Objective: The present qualitative study explored health perceptions, diet and the social construction of obesity and how this relates to the initiation and maintenance of a healthier diet in UK Pakistani women. Design: Pakistani women in Greater Manchester participated in focus group and one-to-one discussions. Semi-structured interviews employing fictional vignettes and body shape images were used to explore the participants' beliefs and practices regarding diet, overweight/obesity and the risk of type 2 diabetes. Transcripts were analysed using phenomenological and sociological approaches. Setting: Interviews took place either in local community and Pakistani resource centres or in private homes. Subjects: First-and second-generation women who were both active in the community and housebound. The women spoke English and/or Urdu. Results: The fifty-five participants lacked the motivation to address weight gain and were unsure how to do so. There was a limited awareness of the link between weight gain and type 2 diabetes. Other barriers included the influence of Islam, culture and familial expectations on home cooking, perceptions that weight gain is inevitable (owing to ageing, childbirth or divine predestination) and the prioritisation of family concerns over individual lifestyle changes. As the findings of the present research did not correspond to existing educational and behaviour change models, a new Health Action Transition conceptual model is proposed. Conclusions: Health education programmes that aim to address obesity and its associated risks in the South Asian community must take into account the complex beliefs and practices and the multiple dimensions of religion, ethnic and social identity within this population. The present study provides further insight into these factors and proposes a novel model for use in designing and implementing education interventions for British Pakistani women. Keywords Diet Educational models Pakistani ObesityActions to address the rising levels of obesity and type 2 diabetes (T2D), which predispose people to CVD, are a health-care priority. There is a particular need for culturally specific educational interventions targeted at black and minority ethnic groups, including South Asian populations (4)(5)(6) . In 2001, approximately two million ethnic South Asians were living in England and Wales (7) . Approximately 215 000 South Asians were living in North West England (7) and this population is growing faster than those of other minorities (8) . South Asian men and women have a 2-fold and 1?5-fold higher risk of T2D, respectively, than the general population (9) . Central obesity is more common in South Asians than in Caucasians (4,9,10) and is particularly prevalent in Pakistani women (10,11) . Overall, South Asians are approximately 50 % more likely to die from CHD than the general population (4) . In the South Asian context, women's health is devalued and neglected (12) . Dietary differences are likely to contribute to these health inequalities (4,13,14) . A...

Health professionals face two complicated but contradictory epidemics: obesity and osteoporosis (OP). While obesity is obvious, OP progresses silently affecting one in two UK women. Both South Asian and Caucasian women are at OP risk. This study compared experiences of osteoporotic Caucasian and South Asian women in a purposive sample of 21 volunteers from south east England, aged 43 to 82 years. The women had been diagnosed for eight months to 40 years. Long disease duration was marked by complacent OP dialogue, although OP was objectionable and marked a loss of quality of life. Inductive content analysis of transcripts showed that 'uncertainty'--about one another and about what constituted helpful self-care--affected both GPs and patients. Instead, support groups and the media supported learning about OP care. Beyond providing drug prescriptions, women reported desiring, but rarely feeling, that GPs fully supported their preferences for self-care. Self-care often included specialist exercise classes. Some younger women led their GPs to better understand the range of self-care options. GPs were seen as being unsure about how and when to discuss physical activity (PA). In conclusion, women with OP in this sample are sensitive to their GP's hesitance about offering detailed PA recommendations. Regardless of ethnicity, younger women undertook PA based on personal initiative. Positive PA experiences stimulated an interest in discussing PA with GPs, and these dialogues broke the silence surrounding OP care. By providing important information regarding the OP patient experience, the findings highlight the unmet desire of OP sufferers for better and closer attention from GPs.

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