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Tan JY, Guan A, Albers AE, Canchola AJ, Allen L, Shariff-Marco S, Gomez SL. Acculturating to multiculturalism: a new dimension of dietary acculturation among Asian American, Native Hawaiian, and Pacific Islander women in the San Francisco Bay Area, USA. BMC Public Health 2024; 24:2128. [PMID: 39107722 PMCID: PMC11302078 DOI: 10.1186/s12889-024-19435-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 07/10/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Dietary acculturation is the process by which diet and dietary practises from the environment of origin are retained or changed and/or those prevalent in a new environment are adopted. Despite rapid population growth the U.S., knowledge gaps exist on characterising dietary acculturation among Asian American, Native Hawaiian, and Pacific Islander communities (AANHPI). This study characterise dietary patterns in a sample representative of AANHPI on key demographic characteristics. METHODS Data were from a 2013-2014 population-based case-control study in the San Francisco Bay Area, U.S. Survey items were adapted from dietary acculturation scales developed for AANHPI populations. Validated measures assessed social capital, social standing, discrimination and immigration experiences. A principal components factor analysis was conducted to characterise dietary patterns of acculturation. RESULTS Three dietary patterns were identified: "Asian," "Western," and a distinct "Multicultural" factor. Respondents reporting a high-Asian diet tended to also report smaller social networks, higher levels of stress, and, among those born outside of the U.S., an educational standing that was better before immigration. Respondents reporting a high-Western diet tended to also report the highest level of discrimination. Those reporting a high-Multicultural diet tended to report higher neighbourhood collective efficacy. CONCLUSIONS The finding of a distinct "Multicultural" factor beyond the typical "Asian" and "Western" factors may reflect the multidirectional relationships between culture, diet, and dietary behavior, in which origin and destination cultures interact in complex ways and where foods from multiple ethnicities intermix.
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Affiliation(s)
- Judy Y Tan
- Cancer Research Center on Health Equity, Division of Population Sciences, Cedars-Sinai Medical Center, 6500 Wilshire Blvd., Los Angeles, CA, 90048, USA.
| | - Alice Guan
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, 94114, USA
| | | | - Alison J Canchola
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, 94114, USA
| | - Laura Allen
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, 94114, USA
| | - Salma Shariff-Marco
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, 94114, USA
| | - Scarlett Lin Gomez
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, 94114, USA
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Rivera FB, Cha SW, Ansay MFM, Taliño MKV, Flores GP, Nguyen RT, Bonuel N, Happy Araneta MR, Volgman AS, Shah N, Vahidy F, Cainzos-Achirica M. Cardiovascular disease in Filipino American men and women: A 2023 update. Am Heart J 2023; 266:1-13. [PMID: 37544493 DOI: 10.1016/j.ahj.2023.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 07/15/2023] [Accepted: 07/27/2023] [Indexed: 08/08/2023]
Abstract
With more than 4.2 million people, Filipino Americans are the third largest Asian group in the US and the largest Southeast Asian group in the country. Despite relatively favorable average socioeconomic indicators compared to the general US population, Filipino Americans face a significant burden of traditional cardiovascular risk factors, particularly among men. Moreover, Filipino Americans have high rates of cardiovascular death, often occurring at a younger age compared to other minority groups and Non-Hispanic White adults. In view of these trends, in 2010 the American Heart Association designated Filipino Americans as a high cardiovascular risk group. Despite this, in 2023, Filipino Americans remain underrepresented in landmark cardiovascular cohort studies and are often over looked as a group at increased cardiovascular risk. In this updated narrative review, we summarize the current state of knowledge about the burden of cardiovascular risk factors and diseases experienced by the Filipino American population. Our aim is to inform enhanced clinical, population, and policy-level prevention interventions and boost research in this space.
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Affiliation(s)
| | | | | | | | | | - Ryan T Nguyen
- Department of Medicine, Houston Methodist, Houston, TX
| | | | | | | | - Nilay Shah
- Blum Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Farhaan Vahidy
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX
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Ali A, Alfajjam S, Gasana J. Diabetes Mellitus and Its Risk Factors among Migrant Workers in Kuwait. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073943. [PMID: 35409622 PMCID: PMC8997920 DOI: 10.3390/ijerph19073943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 03/01/2022] [Accepted: 03/16/2022] [Indexed: 12/14/2022]
Abstract
The prevalence of diabetes mellitus (DM) is growing enormously worldwide, and actions need to be taken in order to minimize the burden of diabetes mellitus and reduce its complications. Since two-thirds of Kuwait's population are expatriates, the prevalence of and factors associated with diabetes among migrant workers was assessed as it has a significant impact on migrant workers' quality of life, health, and productivity. The data used in this study was for all migrant workers who attended Shuaiba Industrial Medical Center (SIMC) for physical examination in the year 2018. Univariate and multivariate regression were used to assess the relationship between diabetes mellitus and the other independent factors where odds ratios with confidence intervals were delineated. Information for a total of 3477 participants was recorded in the dataset for 2018. Of the total participants, 10.1% had diabetes mellitus. About 49% of the participants were overweight. The largest age group of participants was between 31 and 40 years of age. A small percentage of the participants were diagnosed with hypertension at 11.8%. Additionally, 76.1% of the participants reported themselves as non-smokers. Diabetes was positively associated with age, hypertension, and nationalities. However, no association was found between BMI and smoking tobacco. This is the first study in SIMC to assess DM and its associated risk factor among migrants, since migrant workers are neglected subpopulations that need our focus and attention to achieve justice and fairness. The findings revealed that the prevalence of DM among our study population was considerably lower. However, a healthy lifestyle, including a healthy diet and being physically active, need to be introduced to prevent any further damage.
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Affiliation(s)
- Anwar Ali
- Public Health Department, Ministry of Health, P.O. Box 5, Kuwait City 12009, Kuwait;
| | - Shaikhah Alfajjam
- Occupational Health Department, Ministry of Health, P.O. Box 5, Kuwait City 12009, Kuwait;
| | - Janvier Gasana
- Department of Environmental and Occupational Health, Faculty of Public Health, Kuwait University, P.O. Box 24923, Kuwait City 13110, Kuwait
- Correspondence:
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Raquinio PASH, Maskarinec G, Dela Cruz R, Setiawan VW, Kristal BS, Wilkens LR, Le Marchand L. Type 2 Diabetes Among Filipino American Adults in the Multiethnic Cohort. Prev Chronic Dis 2021; 18:E98. [PMID: 34818147 PMCID: PMC8673944 DOI: 10.5888/pcd18.210240] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Several Asian racial and ethnic groups, including individuals of Filipino ancestry, are at higher risk of developing type 2 diabetes than White individuals, despite their lower body mass index (BMI). This study examined determinants of type 2 diabetes among Filipino American adults in the Multiethnic Cohort Study. METHODS Participants in Hawaii and Los Angeles completed questionnaires on demographics, diet, and anthropometrics. Generational status was determined according to birthplace of participants and their parents. Based on self-reported data and data on medications, type 2 diabetes status was classified as no, prevalent, or incident. We used polytomous logistic regression, while adjusting for confounders, to obtain odds ratios. RESULTS Among 10,681 Multiethnic Cohort Study participants reporting any Filipino ancestry, 57% were 1st-, 17% were 2nd-, and 25% were 3rd-generation Filipino Americans. Overall, 13% and 17% of participants had a prevalent or incident type 2 diabetes diagnosis. Overweight and obesity and the presence of other risk factors increased from the 1st to subsequent generations. First-generation immigrants were less likely to report type 2 diabetes at cohort entry than immigrants of subsequent generations who were born in the US or whose parents were born in the US; only the prevalence of type 2 diabetes was significantly elevated in the 2nd generation compared with the 1st generation. CONCLUSION The results support the hypothesis that Filipino migrants adopt lifestyle factors of the host country and subsequent generations experience higher type 2 diabetes rates due to changes in risk factor patterns.
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Affiliation(s)
| | - Gertraud Maskarinec
- University of Hawaii Cancer Center, Honolulu, Hawaii
- University of Hawaii Cancer Center, 701 Ilalo St, Honolulu, HI 96813.
| | | | | | - Bruce S Kristal
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
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Patalen CF, Ikeda N, Angeles-Agdeppa I, Vargas MB, Nishi N, Duante CA, Capanzana MV. Data Resource Profile: The Philippine National Nutrition Survey (NNS). Int J Epidemiol 2021; 49:742-743f. [PMID: 32526014 DOI: 10.1093/ije/dyaa045] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 03/03/2020] [Indexed: 11/12/2022] Open
Affiliation(s)
- Chona F Patalen
- Nutritional Assessment and Monitoring Division, Department of Science and Technology, Food and Nutrition Research Institute, Taguig City, Philippines
| | - Nayu Ikeda
- International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Imelda Angeles-Agdeppa
- Nutritional Assessment and Monitoring Division, Department of Science and Technology, Food and Nutrition Research Institute, Taguig City, Philippines
| | - Marina B Vargas
- Nutritional Assessment and Monitoring Division, Department of Science and Technology, Food and Nutrition Research Institute, Taguig City, Philippines
| | - Nobuo Nishi
- International Center for Nutrition and Information, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Charmaine A Duante
- Nutritional Assessment and Monitoring Division, Department of Science and Technology, Food and Nutrition Research Institute, Taguig City, Philippines
| | - Mario V Capanzana
- Office of the Director, Department of Science and Technology-Food and Nutrition Research Institute, Taguig City, Philippines
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Comparison of dietary intakes and anthropometric measurements among Native Filipino Nurses and Immigrant Filipino Nurses in the UK – a potential role for acculturation? Proc Nutr Soc 2019. [DOI: 10.1017/s0029665119000375] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Engaging the ASEAN Diaspora: Type 2 Diabetes Prevalence, Pathophysiology, and Unique Risk Factors among Filipino Migrants in the United States. J ASEAN Fed Endocr Soc 2019; 34:126-133. [PMID: 33442147 PMCID: PMC7784106 DOI: 10.15605/jafes.034.02.02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 10/30/2019] [Indexed: 12/16/2022] Open
Abstract
Type 2 diabetes prevalence is rising rapidly in Southeast Asia (SEA) where urbanization and adoption of ‘western’ behavioral lifestyles are attributed as predominant risk factors. The Southeast Asian diaspora to the United States has resulted in a sizable portion of migrant and US born SEAs, with approximately 4 million Filipino Americans, 2 million Vietnamese-Americans, Cambodians (330,000), and Thai (300,000) as the most populous. Their longer exposure to a western lifestyle and participation in clinical studies with other racial/ethnic groups, provide opportunities to evaluate etiologic factors which might inform trends and intervention opportunities among residents of Southeast Asia. Epidemiologic studies in the US have identified higher T2D prevalence among Filipinos (16.1%) compared to groups perceived to be at highest risk for T2D, namely Latinos (14.0%), Black (13.7%), and Native Americans (13.4%), while SEAs (including Burmese, Cambodian, Indonesian, Laotian, Malaysian, and Thai, 10.5%) and Vietnamese (9.9%) had higher T2D risk compared to Whites (7.7%), despite their absence of general obesity. Asian-Americans, including SEAs, East and South Asians, collectively have higher rates of undiagnosed T2D compared to other racial/ethnic groups in the US. Almost half (44%) of Filipinos with newly diagnosed T2D have isolated post-challenge hyperglycemia and will remain undiagnosed if current screening practices remain limited to measures of glycosylated hemoglobin and fasting plasma glucose. The University of California San Diego Filipino Health Study found excess visceral adipose tissue accumulation, low ratio of muscle to total abdominal mass area, low adiponectin concentration, multiparity (≥ 6 live births), and sleep insufficiency (<7 hours) to be unique T2D risk factors among Filipino-American women, even after adjusting for established T2D risk factors including hypertension and parental history of T2D. Social determinants such as low educational attainment (less than college completion), and sustained social disadvantage during childhood and adulthood were independently associated with T2D risk. Gestational diabetes is a known risk factor for future T2DM among women; Northern California data shows that following Asian Indians, gestational diabetes was highest among Filipina and SEA parturients, who had twice the GDM prevalence as Black, Hispanic, and White women. Identification of novel T2D risk factors among SEAs may guide early diagnosis, inform pathophysiology, and identify unique opportunities for T2D prevention and management.
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Shah SM, Ali R, Loney T, Aziz F, ElBarazi I, Al Dhaheri S, Farooqi MH, Blair I. Prevalence of Diabetes among Migrant Women and Duration of Residence in the United Arab Emirates: A Cross Sectional Study. PLoS One 2017; 12:e0169949. [PMID: 28099445 PMCID: PMC5242528 DOI: 10.1371/journal.pone.0169949] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 12/24/2016] [Indexed: 01/03/2023] Open
Abstract
Background The prevalence rate of type 2 diabetes mellitus (T2DM) is one of the highest in United Arab Emirates (UAE), however data for the expatriate population is limited. This study aimed to identify the prevalence of T2DM amongst migrant women and test the hypothesis that acculturation (measured by years of residency) is associated with an increased risk of T2DM. Methods This was a cross-sectional study and we recruited a representative sample (n = 599, 75% participation rate) of migrant women aged 18 years and over in Al Ain, UAE. The American Diabetes Association criteria were used to diagnose T2DM. An adapted WHO STEPS questionnaire was used to collect socio-demographic, lifestyle and clinical data. Logistic regression analysis was performed to identify correlates of T2DM including length of UAE residence. Results The mean age of participants was 34.1 (± 9.5) years. Of the study participants, based on HbA1C levels, 18.6% (95% CI: 13.9–24.4) had prediabetes and 10.7% (95% CI: 7.2–15.6) had T2DM. Prevalence of prediabetes was 8.5% for Filipinos, 16.7% for Arabs and 30.3% for South Asians. Similarly the prevalence of T2DM was 1.7% for Filipinos, 12.2% for Arabs and 16.7% for South Asians. Significant correlates of overall T2DM (measured and known diabetes) included length of UAE residence for more than 10 years (Adjusted Odds Ratio [AOR] 2.74, 95% CI: 1.21–6.20), age ≥40 years (AOR = 3.48, 95% CI: 1.53–7.87) and South Asian nationality (AOR 2.10, 95% CI: 0.94–4.70). Conclusion Diabetes is a significant public health problem among migrant women in the UAE, particularly for South Asians. Longer length of residence in the UAE is associated with a higher prevalence of diabetes.
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Affiliation(s)
- Syed M. Shah
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Raghib Ali
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Tom Loney
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Faisal Aziz
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Iffat ElBarazi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | | | - M. Hamed Farooqi
- Dubai Diabetes Center, Dubai Health Authority, Dubai, United Arab Emirates
| | - Iain Blair
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- * E-mail:
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Abris GP, Hong S, Provido SMP, Lee JE, Lee CB. Filipino women's diet and health study (FiLWHEL): design and methods. Nutr Res Pract 2016; 11:70-75. [PMID: 28194268 PMCID: PMC5300950 DOI: 10.4162/nrp.2017.11.1.70] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 10/13/2016] [Accepted: 10/18/2016] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Immigration to South Korea from neighboring Asian countries has risen dramatically, primarily due to marriage between Korean men and foreign women. Although Filipino women rank fourth among married immigrant women, little is known about the health condition of this population. This manuscript focuses on the design and methods of Filipino women's diet and health study (FiLWHEL). SUBJECTS/METHODS FiLWHEL is a cohort of Filipino women married to Korean men, aged 19 years old or over. The data collection comprised three parts: questionnaire, physical examination, and biospecimen collection. Questionnaires focused on demographic factors, diet, other health-related behaviors, acculturation and immigration-related factors, medical history, quality of life, and children's health information. Participants visited the recruitment site and answered the structured questionnaires through a face-to-face interview. We also measured their anthropometric features and collected fasting blood samples, toenails, and DNA samples. Recruitment started in 2014. RESULTS/CONCLUSIONS Collection of data is ongoing, and we plan to prospectively follow our cohort participants. We expect that our study, which is focused on married Filipino women immigrants, can elucidate nutritional/health status and the effects of transitional experiences from several lifestyle factors.
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Affiliation(s)
- Grace P Abris
- Department of Food and Nutrition, Sookmyung Women's University, Seoul 04310, Korea
| | - Sangmo Hong
- Division of Endocrinology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Gyeonggi 18450, Korea
| | | | - Jung Eun Lee
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Korea
| | - Chang Beom Lee
- Department of Endocrinology and Metabolism, Hanyang University School of Medicine, 153, Gyeongchun-ro, Guri City, Gyeonggi 11923, Korea
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Dietary Acculturation among Filipino Americans. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 13:ijerph13010016. [PMID: 26703646 PMCID: PMC4730407 DOI: 10.3390/ijerph13010016] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 10/06/2015] [Accepted: 10/12/2015] [Indexed: 01/20/2023]
Abstract
Acculturation, the subsequent changes that occur in one culture after continuous first hand contact with another culture, impacts the dietary habits and health risks of individuals. This study examines the acculturation, dietary habits and anthropometric measurements in a sample of 210 first generation Filipino American immigrants in New Jersey (NJ). Acculturation was measured using the Short Acculturation Scale for Filipino Americans (ASASFA). Dietary acculturation was measured using the Dietary Acculturation Questionnaire for Filipino Americans (DAQFA) and dietary intake was determined using the Block's Brief Food Frequency Questionnaire (BFFQ). Anthropometric measurements were obtained including weight, height and waist circumference. Acculturation had a significant negative relationship with Filipino Dietary acculturation. Western dietary acculturation was significantly correlated with caloric intake (r(208) = 0.193, p < 0.01), percentage fat intake (r(208) = 0.154, p < 0.05), percentage carbohydrate intake (r(208) = -0.172, p < 0.05), Body Mass Index (BMI) (r(208) = 0.216, p < 0.01) and waist circumference (r(208) = 0.161, p < 0.01). There was no significant correlation between Filipino dietary acculturation, dietary intake and anthropometric measurements. The results showed that Filipino American immigrants have increased risks including increased BMI, waist circumference and increased fat intake. Over all, this research highlighted some dietary changes and their effects on dietary intake and health status.
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Angosta AD, Speck KE. Assessment of heart disease knowledge and risk factors among first-generation Filipino Americans residing in Southern Nevada: A cross-sectional survey. CLINICAL NURSING STUDIES 2014; 2:123-132. [PMID: 35602552 PMCID: PMC9121820 DOI: 10.5430/cns.v2n2p123] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective Filipino Americans are the second largest Asian subgroup in the United States and heart disease is their leading cause of death. Despite this, they remain an invisible minority and experience health disparities in cardiovascular health. Prior to implementing and designing health promotion programs, it is important to assess their level of knowledge about heart disease and to identify their risk factors. Purpose We examined the baseline knowledge of heart disease among first-generation Filipino Americans and the risk factors prevalent among them. Method A convenience sample of 300 Filipino Americans aged 35-75 years completed the Heart Disease Fact Questionnaire to assess their knowledge of heart disease and a researcher-developed questionnaire to assess the heart disease risk factors. Data were collected in Southern Nevada in the fall of 2011. Descriptive statistics, correlations, and multiple regression were used for data analysis. Result The sample had an average knowledge score of 82.81% out of a maximum correct score of 100%. The risk factors prevalent among them included: hypertension (47.7%), diabetes (14%), dyslipidemia (27.7%), overweight (36.7%), abdominal obesity (80.6%), smoking (11.7%), and lack of exercise (48%). Conclusion Heart disease is the leading cause of death among Filipino Americans. In this study, Filipino Americans had adequate knowledge of heart disease but many reported having risk factors. Understanding the behavioral determinants of heart disease knowledge and specific risk factors is helpful in designing effective health prevention strategies. Early screening targeting the younger generation is also important to help detect the risk factors in their earliest stages. The screening results may also induce individuals to take action.
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Affiliation(s)
- Alona D Angosta
- University of Nevada, Las Vegas School of Nursing, Las Vegas, Nevada, United States
| | - Kirsten E Speck
- University of Nevada, Las Vegas School of Nursing, Las Vegas, Nevada, United States
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Abstract
Filipino Americans are at risk of coronary heart disease due to the presence of multiple cardiometabolic factors. Selecting a framework that addresses the factors leading to coronary heart disease is vital when providing care for this population. The Neuman systems model is a comprehensive and wholistic framework that offers an innovative method of viewing clients, their families, and the healthcare system across multiple dimensions. Using the Neuman systems model, advanced practice nurses can develop and implement interventions that will help reduce the potential cardiovascular problems of clients with multiple risk factors. The authors in this article provides insight into the cardiovascular health of Filipino Americans and has implications for nurses and other healthcare providers working with various Southeast Asian groups in the United States.
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Dalusung-Angosta A, Gutierrez A. Prevalence of metabolic syndrome among Filipino-Americans: a cross-sectional study. Appl Nurs Res 2013; 26:192-7. [PMID: 23906437 PMCID: PMC4036682 DOI: 10.1016/j.apnr.2013.06.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Revised: 04/12/2013] [Accepted: 06/20/2013] [Indexed: 11/30/2022]
Abstract
AIM The aims of this study are a) to examine the prevalence of metabolic syndrome among Filipino-Americans, b) to compare the rate of metabolic syndrome between Filipino men and women, and c) to examine the prevalence of central adiposity. BACKGROUND Filipino-Americans are the second largest Asian subgroup in the United States and their leading cause of death is coronary heart disease (CHD). METHODS This study utilized a descriptive correlational, cross-sectional design that included a convenience sample of 300 Filipino-Americans residing in Southern Nevada. Survey questionnaires were used to collect the sample's demographic data and presence of CHD risk factors. Waist circumference measurements were used to examine central adiposity. RESULTS Metabolic syndrome and central adiposity are highly prevalent among Filipino-Americans residing in Southern Nevada. More men than women had the syndrome, but the rate of central adiposity was significantly higher in women than in men. CONCLUSIONS Intensive lifestyle modifications and treatment are indicated to decrease the prevalence of metabolic syndrome and the risk of heart disease in this group.
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Affiliation(s)
- Alona Dalusung-Angosta
- University of Nevada, Las Vegas, 4505 Maryland Parkway, Box 453018, Las Vegas, NV 89154-3018, USA.
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Staimez LR, Weber MB, Narayan KMV, Oza-Frank R. A systematic review of overweight, obesity, and type 2 diabetes among Asian American subgroups. Curr Diabetes Rev 2013; 9:312-31. [PMID: 23590534 PMCID: PMC4465442 DOI: 10.2174/15733998113099990061] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 04/06/2013] [Accepted: 04/08/2013] [Indexed: 11/22/2022]
Abstract
This systematic review synthesizes data published between 1988 and 2009 on mean BMI and prevalence of overweight, obesity, and type 2 diabetes among Asian subgroups in the U.S. We conducted systematic searches in Pub- Med for peer-reviewed, English-language citations that reported mean BMI and percent overweight, obesity, and diabetes among South Asians/Asian Indians, Chinese, Filipinos, Koreans, and Vietnamese. We identified 647 database citations and 23 additional citations from hand-searching. After screening titles, abstracts, and full-text publications, 97 citations remained. None were published between 1988 and 1992, 28 between 1993 and 2003, and 69 between 2004 and 2009. Publications were identified for the following Asian subgroups: South Asian (n=8), Asian Indian (n=20), Chinese (n=44), Filipino (n=22), Korean (n= 8), and Vietnamese (n=3). The observed sample sizes ranged from 32 to 4245 subjects with mean ages from 24 to 78 years. Among samples of men and women, the lowest reported mean BMI was in South Asians (22.1 kg/m(2)), and the highest was in Filipinos (26.8 kg/m(2)). Estimates for overweight (12.8-46.7%) and obesity (2.1-59.0%) were variable. Among men and women, the highest rate of diabetes was reported in Asian Indians with BMI ≥ 30 kg/m(2) (32.9%, age and sex standardized). This review suggests heterogeneity among U.S. Asian populations in cardiometabolic risk factors, yet comparisons are limited due to variability in study populations, methods, and definitions used in published reports. Future efforts should adopt standardized methods to understand overweight, obesity and diabetes in this growing U.S. ethnic population.
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Affiliation(s)
- Lisa R Staimez
- Emory University, Laney Graduate School, Division of Biological and Biomedical Sciences, Nutrition and Health Sciences Program, Atlanta, GA, USA.
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Disentangling the effects of migration, selection and acculturation on weight and body fat distribution: results from a natural experiment involving Vietnamese Americans, returnees, and never-leavers. J Immigr Minor Health 2013; 14:786-96. [PMID: 22427069 DOI: 10.1007/s10903-012-9595-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
We distinguish between selection and true migration effects on weight and body fat for Vietnamese immigrants; and examine the role of acculturation on these outcomes. Data (n = 703) were collected among three population-based samples of working-age Vietnamese immigrants, repatriated emigrants and never-migrated Vietnamese nationals. This allows for a decomposition exercise to separate the effects of migration effects from selection effects on body mass index (BMI) and waist-hip ratio (WHR). Immigrants are more likely to be overweight and to have high WHR, relative to both never-leavers and returnees, a pattern reflecting the importance of migration over selection. Among immigrants, coming to the US at a younger age is associated with higher BMI and WHR levels. And longer length of residence in the US is related to higher BMI. While higher Vietnamese language proficiency is related to a lower BMI level, being bilingual (proficient in both English and Vietnamese) is associated with lower risks for being overweight. The distinct pattern of results suggests that more problematic weight status and fat distribution among Vietnamese immigrants relative to Vietnamese nationals are not artifacts of the types of persons choosing to emigrate, but rather are due to acculturation to American diet and lifestyles. While efforts to promote and maintain traditional patterns of diet and lifestyle are likely to help Vietnamese and other immigrants avoid the perils of American patterns, facilitating a bi-cultural orientation is perhaps the most realistic approach for preserving protective features of the culture of origin with regard to body weight and fat distribution.
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Weber MB, Oza-Frank R, Staimez LR, Ali MK, Narayan KMV. Type 2 diabetes in Asians: prevalence, risk factors, and effectiveness of behavioral intervention at individual and population levels. Annu Rev Nutr 2012; 32:417-39. [PMID: 22524185 DOI: 10.1146/annurev-nutr-071811-150630] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
This review summarizes the current data on diabetes risk factors, prevalence, and prevention efforts in Asia and Asian migrant populations. Studies indicate that type 2 diabetes mellitus is a large and growing threat to public health in Asian populations. Furthermore, Asian subgroups (e.g., South Asians/Asian Indians, Chinese) have unique risk factor profiles for developing diabetes, which differ from other populations and between Asian ethnic groups. Lifestyle intervention programs are effective in preventing diabetes in Asians, as with other ethnicities. The strength of these findings is lessened by the lack of systematically collected data using objective measurements. Large epidemiologic studies of diabetes prevalence and risk factor profiles and translational trials identifying sustainable and culturally acceptable lifestyle programs for Asian subgroups are needed.
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Affiliation(s)
- Mary Beth Weber
- Nutrition and Health Sciences Department, Division of Biological and Biomedical Sciences, Emory University, Atlanta, Georgia 30322, USA.
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Brooks MV, Leake A, Parsons C, Pham V. A review of the literature: evaluating dietary intake of Filipino Americans at risk for type 2 diabetes. Nurs Forum 2012; 47:27-33. [PMID: 22309379 DOI: 10.1111/j.1744-6198.2011.00226.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The purpose of this literature review is to investigate the research on the dietary intake of Filipino Americans. Evaluating the dietary practices of Filipino Americans may have an effect on the development of type 2 diabetes. Data collection was obtained, and four databases were included: Pub Medical, Cumulative Index of Nursing and Allied Health Literature, Journals at OVID, and Medline. The key words used in the search were "diet,""type 2 diabetes," and "Filipinos." A total of nine articles were relevant and met the inclusion criteria. The following articles were excluded: studies in a foreign language, letters to the editor, and program descriptions.
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Jordan DN, Jordan JL. Foot self-care practices among Filipino American women with type 2 diabetes mellitus. Diabetes Ther 2011; 2:1-8. [PMID: 22127764 PMCID: PMC3124639 DOI: 10.1007/s13300-010-0016-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2010] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION To determine the foot self-care practices performed by Filipino American (FA) women with type 2 diabetes mellitus (DM). METHOD The Summary of Diabetes Self Care Activities - Revised and Expanded measure was administered to 118 FA adult female immigrants with type 2 DM. RESULTS Younger FA women (<65 years), participants with higher education, those who immigrated to the United States (US) at younger ages, and participants diagnosed with type 2 DM at younger ages reported they washed their feet every day during the past week. Moreover, FA women who immigrated to the US at younger ages and participants who were diagnosed with the disease at younger ages reported that they dried their feet (in between toes) daily during the previous week. Further, FA women who were diagnosed with type 2 DM at younger ages were more likely to report that they checked their feet every day during the past week, when compared with participants who were diagnosed with the disease at older ages. Finally, most FA women did not inspect the inside of their shoes. CONCLUSION Foot self-care practices were less frequently performed by older FA women with type 2 DM (≥65 years), making them more prone to the development of foot problems such as ulcers, infections, and disfigurations. Optimum foot self-care practices must be encouraged in older FA women to prevent such foot problems, and subsequent amputations.
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Affiliation(s)
- Deovina Nasis Jordan
- Department of Nursing, 5 West, Ronald Reagan UCLA Medical Center 5354, 757 Westwood Plaza, Los Angeles, CA 90095-7404 USA
| | - James Lowell Jordan
- Department of Nursing, 5 West, Ronald Reagan UCLA Medical Center 5354, 757 Westwood Plaza, Los Angeles, CA 90095-7404 USA
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Jordan DN, Jordan JL. Self-care behaviors of Filipino-American adults with type 2 diabetes mellitus. J Diabetes Complications 2010; 24:250-8. [PMID: 19615920 DOI: 10.1016/j.jdiacomp.2009.03.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2009] [Accepted: 03/28/2009] [Indexed: 11/28/2022]
Abstract
AIM To examine the diabetes self-care behaviors of Filipino-American (FA) adults with type 2 diabetes mellitus (DM). METHOD The Summary of Diabetes Self Care Activities-Revised and Expanded measure was administered to 192 (74 males and 118 females) FA adult immigrants with type 2 DM. RESULTS Older FAs (> or =65 years), females, those who were older when they immigrated, and participants diagnosed with type 2 DM longer were more likely to follow recommended medication regimens. Younger FAs (<65 years) and participants diagnosed with type 2 DM for shorter duration of time were less likely to perform blood glucose testing. Most FAs reported following their eating plans; however, those who lived in the United States (US) longer followed healthful eating plans. Likewise, females reported eating five or more servings of fruits and/or vegetables daily. Moreover, older FAs reported evenly spacing carbohydrate intake everyday. Furthermore, older participants, those with less education, participants who were older when they immigrated, and those older when diagnosed with type 2 DM ate fewer foods high in fats. As to physical activity, FA males and participants with higher education exercised more frequently. CONCLUSION Younger FAs were less likely to perform optimum type 2 DM self-care behaviors pertaining to diet, medication taking, and blood glucose testing compared to their older counterparts. This finding suggests an increased risk for type 2 DM comorbidities and/or complications in younger FAs, which may require more intensive treatments in later years.
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Affiliation(s)
- Deovina N Jordan
- Department of Nursing, Ronald Reagan UCLA Medical Center, Los Angeles, CA 90095-7404, USA.
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Elevated risk factors for adverse pregnancy outcomes among Filipina-Canadian women. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2010; 32:113-119. [PMID: 20181311 DOI: 10.1016/s1701-2163(16)34424-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Filipina immigrant women have higher than expected rates of preeclampsia and perinatal morbidity. Since obesity, diabetes mellitus (DM), and chronic hypertension are established risk factors for adverse pregnancy outcomes, we sought to determine whether they are more prevalent among Filipina women than other East Asian and Caucasian women. METHODS We pooled data from the 2000-01, 2003, 2005, and 2007 cycles of the nationally administered Canadian Community Health Survey. We generated data representative of 115,842 Filipina, 394,357 other East Asian, and 5,812 851 Caucasian women aged 18 to 49 years and living in Canada. Crude and adjusted odds ratios and 95% confidence intervals expressed the association between ethnicity and the risk of overweight (BMI >or= 25.0 kg/m(2)), obesity (BMI >or= 30.0 kg/m(2)), DM, and chronic hypertension. RESULTS The respective rates of obesity were approximately 5% for Filipinas, 2% for other East Asian women, and 14% for Caucasian women. The adjusted OR of obesity was 0.28 (95% CI 0.16 to 0.47) among Filipina women and 0.14 (95% CI 0.10 to 0.20) among other East Asians. The risk of DM was not significantly lower in Filipina women or other East Asian women than in Caucasians. Relative to a rate of 4.8% among Caucasians, chronic hypertension was significantly more prevalent among Filipinas (7.1%; adjusted OR 2.14, 95% CI 1.51 to 3.03), but not other East Asians (3.9%; adjusted OR 1.27, 95% CI 0.96 to 1.70). Post-hoc analyses showed that Filipina women were more likely to be hypertensive (adjusted OR 1.79, 95% CI 1.12 to 2.85) than other East Asian women; for obesity the adjusted OR was 1.88 (95% CI 0.97 to 3.66), and for DM it was 1.62 (95% CI 0.65 to 4.02). CONCLUSION Filipina women have higher than expected rates of excess weight and chronic hypertension, underlining the need to consider Filipina and other East Asian women separately.
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Gentilucci UV, Picardi A, Manfrini S, Khazrai YM, Fioriti E, Altomare M, Guglielmi C, Di Stasio E, Pozzilli P. Westernization of the Filipino population resident in Rome: obesity, diabetes and hypertension. Diabetes Metab Res Rev 2008; 24:364-70. [PMID: 18273866 DOI: 10.1002/dmrr.807] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Aims of the present study were to examine the anthropometrical and metabolic characteristics of the Filipino population migrant to the Southern European city of Rome, Italy. METHODS A cross-sectional study was carried out in the city of Rome. Three hundred thirty-five Filipinos (95 M/240 F, mean age: 44.0+/-9.8 years, mean residence in Italy: 12.9+/-6.3 years) were studied. Data were collected by standardized questionnaires; anthropometrical parameters, arterial pressure, and fasting capillary blood glucose (FCG) were measured. RESULTS Abdominal obesity was found in 52.5%, and BMI >or= 25 kg/m(2) in 44.5% of subjects. History of type 2 diabetes mellitus (T2DM) and hypertension were reported by 6.0 and 9.0% of subjects, respectively. Impaired fasting glucose was found in 13.1%, and FCG >or= 110 mg/dl in 18.5% of subjects. Altered systolic and/or diastolic blood pressure was found in 34.3% of subjects. About three-fourths of subjects were unaware of being diabetic and/or hypertensive. Years of Italy residence showed a direct significant correlation with the degree of changes in alimentary behaviours (rho=0.18, p=0.001), and with weight gain (rho=0.27, p<0.001). Multivariate analysis showed only age and waist circumference to be associated with both diabetes and hypertension. CONCLUSIONS In the present study, the first to examine the metabolic disorders in a migrant Filipino population resident in Rome, a high prevalence of obesity, diabetes, and hypertension was found. The alarming results emerging from this study should be seriously considered by public health practitioners and decision makers, and made known to the Filipinos resident in Europe.
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Argeseanu Cunningham S, Ruben JD, Narayan KMV. Health of foreign-born people in the United States: a review. Health Place 2008; 14:623-35. [PMID: 18242116 DOI: 10.1016/j.healthplace.2007.12.002] [Citation(s) in RCA: 256] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2007] [Revised: 12/06/2007] [Accepted: 12/09/2007] [Indexed: 12/12/2022]
Abstract
This paper identifies the overarching patterns of immigrant health in the US. Most studies indicate that foreign-born individuals are in better health than native-born Americans, including individuals of the same race/ethnicity. They tend to have lower mortality rates and are less likely to suffer from circulatory diseases, overweight/obesity, and some cancers. However, many foreign-born groups have higher rates of diabetes, some infections, and occupational injuries. There is heterogeneity in health among immigrants, whose health increasingly resembles that of natives with duration of US residence. Prospective studies are needed to better understand migrant health and inform interventions for migrant health maintenance.
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Bibliography. Current world literature. Diabetes and the endocrine pancreas. Curr Opin Endocrinol Diabetes Obes 2007; 14:170-96. [PMID: 17940437 DOI: 10.1097/med.0b013e3280d5f7e9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Langenberg C, Araneta MRG, Bergstrom J, Marmot M, Barrett-Connor E. Diabetes and coronary heart disease in Filipino-American women: role of growth and life-course socioeconomic factors. Diabetes Care 2007; 30:535-41. [PMID: 17327317 PMCID: PMC2542981 DOI: 10.2337/dc06-1403] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To investigate associations between adult markers of childhood growth and the prevalence of diabetes and coronary heart disease (CHD) in Filipino-American women and to determine the role of social and educational differences, including the influence of social mobility between childhood and adulthood. RESEARCH DESIGN AND METHODS Socioeconomic disadvantage and poor infant growth, resulting in short leg length, may contribute to the dramatically increased risk of diabetes and CHD in Filipino-American women, but this has not been investigated. This study is a cross-sectional study of 389 Filipino-American women (age 58.7 +/- 9.4 years [mean +/- SD]). Diabetes was defined by 1999 World Health Organization criteria and CHD by ischemic electrocardiogram changes, Rose angina, a history of myocardial infarction, or revascularization surgery. A score of social mobility (0-4) was calculated by summarizing childhood and adult financial circumstances. RESULTS Diabetes prevalence (31.4%) was not associated with measures of growth but was significantly lower in women with greater education, childhood and adult income, or social mobility score. Compared with Filipinas who were poorest in childhood and adulthood, respective odds ratios (95% CI) for diabetes were 0.55 (0.18-1.68), 0.19 (0.06-0.62), and 0.11 (0.03-0.42), down to 0.07 (0.01-0.51) in the most advantaged women (P < 0.0001). Family history of diabetes [5.14 (2.72-9.70)] and larger waist [1.07 per cm (1.03-1.10)] were also significant predictors in multiple adjusted models. In contrast, CHD prevalence (22.4%) was most strongly associated with leg length, but not trunk length; compared with individuals with the shortest legs, respective odds ratios (95% CI) for CHD were 0.60 (0.31-1.19), 0.53 (0.26-1.05), and 0.44 (0.22-0.91) in the tallest group, in age- (P(trend) = 0.02) and multiple-adjusted models (P(trend) = 0.01). CONCLUSIONS Socioeconomic disadvantage contributes to the high prevalence of diabetes in Filipinas. Factors limiting early growth of the legs may increase the risk of CHD in this comparatively short population.
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Affiliation(s)
- Claudia Langenberg
- Department of Family and Preventive Medicine, School of Medicine, University of California, San Diego, 9500 Gilman Dr., La Jolla, CA 92093-0607, USA
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