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Mahadevan M, Bose M, Gawron KM, Blumberg R. Metabolic Syndrome and Chronic Disease Risk in South Asian Immigrants: A Review of Prevalence, Factors, and Interventions. Healthcare (Basel) 2023; 11:healthcare11050720. [PMID: 36900725 PMCID: PMC10000781 DOI: 10.3390/healthcare11050720] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/21/2023] [Accepted: 02/26/2023] [Indexed: 03/05/2023] Open
Abstract
South Asians (SAs) are among the fastest-growing ethnic groups in the U.S. Metabolic syndrome (MetS) is a condition that is characterized by multiple health factors that increase the risk for chronic diseases, such as cardiovascular disease (CVD) and diabetes. MetS prevalence among SA immigrants ranges from 27-47% in multiple cross-sectional studies using different diagnostic criteria, which is generally higher compared to other populations in the receiving country. Both genetic and environmental factors are attributed to this increased prevalence. Limited intervention studies have shown effective management of MetS conditions within the SA population. This review reports MetS prevalence in SAs residing in non-native countries, identifies contributing factors, and discusses ways to develop effective community-based strategies for health promotion targeting MetS among SA immigrants. There is a need for more consistently evaluated longitudinal studies to facilitate the development of directed public health policy and education to address chronic diseases in the SA immigrant community.
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Affiliation(s)
- Meena Mahadevan
- Department of Nutrition and Food Studies, Montclair State University, Montclair, NJ 07043, USA
- Correspondence: ; Tel.: +1-973-655-7574
| | - Mousumi Bose
- Department of Nutrition and Food Studies, Montclair State University, Montclair, NJ 07043, USA
| | | | - Renata Blumberg
- Department of Nutrition and Food Studies, Montclair State University, Montclair, NJ 07043, USA
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Post-migration food habits of New Zealand South Asian migrants: Implications for health promotion practice. J Migr Health 2023; 7:100182. [PMID: 36994424 PMCID: PMC10041552 DOI: 10.1016/j.jmh.2023.100182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 02/07/2023] [Accepted: 03/16/2023] [Indexed: 03/19/2023] Open
Abstract
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.
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Gupta K, Al Rifai M, Hussain A, Minhas AMK, Patel J, Kalra D, Samad Z, Virani SS. South Asian ethnicity: What can we do to make this risk enhancer a risk equivalent? Prog Cardiovasc Dis 2022; 75:21-32. [PMID: 36279943 DOI: 10.1016/j.pcad.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
Abstract
South Asians account for around 25% of the global population and are the fastest-growing ethnicity in the US. This population has an increasing burden of atherosclerotic cardiovascular disease (ASCVD) which is also seen in the diaspora. Current risk prediction equations underestimate this risk and consider the South Asian ethnicity as a risk-enhancer among those with borderline-intermediate risk. In this review, we discuss why the South Asian population is at a higher risk of ASCVD and strategies to mitigate this increased risk.
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Affiliation(s)
- Kartik Gupta
- Department of Medicine, Henry Ford Hospital, Detroit, MI, USA
| | - Mahmoud Al Rifai
- Section of Cardiology and Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Aliza Hussain
- Section of Cardiology and Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | | | - Jaideep Patel
- Pauley Heart Center, Division of Cardiology, Virginia Commonwealth University Medical Center, Richmond, VA, USA; Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD, USA
| | - Dinesh Kalra
- Rudd Heart & Lung Center, University of Louisville School of Medicine, Louisville, KY, USA
| | - Zainab Samad
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Salim S Virani
- Section of Cardiology and Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA; Health Policy, Quality & Informatics Program, Health Services Research and Development Center for Innovations in Quality, Effectiveness, and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA; Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA.
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Krishan P, Bhopal RS, Vlassopoulos A, Curry G, Kakde S. Could high heat cooking and food processing promoting neo-formed contaminants partially explain the high prevalence of chronic kidney disease in South Asian populations? A hypothesis. Diabetes Metab Syndr 2022; 16:102398. [PMID: 35182827 DOI: 10.1016/j.dsx.2022.102398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 12/28/2021] [Accepted: 01/13/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND AIMS The occurrence of chronic heart and kidney diseases among the South Asian populations has been rising exponentially over the years. Research has been carried out in the past to explain the increased susceptibility with no resultant strong evidence. Various possible causes have been suggested with a previous hypothesis suggestive of high heat cooking techniques being responsible for increased production of neo-formed contaminants such as advanced glycation end products (AGEs) and trans-fatty acids (TFAs) leading to increased chronic heart diseases among the South Asian diaspora (India, Pakistan, Bangladesh, Sri Lanka in South Asia and overseas). The aim of this study proposes the high-heating cooking techniques and subsequent NFCs also to be responsible for the development of chronic kidney ailments among the South Asians. METHODS Review of the literature was conducted to ascertain the burden of accumulation and actions of AGEs and TFAs on kidney structure and functions. The varied high-heat cooking techniques including reheating of oils, food processing and kinds of food sources and their association with increased NFCs production and kidney damage were explored. RESULTS Higher NFCs content of AGEs/TFAs in reheated oils at elevated temperatures and TFAs among processed and fast foods of South Asians was associated with elevated diabetic complications and CKDs progression in few animal and human studies but the research on the actual burden of NFCs in the renal tissues of South Asians was lacking. CONCLUSION We hypothesize the high heat cooked foods generating increased levels of NFCs to be responsible for the preponderance of higher risk of CKDs among South Asians. Scientific exploration of the hypothesis to obtain quantifiable evidence of NFCs is suggested.
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Affiliation(s)
- Prerna Krishan
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Old Medical School, Teviot Place, Edinburgh, EH8 9AG, UK
| | - Raj S Bhopal
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Old Medical School, Teviot Place, Edinburgh, EH8 9AG, UK
| | - Antonis Vlassopoulos
- Department of Food Science & Human Nutrition, Agricultural University of Athens, Iera Odos 75, 11855, Athens, Greece
| | - Gwenetta Curry
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Old Medical School, Teviot Place, Edinburgh, EH8 9AG, UK.
| | - Smitha Kakde
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Old Medical School, Teviot Place, Edinburgh, EH8 9AG, UK
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Liu J, Fulda KG, Tao MH. Association between acculturation and metabolic syndrome in Hispanic adults mediated by fruits intake. Public Health Nutr 2021; 24:6472-6476. [PMID: 34392859 PMCID: PMC8608711 DOI: 10.1017/s1368980021003530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 07/20/2021] [Accepted: 08/11/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVES Hispanic adults in the USA tend to have a disproportionate prevalence of metabolic syndrome (MetS) as compared to other races. DESIGN We examined whether the association between acculturation and MetS and its components are mediated by the intake of fruit in Hispanics. SETTING Data from the National Health and Nutrition Examination Surveys 2009-2016 were used in this study. PARTICIPANTS A total of 2078 Hispanics aged ≥ 20 years were included in this analysis. RESULTS The mediating role of total fruit intake was assessed using multivariable-adjusted logistic structural equation models with the bootstrapping method by estimating indirect (IE) and direct (DE) effects from acculturation to MetS. High acculturation was associated with increased odds of MetS (adjusted OR = 1·20, 95 % CI 1·04, 1·39), central obesity (OR = 1·24, 95 % CI 1·07, 1·44) and high blood pressure (OR = 1·16, 95 % CI 1·02, 1·32) among Hispanic adults. Total fruits intake partially mediated the associations of acculturation with MetS (ORIE = 1·02, 95 % CI 1·00, 1·03) and central obesity (ORIE = 1·02, 95 % CI 1·00, 1·03), whereas fully mediated the association between acculturation and high blood pressure (ORIE = 1·03, 95 % CI 1·01, 1·06). Moreover, intake of total fruits fully mediated the acculturation-MetS association among Mexican Americans (ORIE = 1·02, 95 % CI 1·00, 1·05). CONCLUSIONS Our findings suggested that increasing fruit consumption may reduce the impact of high acculturation on MetS development in Hispanic adults. Further studies are needed to confirm these findings.
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Affiliation(s)
- Jialiang Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadelphia, PA, USA
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Kimberly G Fulda
- Department of Family Medicine and Osteopathic Manipulative Medicine, The North Texas Primary Care Practice-Based Research Network (NorTex), University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Meng-Hua Tao
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX, USA
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Agyemang C, van der Linden EL, Bennet L. Type 2 diabetes burden among migrants in Europe: unravelling the causal pathways. Diabetologia 2021; 64:2665-2675. [PMID: 34657183 PMCID: PMC8563673 DOI: 10.1007/s00125-021-05586-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/17/2021] [Indexed: 12/16/2022]
Abstract
European populations are ethnically and culturally diverse due to international migration. Evidence indicates large ethnic inequalities in the prevalence of type 2 diabetes. This review discusses the burden of type 2 diabetes and its related complications, and the potential explanatory mechanisms among migrants in Europe. The current available data suggest that the rate of type 2 diabetes is higher in all migrant groups and that they develop this disease at an earlier age than the host European populations. The level of diabetes awareness among migrant populations is high, but glycaemic control remains suboptimal compared with Europeans. The culturally adapted lifestyle modification intervention trials to prevent type 2 diabetes mainly focus on South Asian adults in Europe. Diabetes-related microvascular and macrovascular complications remain a major burden among migrant populations in Europe. Earlier studies found higher mortality rates among migrants, but recent studies seem to suggest a shifting trend in favour of first-generation migrants. However, the extent of the burden of type 2 diabetes varies across migrant groups and European countries. Despite the higher burden of type 2 diabetes among migrants, the key underlying factors are not well understood mainly due to limited investment in basic science research and development of prospective cohort studies. We hypothesise that the underlying risk factors for the high burden of type 2 diabetes and its related complications in migrants are multifaceted and include pre-migration factors, post-migration factors and genetic predispositions. Given the multi-ethnic nature of the current European population, there is a clear need for investment in research among migrant populations to gain insight into factors driving the high burden of type 2 diabetes and related complications to facilitate prevention and treatment efforts in Europe.
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Affiliation(s)
- Charles Agyemang
- Department of Public & Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands.
| | - Eva L van der Linden
- Department of Public & Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
- Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Louise Bennet
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
- Clinical Research and Trial Centre, Lund University Hospital, Lund, Sweden
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Wulan SN, Raza Q, Prasmita HS, Martati E, Maligan JM, Mageshwari U, Fatima I, Plasqui G. Energy Metabolism in Relation to Diet and Physical Activity: A South Asian Perspective. Nutrients 2021; 13:nu13113776. [PMID: 34836031 PMCID: PMC8617748 DOI: 10.3390/nu13113776] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/14/2021] [Accepted: 10/21/2021] [Indexed: 12/11/2022] Open
Abstract
The prevalence of overweight and obesity is on the rise around the world, not only in the West, but also in Asian countries. South Asian countries in particular are experiencing a rapid increase in overweight and obesity, that coexists with the rapid increase in non-communicable diseases linked to obesity such as diabetes and cardiovascular disease than any other country in Asia. The phenomena observed in South Asian countries are due to the size of the population, the ageing of the population, the high degree of urbanization and the lifestyle changes in favor of increased energy consumption and reduced physical activity. The imbalance between energy consumption and energy expenditure results in the development of a positive energy balance that, over time, accumulates in higher body fat. South Asians were reported to have a more unfavorable body composition with a higher percentage of body fat than Caucasians with an equivalent BMI. Body composition is a major determinant of resting energy expenditure. It has been reported that South Asians have a lower resting energy expenditure than Caucasians with the same BMI. Resting energy expenditure accounts for the majority of total daily energy expenditure and, therefore, plays a crucial role in achieving the balance between energy intake and expenditure.
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Affiliation(s)
- Siti N. Wulan
- Study Program of Food Science and Technology, Department of Agricultural Product Technology, Faculty of Agricultural Technology, Brawijaya University, Malang 65145, Indonesia; (H.S.P.); (E.M.); (J.M.M.)
- Correspondence: (S.N.W.); (Q.R.); Tel.: +92-30-0247-9044 (Q.R.)
| | - Qaisar Raza
- Department of Food Science and Human Nutrition, Faculty of Biosciences, University of Veterinary and Animal Sciences, Lahore 54000, Pakistan
- Department of Health Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, 1081 HV Amsterdam, The Netherlands
- Correspondence: (S.N.W.); (Q.R.); Tel.: +92-30-0247-9044 (Q.R.)
| | - Hera S. Prasmita
- Study Program of Food Science and Technology, Department of Agricultural Product Technology, Faculty of Agricultural Technology, Brawijaya University, Malang 65145, Indonesia; (H.S.P.); (E.M.); (J.M.M.)
| | - Erryana Martati
- Study Program of Food Science and Technology, Department of Agricultural Product Technology, Faculty of Agricultural Technology, Brawijaya University, Malang 65145, Indonesia; (H.S.P.); (E.M.); (J.M.M.)
| | - Jaya M. Maligan
- Study Program of Food Science and Technology, Department of Agricultural Product Technology, Faculty of Agricultural Technology, Brawijaya University, Malang 65145, Indonesia; (H.S.P.); (E.M.); (J.M.M.)
| | - Uma Mageshwari
- Department of Food Service Management and Dietetics, Faculty of Home Science, Avinashilingham University, Coimbatore 641043, India;
| | - Itrat Fatima
- Department of Food Science and Technology, Faculty of Life Sciences, University of Central Punjab, Lahore 54000, Pakistan;
| | - Guy Plasqui
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center (MUMC+), 6229 HX Maastricht, The Netherlands;
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Liu TC, Kern JT, Jain U, Sonnek NM, Xiong S, Simpson KF, VanDussen KL, Winkler ES, Haritunians T, Malique A, Lu Q, Sasaki Y, Storer C, Diamond MS, Head RD, McGovern DPB, Stappenbeck TS. Western diet induces Paneth cell defects through microbiome alterations and farnesoid X receptor and type I interferon activation. Cell Host Microbe 2021; 29:988-1001.e6. [PMID: 34010595 DOI: 10.1016/j.chom.2021.04.004] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 12/22/2020] [Accepted: 04/09/2021] [Indexed: 02/07/2023]
Abstract
Intestinal Paneth cells modulate innate immunity and infection. In Crohn's disease, genetic mutations together with environmental triggers can disable Paneth cell function. Here, we find that a western diet (WD) similarly leads to Paneth cell dysfunction through mechanisms dependent on the microbiome and farnesoid X receptor (FXR) and type I interferon (IFN) signaling. Analysis of multiple human cohorts suggests that obesity is associated with Paneth cell dysfunction. In mouse models, consumption of a WD for as little as 4 weeks led to Paneth cell dysfunction. WD consumption in conjunction with Clostridium spp. increased the secondary bile acid deoxycholic acid levels in the ileum, which in turn inhibited Paneth cell function. The process required excess signaling of both FXR and IFN within intestinal epithelial cells. Our findings provide a mechanistic link between poor diet and inhibition of gut innate immunity and uncover an effect of FXR activation in gut inflammation.
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Affiliation(s)
- Ta-Chiang Liu
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA.
| | - Justin T Kern
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Umang Jain
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Naomi M Sonnek
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Shanshan Xiong
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Katherine F Simpson
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Kelli L VanDussen
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Emma S Winkler
- Department of Medicine, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Talin Haritunians
- The F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles 90048, USA
| | - Atika Malique
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Qiuhe Lu
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Yo Sasaki
- Department of Genetics, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Chad Storer
- Department of Genetics, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Michael S Diamond
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA; Department of Medicine, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Richard D Head
- Department of Genetics, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Dermot P B McGovern
- The F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles 90048, USA
| | - Thaddeus S Stappenbeck
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA.
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Stepwise tailoring and test-retest of reproducibility of an ethnic-specific FFQ to estimate nutrient intakes for South Asians in New Zealand. Public Health Nutr 2021; 24:2447-2454. [PMID: 33745497 DOI: 10.1017/s1368980021001208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
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.
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Acculturation is Associated with Dietary Patterns in South Asians in America. J Immigr Minor Health 2020; 22:1135-1140. [PMID: 32358772 DOI: 10.1007/s10903-020-01016-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Acculturation may influence diet pattern, a risk factor for cardiometabolic disease. We assessed whether strength of traditional cultural beliefs and practices, a robust measure of acculturation, affects diet pattern among South Asians in America. With data from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) cohort, we used ordinal logistic regression to assess the association between strength of traditional cultural beliefs, 6 cultural practices and diet pattern. Of 892 participants, 47% were women. Weaker traditional cultural beliefs [OR(95%CI) 1.07(1.04,1.10)] and cultural practices (p < 0.05) were associated with consuming more of the Animal Protein dietary pattern and less [0.95(0.93,0.97)] of the Fried snacks, Sweets, High-fat dairy (FSHD) pattern (P < 0.05). South Asians in America with stronger traditional cultural beliefs and practices were more likely to consume the FSHD pattern. Prevention programs may consider dietary pattern modification as part of comprehensive risk reduction in South Asians.
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Mitra M, Ghosh A. Factor analyses of metabolic syndrome: A systematic review with special reference to Asian Indians. Diabetes Metab Syndr 2020; 14:697-705. [PMID: 32446244 DOI: 10.1016/j.dsx.2020.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 05/06/2020] [Accepted: 05/06/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Metabolic syndrome is the constellation of cardiovascular disease risk factors and a growing public health issue affecting more than 20% of world population. Factor analysis is a powerful mathematical tool in exploring the underlying factors of any chronic diseases. Although it is most often criticized for its contrasting results for a common expression differently interpreted by the researchers yet fit the original data equally well. OBJECTIVE The present study aims to find out the underlying physiological domains for the phenotypic attribution of metabolic syndrome as documented in several studies. METHODOLOGY Literature search was done using Google Scholar, PUBMED, Research Gate and manual searching to identify relevant studies of the selected topic. CONCLUSION More than one physiological domain has been explored for the expression of metabolic syndrome explored in different studies. A reason for this disparity may be because most of explored factors are just mathematically significant but not biologically. Another reason may be the varied factor load concern. Therefore, a fixed factor load value is needed to be restricted for all studies across world.
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Affiliation(s)
- Maitrayee Mitra
- Biomedical Research Laboratory, Department of Anthropology, Visva-Bharati (A Central University and an Institution of National Importance), Santiniketan, West Bengal, India
| | - Arnab Ghosh
- Biomedical Research Laboratory, Department of Anthropology, Visva-Bharati (A Central University and an Institution of National Importance), Santiniketan, West Bengal, India.
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Lee MM, Jebb SA, Oke J, Piernas C. Reference values for skeletal muscle mass and fat mass measured by bioelectrical impedance in 390 565 UK adults. J Cachexia Sarcopenia Muscle 2020; 11:487-496. [PMID: 31943835 PMCID: PMC7113534 DOI: 10.1002/jcsm.12523] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 09/25/2019] [Accepted: 11/14/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Loss of skeletal muscle mass (SMM) increases the risk of frailty and, together with excess fat mass (FM), is a risk factor for cardio-metabolic disease. However, use of body composition measurements in nutritional surveillance and routine clinical practice is limited by the lack of reference data. Our aim was to produce age-specific and sex-specific reference values for SMM and FM in the White ethnic adult population in the UK. Secondary objectives were to examine the tracking over time using a subsample of the population with repeated measures of body composition and to assess the validity of these reference values in different ethnic subgroups. METHODS We used data from segmental bioelectrical impedance analysis (BIA) in 390 565 participants, aged 40-69 years, in the UK Biobank, and data from dual-energy X-ray absorptiometry from n = 905 participants to validate the BIA measurements. SMM was calculated as the sum of the predicted muscle mass from the limbs. The LMS method was used to produce percentile curves for the SMM index (SMMI = SMM/height2 ) and the FM index (FMI = FM/height2 ). We investigated the validity of the White ethnic reference values by plotting z-scores (99.7% confidence interval) from Black and Asian groups to check if their confidence interval included zero. Longitudinal trajectories were predicted based on the baseline z-scores and the correlation between repeated measurements at follow-up. RESULTS The percentile curves show that SMMI declines in men from the age of 40, whereas in women, SMMI is more stable and decreases only slightly among women in the higher percentiles. FMI increases with age in both men and women. Women have higher FMI and lower SMMI than men in all age groups. The validity of the White-based reference values for non-White ethnic groups is poor. Longitudinal trajectories in body composition in the subsample of participants with a follow-up assessment show regression towards the mean in both men and women, with some evidence of declining SMMI only among men. The predicted 90% limits for the expected 5 year trajectories of SMMI and FMI can be used to identify people with unusual trajectories and in clinical practice to identify and track individuals at risk of excessive loss of SMM. CONCLUSIONS These body composition reference values developed from BIA in a middle/older-aged healthy White ethnic population in the UK could be used as a simple assessment tool for nutritional surveillance and to identify individuals with low SMMI or high FMI who may be at increased risk of disease and/or frailty.
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Affiliation(s)
- Mei-Man Lee
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.,The George Institute for Global Health, University of Oxford, Oxford, UK
| | - Susan A Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Jason Oke
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Carmen Piernas
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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13
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Molecular adaptation in adipose tissue in response to overfeeding with a high-fat diet under sedentary conditions in South Asian and Caucasian men. Br J Nutr 2019; 122:241-251. [PMID: 31475655 DOI: 10.1017/s0007114519001260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
For the same BMI, South Asians have a higher body fat percentage than Caucasians. There might be differences in the fatty acid (FA) handling in adipose tissue when both ethnicities are exposed to high-fat overfeeding. The objective of the present study was to investigate the molecular adaptation in relation to FA metabolism in response to overfeeding with a high-fat diet (OHFD) in South Asian and Caucasian men. Ten South Asian men (BMI 18-29 kg/m2) and ten Caucasian men (BMI 22-33 kg/m2), matched for body fat percentage, aged 20-40 years were included. A weight-maintenance diet (30 % fat, 55 % carbohydrate and 15 % protein) was given for 3 d followed by 3 d of overfeeding (150 % energy requirement) with a high-fat diet (60 % fat, 25 % carbohydrate and 15 % protein) while staying in a respiration chamber. Before and after overfeeding, abdominal subcutaneous fat biopsies were taken. Proteins were isolated, analysed and quantified for short-chain 3-hydroxyacyl-CoA dehydrogenase (HADH), carnitine palmitoyl-transferase 1α (CPT1a), adipose TAG lipase, perilipin A (PLINA), perilipin B, lipoprotein lipase and fatty acid binding protein 4 using Western blotting. OHFD decreased the HADH level (P < 0·05) in Caucasians more than in Asians (P < 0·05), but the baseline and after intervention HADH level was relatively higher in Caucasians. The level of CPT1a decreased in South Asians and increased in Caucasians (P < 0·05). PLINA did not change with diet but the level was higher in South Asians (P < 0·05). The observed differences in HADH and PLINA levels as well as in CPT1a response may be important for differences in the long-term regulation of energy (fat) metabolism in these populations.
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Hirode G, Vittinghoff E, Bharmal NH, Kandula NR, Kanaya AM. The association of religious affiliation with cholesterol levels among South Asians: the Mediators of Atherosclerosis in South Asians Living in America study. BMC Cardiovasc Disord 2019; 19:75. [PMID: 30925868 PMCID: PMC6441170 DOI: 10.1186/s12872-019-1045-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 03/14/2019] [Indexed: 01/04/2023] Open
Abstract
Background South Asians have disproportionately high rates of cardiovascular disease. Dyslipidemia, a contributing factor, may be influenced by lifestyle, which can vary by religious beliefs. Little is known about South Asian religions and associations with dyslipidemia. Methods Cross-sectional analyses of the MASALA study (n = 889). We examined the associations between religious affiliation and cholesterol levels using multivariate linear regression models. We determined whether smoking, alcohol use, physical activity, and dietary pattern mediated these associations. Results Mean LDL was 112 ± 32 mg/dL, median HDL was 48 mg/dL (IQR:40–57), and median triglycerides was 118 mg/dL (IQR:88–157). Muslims had higher LDL and triglycerides, and lower HDL, while participants with no religious affiliation had lower LDL and higher HDL. The difference in HDL between Muslims and those with no religious affiliation was partly explained by alcohol consumption. Conclusions Religion-specific tailoring of interventions designed to promote healthy lifestyle to reduce cholesterol among South Asians may be useful.
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Affiliation(s)
- Grishma Hirode
- OakCare Medical Group, Highland Hospital, 1411 E 31st St, Oakland, CA, 94602, USA
| | - Eric Vittinghoff
- UCSF Department of Epidemiology and Biostatistics, 550 16th St, San Francisco, CA, 94158, USA
| | - Nazleen H Bharmal
- U.S. Department of Health and Human Services, 200 Independence Avenue, Washington DC, 20201, USA
| | - Namratha R Kandula
- Department of General Internal Medicine, Northwestern University Feinberg School of Medicine, 750 N Lake Shore Drive, 6th Floor, Chicago, IL, 60611, USA
| | - Alka M Kanaya
- UCSF Department of Epidemiology and Biostatistics, 550 16th St, San Francisco, CA, 94158, USA. .,UCSF Division of General Internal Medicine, 1545 Divisadero Street, Suite 311, San Francisco, CA, 94115, USA.
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15
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Fontefrancesco M, Barstow C, Grazioli F, Lyons H, Mattalia G, Marino M, McKay AE, Sõukand R, Corvo P, Pieroni A. Keeping or changing? Two different cultural adaptation strategies in the domestic use of home country food plant and herbal ingredients among Albanian and Moroccan migrants in Northwestern Italy. JOURNAL OF ETHNOBIOLOGY AND ETHNOMEDICINE 2019; 15:11. [PMID: 30755237 PMCID: PMC6371435 DOI: 10.1186/s13002-019-0290-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 01/27/2019] [Indexed: 05/22/2023]
Abstract
BACKGROUND Ethnobotanical field studies concerning migrant groups are crucial for understanding temporal changes of folk plant knowledge as well as for analyzing adaptation processes. Italy still lacks in-depth studies on migrant food habits that also evaluate the ingredients which newcomers use in their domestic culinary and herbal practices. METHODS Semi-structured and open in-depth interviews were conducted with 104 first- and second-generation migrants belonging to the Albanian and Moroccan communities living in Turin and Bra, NW Italy. The sample included both ethnic groups and genders equally. RESULTS While the number of plant ingredients was similar in the two communities (44 plant items among Albanians vs 47 plant items among Moroccans), data diverged remarkably on three trajectories: (a) frequency of quotation (a large majority of the ingredients were frequently or moderately mentioned by Moroccan migrants whereas Albanians rarely mentioned them as still in use in Italy); (b) ways through which the home country plant ingredients were acquired (while most of the ingredients were purchased by Moroccans in local markets and shops, ingredients used by Albanians were for the most part informally "imported" during family visits from Albania); (c) quantitative and qualitative differences in the plant reports mentioned by the two communities, with plant reports recorded in the domestic arena of Moroccans nearly doubling the reports recorded among Albanians and most of the plant ingredients mentioned by Moroccans representing "medicinal foods". CONCLUSION A large portion of the differences shown by the two communities are linked to different methods of procurement of home country gastronomic botanical ingredients, the different transnational informal exchanges that exist between Italy and migrants' home countries, the presence of markets and ethnic shops in Italy selling these items, and the different degree of difficulty in accessing public health services. The observed divergences were also clearly related to very diverse adaptation strategies, i.e., processes of negotiating and elaborating Albanian and Moroccan cultural identities.
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Affiliation(s)
- Michele Fontefrancesco
- University of Gastronomic Sciences, Piazza Vittorio Emanuele II, 9, I-12060 Pollenzo, Cuneo Italy
| | - Charles Barstow
- University of Gastronomic Sciences, Piazza Vittorio Emanuele II, 9, I-12060 Pollenzo, Cuneo Italy
- Present address: Ark of Taste Office, Slow Food, Via Mendicità Istruita 14, I-12042 Bra, Cuneo Italy
| | - Francesca Grazioli
- University of Gastronomic Sciences, Piazza Vittorio Emanuele II, 9, I-12060 Pollenzo, Cuneo Italy
- Present address: Bioversity International, Viale Tre Danari 472, I-00054 Maccarese Stazione, Rome Italy
| | - Hillary Lyons
- University of Gastronomic Sciences, Piazza Vittorio Emanuele II, 9, I-12060 Pollenzo, Cuneo Italy
| | - Giulia Mattalia
- University of Gastronomic Sciences, Piazza Vittorio Emanuele II, 9, I-12060 Pollenzo, Cuneo Italy
- Department of Environmental Sciences, Informatics, and Statistics, Ca’ Foscari University of Venice, Via Torino 155, I-30172 Mestre, Venezia Italy
| | - Mattia Marino
- University of Gastronomic Sciences, Piazza Vittorio Emanuele II, 9, I-12060 Pollenzo, Cuneo Italy
| | - Anne E. McKay
- University of Gastronomic Sciences, Piazza Vittorio Emanuele II, 9, I-12060 Pollenzo, Cuneo Italy
| | - Renata Sõukand
- Department of Environmental Sciences, Informatics, and Statistics, Ca’ Foscari University of Venice, Via Torino 155, I-30172 Mestre, Venezia Italy
| | - Paolo Corvo
- University of Gastronomic Sciences, Piazza Vittorio Emanuele II, 9, I-12060 Pollenzo, Cuneo Italy
| | - Andrea Pieroni
- University of Gastronomic Sciences, Piazza Vittorio Emanuele II, 9, I-12060 Pollenzo, Cuneo Italy
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Costa L, Dias S, Martins MDRO. Fruit and Vegetable Consumption among Immigrants in Portugal: A Nationwide Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102299. [PMID: 30347692 PMCID: PMC6210251 DOI: 10.3390/ijerph15102299] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 10/12/2018] [Accepted: 10/17/2018] [Indexed: 12/25/2022]
Abstract
This study aims to compare adequate fruit and vegetable (F&V) intake between immigrants and natives in Portugal, and to analyse factors associated with consumption of F&V among immigrants. Data from a population based cross-sectional study (2014) was used. The final sample comprised 17,410 participants (≥20 years old), of whom 7.4% were immigrants. Chi-squared tests and logistic regression models were conducted to investigate the association between adequate F&V intake, sociodemographic, anthropometric, and lifestyle characteristics. Adequate F&V intake was more prevalent among immigrants (21.1% (95% CI: 19.0–23.4)) than natives (18.5% (95% CI: 17.9–19.1)), (p = 0.000). Association between migrant status and adequate F&V intake was only evident for men: immigrants were less likely to achieve an adequate F&V intake (OR = 0.67, 95% CI = 0.66–0.68) when compared to Portuguese. Among immigrants, being female, older, with a higher education, and living in a low urbanisation area increased the odds of having F&V consumption closer to the recommendations. Adjusting for other factors, length of residence appears as a risk factor (15 or more years vs. 0–9 years: OR = 0.52, 95% CI = 0.50–0.53), (p = 0.000) for adequate F&V intake. Policies aiming to promote adequate F&V consumption should consider both populations groups, and gender-based strategies should address proper sociodemographic, anthropometric, and lifestyle determinants.
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Affiliation(s)
- Liliane Costa
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Rua da Junqueira 100, 1349-008 Lisboa, Portugal.
| | - Sónia Dias
- Escola Nacional de Saúde Pública, Centro de Investigação em Saúde Pública, Universidade NOVA de Lisboa & Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, 1600-560 Lisboa, Portugal.
| | - Maria do Rosário O Martins
- Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Rua da Junqueira 100, 1349-008 Lisboa, Portugal.
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17
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Tabung FK, Giovannucci EL, Giulianini F, Liang L, Chandler PD, Balasubramanian R, Manson JE, Cespedes Feliciano EM, Hayden KM, Van Horn L, Rexrode KM. An Empirical Dietary Inflammatory Pattern Score Is Associated with Circulating Inflammatory Biomarkers in a Multi-Ethnic Population of Postmenopausal Women in the United States. J Nutr 2018; 148:771-780. [PMID: 29897561 PMCID: PMC5972616 DOI: 10.1093/jn/nxy031] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 01/05/2018] [Accepted: 02/01/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The empirical dietary inflammatory pattern (EDIP) score has been associated with concentrations of circulating inflammatory biomarkers in European Americans. OBJECTIVE We used the EDIP score, a weighted sum of 18 food groups that characterizes dietary inflammatory potential based on circulating concentrations of inflammatory biomarkers, to test the hypothesis that a pro-inflammatory dietary pattern is associated with inflammatory biomarker concentrations in a US multi-ethnic population. METHODS In this cross-sectional study, we calculated EDIP scores using baseline food frequency questionnaire data from 31,472 women, aged 50-79 y, in the Women's Health Initiative observational study and clinical trials. Circulating biomarkers outcomes at baseline were: C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor (TNF)-α, TNF receptor (TNFR) 1 and 2, and adiponectin. We used multivariable-adjusted linear regression analyses to estimate absolute concentrations and relative differences in biomarker concentrations, overall and in subgroups of race/ethnicity and BMI (body mass index) categories. RESULTS Independent of energy intake, BMI, physical activity, and other potential confounding variables, higher EDIP scores were significantly associated with higher (lower for adiponectin) absolute concentrations of all 6 biomarkers. On the relative scale, the percentage of difference in the concentration of biomarkers, among women in the highest compared to the lowest EDIP quintile, was: CRP, +13% (P-trend < 0.0001); IL-6, +15% (P-trend < 0.0001); TNF-α, +7% (P-trend = 0.0007); TNFR1, +4% (P-trend = 0.0009); TNFR2, +5% (P-trend < 0.0001); and adiponectin, -13% (P-trend <0.0001). These associations differed by racial/ethnic groups and by BMI categories. Whereas the absolute biomarker concentrations were lower among European-American women and among normal-weight women, the associations with diet were stronger than among women of African-American or Hispanic/Latino origin and among overweight and obese women. CONCLUSIONS Findings demonstrate the successful replication of an empirical hypothesis-oriented a posteriori dietary pattern score in a multi-ethnic population of postmenopausal women, with subgroup differences by race/ethnicity and body weight. Future research needs to apply the score in non-US populations.
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Affiliation(s)
- Fred K Tabung
- Departments of Nutrition, Epidemiology, and Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA,Departments of Epidemiology, and Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA,Division of Preventive Medicine, Department of Medicine,Address correspondence to FKT (e-mail: )
| | - Edward L Giovannucci
- Departments of Nutrition, Epidemiology, and Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA,Departments of Epidemiology, and Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA,Channing Division of Network Medicine, Department of Medicine
| | | | - Liming Liang
- Departments of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
| | | | - Raji Balasubramanian
- Department of Biostatistics and Epidemiology, University of Massachusetts-Amherst, Amherst, MA
| | - JoAnn E Manson
- Departments of Epidemiology, and Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA,Division of Preventive Medicine, Department of Medicine,Channing Division of Network Medicine, Department of Medicine
| | | | - Kathleen M Hayden
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC
| | - Linda Van Horn
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Kathryn M Rexrode
- Division of Preventive Medicine, Department of Medicine,Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
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Bharmal NH, McCarthy WJ, Gadgil MD, Kandula NR, Kanaya AM. The Association of Religious Affiliation with Overweight/Obesity Among South Asians: The Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study. JOURNAL OF RELIGION AND HEALTH 2018; 57:33-46. [PMID: 27460674 PMCID: PMC5269531 DOI: 10.1007/s10943-016-0290-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Religiosity has been associated with greater body weight. Less is known about South Asian religions and associations with weight. Cross-sectional analysis of the MASALA study (n = 906). We examined associations between religious affiliation and overweight/obesity after controlling for age, sex, years lived in the USA, marital status, education, insurance status, health status, and smoking. We determined whether traditional cultural beliefs, physical activity, and dietary pattern mediated this association. The mean BMI was 26 kg/m2. Religious affiliation was associated with overweight/obesity for Hindus (OR 2.12; 95 % CI: 1.16, 3.89), Sikhs (OR 4.23; 95 % CI: 1.72, 10.38), and Muslims (OR 2.79; 95 % CI: 1.14, 6.80) compared with no religious affiliation. Traditional cultural beliefs (7 %), dietary pattern (1 %), and physical activity (1 %) mediated 9 % of the relationship. Interventions designed to promote healthy lifestyle changes to reduce the burden of overweight/obesity among South Asians need to be culturally and religiously tailored.
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Affiliation(s)
| | - William J. McCarthy
- UCLA Fielding School of Public Health Department Cancer Prevention & Control Res/FSPH & JCCC BOX 956900, A2-125 CHS Los Angeles, CA 90095-6900, USA
| | - Meghana D. Gadgil
- UCSF Division of General Internal Medicine 1545 Divisadero Street San Francisco, CA 94115, USA
| | - Namratha R. Kandula
- Northwestern University Feinberg School of Medicine, Department of General Internal Medicine 750 N Lake Shore Drive, 10 Floor Chicago, IL 60611, USA
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19
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Gupta SS, Teede H, Aroni R. Spicing up your advice for South Asian and Anglo-Australians with type 2 diabetes and CVD: Do cultural constructions of diet matter? Appetite 2018; 120:679-697. [DOI: 10.1016/j.appet.2017.10.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 09/29/2017] [Accepted: 10/05/2017] [Indexed: 10/18/2022]
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Sandhu SK, Tang TS. When's dinner? Does timing of dinner affect the cardiometabolic risk profiles of South-Asian Canadians at risk for diabetes. Diabet Med 2017; 34:539-542. [PMID: 26802477 DOI: 10.1111/dme.13081] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Revised: 10/28/2015] [Accepted: 01/19/2016] [Indexed: 11/29/2022]
Abstract
AIM To explore the relationship between the time dinner is consumed (dinnertime or timing of dinner) and cardiometabolic risk factors among South-Asian Canadians at risk for diabetes. METHODS We recruited 432 South-Asian adults affiliated with Sikh and Hindu Temples in Metro Vancouver. Participants deemed to be at risk of diabetes underwent a clinical and behavioural assessment. Dinnertime was measured via self-report. Clinical endpoints included HbA1c , apolipoprotein, blood pressure, weight, BMI and waist circumference. RESULTS The mean age of participants was 65 years and 59% were male. Dinnertime was categorized into three groups: early (before 18:00 h); average (18:00 to 20:00 h); and late (later than 20:00 h). Among the participants, 19% (n = 79), 44% (n = 187) and 37% (n = 157) reported early, average and late dinnertimes, respectively. Significant differences were found for dinnertime groups and years of residence in Canada, gender and employment. Compared with the early dinnertime group, the late dinnertime group lived in Canada for a shorter duration, comprised a higher proportion of males (66 vs 48%; P = 0.01) and were currently employed (37 vs 22%; P = 0.02). With regard to clinical endpoints, compared with the early dinnertime group, the late dinnertime group had lower systolic blood pressure (135.9 vs 131.7 mmHg; P = 0.03). After controlling for demographic characteristics, this difference was diminished. No significant differences were found between dinnertime and HbA1c , apolipoprotein, diastolic blood pressure, weight, BMI and waist circumference. CONCLUSION Findings suggest that, among this sample of South-Asian Canadians at risk of Type 2 diabetes, there was no association between timing of the evening meal and cardiometabolic profiles.
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Affiliation(s)
- S K Sandhu
- Division of Endocrinology and Metabolism, University of British Columbia, Vancouver, Canada
| | - T S Tang
- Division of Endocrinology and Metabolism, University of British Columbia, Vancouver, Canada
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21
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Robberecht H, De Bruyne T, Hermans N. Effect of various diets on biomarkers of the metabolic syndrome. Int J Food Sci Nutr 2016; 68:627-641. [PMID: 28027691 DOI: 10.1080/09637486.2016.1269726] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The impact of the normal whole diet in different countries and of special types of diet on the biomarkers of the metabolic syndrome (MetS) is reviewed. Diet type, specification, risk of MetS and studied biomarkers, as far as could be traced, are included. Critical points in published studies are mentioned. Description of the traditional dietary patterns for the various countries is not always well-defined and numbers of persons in the studied population are sometimes quite limited, which hamper drawing definite conclusions. Since a Nordic diet, a dietary approach to stop hypertension (DASH), and especially a Mediterranean diet are quite promising, due to its health claims, the food pattern is studied more in detail and a large spectrum of vegetarian diets are included as well. Most of the time lipid profile and high sensitive C-reactive protein (hsCRP) are the studied biomarkers in response to diet intake.
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Affiliation(s)
- Harry Robberecht
- a Department of Pharmaceutical Sciences, Laboratory of Nutrition and Functional Foods , NatuRA (Natural Products and Food-Research and Analysis), University of Antwerp , Antwerp , Belgium
| | - Tess De Bruyne
- a Department of Pharmaceutical Sciences, Laboratory of Nutrition and Functional Foods , NatuRA (Natural Products and Food-Research and Analysis), University of Antwerp , Antwerp , Belgium
| | - Nina Hermans
- a Department of Pharmaceutical Sciences, Laboratory of Nutrition and Functional Foods , NatuRA (Natural Products and Food-Research and Analysis), University of Antwerp , Antwerp , Belgium
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22
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Tabung FK, Steck SE, Zhang J, Ma Y, Liese AD, Tylavsky FA, Vitolins MZ, Ockene JK, Hebert JR. Longitudinal changes in the dietary inflammatory index: an assessment of the inflammatory potential of diet over time in postmenopausal women. Eur J Clin Nutr 2016; 70:1374-1380. [PMID: 27380883 PMCID: PMC5143205 DOI: 10.1038/ejcn.2016.116] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 03/21/2016] [Accepted: 05/31/2016] [Indexed: 12/02/2022]
Abstract
BACKGROUND/OBJECTIVES The dietary inflammatory index (DII) measured at one time point is associated with risk of several chronic diseases, but disease risk may change with longitudinal changes in DII scores. Data are lacking regarding changes in DII scores over time; therefore, we assessed changes in the DII in the Women's Health Initiative (WHI). SUBJECTS/METHODS DII scores were calculated using data from repeated food frequency questionnaires in the WHI Observational Study (OS; n=76 671) at baseline and year 3, and the WHI Dietary Modification trial (DM; n=48482) at three time points. Lower DII scores represent more anti-inflammatory diets. We used generalized estimating equations to compare mean changes in DII over time, adjusting for multiple comparisons, and multivariable-adjusted linear regression analyses to determine predictors of DII change. RESULTS In the OS, mean DII decreased modestly from -1.14 at baseline to -1.50 at year 3. In the DM, DII was -1.32 in year 1, -1.60 in year 3 and -1.48 in year 6 in the intervention arm and was -0.65 in year 1, -0.94 in year 3 and -0.96 in year 6 in the control arm. These changes were modified by body mass index, education and race/ethnicity. A prediction model explained 22% of the variance in the change in DII scores in the OS. CONCLUSIONS In this prospective investigation of postmenopausal women, reported dietary inflammatory potential decreased modestly over time. Largest reductions were observed in normal-weight, highly educated women. Future research is warranted to examine whether reductions in DII are associated with decreased chronic disease risk.
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Affiliation(s)
- Fred K. Tabung
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health
- Department of Epidemiology and Biostatistics, University of South Carolina
- Cancer Prevention and Control Program, University of South Carolina
| | - Susan E. Steck
- Department of Epidemiology and Biostatistics, University of South Carolina
- Cancer Prevention and Control Program, University of South Carolina
- Center for Research in Nutrition and Health Disparities, University of South Carolina
| | - Jiajia Zhang
- Department of Epidemiology and Biostatistics, University of South Carolina
| | - Yunsheng Ma
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School
| | - Angela D. Liese
- Department of Epidemiology and Biostatistics, University of South Carolina
- Center for Research in Nutrition and Health Disparities, University of South Carolina
| | - Frances A. Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Science Center
| | - Mara Z. Vitolins
- Department of Epidemiology & Prevention, Wake Forest School of Medicine
| | - Judith K. Ockene
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School
| | - James R. Hebert
- Department of Epidemiology and Biostatistics, University of South Carolina
- Cancer Prevention and Control Program, University of South Carolina
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Kandola K, Sandhu S, Tang T. Immigration and dietary patterns in South Asian Canadians at risk for diabetes. J Diabetes Complications 2016; 30:1462-1466. [PMID: 27591030 DOI: 10.1016/j.jdiacomp.2016.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 08/04/2016] [Accepted: 08/05/2016] [Indexed: 11/16/2022]
Abstract
AIM To examine the relationship between immigration and dietary patterns among South Asian adults at risk for diabetes and living in Canada. METHODS We recruited 428 South Asian adults affiliated with Sikh and Hindu temples in Metro Vancouver. Of the total sample, 422 completed self-report surveys including demographic background information, and two brief food screeners (fruit/vegetable/fiber intake and fat intake). Food screeners were culturally tailored to include traditional foods consumed in the South Asian community. RESULTS Multiple linear regressions examined the relationship between diet and immigration. All models were adjusted for age, sex, marital status, education, income, and employment. Participants reported low levels of meat, fruit and vegetable consumption. Intake of whole milk products, traditional South Asian desserts and snacks were relatively high in comparison to other fat-containing food items. Specific trends in diet were seen in relation to time following immigration with the longer duration of years living in Canada the greater consumption of fruit/vegetable/fiber, non-starchy vegetables, total fat and meat reported; and lower intake of whole milk. CONCLUSION Acculturation appears to influence some dietary patterns in our sample of South Asian Canadian adults. These findings should be considered when designing culturally tailored lifestyle modification interventions for this community.
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Affiliation(s)
| | - Supna Sandhu
- University of British Columbia, Division of Endocrinology.
| | - Tricia Tang
- University of British Columbia, Division of Endocrinology
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Muga MA, Owili PO, Hsu CY, Rau HH, Chao JCJ. Association between Dietary Patterns and Cardiovascular Risk Factors among Middle-Aged and Elderly Adults in Taiwan: A Population-Based Study from 2003 to 2012. PLoS One 2016; 11:e0157745. [PMID: 27366909 PMCID: PMC4930186 DOI: 10.1371/journal.pone.0157745] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 06/04/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is one of the leading causes of mortality and loss of disability-adjusted life years in developed countries. This study derived a dietary pattern using an a priori method and additionally derived dietary patterns using a posteriori methods, and assessed the relationship with CVD risk factors in Taiwanese middle-aged and elderly adults. METHODS Cross-sectional analyses of 62,965 subjects aged 40 years and above from the Mei Jau (MJ) database collected between 2003 and 2012 in Taiwan. Diet was assessed using a 22 item semi-quantitative food frequency questionnaire. Using this information, three dietary patterns were generated. The a priori diet was labeled the Taiwanese dietary pattern and was derived using hypothesized effect of 22 food groups, while two a posteriori dietary patterns, "vegi-fruits" and "meat-processed", were derived using principal component analysis. The association between dietary patterns and a range of CVD risk factors (i.e. blood lipids, blood glucose and C-reactive protein) was evaluated using linear regression. RESULTS The results showed that high intake (Q5, quintile 5) of Taiwanese diet was negatively associated with CVD risk factors at (p < 0.001, model 3), but not with triacylglycerol. In addition, high intake of vegi-fruit dietary pattern (Q5) was negatively associated with CVD risk factors (p < 0.001), but not with high-density lipoprotein, while high consumption of meat-processed dietary pattern (Q5) was positively associated with CVD risk factors (p < 0.001), but negatively related with triacylglycerol in Q3 level and no association with C-reactive protein. CONCLUSION A negative association was observed between Taiwanese or vegi-fruit dietary patterns and CVD risk factors, while a positive association was found between meat-processed dietary pattern and CVD risk factors. The findings suggested that a diet rich in vegetables and fruits has a beneficial effect in the management of CVD risk factors.
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Affiliation(s)
- Miriam Adoyo Muga
- School of Nutrition and Health Sciences, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Patrick Opiyo Owili
- International Health Program, Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
| | - Chien-Yeh Hsu
- Department of Information Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
- Master Program in Global Health and Development, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Hsiao-Hsien Rau
- Graduate Institute of Biomedical Informatics, College of Medical Technology, Taipei Medical University, Taipei, Taiwan
| | - Jane C-J Chao
- School of Nutrition and Health Sciences, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan
- Master Program in Global Health and Development, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, Taipei, Taiwan
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Khan SA, Jackson RT, Momen B. The Relationship between Diet Quality and Acculturation of Immigrated South Asian American Adults and Their Association with Metabolic Syndrome. PLoS One 2016; 11:e0156851. [PMID: 27299862 PMCID: PMC4907444 DOI: 10.1371/journal.pone.0156851] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 05/22/2016] [Indexed: 01/30/2023] Open
Abstract
Even though the total SA American population is increasing rapidly, there is a paucity of information on the relationship between diet quality, acculturation and health outcomes such as Metabolic Syndrome (MetS) in the low-income South Asian (SA) sub-population. Our goal was to examine diet quality, degree of acculturation and their potential influence on MetS in a diverse sample of SA Americans. A convenience sample of 401 adult SA men and women were studied using a cross-sectional study design. Volunteers from two low-income community health clinics in Maryland were interviewed by questionnaires. MetS, defined by the consensus harmonized definition by the presence of ≥ 3 of the 5 abnormal indicators, was studied. An interviewer obtained an automated self-administered 24-hour Recall (ASA24) and an acculturation index (using a previously validated (SL-ASIA). SA had a composite HEI2010 score of 68 suggesting an overall need for diet improvements. Males had a higher diet quality (mean HEI2010 score) than females. Males with MetS had lower diet quality (68) than males without MetS (73). The converse was true for females (68 vs. 65). Americanized (more acculturated) subjects had a higher diet quality compared to less acculturated SA. Small differences were found in diet quality scores among SA adults from different countries. Less acculturated females, had a higher percentage of MetS and lower diet quality compared to males. These results suggest that interventions are needed in males and females who were less acculturated because they may have greater MetS and lower diet quality compared to more Americanized SA.
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Affiliation(s)
- Saira A. Khan
- Department of Nutrition and Food Science, The University of Maryland, College Park, Maryland, United States of America
| | - Robert T. Jackson
- Department of Nutrition and Food Science, The University of Maryland, College Park, Maryland, United States of America
| | - Bahram Momen
- Department of Environmental Science, The University of Maryland, College Park, Maryland, United States of America
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Grover S, Hazari N, Chakrabarti S, Avasthi A. Metabolic Disturbances, Side Effect Profile and Effectiveness of Clozapine in Adolescents. Indian J Psychol Med 2016; 38:224-33. [PMID: 27335518 PMCID: PMC4904759 DOI: 10.4103/0253-7176.183091] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Data on effect of clozapine on metabolic syndrome in adolescent patients with psychosis are limited. This study aimed to evaluate the prevalence and incidence of metabolic syndrome in children and adolescents with psychotic disorders prior to clozapine and while receiving clozapine. Secondary aims were to study the effectiveness and side effect profile of clozapine. MATERIALS AND METHODS Thirteen child and adolescent patients were evaluated at baseline, 3 months, and a follow-up beyond 6 months. Assessments were made for metabolic profile, effectiveness by positive and negative syndrome scale (PANSS), and side effects. RESULTS Prior to starting of clozapine, the prevalence of metabolic syndrome was 23%. After 3 months on clozapine, 38.5% (5/13) patients fulfilled criteria of metabolic syndrome and further on follow-up beyond 6 months (with last observation carried forward) 46.2% (6/13) had developed metabolic syndrome. There was a significant reduction in PANSS scores at 3 months and follow-up more so in those who developed metabolic syndrome at 3 months. Among the other side effects, hypersalivation was the most common side effect (100%) followed by sedation (69%). CONCLUSION Half the prevalence of metabolic syndrome in adolescents on clozapine can be attributed to other factors prior to starting of clozapine, and another half can be attributed to clozapine. Clozapine is effective in an adolescent population.
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Affiliation(s)
- Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Nandita Hazari
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Subho Chakrabarti
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ajit Avasthi
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Gender Differences in Dietary Patterns and Their Association with the Prevalence of Metabolic Syndrome among Chinese: A Cross-Sectional Study. Nutrients 2016; 8:180. [PMID: 27023599 PMCID: PMC4848649 DOI: 10.3390/nu8040180] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 03/16/2016] [Accepted: 03/17/2016] [Indexed: 12/31/2022] Open
Abstract
Few studies have investigated gender differences in dietary intake. The objective of this cross-sectional study was to examine gender differences in dietary patterns and their association with the prevalence of metabolic syndrome. The food intakes of 3794 subjects enrolled by a two-stage cluster stratified sampling method were collected using a valid semi-quantitative food frequency questionnaire (FFQ). Metabolic syndrome (MetS) was defined according to the International Diabetes Federation (IDF) and its prevalence was 35.70% in the sample (37.67% in men and 24.67% in women). Dietary patterns were identified using factor analysis combined with cluster analysis and multiple group confirmatory factor analysis was used to assess the factorial invariance between gender groups. The dominating dietary pattern for men was the “balanced” dietary pattern (32.65%) and that for women was the “high-salt and energy” dietary pattern (34.42%). For men, the “animal and fried food” dietary pattern was related to higher risk of MetS (odds ratio: 1.27; 95% CI: 1.01–1.60), after adjustment for age, marital status, socioeconomic status and lifestyle factors. For women, the “high-salt and energy” dietary pattern was related to higher risk of MetS (odds ratio: 2.27; 95% CI: 1.24–4.14). We observed gender differences in dietary patterns and their association with the prevalence of MetS. For men, the “animal and fried food” dietary pattern was associated with enhancive likelihood of MetS. For women, it was the “high-salt and energy” dietary pattern.
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Analysis of Dietary Pattern Impact on Weight Status for Personalised Nutrition through On-Line Advice: The Food4Me Spanish Cohort. Nutrients 2015; 7:9523-37. [PMID: 26593942 PMCID: PMC4663610 DOI: 10.3390/nu7115482] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 10/23/2015] [Accepted: 11/03/2015] [Indexed: 11/17/2022] Open
Abstract
Obesity prevalence is increasing. The management of this condition requires a detailed analysis of the global risk factors in order to develop personalised advice. This study is aimed to identify current dietary patterns and habits in Spanish population interested in personalised nutrition and investigate associations with weight status. Self-reported dietary and anthropometrical data from the Spanish participants in the Food4Me study, were used in a multidimensional exploratory analysis to define specific dietary profiles. Two opposing factors were obtained according to food groups’ intake: Factor 1 characterised by a more frequent consumption of traditionally considered unhealthy foods; and Factor 2, where the consumption of “Mediterranean diet” foods was prevalent. Factor 1 showed a direct relationship with BMI (β = 0.226; r2 = 0.259; p < 0.001), while the association with Factor 2 was inverse (β = −0.037; r2 = 0.230; p = 0.348). A total of four categories were defined (Prudent, Healthy, Western, and Compensatory) through classification of the sample in higher or lower adherence to each factor and combining the possibilities. Western and Compensatory dietary patterns, which were characterized by high-density foods consumption, showed positive associations with overweight prevalence. Further analysis showed that prevention of overweight must focus on limiting the intake of known deleterious foods rather than exclusively enhance healthy products.
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de Lanerolle-Dias M, Lanerolle P, Atukorala S, de Silva A. Urbanisation, dietary patterns and body composition changes in adolescent girls: a descriptive cross sectional study. BMC Nutr 2015. [DOI: 10.1186/s40795-015-0027-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Abstract
The vegetarian dietary pattern is traditionally a plant-based diet that includes fruits, vegetables, cereals, legumes, nuts, vegetable oils, soya, and possibly dairy products and/or eggs. Vegetarians and other populations who follow a plant-based dietary pattern enjoy longevity. Specifically, vegetarian dietary patterns have been associated with a lower risk for developing IHD, type 2 diabetes, hypertension, specific cancers, lower all-cause mortality and reduction in cause-specific mortality. The prevalence of the metabolic syndrome (MetS) in the USA is approximately 20 % and is currently increasing in developing countries in line with the obesity epidemic. The health care costs associated with the MetS are on a magnitude of 1.6 overall compared with healthy individuals, which makes it an important public health problem. Current evidence from several cross-sectional and case-control studies shows an association between consumption of a vegetarian dietary pattern and a reduced prevalence or risk of developing the MetS. There is a need for further research to be conducted, particularly prospective cohort studies to evaluate the effect of vegetarian dietary patterns on reducing the incidence of the MetS and, clinical trials should be designed to explore vegetarian dietary patterns for the reversal of the MetS in high-risk populations. This research could contribute to reduce the societal and economic burdens associated with the disorder.
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Goulão B, Santos O, Carmo ID. The impact of migration on body weight: a review. CAD SAUDE PUBLICA 2015; 31:229-45. [PMID: 25760158 DOI: 10.1590/0102-311x00211913] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Accepted: 10/31/2014] [Indexed: 12/16/2022] Open
Abstract
Immigrants may be more vulnerable to obesity as a result of the immigration process. The aim of this article is to summarize current knowledge about the impact of immigration on body mass index (BMI). A systematic review was performed in accordance with PRISMA guidelines through a database search of scientific articles (last updated in August 2014). Thirty-nine articles were included and assessed. Results varied according to ethnic background, country of origin and host country. A consistent positive association between BMI and time since immigration was found among Hispanic, European and African immigrants. Less than half of the studies observed a positive association among Asian immigrants. The quality of the majority of the studies assessed was poor, reflecting a need to improve methodology and concept definition. Immigration appears to have a deteriorative effect on BMI. Underlying causes may include changes in nutrition and physical activity, psychological and social factors, and genetic susceptibility and these aspects should be included as moderator variables in future studies.
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Fernando E, Razak F, Lear SA, Anand SS. Cardiovascular Disease in South Asian Migrants. Can J Cardiol 2015; 31:1139-50. [PMID: 26321436 DOI: 10.1016/j.cjca.2015.06.008] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 06/11/2015] [Accepted: 06/11/2015] [Indexed: 02/09/2023] Open
Abstract
Cardiovascular disease (CVD) represents a significant cause of global mortality and morbidity. South Asians (SAs) have a particularly high burden of coronary artery disease (CAD). This review describes current literature regarding the prevalence, incidence, etiology, and prognosis of CVD in SA migrants to high-income nations. We conducted a narrative review of CVD in the SA diaspora through a search of MEDLINE and PubMed. We included observational studies, randomized clinical trials, nonsystematic reviews, systematic reviews, and meta-analyses written in English. Of 15,231 articles identified, 827 articles were screened and 124 formed the basis for review. SA migrants have a 1.5-2 times greater prevalence of CAD than age- and sex-adjusted Europids. Increased abdominal obesity and body fat and increased burden of type 2 diabetes mellitus and dyslipidemia appear to be primary drivers of the excess CAD burden in SAs. Sedentary lifestyle and changes in diet after immigration are important contributors to weight gain and adiposity. Early life factors, physical activity patterns and, in some cases, reduced adherence to medical therapy may contribute to increased CVD risks in SAs. Novel biomarkers like leptin and adipokines may show distinct patterns in SAs and provide insights into cardiometabolic risk determinants. In conclusion, SAs have distinct CVD risk predispositions, with a complex relationship to cultural, innate, and acquired factors. Although CVD risk factor management and treatment among SAs is improving, opportunities exist for further advances.
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Affiliation(s)
- Eshan Fernando
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Fahad Razak
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada; Harvard Center for Population and Development Studies, Boston, Massachusetts, USA
| | - Scott A Lear
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada; Division of Cardiology, Providence Health Care, Vancouver, British Columbia, Canada
| | - Sonia S Anand
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Department of Epidemiology, McMaster University, Hamilton, Ontario, Canada; Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada; Chanchlani Research Centre, McMaster University, Hamilton, Ontario, Canada.
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Fernandez R, Rolley JX, Rajaratnam R, Everett B, Davidson PM. Reducing the risk of heart disease among Indian Australians: knowledge, attitudes, and beliefs regarding food practices - a focus group study. Food Nutr Res 2015; 59:25770. [PMID: 26051008 PMCID: PMC4458512 DOI: 10.3402/fnr.v59.25770] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 04/19/2015] [Accepted: 04/27/2015] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Australia has a growing number of Asian Indian immigrants. Unfortunately, this population has an increased risk for coronary heart disease (CHD). Dietary adherence is an important strategy in reducing risk for CHD. This study aimed to gain greater understanding of the knowledge, attitudes and beliefs relating to food practices in Asian Indian Australians. METHODS Two focus groups with six participants in each were recruited using a convenience sampling technique. Verbatim transcriptions were made and thematic content analysis undertaken. RESULTS Four main themes that emerged from the data included: migration as a pervasive factor for diet and health; importance of food in maintaining the social fabric; knowledge and understanding of health and diet; and elements of effective interventions. DISCUSSION Diet is a complex constructed factor in how people express themselves individually, in families and communities. There are many interconnected factors influencing diet choice that goes beyond culture and religion to include migration and acculturation. CONCLUSIONS Food and associated behaviors are an important aspect of the social fabric. Entrenched and inherent knowledge, attitudes, beliefs and traditions frame individuals' point of reference around food and recommendations for an optimal diet.
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Affiliation(s)
- Ritin Fernandez
- School of Nursing, University of Wollongong, Wollongong, NSW, Australia
- Centre for Research in Nursing and Health, St George Hospital, Kogarah, NSW, Australia;
| | - John X Rolley
- School of Nursing and Midwifery, Strategic Research Centre for Quality and Patient Safety, Deakin University, Melbourne, Victoria, Australia
| | - Rohan Rajaratnam
- South Western Sydney Local Health District, Liverpool, NSW, Australia
| | - Bronwyn Everett
- University of Western Sydney, Parramatta, NSW, Australia
- Centre for Applied Nursing Research, Ingham Institute, South Western Sydney Local Health District, Liverpool, NSW, Australia
| | - Patricia M Davidson
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
- Centre for Cardiovascular and Chronic Care, Ultimo, NSW, Australia
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Jo HB, Lee JK, Choi MY, Han IW, Choi HS, Kang HW, Kim JH, Lim YJ, Koh MS, Lee JH. Is the Prevalence of Gallbladder Polyp Different between Vegetarians and General Population? THE KOREAN JOURNAL OF GASTROENTEROLOGY 2015; 66:268-73. [DOI: 10.4166/kjg.2015.66.5.268] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Hee Bum Jo
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Jun Kyu Lee
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Min Young Choi
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Korea
| | - In Woong Han
- Department of Surgery, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Han Seok Choi
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Hyoun Woo Kang
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Jae Hak Kim
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Yun Jeong Lim
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Moon-Soo Koh
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Korea
| | - Jin Ho Lee
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Korea
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Abstract
Specific dietary patterns are associated with the risk of chronic disease. An in-depth understanding more reflective of lifestyle would be possible when assessing the synergistic effects of both diet and physical activity in pattern analysis. In the present study, we examined the biochemical markers of dysglycaemia and cardiometabolic risk in relation to lifestyle patterns using principal component analysis (PCA). Urban women (n 2800) aged 30-45 years were screened for dysglycaemia using cluster sampling from the Colombo Municipal Council area. All the 272 dysglycaemic women detected through screening and 345 randomly selected normoglycaemic women were enrolled. The International Physical Activity Questionnaire and a quantitative FFQ were used to assess physical activity and diet, respectively. Anthropometric measurements, bioelectrical impedance analysis and biochemical estimations were carried out. Lifestyle patterns were identified based on dietary and physical activity data using exploratory factor analysis. PCA was used for the extraction of factors. A total of three lifestyle patterns were identified. Women who were predominantly physically inactive and consumed snacks and dairy products had the greatest cardiometabolic risk, with a higher likelihood of having unfavourable obesity indices (increased waist circumference, fat mass percentage and BMI and decreased fat-free mass percentage), glycaemic indices (increased glycosylated Hb (HbA1c) and fasting blood sugar concentrations) and lipid profile (increased total cholesterol/TAG and decreased HDL-cholesterol concentrations) and increased high-sensitivity C-reactive protein concentrations. For the first time, we report lifestyle patterns and demonstrate the synergistic effects of physical activity/inactivity and diet and their relative association with cardiometabolic risk in urban women. Lifestyle pattern analysis greatly increases our understanding of high-risk behaviours occurring within real-life complexities.
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Shah AD, Vittinghoff E, Kandula NR, Srivastava S, Kanaya AM. Correlates of prediabetes and type II diabetes in US South Asians: findings from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study. Ann Epidemiol 2014; 25:77-83. [PMID: 25459085 DOI: 10.1016/j.annepidem.2014.10.013] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 10/14/2014] [Accepted: 10/16/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE In this study, we aim to elucidate the role of sociodemographic, lifestyle, and cultural factors in prediabetes and diabetes in South Asian immigrants to the United States, a population at high risk of type II diabetes. METHODS We performed a cross-sectional analysis of a community-based cohort of 899 South Asians without known cardiovascular disease from the Mediators of Atherosclerosis in South Asians Living in America study. Glycemic status was determined by fasting glucose, 2-hour postchallenge glucose, and use of diabetes medication. We used multinomial logistic regression models to estimate the independent associations of sociodemographic, lifestyle, and cultural factors with prediabetes and diabetes, adjusting for confounders identified using directed acyclic graphs. RESULTS Approximately 33% of participants had prediabetes and 25% had diabetes. In multivariate analyses, an independent correlate of prediabetes was low exercise. Additional covariates associated with diabetes included lower family income, less education, high chronic psychological burden score, and greater time spent watching television; and fasting monthly or annually was inversely associated with diabetes prevalence. CONCLUSIONS We found several modifiable risk factors associated with prediabetes and diabetes that may help guide diabetes prevention interventions for South Asian immigrants to the United States.
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Affiliation(s)
- Arti D Shah
- Division of Endocrinology and Metabolism, Department of Medicine, University of California, San Francisco, San Francisco.
| | - Eric Vittinghoff
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco
| | - Namratha R Kandula
- Division of General Internal Medicine and Geriatrics, Department of Medicine, Northwestern University, Chicago, IL
| | - Shweta Srivastava
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco
| | - Alka M Kanaya
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco; Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, San Francisco
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Tiedje K, Wieland ML, Meiers SJ, Mohamed AA, Formea CM, Ridgeway JL, Asiedu GB, Boyum G, Weis JA, Nigon JA, Patten CA, Sia IG. A focus group study of healthy eating knowledge, practices, and barriers among adult and adolescent immigrants and refugees in the United States. Int J Behav Nutr Phys Act 2014; 11:63. [PMID: 24886062 PMCID: PMC4030459 DOI: 10.1186/1479-5868-11-63] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 05/12/2014] [Indexed: 11/23/2022] Open
Abstract
Background Immigrants and refugees to the United States exhibit lower dietary quality than the general population, but reasons for this disparity are poorly understood. In this study, we describe the meanings of food, health and wellbeing through the reported dietary preferences, beliefs, and practices of adults and adolescents from four immigrant and refugee communities in the Midwestern United States. Methods Using a community based participatory research approach, we conducted a qualitative research study with 16 audio-recorded focus groups with adults and adolescents who self-identified as Mexican, Somali, Cambodian, and Sudanese. Focus group topics were eating patterns, perceptions of healthy eating in the country of origin and in the U.S., how food decisions are made and who in the family is involved in food preparation and decisions, barriers and facilitators to healthy eating, and gender and generational differences in eating practices. A team of investigators and community research partners analyzed all transcripts in full before reducing data to codes through consensus. Broader themes were created to encompass multiple codes. Results Results show that participants have similar perspectives about the barriers (personal, environmental, structural) and benefits of healthy eating (e.g., ‘junk food is bad’). We identified four themes consistent across all four communities: Ways of Knowing about Healthy Eating (‘Meanings;’ ‘Motivations;’ ‘Knowledge Sources’), Eating Practices (‘Family Practices;’ ‘Americanized Eating Practices’ ‘Eating What’s Easy’), Barriers (‘Taste and Cravings;’ ‘Easy Access to Junk Food;’ ‘Role of Family;’ Cultural Foods and Traditions;’ ‘Time;’ ‘Finances’), and Preferences for Intervention (‘Family Counseling;’ Community Education;’ and ‘Healthier Traditional Meals.’). Some generational (adult vs. adolescents) and gender differences were observed. Conclusions Our study demonstrates how personal, structural, and societal/cultural factors influence meanings of food and dietary practices across immigrant and refugee populations. We conclude that cultural factors are not fixed variables that occur independently from the contexts in which they are embedded.
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Affiliation(s)
| | - Mark L Wieland
- Department of Medicine, Mayo Clinic, 200 First St, SW, Rochester, MN 55905, USA.
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Gadgil MD, Anderson CAM, Kandula NR, Kanaya AM. Dietary patterns in Asian Indians in the United States: an analysis of the metabolic syndrome and atherosclerosis in South Asians Living in America study. J Acad Nutr Diet 2014; 114:238-243. [PMID: 24295929 PMCID: PMC3947024 DOI: 10.1016/j.jand.2013.09.021] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 09/10/2013] [Indexed: 11/18/2022]
Abstract
Dietary patterns contribute to cardiovascular disease (CVD) risk. Asian Indians have earlier onset, more severe, and more prevalent CVD than many other racial/ethnic groups. We aimed to characterize dietary patterns in Asian Indians living in the United States and examine associations with cardiometabolic risk factors. One hundred fifty Asian Indians, aged 45 to 84 years, without known CVD, living in the San Francisco Bay, CA, area between August 2006 and October 2007 were enrolled into the Metabolic syndrome and Atherosclerosis in South Asians Living in America study. A food frequency questionnaire validated in Asian Indians, fasting blood samples, and computed tomography scans were obtained for all participants. Principal component analysis with varimax rotation was used to determine prevalent dietary patterns. Linear regression analyses were performed for associations between dietary patterns and metabolic factors, adjusting initially for age and sex, then additionally for BMI, income, education, metabolic equivalent of task-minutes of exercise, alcohol consumption, and smoking. Two distinct dietary patterns were identified that we termed "Western," and "Vegetarian." Compared with the Western diet, the Vegetarian diet was associated with lower homeostasis model of assessment-insulin resistance (-1.12 mmol/L × mU/L; P=0.05) and lower high-density lipoprotein cholesterol (-4.77 mg/dL; P=0.09). Given that the Western and Vegetarian dietary patterns were each associated with adverse metabolic changes, healthful diet choices may help Asian Indians improve risk factors for CVD.
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Bharmal N, Kaplan RM, Shapiro MF, Kagawa-Singer M, Wong MD, Mangione CM, Divan H, McCarthy WJ. The association of religiosity with overweight/obese body mass index among Asian Indian immigrants in California. Prev Med 2013; 57:315-21. [PMID: 23769898 DOI: 10.1016/j.ypmed.2013.06.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 05/31/2013] [Accepted: 06/02/2013] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The aim of this study was to examine the association between religiosity and overweight or obese body mass index among a multi-religious group of Asian Indian immigrants residing in California. METHODS We examined cross-sectional survey data obtained from in-language telephone interviews with 3228 mostly immigrant Asian Indians in the 2004 California Asian Indian Tobacco Survey using multivariate logistic regression. RESULTS High self-identified religiosity was significantly associated with higher BMI after adjusting for socio-demographic and acculturation measures. Highly religious Asian Indians had 1.53 greater odds (95% CI: 1.18, 2.00) of being overweight or obese than low religiosity immigrants, though this varied by religious affiliation. Religiosity was associated with greater odds of being overweight/obese for Hindus (OR 1.54; 95% CI: 1.08, 2.22) and Sikhs (OR 1.88; 95% CI: 1.07, 3.30), but not for Muslims (OR 0.69; 95% CI: 0.28, 1.70). CONCLUSIONS Religiosity in Hindus and Sikhs, but not immigrant Muslims, appears to be independently associated with greater body mass index among Asian Indians. If this finding is confirmed, future research should identify potentially mutable mechanisms by which religion-specific religiosity affects overweight/obesity risk.
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Affiliation(s)
- Nazleen Bharmal
- Department of Medicine, General Internal Medicine & Health Services Research, University of California, Los Angeles, CA, USA.
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Garduño-Diaz SD, Husain W, Ashkanani F, Khokhar S. Meeting challenges related to the dietary assessment of ethnic minority populations. J Hum Nutr Diet 2013; 27:358-66. [PMID: 24033680 DOI: 10.1111/jhn.12153] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Migrants from the Indian subcontinent comprise the largest minority group in the UK. With the process of migration come alterations in lifestyle and eating habits. The present study aimed to disseminate the valuable information, experiences and challenges faced by researchers who conduct studies with ethnic minority groups in the area of diet and nutritional surveys, with an emphasis on migrant South Asians. METHODS The findings reported are the result of research carried out during 2008-2012, involving 1100 face-to-face dietary recalls conducted in the UK among South Asian children (aged 1.5-11 years; n = 300) and adults (≥30 years; n = 100). RESULTS Factors to consider when planning and carrying out diet and nutrition survey studies among migrant South Asians were identified and include the employment of culture-specific tools, visual aid reinforcement and the involvement of key community members and translators to facilitate recruitment and data collection. One of the best practices found when working with minority groups was the use of incentives and tangible benefits to reward study participants. It was also found that constant communication and follow-up of the study participants improved the quality of the data and the likelihood of maintaining links with community members for future studies. CONCLUSIONS From the results of in-house studies and a revision of practices reported in earlier literature, two 24-h face-to-face dietary recalls are recommended as the optimal method for the dietary assessment of migrant South Asians. To complement this assessment, ethnic-specific food frequency questionnaires such as that developed and successfully implemented among South Asians in the present study must be employed.
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Affiliation(s)
- S D Garduño-Diaz
- Department of General Education, American University of the Middle East, Egaila, Kuwait
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