Skip to main content
Top
Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

Association between acculturation, obesity and cardiovascular risk factors among male South Asian migrants in the United Arab Emirates – a cross-sectional study

Authors: Syed M Shah, Tom Loney, Salma Al Dhaheri, Hassan Vatanparast, Iffat Elbarazi, Mukesh Agarwal, Iain Blair, Raghib Ali

Published in: BMC Public Health | Issue 1/2015

Login to get access

Abstract

Background

Approximately 65% of the United Arab Emirates (UAE) population are economic migrants from the low- and middle-income countries of South Asia. Emerging evidence suggests that expatriate populations from low or middle-income countries that migrate to high-income countries acculturate their lifestyle with the obesogenic behaviours of the host country. Previous research has focussed on migrant populations in the United States. The objective of this study was to assess the prevalence of obesity and explore the relationship between years of residency (surrogate measure for acculturation) and obesity among South Asian (from India, Pakistan and Bangladesh) male immigrants residing in the UAE.

Methods

A random sample of 1375 males was recruited from a mandatory residency visa health screening centre in Abu Dhabi (UAE). Employing a cross-sectional design, participants completed an interviewer-led adapted version of the World Health Organisation STEPS questionnaire, and anthropometric and blood pressure measurements were collected. Glycated haemoglobin (HbA1c) was measured in a random sub-sample (n = 100). Logistic regression was used to determine risk factors for being classified as obese, and to assess the relationship between years of residency and adiposity.

Results

The overall prevalence of body mass index-derived overweight and obesity estimates and waist-to-hip-derived central obesity rates was 615 (44.7%) and 917 (66.7%) males, respectively. Hypertension was present in 419 (30.5%) of the sample and diabetes in 9 (9.0%) of the sub-sample. Living in the UAE for six to 10 years or more than 10 years was independently associated with being classified with central obesity (adjusted odds ratio [AOR] 1.63 95% confidence intervals [CI] 1.13 - 2.35, p < 0.008; AOR 1.95 95% CI 1.26 - 3.01, p < 0.002; respectively) compared to residing in the UAE for one to five years.

Conclusions

Our study revealed a high prevalence of overweight, central obesity and hypertension amongst a young South Asian male migrant population in the UAE. Study findings suggest a diminished ‘Healthy Migrant Effect’ with increased years of residency possibly due to greater acculturation and a transition in lifestyle behaviours. Health initiatives targeting the maintenance of a healthy body size, coupled with regular assessments of glucose control and blood pressure are urgently required in this population.
Literature
3.
go back to reference Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of diseases: part 1: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation. 2001;104(22):2746–53.CrossRefPubMed Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of diseases: part 1: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation. 2001;104(22):2746–53.CrossRefPubMed
4.
5.
go back to reference Joshi P, Islam S, Pais P, Reddy S, Dorairaj P, Kazmi K, et al. Risk factors for early myocardial infarction in South Asian compared with individuals in other countries. JAMA. 2007;297(3):286–94.CrossRefPubMed Joshi P, Islam S, Pais P, Reddy S, Dorairaj P, Kazmi K, et al. Risk factors for early myocardial infarction in South Asian compared with individuals in other countries. JAMA. 2007;297(3):286–94.CrossRefPubMed
6.
go back to reference Hodge AM, Dowse GK, Collins VR, Alberti KG, Gareeboo H, Tuomilehto J, et al. Abdominal fat distribution and insulin levels only partially explain adverse cardiovascular risk profile in Asian Indians. J Cardiovasc Risk. 1996;3(3):263–70.CrossRefPubMed Hodge AM, Dowse GK, Collins VR, Alberti KG, Gareeboo H, Tuomilehto J, et al. Abdominal fat distribution and insulin levels only partially explain adverse cardiovascular risk profile in Asian Indians. J Cardiovasc Risk. 1996;3(3):263–70.CrossRefPubMed
7.
go back to reference McKeigue PM, Miller GJ, Marmot MG. Coronary heart disease in South Asians overseas: a review. J Clin Epidemiol. 1989;42(7):597–609.CrossRefPubMed McKeigue PM, Miller GJ, Marmot MG. Coronary heart disease in South Asians overseas: a review. J Clin Epidemiol. 1989;42(7):597–609.CrossRefPubMed
8.
go back to reference Harding S. Mortality of migrants from the Indian subcontinent to England and Wales: effect of duration of residence. Epidemiology. 2003;14(3):287–92.PubMed Harding S. Mortality of migrants from the Indian subcontinent to England and Wales: effect of duration of residence. Epidemiology. 2003;14(3):287–92.PubMed
9.
go back to reference Narayan KM, Ali MK, Koplan JP. Global noncommunicable diseases - where worlds meet. N Engl J Med. 2010;363(13):1196–8.CrossRefPubMed Narayan KM, Ali MK, Koplan JP. Global noncommunicable diseases - where worlds meet. N Engl J Med. 2010;363(13):1196–8.CrossRefPubMed
10.
go back to reference World Health Organization Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363(9403):157–63.CrossRef World Health Organization Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363(9403):157–63.CrossRef
11.
12.
go back to reference Delavari M, Sønderlund AL, Swinburn B, Mellor D, Renzaho A. Acculturation and obesity among migrant populations in high income countries-a systematic review. BMC Public Health. 2013;13:458.CrossRefPubMedPubMedCentral Delavari M, Sønderlund AL, Swinburn B, Mellor D, Renzaho A. Acculturation and obesity among migrant populations in high income countries-a systematic review. BMC Public Health. 2013;13:458.CrossRefPubMedPubMedCentral
13.
go back to reference Ng SW, Zaghloul S, Ali H, Harrison G, Yeatts K, El Sadig M, et al. Nutrition transition in the United Arab Emirates. Eur J Clin Nutr. 2011;65(12):1328–37.CrossRefPubMedPubMedCentral Ng SW, Zaghloul S, Ali H, Harrison G, Yeatts K, El Sadig M, et al. Nutrition transition in the United Arab Emirates. Eur J Clin Nutr. 2011;65(12):1328–37.CrossRefPubMedPubMedCentral
14.
go back to reference Al Junaibi AA, Abdulle A, Sabri S, Hag-Ali M, Nagelkerke N. The prevalence and potential determinants of obesity among school children and adolescents in Abu Dhabi. United Arab Emirates Int J Obes. 2013;37(1):68–74.CrossRef Al Junaibi AA, Abdulle A, Sabri S, Hag-Ali M, Nagelkerke N. The prevalence and potential determinants of obesity among school children and adolescents in Abu Dhabi. United Arab Emirates Int J Obes. 2013;37(1):68–74.CrossRef
15.
go back to reference Walpole SC, Prieto-Merino D, Edwards P, Cleland J, Stevens G, Roberts I. The weight of nations: an estimation of adult human biomass. BMC Public Health. 2012;12:439.CrossRefPubMedPubMedCentral Walpole SC, Prieto-Merino D, Edwards P, Cleland J, Stevens G, Roberts I. The weight of nations: an estimation of adult human biomass. BMC Public Health. 2012;12:439.CrossRefPubMedPubMedCentral
17.
go back to reference Abu Dhabi Health Services Company. Statistical Summary Report for Application Summary by Nationalities, Professions and Gender, From January 1 to December 31, 2012. Al Ain, Abu Dhabi: Disease Prevention and Screening Centre, Preventive Medicine Department; 2012. Abu Dhabi Health Services Company. Statistical Summary Report for Application Summary by Nationalities, Professions and Gender, From January 1 to December 31, 2012. Al Ain, Abu Dhabi: Disease Prevention and Screening Centre, Preventive Medicine Department; 2012.
18.
go back to reference Al-Maskari F, Shah SM, Al-Sharhan R, Al-Haj E, Al-Kaabi K, Khonji D, et al. Prevalence of depression and suicidal behaviours among male migrant workers in United Arab Emirates. J Immigr Minor Health. 2011;13(6):1027–32.CrossRefPubMed Al-Maskari F, Shah SM, Al-Sharhan R, Al-Haj E, Al-Kaabi K, Khonji D, et al. Prevalence of depression and suicidal behaviours among male migrant workers in United Arab Emirates. J Immigr Minor Health. 2011;13(6):1027–32.CrossRefPubMed
21.
go back to reference World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000;894:1–253. World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000;894:1–253.
23.
go back to reference 1999 World Health Organization-International Society of Hypertension Guidelines for the Management of Hypertension. Guidelines Subcommittee. J Hypertens. 1999;17(2):151–83. 1999 World Health Organization-International Society of Hypertension Guidelines for the Management of Hypertension. Guidelines Subcommittee. J Hypertens. 1999;17(2):151–83.
24.
go back to reference Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo Jr JL, et al. Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute; National High Blood Pressure Education Program Coordinating Committee: Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42(6):1206–52.CrossRefPubMed Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo Jr JL, et al. Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute; National High Blood Pressure Education Program Coordinating Committee: Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42(6):1206–52.CrossRefPubMed
25.
go back to reference Reddy KS, Prabhakaran D, Chaturvedi V, Jeemon P, Thankappan KR, Ramakrishnan L, et al. Methods for establishing a surveillance system for chronic diseases in Indian Industrial population. Bull World Health Organ. 2006;84(6):461–9.CrossRefPubMedPubMedCentral Reddy KS, Prabhakaran D, Chaturvedi V, Jeemon P, Thankappan KR, Ramakrishnan L, et al. Methods for establishing a surveillance system for chronic diseases in Indian Industrial population. Bull World Health Organ. 2006;84(6):461–9.CrossRefPubMedPubMedCentral
26.
go back to reference Hussain A, Vaaler S, Sayeed MA, Mahtab H, Ali SM, Khan AK. Type 2 diabetes and impaired fasting blood glucose in rural Bangladesh: a population-based study. Eur J Public Health. 2007;17(3):291–6.CrossRefPubMed Hussain A, Vaaler S, Sayeed MA, Mahtab H, Ali SM, Khan AK. Type 2 diabetes and impaired fasting blood glucose in rural Bangladesh: a population-based study. Eur J Public Health. 2007;17(3):291–6.CrossRefPubMed
27.
go back to reference Jafar TH, Chaturvedi, Pappas G. Prevalence of overweight and obesity and their association with hypertension, and diabetes mellitus in an Indo-Asian population. CMAJ. 2006;175(9):1071–7.CrossRefPubMedPubMedCentral Jafar TH, Chaturvedi, Pappas G. Prevalence of overweight and obesity and their association with hypertension, and diabetes mellitus in an Indo-Asian population. CMAJ. 2006;175(9):1071–7.CrossRefPubMedPubMedCentral
28.
go back to reference Hajat C, Harrison O, Al Siksek Z. Weqaya: a population-wide cardiovascular screening program in Abu Dhabi, United Arab Emirates. Am J Public Health. 2012;102(25):909–14.CrossRefPubMedPubMedCentral Hajat C, Harrison O, Al Siksek Z. Weqaya: a population-wide cardiovascular screening program in Abu Dhabi, United Arab Emirates. Am J Public Health. 2012;102(25):909–14.CrossRefPubMedPubMedCentral
29.
go back to reference Fernandez R, Miranda C, Everett B. Prevalence of obesity among migrant Asian Indians: a systematic review and meta-analysis. Int J Evid Based Healthc. 2011;9(4):420–8.CrossRefPubMed Fernandez R, Miranda C, Everett B. Prevalence of obesity among migrant Asian Indians: a systematic review and meta-analysis. Int J Evid Based Healthc. 2011;9(4):420–8.CrossRefPubMed
30.
go back to reference Kumar BN, Meyer HE, Wandel M, Dalen I, Holmboe-Ottesen G. Ethnic differences in obesity among immigrants from developing countries in Oslo. Norway Int J Obes. 2006;30(4):684–90.CrossRef Kumar BN, Meyer HE, Wandel M, Dalen I, Holmboe-Ottesen G. Ethnic differences in obesity among immigrants from developing countries in Oslo. Norway Int J Obes. 2006;30(4):684–90.CrossRef
31.
go back to reference Prasad DS, Kabir Z, Dash AK, Das BC. Abdominal obesity, an independent cardiovascular risk factor in Indian subcontinent: a clinic epidemiological evidence summary. J Cardiovasc Dis Res. 2011;2(4):199–205.CrossRefPubMedPubMedCentral Prasad DS, Kabir Z, Dash AK, Das BC. Abdominal obesity, an independent cardiovascular risk factor in Indian subcontinent: a clinic epidemiological evidence summary. J Cardiovasc Dis Res. 2011;2(4):199–205.CrossRefPubMedPubMedCentral
32.
go back to reference Holmboe-Ottesen G, Wandel M: Changes in dietary habits after migration and consequences for health: a focus on South Asians in Europe. Food Nutr Res 2012, 56. Doi:10.3402/fnr.v56i0. 18891. Holmboe-Ottesen G, Wandel M: Changes in dietary habits after migration and consequences for health: a focus on South Asians in Europe. Food Nutr Res 2012, 56. Doi:10.3402/fnr.v56i0. 18891.
33.
go back to reference Kim IH, Carrasco C, Muntaner C, McKenzie K, Noh S. Ethnicity and post migration health trajectory in new immigrants to Canada. Am J Public Health. 2013;103(4):e96–104.CrossRefPubMedPubMedCentral Kim IH, Carrasco C, Muntaner C, McKenzie K, Noh S. Ethnicity and post migration health trajectory in new immigrants to Canada. Am J Public Health. 2013;103(4):e96–104.CrossRefPubMedPubMedCentral
34.
go back to reference Uretsky MC, Mathiesen SG. The effects of years lived in the United States on the general health status of California’s foreign-born populations. J Immigr Minor Health. 2007;9(2):125–36.CrossRefPubMed Uretsky MC, Mathiesen SG. The effects of years lived in the United States on the general health status of California’s foreign-born populations. J Immigr Minor Health. 2007;9(2):125–36.CrossRefPubMed
35.
go back to reference Chiu M, Austin PC, Manuel DG, Tu JV. Cardiovascular risk factor profiles of recent immigrants vs long-term residents of Ontario: a multi-ethnic study. Can J Cardiol. 2012;28(1):20–6.CrossRefPubMed Chiu M, Austin PC, Manuel DG, Tu JV. Cardiovascular risk factor profiles of recent immigrants vs long-term residents of Ontario: a multi-ethnic study. Can J Cardiol. 2012;28(1):20–6.CrossRefPubMed
36.
go back to reference Jonnalagadda S, Diwan S. Regional variation in dietary intake and body mass index of first generation-Indian immigrants in the United States. J Am Diet Assoc. 2002;102(9):1286–9.CrossRefPubMed Jonnalagadda S, Diwan S. Regional variation in dietary intake and body mass index of first generation-Indian immigrants in the United States. J Am Diet Assoc. 2002;102(9):1286–9.CrossRefPubMed
37.
go back to reference Popkin BM. What is unique about the experience in lower- and middle-income less-industrialised countries compared with the very-high income countries? The shift in the stages of the nutrition transition differs from past experiences. Public Health Nutr. 2002;5(1A):205–14.CrossRefPubMed Popkin BM. What is unique about the experience in lower- and middle-income less-industrialised countries compared with the very-high income countries? The shift in the stages of the nutrition transition differs from past experiences. Public Health Nutr. 2002;5(1A):205–14.CrossRefPubMed
38.
go back to reference Misra A, Khurana L. Obesity-related non-communicable diseases: South Asians vs White Caucasians. Int J Obes. 2011;35(2):167–87.CrossRef Misra A, Khurana L. Obesity-related non-communicable diseases: South Asians vs White Caucasians. Int J Obes. 2011;35(2):167–87.CrossRef
39.
go back to reference Palmer B, Macfarlane G, Afzal C, Esmail A, Silman A, Lunt M. Acculturation and the prevalence of pain amongst South Asian minority ethnic groups in the UK. Rheumatology. 2007;46(6):1009–14.CrossRefPubMed Palmer B, Macfarlane G, Afzal C, Esmail A, Silman A, Lunt M. Acculturation and the prevalence of pain amongst South Asian minority ethnic groups in the UK. Rheumatology. 2007;46(6):1009–14.CrossRefPubMed
40.
go back to reference Kanaya A, Ewing S, Vittinghoff E, Herrington D, Tegeler C, Mills C, et al. Acculturation and Subclinical Atherosclerosis among U.S. South Asians: findings from the MASALA study. J Clin Exp Res Cardiol. 2014;1(1):102.PubMedPubMedCentral Kanaya A, Ewing S, Vittinghoff E, Herrington D, Tegeler C, Mills C, et al. Acculturation and Subclinical Atherosclerosis among U.S. South Asians: findings from the MASALA study. J Clin Exp Res Cardiol. 2014;1(1):102.PubMedPubMedCentral
Metadata
Title
Association between acculturation, obesity and cardiovascular risk factors among male South Asian migrants in the United Arab Emirates – a cross-sectional study
Authors
Syed M Shah
Tom Loney
Salma Al Dhaheri
Hassan Vatanparast
Iffat Elbarazi
Mukesh Agarwal
Iain Blair
Raghib Ali
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-1568-x

Other articles of this Issue 1/2015

BMC Public Health 1/2015 Go to the issue