Ethnicity, length of residence, and prospective trends in body mass index in a national sample of Australian adults (2006–2014)

Gestational diabetes mellitus by maternal country of birth and length of residence in immigrant women in Norway

AIMS

Immigrant women are at higher risk for gestational diabetes mellitus (GDM) than non-immigrant women. This study described the prevalence of GDM in immigrant women by maternal country of birth and examined the associations between immigrants' length of residence in Norway and GDM.

METHODS

This Norwegian national population-based study included 192,892 pregnancies to immigrant and 1,116,954 pregnancies to non-immigrant women giving birth during the period 1990-2013. Associations were reported as odds ratios (ORs) with 95% confidence intervals (CIs) using logistic regression models, adjusted for year of delivery, maternal age, marital status, health region, parity, education and income.

RESULTS

The prevalence and adjusted OR [CI] for GDM were substantially higher in immigrant women from Bangladesh (7.4%, OR 8.38 [5.41, 12.97]), Sri Lanka (6.3%, OR 7.60 [6.71, 8.60]), Pakistan (4.3%, OR 5.47 [4.90, 6.11]), India (4.4%, OR 5.18 [4.30, 6.24]) and Morocco (4.3%, OR 4.35 [3.63, 5.20]) compared to non-immigrants (prevalence 0.8%). Overall, GDM prevalence increased from 1.3% (OR 1.25 [1.14, 1.36]) to 3.3% (OR 2.55 [2.39, 2.71]) after 9 years of residence in immigrants compared to non-immigrant women. This association was particularly strong for women from South Asia.

CONCLUSIONS

Gestational diabetes mellitus prevalence varied substantially between countries of maternal birth and was particularly high in immigrants from Asian countries. GDM appeared to increase with longer length of residence in certain immigrant groups.

The effectiveness of living well multicultural-lifestyle management program among ethnic populations in Queensland, Australia

ISSUE

Some migrant groups have higher risks of deaths and chronic diseases due to barriers associated with socioeconomic disadvantage, social isolation, racism, language, poor access to health services and low levels of health literacy. However, few culturally tailored interventions have targeted ethnic groups in Australia. This study evaluated the effectiveness of the Living Well Multicultural-Lifestyle Management Program (LWM-LMP) in Queensland, Australia.

METHODS

The LWM-LMP was originally co-designed with the targeted communities. Participants aged ≥18 years were eligible to participate without a fee. The evaluation was a quasi-experimental design without a control group, with data collected at baseline, the end of the programme and after-programme follow-up at week 14. The programme lasted 8 weeks with one group-based session of 120 minutes delivered each week in local community venues. Each session also included time to undertake physical activity (PA). Eating and PA behaviours were self-reported. Weight, height, waist circumference and blood pressure were measured using standard protocols.

RESULTS

Participants were more likely to consume ≥2 servings of fruit/day, five servings of vegetable/day, low-fat milk, processed meat, fast food, hot chips/fries, salty snacks, sweet snacks, sweet beverages less than once per week and meet the PA recommendation of ≥150 minutes/wk (P < .001) at week 8. Weight, BMI, waist circumference, waist-to-height ratio and blood pressure were also improved at week 8. Many of the changes were sustained at week 14.

CONCLUSIONS

The LWM-LMP was effective in improving participants' lifestyle behaviours and cardiometabolic indicators.

SO WHAT

Engaging targeted communities in designing interventions focussed on healthy personal behaviours helps with delivery and implementation. Behavioural interventions should be culturally tailored to increase their effectiveness.

Acculturation of immigrant diet, basic taste responses and sodium appetite

In young new Ethiopian immigrants (EI, about 0·5 years since immigration; n 20), veteran Ethiopian immigrant students (ES, about 13 years since immigration; n 30) and native Israeli students (NS; n 82), dietary macronutrients and electrolytes, and responses to basic tastes were compared in a cross-sectional design. From EI, to ES, to NS, dietary energy, protein, fat, and Na⁺ increase, whereas carbohydrates, K⁺ and Ca²⁺ do not differ. Corrected for energy intake, only Na⁺ increases. EI consume less dietary Na⁺, like foods with less Na⁺ content, salt their food less, yet show a greater hedonic response to salt taste. In contrast, preference for sweet does not differ. Taste psychophysics, 6-n-propylthiouracil (PROP) responses and lingual fungiform papillae density differ by group (and sex), but do not relate to dietary intake. Together, these changes could reflect dietary acculturation, increasing overall intake, Na⁺ in particular, accompanied by decreasing taste sensitivity, and changes in sensory perception and preference in these Ethiopian immigrants. The fact that immigrants find salt more hedonic, yet eat less of it, could suggest increased sensitivity to its taste, and might suggest restoring sensitivity to reduce Na⁺ intake for all. Similar alterations in taste sensory responses might be obtained in other forms of dietary flux. Understanding dietary acculturation can focus efforts (e.g. on Na⁺), to anticipate the disease burden of diets of affluence among immigrants. Yet, these immigrants’ nutrition is healthier in its low fat and Na⁺, suggesting that nutritional advice should focus on preservation, as well as prevention. Our study adds Ethiopian nutritional acculturation to that of the varied immigrant groups around the world.