Dietary habits after migration and consequences for Health: a focus on South Asians in Europe

Department of Community Health, Institute of Health and Society, University of Oslo, Oslo, Norway.
Food & Nutrition Research (Impact Factor: 1.79). 11/2012; 56. DOI: 10.3402/fnr.v56i0.18891
Source: PubMed


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.

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Available from: Margareta Wandel
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    • "These results can be explained by changes in milk and dairy food consumption, which were observed clearly in our study. The reduced fiber intake, partly due to decreased consumption of fruit and vegetable, may be attributable to increased blood glucose levels in our study subjects, as shown in other South Asian immigrant studies in Europe [42]. "
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    ABSTRACT: BACKGROUND/OBJECTIVES The immigrant population has grown considerably in South Korea since the early 1990s due to international marriages. Dietary changes in immigrants are an important issue, because they are related to health and disease patterns. This study was conducted to compare changes in dietary intake between baseline and follow-up periods. SUBJECTS/METHODS Two hundreds thirty three Vietnamese female married immigrants. Baseline data were collected during 2006-2009, and the follow-up data were collected during 2008 and 2010. Food consumption was assessed using a 1-day 24-hour recall. RESULTS The amount of the total food consumed (P < 0.001) including that of cereals (P = 0.004), vegetables (P = 0.003), and fruits (P = 0.002) decreased at follow-up compared to that at baseline, whereas consumption of milk and dairy products increased (P = 0.004). Accordingly, the overall energy and nutrient intake decreased at follow-up, including carbohydrates (P = 0.012), protein (P = 0.021), fiber (P = 0.008), iron (P = 0.009), zinc (P = 0.006), and folate (P = 0.002). Among various anthropometric and biochemical variables, mean skeletal muscle mass decreased (P = 0.012), plasma high density lipoprotein-cholesterol increased, (P = 0.020) and high sensitivity C-reactive protein decreased at follow-up (P < 0.001). CONCLUSIONS A long-term follow-up study is needed to investigate the association between changes in food and nutrient intake and anthropometric and biochemical variables in these Vietnamese female marriage immigrants.
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    • "There was an inverse relationship between GDP (gross domestic product) of country of birth and diabetes mortality rates: the highest rates were documented in migrants from low GDP per capita countries, especially those from the Caribbean, North Africa and South Asia [19]. Etiologically, these increased stroke rates are attributed to changes in nutrition habits and life-style factors [20], however further research and the search for novel risk factors in various migrant populations are needed [21]. "
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    ABSTRACT: Stroke campaigns are educating about the need to immediately contact the emergency medical system if symptoms occur. Despite higher stroke rates among patients with diabetics and some migrant populations, there are few data about stroke knowledge in these groups. We performed a cross-sectional questionnaire survey among 250 diabetes patients from Germany and Turkey in a primary care and diabetes practice center. The two-page questionnaire asked for stroke knowledge and socio-demographic data. Also, medical and communication data were obtained. Stroke knowledge was defined as good if a participant knew (1) at least two stroke symptoms (good symptom knowledge) and (2) that immediate hospital admission or an emergency call is necessary in case of stroke symptoms (good action knowledge). A total of 231 of 250 patients took part in the survey (participation rate 92.4%) with 134 natives (53.6%), 84 migrants from Turkey (33.6%) and 13 migrants (5.2%) from other countries. Comparing natives and migrants from Turkey good symptom knowledge was documented in 52.8% of the participants, good action knowledge in 67.9%, and good stroke knowledge in nearly forty percent (39.4%) of patients (n = 218). A logistic regression analysis showed better stroke knowledge if patients were younger than 61 years, had good language abilities and were living in an one-generation household (p < 0.05), while gender, years since migration and diabetes control did not play a role. We documented stroke knowledge deficits among patients with diabetes, both natives and migrants. Additional information strategies for these high risk populations are needed.
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    • "The traditional South Asian diet consists largely of carbohydrate-rich foods including wheat, rice, sorghum, and pearl millet, with minimal consumption of fat-rich foods and sugary drinks (17). A low meat, fish, and dairy diet are influenced both by the countries high levels of poverty, along with religious and cultural beliefs (18). In contrast, Western countries have exposed the South Asian population to a more processed diet with reduced nutritional quality including foods higher in fats, sugars, and refined carbohydrates. "
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    ABSTRACT: Inflammatory bowel disease (IBD) is a chronic relapsing inflammatory disorder of the gastrointestinal tract associated with significant morbidity. While IBD occurs in genetically susceptible individuals, the etiology is multifactorial, involving environmental influences, intestinal dysbiosis, and altered immune responses. The rising incidence of IBD in industrialized countries and the emergence of IBD in countries with traditionally low prevalence underscore the importance of environmental influences in the pathobiology of the disease. Moreover the high incidence of IBD observed in the South Asian immigrant population in the United Kingdom and Canada further supports the influence of environmental factors.
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