Eating habits and nutrient intake of migrant South Asians in the UK

Post-migration food habits of New Zealand South Asian migrants: Implications for health promotion practice

Introduction

South Asian migrants in western countries have a high risk for diet related diseases post-migration. Hence knowledge on food habits that change post-migration, which are detrimental to health, are critical for health promotion initiatives to reduce this disease burden.

Objective

to describe food consumption changes post-migration according to sex and duration of residence in New Zealand among South Asian migrants.

Methods

A cross-sectional mail survey of 150 self-selected people of South Asian ethnicity aged 25-59 years in New Zealand.

Results

The study achieved responses from 112 participants (75%) with a mean age of 36 (7.5) years. Consumption of green leafy vegetables reduced post-migration for females and in new migrants (P < 0.05). Fruit consumption increased in both genders and across duration of residence (P < 0.05). Only 15% of males and 36% of females met the 3 + a day recommendation for vegetable consumption. Consumption of traditional breads, breakfast items and rice (males) decreased whilst that of breakfast cereals increased (P < 0.05). Consumption of low-fat milk, cheese, ice-cream, butter (females) and margarine increased, whilst ghee decreased (P < 0.05). Consumption of fish, lentils, traditional sweets and savouries decreased, whilst meat, processed meat, chicken, potato chips, cakes and pastries (females) and alcohol (males) increased (P < 0.05), post-migration. Thirty-three percent of males and 24% of females consumed takeaways "weekly or more often", with the majority (male: 51%; female: 36%) consuming European foods such as pizzas and pastas. Thirteen percent of males and 26% of females consumed festival foods "weekly or more often." More than half the participants were obese with BMI increasing with duration of residence (P = 0.025).

Conclusions

A food-based health promotion initiative focused on inadequate consumption of fruits and vegetables, increased consumption of dairy foods such as cheese and ice cream, and high fat European takeaway foods would be warranted particularly in new South Asian migrants.

Stepwise tailoring and test-retest of reproducibility of an ethnic-specific FFQ to estimate nutrient intakes for South Asians in New Zealand

OBJECTIVE

To develop and test-retest the reproducibility of an ethnic-specific FFQ to estimate nutrient intakes for South Asians (SA) in New Zealand (NZ).

DESIGN

Using culturally appropriate methods, the NZFFQ, a validated dietary assessment tool for NZ adults, was modified to include SA food items by analysing foods consumed by SA participants of the Adult Nutrition Survey, in-person audit of ethnic food stores and a web scan of ethnic food store websites in NZ. This was further refined via three focus group discussions, and the resulting New Zealand South Asian Food Frequency Questionnaire (NZSAFFQ) was tested for reproducibility.

SETTING

Auckland and Dunedin, NZ.

PARTICIPANTS

Twenty-nine and 110 males and females aged 25-59 years of SA ethnicity participated in the focus group discussions and the test-retest, respectively.

RESULTS

The development phase resulted in a SA-specific FFQ comprising of 11 food groups and 180 food items. Test-retest of the NZSAFFQ showed good reproducibility between the two FFQ administrations, 6 months apart. Most reproducibility coefficients were within or higher than the acceptable range of 0·5-0·7. The lowest intraclass correlation coefficients (ICC) were observed for β-carotene (0·47), vitamin B12 (0·50), fructose (0·55), vitamin C (0·57) and selenium (0·58), and the highest ICC were observed for alcohol (0·81), iodine (0·79) and folate (0·77). The ICC for fat ranged from 0·70 for saturated fats to 0·77 for polyunsaturated fats. The ICC for protein and energy were 0·68 and 0·72, respectively.

CONCLUSIONS

The developed FFQ showed good reproducibility to estimate nutrient intakes and warrants the need for validation of the instrument.

The association between nutrient intake, nutritional status and physical function of community-dwelling ethnically diverse older adults

Background

There are limited longitudinal data regarding nutrient intake, nutritional status and physical function in community-dwelling ethnically diverse older adults. This study explored these variables and their relationship at baseline (n = 100) and 8-months' follow-up (n = 81) among community-dwelling ethnically diverse older adults (≥60 years) in Birmingham, United Kingdom.

Methods

Multiple-pass 24-h dietary recalls and the Mini Nutritional Assessment-Short Form assessed nutritional intake and status, respectively. Short Physical Performance Battery (SPPB) and handgrip strength measured physical function. Linear and multinomial regressions were used to predict relationships between physical function, nutritional status and nutrient intake.

Results

Complete data were collected at baseline (n = 100) and 8-months' follow-up (n = 81). Mean (SD) age was 70 (8.1) years (60% male), with 62% being obese. Statistically significant decreases in intakes of vitamin B6, vitamin B1, iron, folate, and magnesium occurred over time. Daily intake of all micronutrients except vitamin B12, phosphorus and manganese were below the Recommended Nutrient Intakes (RNI). SPPB (Z = -4.01, p < 0.001) and nutritional status (Z = -2.37, p = 0.018) declined over time. Higher SPPB scores at baseline (OR = 0.54 95% CI 0.35, 0.81) were associated with a slower decline in nutritional status.

Conclusion

The observed declines and inadequate nutrient intakes in the absence of weight loss in just 8 months may pose serious challenges to healthy ageing, identifying an urgent need to re-evaluate and tailor appropriate dietary advice for this population. Additionally, the associations of nutrition and physical function observed in this study serves as an essential resource to design and implement community/faith-based interventions targeting early screening of nutritional status and physical function to ensure most older adults are assessed and treated accordingly.

Improving Dietary Behavior Among Ethnic Minority Women in Denmark: A Feasibility Study Based on a Participatory and Culturally Adapted Intervention

The Danish Heart Foundation and the non-governmental organization Neighborhood Mothers have co-developed a culturally adapted intervention seeking to promote healthy dietary behaviour among ethnic minority women. This feasibility study explores the potential of the intervention to reach ethnic minority women using health promotion initiatives. Participants attended instructor courses or cooking events, where culturally adapted, healthy recipes were introduced and meals prepared. Feasibility was explored using a mixed-method approach. Surveys were completed by 59 volunteers and 150 participants at five instructor courses and 21 cooking events. Individual interviews and focus group discussions were conducted with volunteers and participants after completion of the intervention. After the intervention, 61% of the 150 participants had high levels of knowledge about dietary recommendations, 96% intended to cook healthy dishes in the future and 84% intended to incorporate measuring equipment into their daily cooking routine. Participants with a high level of knowledge reported intention to change dietary behaviour more often than participants with lower levels of knowledge. Interviews confirmed that the participants cooked healthy dishes after participating, and incorporated knowledge about healthy food practices into their daily cooking. Few participants used measuring equipment. The intervention proved to be feasible as a health promotion initiative targeting a hard-to-reach population.

Dietary practices and FODMAPs in South Asia: Applicability of the low FODMAP diet to patients with irritable bowel syndrome

The low Fermentable Oligosaccharides, Disaccharides, and Monosaccharides And Polyols (FODMAP) diet has been described, evaluated, and found efficacious for the treatment of patients with irritable bowel syndrome primarily in Western countries. The aim of this review was to address the applicability of this diet to South Asia. The high prevalence of irritable bowel syndrome in South Asia and its associated effects of quality of life and economics warrant the introduction of efficacious therapies. The considerable heterogeneity of dietary patterns and methods of food preparation across South Asian countries and a paucity of food analysis limit precision in defining foods that are high or low in FODMAPs. Spices and condiments are commonly consumed and mostly have a low FODMAP content. However, major high FODMAP sources are frequently used and include onion, garlic, shallots, legumes/pulses, and wheat-based products, as well as coconut and milk products, offering an opportunity for dietary management to reduce the symptom load. The feasibility of instituting a restrictive diet in which foods with a high FODMAP content are replaced by foods low in FODMAPs must be addressed as a substantial proportion of the nutritional intake including energy, proteins, and micronutrients, is often obtained from FODMAP-rich food. Furthermore, limited knowledge of health professionals together with a paucity of dietitians further challenge the practicality of introducing the diet. Thus, while the use of the low FODMAP diet in South Asia may be more limited than in westernized countries, it does offer potential therapeutic opportunities, the efficacy, and impact of which require further investigation.

Nutrient Intake and Factors Influencing Eating Behaviors in Older Migrant Women Living in the United Kingdom

This study examines nutrient intake and factors influencing eating behaviors in a sample of 76 migrant older women (≥ 60 years) living in the UK. Nutrient intake was assessed using a 24-hr recall enhanced by an in-depth probing dietary interview. Median energy intake was significantly lower than the UK RNIs (5,125.4 v. 7,301.1 kJ/d, p < .001). Main nutrients of concern were retinol, vitamin D, magnesium, potassium, copper, selenium, and monounsaturated fatty acids. Semistructured interviews were conducted with a subsample (n = 46) and analyzed using thematic analysis. Although women were knowledgeable about what constitutes a healthy diet, factors such as the presence and awareness of obesity and noncommunicable diseases, changes to household roles, and dietary restrictions related to religious beliefs were identified key influences on participants' dietary intake. Strategies targeting this population need to promote not only a healthy energy balance, but also dietary adequacy to optimize nutrient intake.

A Pre and Post Survey to Determine Effectiveness of a Dietitian-Based Nutrition Education Strategy on Fruit and Vegetable Intake and Energy Intake among Adults

The purpose of the study was to evaluate the effectiveness of a multicomponent nutrition education program among adults. A pretest—posttest design was used assessing Nutritional Knowledge (NK), BMI, Energy Intake (EI), Physical Activity Level (PAL), Dietary Intake (DI) and attitudes. 353 adults aged 19–55 years (178 control group (CG) and 175 intervention group (IG)) were recruited. IG participants attended nutrition education sessions evaluated through a post-test given at the end of the 12-week program. Statistical tests performed revealed that compared to CG, participants in IG increased fruit intake and decreased intake of snacks high in sugar and fat significantly (p < 0.05). NK and attitudinal scores also increased significantly in the IG (p < 0.05). No intervention effect was found for vegetables intake, EI, BMI and PAL (p > 0.05). Factors influencing NK were age, gender and education level. “Taste” was the main barrier to the application of the nutrition education strategy. Findings are helpful to health practitioners in designing their intervention programs.

Comparable Dietary Patterns Describe Dietary Behavior across Ethnic Groups in the Netherlands, but Different Elements in the Diet Are Associated with Glycated Hemoglobin and Fasting Glucose Concentrations

BACKGROUND

Ethnic minority populations in Western societies suffer from a disproportionate burden of type 2 diabetes (T2D). Insight into the role of dietary patterns in T2D may assist public health nutrition efforts in addressing these health disparities.

OBJECTIVE

We explored the association between dietary patterns and biomarkers of T2D in 5 ethnic groups living in Amsterdam, Netherlands.

METHODS

A total of 3776 men and women aged 18-70 y of Dutch, South Asian Surinamese, African-Surinamese, Turkish, and Moroccan origin from the HELIUS (HEalthy LIfe in an Urban Setting) study were included. Diet was assessed by using a food-frequency questionnaire, and dietary patterns were derived separately per ethnic group. First, food group-based dietary patterns were derived by using principal components analysis and the association with glycated hemoglobin (HbA1c) and plasma fasting glucose was assessed by using multivariable linear regression. Second, biomarker-driven dietary patterns based on HbA1c and fasting glucose concentrations were derived by applying reduced rank regression.

RESULTS

Two comparable food group-based dietary patterns were identified in each ethnic group: a "meat and snack" pattern and a "vegetable" pattern. The meat-and-snack pattern derived within the Dutch origin population was significantly associated with HbA1c (β = 0.09; 95% CI: 0.00, 0.19) and fasting glucose (β = 0.18; 95% CI: 0.09, 0.26) concentrations. A biomarker-derived pattern characterized by red and processed meat was observed among Dutch-origin participants; however, among ethnic minority groups, this pattern was characterized by other foods including ethnicity-specific foods (e.g., roti, couscous).

CONCLUSIONS

Although similar food group dietary patterns were derived within 5 ethnic groups, the association of the meat-and-snack pattern with fasting glucose concentrations differed by ethnicity. Taken together with the finding of ethnic differences in biomarker-driven dietary patterns, our results imply that addressing T2D risk in multiethnic populations requires ethnicity-specific approaches.