Changes in dietary intake following a culturally adapted lifestyle intervention among Iraqi immigrants to Sweden at high risk of type 2 diabetes: a randomised trial

Abstract

Objective: To investigate the effectiveness of a culturally adapted lifestyle intervention for changing dietary intake, particularly energy, fat and fibre intakes, in the intervention group (IG) compared with the control group (CG). Design: Randomised controlled trial. Setting: IG (n 50) and CG (n 46). The IG was offered seven group sessions, including one cooking class, over a period of 4 months. The participants filled out 4 d food diaries at the start, mid and end of the study. Subjects: Iraqi-born residents of Malmö, Sweden, at increased risk for developing diabetes. Results: At baseline, participants' fat intake was high (40 % of total energy intake (E%)). The predefined study goals of obtaining <30 E% from fat and ≥15 g fibre/ 4184 kJ (1000 kcal) were met by very few individuals. In the IG v. the CG, the proportion of individuals obtaining <40 E% from fat (48·4 v. 34·6 %, P = 0·65), <10 E% from saturated fat (32·3 v. 11·5 %, P = 0·14) and ≥10 g fibre/4184 kJ (45·2 v. 26·9 %, P = 0·46) appeared to be higher at the last visit, although the differences were statistically non-significant. A trend towards decreased mean daily intakes of total energy (P = 0·03), carbohydrate (P = 0·06), sucrose (P = 0·02) and fat (P = 0·02) was observed within the IG. Differences in changes over time between the groups did not reach statistical significance. Conclusions: Although no significant differences were observed in the two groups, our data indicate that this culturally adapted programme has the potential to modify dietary intake in Middle Eastern immigrants. The high fat intake in this group should be addressed.

Metabolite profiling paradoxically reveals favorable levels of lipids, markers of oxidative stress and unsaturated fatty acids in a diabetes susceptible group of Middle Eastern immigrants

“…In a previously conducted lifestyle intervention study addressing Iraqi immigrants at high T2D risk, we collected 4-day food diaries assessing frequency of intake, but also portion size and food preparation. In that study, dietary fat intake was twice as high in the Iraqi immigrant population as compared to the native Swedish population, with over 40% of total energy intake coming from fat [28]. The high fat content may impact the outcome of our data, and we conclude that although the questionnaires used in this study are validated, they may not fully reflect food composition and eating habits.…”

Effectiveness of information technology–enabled ‘SMART Eating’ health promotion intervention: A cluster randomized controlled trial

“…The intervention had a similar effect on increasing fruit and vegetable intake as reported from developed countries using traditional methods of education [44,47] and mobile technology [48]. In contrast, a lifestyle intervention in Sweden using counseling, group discussions on healthy eating by health workers and cooking classes by a chef to increase fruit and vegetable intake and to reduce fat intake, could not produce a significant change in behaviour outcomes [49]. Similarly, a 9-months web-based computer-tailored intervention aimed at increasing fruit and vegetable intake and decreasing saturated fat intake, did not result in significant intervention effects among Netherland adults [50].…”

Living with Diabetes: Personal Interviews with Pakistani Women in Norway

“…Nordic studies of immigrants from countries where Kurds originate have examined the prevalence of T2DM or risk factors for the disease [14,15,[56][57][58][59][60][61]. A 2013 Swedish study confirmed, as expected, that the prevalence of T2DM was higher among Iraqi immigrants than Swedish participants (8.4% vs. 3.3%) [61].…”