Changes in dietary habits after migration and consequences for health: a focus on South Asians in Europe

Abstract

BackgroundImmigrants from low-income countries comprise an increasing proportion of the population in Europe. Higher prevalence of obesity and nutrition related diseases, such as type 2 diabetes (T2D) and cardiovascular disease (CVD) is found in some immigrant groups, especially in South Asians.AimTo review dietary changes after migration and discuss the implication for health and prevention among immigrants from low-income countries to Europe, with a special focus on South Asians.MethodSystematic searches in PubMed were performed to identify relevant high quality review articles and primary research papers. The searches were limited to major immigrant groups in Europe, including those from South Asia (India, Pakistan, Bangladesh, Sri Lanka). Articles in English from 1990 and onwards from Europe were included. For health implications, recent review articles and studies of particular relevance to dietary changes among South Asian migrants in Europe were chosen.ResultsMost studies report on dietary changes and health consequences in South Asians. The picture of dietary change is complex, depending on a variety of factors related to country of origin, urban/rural residence, socio-economic and cultural factors and situation in host country. However, the main dietary trend after migration is a substantial increase in energy and fat intake, a reduction in carbohydrates and a switch from whole grains and pulses to more refined sources of carbohydrates, resulting in a low intake of fiber. The data also indicate an increase in intake of meat and dairy foods. Some groups have also reduced their vegetable intake. The findings suggest that these dietary changes may all have contributed to higher risk of obesity, T2D and CVD.Implications for preventionA first priority in prevention should be adoption of a low-energy density – high fiber diet, rich in whole grains and grain products, as well as fruits, vegetables and pulses. Furthermore, avoidance of energy dense and hyperprocessed foods is an important preventive measure.

An exploration of dietary practices among South Indians in Brisbane, Australia

“…Almost all the (non-vegetarian) respondents agreed that they ate much more meat after arrival in Australia, confirming the common experience with many immigrants as described by research on migrant food habits (Holmboe-Ottesen & Wandel, 2012;Lesser et al, 2014;Wandel et al, 2008).…”

“…CALD communities have consistently been shown to have higher rates of dietrelated disease than majority populations in many industrialised countries (Anikeeva et al, 2010;Misra & Ganda, 2007;Misra & Khurana, 2011). Indian and other South Asian migrants in particular have been shown to be at a greater risk of overweight, central obesity and T2DM than host populations and other migrant communities in these countries (Holmboe-Ottesen & Wandel, 2012;Johansen et al, 2009;Kumar, Holmboe-Ottesen, Lien, & Wandel, 2004;Kumar, Meyer, Wandel, Dalen, & Holmboe-Ottesen, 2005; 3 See Appendix 2 4 Health screening is mainly for infectious diseases that are a threat to public health in Australia such as TB, HIV, hepatitis B, C and conditions requiring long-term health care (Joint Standing Committee on Migration, 2010) http://www.border.gov.au/Trav/Visa/Heal/meeting-the-health-requirement/healthexaminations; https://www.border.gov.au/about/corporate/information/fact-sheets/22health…”

“…The prevalence of NCDs, especially T2DM is often higher among South Asian migrants than among the host population, as well as other migrant communities (Misra & Khurana, 2011). Migrants from South Asian countries such as Pakistan, Bangladesh and India who live in the United Kingdom, Europe, Canada and the United States are identified as being particularly susceptible to obesity-related chronic diseases, particularly T2DM and CHD (Anderson et al, 2005;Bhopal, 2009;Dassanayake et al, 2009;De Maio, 2010;Gilbert & Khokhar, 2008;Harding, 2003;Holmboe-Ottesen & Wandel, 2012;Johansen et al, 2009;Wandel et al, 2008). Their diet has been examined as a possible factor responsible for the increased prevalence of these conditions.…”

“…Diet has been implicated as one of the many causative factors (Holmboe-Ottesen & Wandel, 2012;Lesser, Gasevic, & Lear, 2014;Wandel Råberg, Kumar, & Holmboe-Otteson, 2008). …”

Ethnicity and risk of cardiovascular disease (CVD): 4.8 year follow-up of patients with type 2 diabetes living in Scotland

“…Therefore, the missing ethnicity group data was explored and it revealed that 50,410 were free of CVD at baseline and 7,810 (15.5%) developed CVD in the followup period giving a rate similar to that in those with known ethnicity (13.4%). Another limitation was that we were unable to adjust our models for physical activity, diet, and family history of diabetes and CVD (which are known to vary by ethnicity) [6,32,43]. At the same time, the effects of many of these factors may act through BMI, BP, total cholesterol, HDL-c, hypertension and age of diabetes diagnosis, which we have adjusted for in the analysis.…”