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Nutrition in an ethnically diverse society : what are some of the key challenges?

By Ala Szczepura

Abstract

The role of nutrition is especially important in certain ‘lifestyle’ diseases that impact disproportionately\ud on ethnic minority populations. The aim of this paper is to review the evidence\ud of risk, health outcomes and interventions for certain diseases that affect the UK’s largest\ud ethnic minority group (South Asians) in order to help professionals better address the needs of\ud this diverse population. Research evidence is presented on factors influencing access to services\ud by ethnic minority populations and the changing UK policy background for public health and\ud preventive care. The available research base on obesity, diabetes and CVD is discussed. Conditions\ud such as type 2 diabetes, which are more prevalent among the South Asian population,\ud are associated with poorer health outcomes and appear to exhibit links to diet and nutrition that\ud start in childhood or even before birth; all making preventive care important. Obesity is a\ud major risk factor and it appears that BMI thresholds may need to be lower for South Asians.\ud Targeted interventions to improve diet and outcomes in the South Asian population also appear\ud promising. Recent moves to promote access to evidence of ethnicity and health and to improve\ud the cultural competence of organisations are discussed. Health professionals will increasingly\ud need to promote lifestyle changes in a manner that meets the needs of a diverse population in\ud order to address future public health challenges. Nutritionists and other professionals will need\ud to ensure that interventions are culturally appropriate and involve engagement with extended\ud family members and communities

Topics: RA, TX
Publisher: Cambridge University Press
Year: 2011
OAI identifier: oai:wrap.warwick.ac.uk:4489

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Citations

  1. (1993). (non-insulin-dependent) diabetes mellitus, hypertension and hyperlipidaemia (syndrome X): relation to reduced fetal growth. Diabetologia.
  2. (2001). A review of ethnicity, health and nutrition-related diseases in relation to migration in the United Kingdom. Public Health Nutr.
  3. (2005). Access to health care for ethnic minority populations. Postgrad Med J.
  4. (2002). Adiposity and hyperinsulinemia in Indians are present at birth. J Clin Endocrinol Metab.
  5. An Overview of the Research Evidence on Ethnicity and Communication in Healthcare.:
  6. (2004). Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet.
  7. (2006). Are obesity-related metabolic risk factors modulated by the degree of insulin resistance in adolescents? Diabetes Care.
  8. (1999). Asian cookery clubs: a community health promotion intervention.
  9. Assessing equity in systematic reviews: realising the recommendations of the Commission on Social Determinants of Health.
  10. (1993). Association of early-onset coronary heart disease in South Asian men with glucose intolerance and hyperinsulinemia. Circulation.
  11. (1994). Birth weight and non-insulin dependent diabetes: thrifty genotype, thrifty phenotype, or surviving small baby genotype? BMJ.
  12. (2000). Black and Minority Ethnic Groups in England: The second health & lifestyles survey. : Health Education Authority,
  13. (2008). Changing dietary habits of ethnic groups in Europe and implications for health. Nutr Rev.
  14. Commission. The state of health care and adult social care in England. Key themes and quality of services
  15. (2004). Committee on National Statistics. Eliminating Health Disparities.: The National Academies Press,
  16. (2009). Consensus statement for diagnosis of obesity, abdominal obesity and the metabolic syndrome for Asian Indians and recommendations for physical activity, medical and surgical management. J Assoc Physicians India.
  17. Coronary risk in a British Punjabi population: comparative profile of non-biochemical factors.
  18. (2010). Culturally appropriate health education for Type 2 diabetes in ethnic minority groups: a systematic and narrative review of randomized controlled trials. Diabet Med.
  19. (2008). Culturally appropriate health education for type 2 diabetes mellitus in ethnic minority groups. Cochrane Database Syst Rev.
  20. (2003). Culturally competent healthcare systems. A systematic review. Am J Prev Med.
  21. (2006). CVD risk factors and ethnicity - a homogeneous relationship? Atheroscler Suppl.
  22. (2007). CVD risk in South Asians: the importance of defining adiposity and influence of dietary polyunsaturated fat. Proc Nutr Soc.
  23. (2008). Deficiency of sunlight and vitamin
  24. (2007). Defining obesity cut points in a multiethnic population. Circulation.
  25. (1995). Department of Health's requirement for mandatory collection of data on ethnic group of inpatients. BMJ.
  26. Developing cultural competence across communities: a coronary heart disease training programme for health advocates and trainers.
  27. (1979). Diabetes and cardiovascular disease. The Framingham study. JAMA.
  28. (1990). Diabetes Care.
  29. Diabetes UK and South Asian Health Foundation recommendations on diabetes research priorities for British South Asians.2009.
  30. (1985). Diet and risk factors for coronary heart disease in Asians in northwest London. Lancet.
  31. Early emergence of ethnic differences
  32. (2008). Educational interventions for migrant South Asians with Type 2 diabetes: a systematic review. Diabet Med.
  33. (2001). Effect of culturally appropriate health education on glycaemic control and knowledge of diabetes in British Pakistani women with type 2 diabetes mellitus. Health Educ Res.
  34. (2007). Effective heart disease prevention: lessons from a qualitative study of user perspectives in Bangladeshi, Indian and Pakistani communities. Public Health.
  35. (2010). Emergence of ethnic differences in blood pressure in adolescence: the determinants of adolescent social well-being and health study. Hypertension.
  36. (2008). Enhanced diabetes care to patients of south Asian ethnic origin (the United Kingdom Asian Diabetes Study): a cluster randomised controlled trial. Lancet.
  37. (2010). Equality Act
  38. (2010). Equality strategy speech.
  39. (2009). Ethnic cancer data for improved commissioning of health services. NHS Evidence;
  40. (2008). Ethnic differences in myocardial infarction in patients with hypertension: effects of diabetes mellitus. QJM.
  41. (1993). Ethnic differences in the incidence of lower extremity amputation secondary to diabetes mellitus. Diabet Med.
  42. (2008). Ethnic diversity in type 2 diabetes. Diabet Med.
  43. (1999). Evaluation of an Asian women's healthy eating and exercise group.
  44. (2004). Evaluation of delivery of enhanced diabetes care to patients of South Asian ethnicity: the United Kingdom Asian Diabetes Study (UKADS). Diabet Med.
  45. (2010). Fair Society, Healthy Lives: a missed opportunity to address ethnic inequalities in health.
  46. (2010). Fair Society, Healthy Lives: A Strategic Review
  47. (2009). Federation B. Diabetes Atlas
  48. (2010). Foundation. Ethnic differences in cardiovascular disease 2010. British Heart Foundation;
  49. (1993). Global estimates for prevalence of diabetes mellitus and impaired glucose tolerance in adults. WHO Ad Hoc Diabetes Reporting Group. Diabetes Care.
  50. Guide for World Class Commissioners. Promoting Health and Well-Being: Reducing Inequalities2009.
  51. (2000). Health care and health status and outcomes for patients with type 2 diabetes. Diabetes Care.
  52. (1994). Health Care Needs Assessment Oxford Radcliffe Publishing Ltd,
  53. (2010). Health Foundation (SAHF). Position Statement on Diagnosis and Treatment of Obesity in British South Asians.
  54. (2000). Health outcomes in type 2 diabetes. Int J Clin Pract Suppl.
  55. Health promotion and prevention interventions in Pakistani, Chinese and Indian communities related to CVD and Cancer. A review of the published evidence in the UK, other parts of Europe and the United States.2008.
  56. (2010). Health. Choosing Health White Paper. Department of Health;
  57. (2010). Health. Equity and excellence: Liberating the NHS. Department of Health;
  58. (2006). Health. Health Survey for England 2004: Health of Ethnic Minorities - Full Report. Department of Health;
  59. (2010). Health. Healthy lives, healthy people: our strategy for public health in England. Department of Health;
  60. (2008). Health. Healthy Weight, Healthy Lives: Consumer Insight Summary.
  61. (1995). Heart disease and diabetes.
  62. (2008). High quality care for all: NHS Next Stage Review
  63. (2010). How can health promotion interventions be adapted for minority ethnic communities? Five principles for guiding the development of behavioural interventions Health Promot Int.
  64. (2007). How does ethnicity affect the association between obesity and diabetes? Diabet Med.
  65. (2004). How physically active are South Asians in the United Kingdom? A literature review. J Public Health (Oxf).
  66. Hypertension and diabetes.
  67. Immigration Policy for a Multi-cultural Society1997.
  68. (2007). Impact of a cardiovascular risk control project for South Asians (Khush Dil) on motivation, behaviour, obesity, blood pressure and lipids. J Public Health (Oxf).
  69. Improving ethnic data collection for statistics of cancer incidence, management, mortality and survival in the UK.2008.
  70. (1991). Inappropriate use of the term 'Asian': an obstacle to ethnicity and health research. J Public Health Med.
  71. (2009). Individual patient education for people with type 2 diabetes mellitus. Cochrane Database Syst Rev.
  72. (1998). Inequalities in health. Report on inequalities in health did give priority for steps to be tackled. BMJ.
  73. (2010). Infant formula, autoimmune triggers, and type 1 diabetes.
  74. (1992). Insulin resistance, diabetes, and risk markers for ischaemic heart disease in Asian men and non-Asian
  75. (2009). Interventions for treating obesity in children. Cochrane Database of Systematic Reviews.
  76. (2009). Is there equity of service delivery and intermediate outcomes in South Asians with type 2 diabetes? Analysis of DARTS database and summary of UK publications. J Public Health (Oxf).
  77. Lack of change in birthweights of infants by generational status among Indian, Pakistani, Bangladeshi, Black Caribbean, and Black African mothers in a British cohort study.
  78. (2010). Let's Move--childhood obesity prevention from pregnancy and infancy onward.
  79. Management of people with diabetes wanting to fast during Ramadan.
  80. (1993). Medicine Committee on Monitoring Access to Personal Health Care Services. Access to Health Care
  81. Metabolic imprinting in obesity. Forum Nutr.
  82. (1988). Mortality from coronary heart disease in Asian communities in
  83. (2010). NHS Evidence: Specialist Collections.
  84. (2010). Nutritional composition of the diets of South Asian, black African-Caribbean and white
  85. (2008). Obesity and intermediate clinical outcomes in diabetes: evidence of a differential relationship across ethnic groups. Diabet Med.
  86. (2009). Obesity and South Asian Children. NHS Evidence;
  87. (2001). Office for National Statistics. Key Statistics for Postcode Sectors in England and Wales. Census
  88. (2008). Pathogenesis of type 2 diabetes: tracing the reverse route from cure to cause. Diabetologia.
  89. Predicting risk of type 2 diabetes in England and Wales: prospective derivation and validation of QDScore.
  90. (2007). Prevalence of cardiovascular risk factors among ethnic groups: results from the Health Surveys for England. Atherosclerosis.
  91. (2003). Programming of lean body mass: a link between birth weight, obesity, and cardiovascular disease? Am J Clin Nutr.
  92. Race and health: an information sources guide: SHARE, King's Fund
  93. (2003). Racial disparities in diabetes care processes, outcomes, and treatment intensity. Med Care.
  94. (2010). Ramadan Education and Awareness in Diabetes (READ) programme for Muslims with Type 2 diabetes who fast during Ramadan. Diabet Med.
  95. Rationale and design of the ADDITION-Leicester study, a systematic screening programme and randomised controlled trial of multi-factorial cardiovascular risk intervention in people with type 2 diabetes mellitus detected by screening.
  96. (2000). Redefining obesity and its treatment.
  97. (1991). Relation of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in South Asians. Lancet.
  98. (2000). Researching ethnic diversity in the British NHS: methodological and practical concerns. J Adv Nurs.
  99. (2010). Review of diabetes management and guidelines during Ramadan. J R Soc Med.
  100. Role of maternal vitamin B12 on the metabolic health of the offspring: a contributor to the diabetes epidemic?
  101. (2007). Self-management education programmes by lay leaders for people with chronic conditions. Cochrane Database Syst Rev.
  102. (2007). Socio-economic status, ethnicity and diabetes management: an analysis of time trends using the health survey for England. J Public Health (Oxf).
  103. (2010). Specialist Collection for Ethnicity and Health. What Are Ethnic Groups? : NHS Evidence;
  104. Systematic review of ethnicity and health service access for London.2001.
  105. (2007). Systematic review of primary healthcare interventions to improve diabetes outcomes in minority ethnic groups. J Ambul Care Manage.
  106. (2004). The effects of diet, sulfonylurea, and Repaglinide therapy on clinical and metabolic parameters in type 2 diabetic patients during Ramadan. Endocr Res.
  107. (2008). The Epidemic of Coronary Disease in South Asians. NHS Evidence;
  108. (1998). The Health of Londoners: A Public Health Report for London.
  109. (2003). The implementation of nutritional advice for people with diabetes. Diabet Med.
  110. (2007). The metabolic syndrome in children and adolescents - an IDF consensus report. Pediatr Diabetes.
  111. (2010). The Office of National Statistics.
  112. (2000). The Race Relations (Amendment) Act.
  113. (2005). The role of health care providers in the prevention of overweight and type 2 diabetes in children and adolescents. Diabetes Spectrum.
  114. (2001). The UKPDS risk engine: a model for the risk of coronary heart disease in Type II diabetes (UKPDS 56). Clin Sci (Lond).
  115. (1998). The Wandsworth Heart and Stroke Study. A population-based survey of cardiovascular risk factor in different ethnic group. Methods and baseline findings.
  116. (2006). Toolkit to Support the Running of Diabetes Awareness Events for the South Asian Communities.
  117. (2001). Treatment of obesity: need to focus on high risk abdominally obese patients. BMJ.
  118. (2008). Type 2 diabetes and obesity in the south Asian population. NHS Evidence;
  119. Type II diabetes and quality of life: a review of the literature.
  120. (2009). Understanding and beliefs of diabetes in the UK Bangladeshi population. Diabet Med.
  121. (2009). Understanding the role of diet in type 2 diabetes prevention. Br J Community Nurs.
  122. Understanding why some ethnic minority patients evaluate medical care more negatively than white patients: a cross sectional analysis of a routine patient survey in English general practices.
  123. (2010). Vitamin D status and markers of bone turnover in Caucasian and South Asian postmenopausal women living in the UK.
  124. (2006). Waist circumference, blood pressure, and lipid components of the metabolic syndrome. J Pediatr.
  125. (2010). Who we are - and why are we different.
  126. (2004). Why ethnic minority groups are under-represented in clinical trials: a review of the literature. Health Soc Care Community.

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