Term
| Ethnic minorities generally have an increased risk of what diseases? |
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Definition
| CVD, Type 2 diabetes, obesity. |
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Term
| 5 factors that affect the risk of disease in ethnic minorities? |
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Definition
Poor healthcare access (language/cultural differences)
More unemployment than mainsteam
Diet & health behaviours
Genetic predisposition (fetal programming)
Socioeconomic |
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Term
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Definition
Ethnicity is subjective
Most data from white europeans in western society (such a healthy survey for england)
Eating habit surveys offer poor EM sample
Variability in ethnic coding
Variations in regional cooking, income and social factors |
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Term
| South asians ore likely to get type 2 diabetes why? |
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Definition
Family history, obesity, central adiposity, ethnicity.
3-4x more in pakistani men and women
South asian children higher incidence of HbA1C gene and higher tendency for insulin resistance |
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Term
| Who is most and least likely to be obese? |
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Definition
Most South asians particularly women from bangladesh, black caribbean, pakistani
Least chinese |
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Term
| Why is BMI not appropriate for asians? |
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Definition
| Higher body fat for a given BMI, More cetral adiposity w/h ratio associated with type 2 diabetes and CVD |
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Term
| Advise from WHO and NICE regarding BMI differences in asians? |
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Definition
WHO advises action points at lower points of BMI.
NICE had advised same thresholds but has more recently advised action points for intervention 2 points lower than normal. |
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Term
| Climatic reason south asians may be more vulnerable? |
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Definition
Adapted to hot climate and nutrition factors
Energy converted to ATP not heat
- disadvantage when moving to western diet higher in energy lower in activity |
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Term
| name the difference 4 ethnicities affected and problems with this definition. |
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Definition
South asians, black african carribeans, chinese + other sub groups due to area and other factors.
Problem with ethnic coding by different studies, also is subjective. |
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Term
| Links with dohad and diseases in ethnic minorities? |
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Definition
| Low b/w common in UK south asians, along with nutritional transition and rapid economic development means catch up fatness and a greater risk of type 2 diabetes at a lower BMI. |
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Term
| What did the health survey for england find out about South Asians? |
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Definition
add more salt without tasting
Less likely to eat 5 a day than mainstream |
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Term
| Dietary reasons south asians are at greater risk of disease? |
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Definition
Poorer asians reuse cooking fats = trans fat fatty acids=poor heart health
Traditional foods expensice to import but important enough to forgoe other foods
Degrees of devotion to religious food habits
Fasting and exclusion of foods
Cultural beliefs such as fat children healthy
Older more likely to follow traditional diets, women don't work.
Younger women, 2nd generation eat more western diet and work |
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Term
| Traditional south asian diet? |
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Definition
Starchy staples - rice, bread, chapattis
Vegetable, beans, meat and fosh currys
Many herbs and spices - salt withou tasting.
High fibre low in fat? Work with eatwell plate so may be otehr confounding factors |
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Term
| Regional/religion based variations of south asian traditional diet? |
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Definition
Pakistani - more sweet foods (rice, milk, sugar)
Punjabi muslims - More paneer
Acculturation +western diet higher in energy/fat/salt |
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Term
| intervention that has worked? |
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Definition
| BHF social cooking scheme in North England, based in places of worship reported a 5% reduction in salt addition. |
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Term
| Considerations for intervention? |
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Definition
Needs to be tailored
South asians large families so target households
Health professional speaking native language shown to help
Places of worship useful
Consider cultural sensitivities in institutions
Healthy eating advice to be tailored to preferences and beliefs |
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Term
| Problems with new advice lowering action points for BMI? |
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Definition
| Normal BMI problems of measurement, muscle,activity. |
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Term
| Why is it not just about the western diet? |
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Definition
| Would see higher problems in western people, is based upon genetics, traditional diet and acculturation |
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Term
| Why is it not just about ethnicity? |
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Definition
| Also about health inequalities |
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Term
| Why may epigenetics/acculturation change long term outcome for EM? |
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Definition
| In 100 years and several generations there may be a complete difference as with dohad. |
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Term
| What are the 'grey areas' of ethnicity variation aside from subjective status? |
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Definition
| Degrees of integration into western diet/lifestyle and mixed races. |
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