migration is a substantial increase in energy and fat intake, a reduction in carbohydrates and a switch from whole grains and pulses to more refined sources of carbohydrates, resulting in a low intake of fiber. The data also indicate an increase in intake of meat and dairy foods. Some groups have also reduced their vegetable intake. The findings suggest that these dietary changes may all have contributed to higher risk of obesity, T2D and CVD. IMPLICATIONS FOR PREVENTION: A first priority in prevention should be adoption of a low-energy density - high fiber diet, rich in whole grains and grain products, as well as fruits, vegetables and pulses. Furthermore, avoidance of energy dense and hyperprocessed foods is an important preventive measure.
Full-textDOI: · Available from: Margareta Wandel, May 30, 2015
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ABSTRACT: Popkin's nutrition transition model proposes that after the change from the traditional to the modern dietary pattern, another change towards "healthy eating" could occur. As health-related practices are associated with social position, with higher socioeconomic groups generally being the first to adopt public health recommendations, a gradient of traditional-modern-healthy dietary patterns should be observed between groups. The objectives of this article were: 1) to describe the dietary patterns of a representative sample of adult women; 2) to assess whether dietary patterns differentiate in traditional, modern and healthy; and 3) to evaluate the association of social position and dietary patterns. We conducted a survey in Tijuana, a Mexican city at the Mexico-United States (US) border. Women 18-65 years old (n=2,345) responded a food frequency questionnaire, and questions about socioeconomic and demographic factors. We extracted dietary patterns through factor analysis, and employed indicators of economic and cultural capital, life course stage and migration to define social position. We evaluated the association of social position and dietary patterns with linear regression models. Three patterns were identified: "tortillas", "hamburgers" and "vegetables". Women in a middle position of economic and cultural capital scored higher in the "hamburgers" pattern, and women in upper positions scored higher in the "vegetables" pattern. Economic and cultural capitals and migration interacted, so that for women lower in economic capital having lived in the US was associated with higher scores in the "hamburgers" pattern. Copyright © 2015. Published by Elsevier Ltd.Appetite 05/2015; 92. DOI:10.1016/j.appet.2015.05.003 · 2.52 Impact Factor
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ABSTRACT: The high prevalence of diabetes among South Asian populations in European countries partially derives from unhealthy changes in dietary patterns. Limited studies address perspectives of South Asian populations with respect to utility of diabetes education in everyday life. This study explores perspectives on dietary diabetes education and healthy food choices of people living in Denmark who have a Pakistani background and type 2 diabetes. In-depth interviews were conducted between October 2012 and December 2013 with 12 participants with type 2 diabetes who had received dietary diabetes education. Data analysis was systematic and was based on grounded theory principles. Participants described the process of integrating and utilizing dietary education in everyday life as challenging. Perceived barriers of the integration and utilization included a lack of a connection between the content of the education and life conditions, a lack of support from their social networks for dietary change, difficulty integrating the education into everyday life, and failure to include the participants' taste preferences in the educational setting. Dietary education that is sensitive to the attitudes, wishes, and preferences of the participants and that aims at establishing a connection to the everyday life of the participants might facilitate successful changes in dietary practices among people with a Pakistani background and type 2 diabetes. The findings suggest that more focus should be placed on collaborative processes in the dietary educational setting in order to achieve appropriate education and to improve communication between this population and health care professionals.Patient Preference and Adherence 02/2015; 9:347-54. DOI:10.2147/PPA.S77380 · 1.49 Impact Factor
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ABSTRACT: Approximately 65% of the United Arab Emirates (UAE) population are economic migrants from the low- and middle-income countries of South Asia. Emerging evidence suggests that expatriate populations from low or middle-income countries that migrate to high-income countries acculturate their lifestyle with the obesogenic behaviours of the host country. Previous research has focussed on migrant populations in the United States. The objective of this study was to assess the prevalence of obesity and explore the relationship between years of residency (surrogate measure for acculturation) and obesity among South Asian (from India, Pakistan and Bangladesh) male immigrants residing in the UAE. A random sample of 1375 males was recruited from a mandatory residency visa health screening centre in Abu Dhabi (UAE). Employing a cross-sectional design, participants completed an interviewer-led adapted version of the World Health Organisation STEPS questionnaire, and anthropometric and blood pressure measurements were collected. Glycated haemoglobin (HbA1c) was measured in a random sub-sample (n = 100). Logistic regression was used to determine risk factors for being classified as obese, and to assess the relationship between years of residency and adiposity. The overall prevalence of body mass index-derived overweight and obesity estimates and waist-to-hip-derived central obesity rates was 615 (44.7%) and 917 (66.7%) males, respectively. Hypertension was present in 419 (30.5%) of the sample and diabetes in 9 (9.0%) of the sub-sample. Living in the UAE for six to 10 years or more than 10 years was independently associated with being classified with central obesity (adjusted odds ratio [AOR] 1.63 95% confidence intervals [CI] 1.13 - 2.35, p < 0.008; AOR 1.95 95% CI 1.26 - 3.01, p < 0.002; respectively) compared to residing in the UAE for one to five years. Our study revealed a high prevalence of overweight, central obesity and hypertension amongst a young South Asian male migrant population in the UAE. Study findings suggest a diminished 'Healthy Migrant Effect' with increased years of residency possibly due to greater acculturation and a transition in lifestyle behaviours. Health initiatives targeting the maintenance of a healthy body size, coupled with regular assessments of glucose control and blood pressure are urgently required in this population.BMC Public Health 12/2015; 15(1):1568. DOI:10.1186/s12889-015-1568-x · 2.32 Impact Factor