Social and cultural construction of obesity among Pakistani Muslim women in North West England

Abstract

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...

‘The Quranic Garden’: Consumption of Fruits, Vegetables, and Whole Grains from an Islamic Perspective

“…Given the global obesity crisis, particularly facing the predominantly-Muslim countries in MENA and other Muslim communities around the world (Aboul-Enein, Bernstein, & Neary, 2017;Cong et al, 2014;Ludwig et al, 2011; World Health Organization Regional Office for the Eastern Mediterranean, 2016), culturally congruent dietary education strategies and interventions targeting Muslim populations are warranted. A diet that closely aligns with plant-based foods mentioned in the Holy Quran can be regarded as part of a healthy dietary pattern comparable to the MD.…”

“…This review adds value for several reasons. Firstly, there is notable growth in the number of studies (Cong et al, 2014;Kalter-Leibovici et al, 2010;Ludwig, Cox, & Ellahi, 2011) that help elucidate the growing obesity crisis facing Muslim populations and communities around the world. Secondly, given the current obesity crisis facing Muslim populations and communities, this review could lead to a better culturallyrelevant understanding of the current and future status of obesity-related strategies and interventions among Muslim populations and communities.…”

Dietary assessment in minority ethnic groups: a systematic review of instruments for portion-size estimation in the United Kingdom

“…As a consequence, dietary acculturation is observed, 4 affecting dietary patterns 5 . Assessing individual diets in these groups is difficult because any tool must capture the complexity of the diet, which may be a combination of ethnic foods and those commonly consumed by the autochthonous (native) population.…”

A focus group study of healthy eating knowledge, practices, and barriers among adult and adolescent immigrants and refugees in the United States

“…Recent studies underscore that environmental influences (e.g., food environment [27]) and sociocultural factors (identity threat, family dynamics, cultural beliefs, socioeconomic position) underpin food preferences and dietary decisions [28-33]. Daily food rituals in immigrant families, such as meal preparation, serve as a means for parents to serve as ‘culture-bearers’ [32] while also incorporating customs of the adoptive culture more desired by the children [34]. Lifestyle and environmental changes that accompany immigration can limit options for access to health-promoting activities such as healthy diet [35].…”