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A review of ethnicity, health and nutrition-related diseases in relation to migration in the United Kingdom

Published online by Cambridge University Press:  01 April 2001

J Landman*
Affiliation:
Queen Margaret University College, Edinburgh
JK Cruickshank
Affiliation:
Clinical Epidemiology Group, Manchester University Medical School, Manchester 2, UK
*
*Corresponding author: Email [email protected]
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Abstract

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Objectives:

To identify lessons from and gaps in research on diet-disease links among former migrants in the United Kingdom (UK).

Results:

Migrant status and self-identified ethnicity do not match so these terms mask differences in social, nutritional and health status within and between population groups. Some former migrants differ in causes of death from the general population, e.g.: fewer coronary heart disease deaths among Caribbean-born; fewer cancer deaths among Caribbean, South Asian- and East African-born adults. Irish- and Scottish-born have higher mortality from all causes. Experience of risk factors differ also, e.g.: higher prevalences of hypertension and diabetes in Caribbean- and South Asian-born adults than representative samples of the general population; obesity and raised waist-hip circumference ratios in South Asian, African-Caribbean and some Irish-born adults. Former migrants experience long-term disadvantage, associated with more self-defined illness and lower reported physical activity. Nutrient intake data from the few, recent, small-scale studies must be interpreted with caution due to methodological diversity. However, second generation offspring of former migrants appear to adopt British dietary patterns, increasing fat and reducing vegetable, fruit and pulse consumption compared with first generation migrants.

Conclusions:

There is insufficient evidence on why some former migrants but not others experience lower specific mortality than the general population. Dietary intake variations provide important clues particularly when examined by age and migration status. Majority ethnic and younger migrant groups could raise and sustain high fruit and vegetable intakes but lower proportions of fat, by adopting many dietary practices from older migrants. Objective measures of physical activity and longitudinal studies of diets among different ethnic groups are needed to explain diversity in health outcomes and provide for evidence-based action.

Type
Research Article
Copyright
Copyright © CABI Publishing 2001

References

1Nazroo, JY. The Health of Britain's Ethnic Minorities. Report no 835. London: Policy Studies Institute, 1997.Google Scholar
2Cruickshank, JK, Beevers, DG. Migration, ethnicity health and disease. In: Cruickshank, JK, Beevers, DG, eds. Ethnic factors in health and disease. Rushden, Northants: Wright, 1989: 13, 36.Google Scholar
3Bhopal, RS, Phillimore, P, Kohli, HS. Inappropriate use of the term Asian: an obstacle to ethnicity and health research. J. Publ. Hlth. Med. 1991; 13: 244–6.Google ScholarPubMed
4Bradby, H. Ethnicity: not a black and white issue. A research note. Soc. Hlth. Illness. 1995; 17: 405–17.CrossRefGoogle Scholar
5Smaje, C. Health, race and ethnicity. Making sense of the evidence. London: Kings Fund Institute, 1995.Google Scholar
6Diamond, J. Guns, Germs and Steel. New York: Norton, 1997.Google Scholar
7Miller, GJ, Kotecha, S, Wilkinson, WH, Wilkes, H, Stirling, Y, Sanders, TAB, Broadhurst, A, Allison, J, Meade, TW. Dietary and other characteristics relevant for coronary heart disease in men of Indian West Indian and European descent in London. Atherosclerosis 1988; 70: 6372.CrossRefGoogle Scholar
8Miller, GJ, Maude, GH, Beckles, GLA. Incidence of hypertension and non-insulin dependent diabetes and associated risk factors in a rapidly developing Caribbean community: the St. James Survey, Trinidad. J. Epidemiol. Comm. Hlth. 1996; 50: 497504.CrossRefGoogle Scholar
9Cruickshank, JK, Cooper, J, Burnett, M, MacDuff, J, Drubra, U. Ethnic differences in fasting plasma C-peptide and insulin in relation to glucose tolerance and blood pressure. Lancet. 1991; 338: 842–7.CrossRefGoogle ScholarPubMed
10Sharma, S, Cade, J, Riste, L, Cruickshank, JK. Nutrient intake trends among African-Caribbeans in Britain: a migrant population and its second generation. Publ. Hlth. Nutr. 1999; 2: 469–76.CrossRefGoogle Scholar
11Chaturvedi, N, McKeigue, PM, Marmot, MG. Resting and ambulatory blood pressure differences in African-Caribbeans and Europeans. Hypertension 1993; 22: 90–6.CrossRefGoogle Scholar
12Cappuccio, FP, Cook, DG, Atkinson, RW, Strazullo, P. Prevalence, detection and management of cardiovascular risk factors in different ethnic groups in south London. Heart. 1997; 78: 555–63.CrossRefGoogle ScholarPubMed
13Williams, R, Bhopal, R, Hunt, K. Coronary risk in a British Punjabi population: comparative profile of non-biochemical factors. Internat. J. Epidemiol. 1994; 23: 2837.CrossRefGoogle Scholar
14Jones, T. Britain's Ethnic Minorities. London: Policy Studies Institute, 1993.Google Scholar
15Balarajan, R. Ethnicity and variations in mortality from coronary heart disease. Health Trends 1996; 27: 114–9.Google Scholar
16Wild, S, McKeigue, P. Cross-sectional analysis of mortality by country of birth in England and Wales, 1970–92. Brit. Med. J. 1997; 314: 705–10CrossRefGoogle ScholarPubMed
17Acheson, D. Independent Inquiry into Inequalities in Health. Report. London: The Stationary Office, 1998.Google Scholar
18Williams, R, Ecob, R. Regional mortality and Irish in Britain: findings from the ONS longitudinal study. Social. Hlth. Illness 1999; 21: 344–67.CrossRefGoogle Scholar
19Harding, S, Maxwell, R. Differences in mortality of migrants In: Drever, F, Whitehead, M, eds. Health Inequalities. London: Office for National Statistics, 1997.Google Scholar
20Balarajan, R, Raleigh, VS. Ethnicity and health in England London: HMSO, 1995.Google Scholar
21Greenhalgh, PM. Diabetes in British south Asians: nature, nurture and culture. Diabetes Med. 1997; 14: 10–8.3.0.CO;2-B>CrossRefGoogle ScholarPubMed
22Bush, H, Williams, R, Sharma, S, Cruickshank, K. Opportunitites for and barriers to good nutritional health in minority ethnic groups. London: Health Education Authority, 1997.Google Scholar
23Cruickshank, JK, Beevers, DG, Osbourne, VL, Haynes, RA, Corlett, RC, Selby, S. Heart attack, stroke, hypertension and diabetes among West Indians, Asians and Whites in Birmingham England: hospital admission analysis. Brit. Med. J. 1980; 281: 1108.CrossRefGoogle Scholar
24McKeigue, P, Marmot, MG, Adelstein, AM, Hunt, SP, Shipley, MP, Butler, SM, Reimersma, RA, Turner, PR. Diet and risk factors for coronary heart disease in Asians in Northwest London. Lancet. 1985; ii: 1086–90.CrossRefGoogle Scholar
25McKeigue, PM, Shah, B, Marmot, HG. Relation of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in South Asians. Lancet. 1991; 337: 382–6.CrossRefGoogle ScholarPubMed
26Mbanya, JC, Cruickshank, JK, Forrester, T, Balau, B, Ngongang, J, Riste, L, Forhan, A, McFarlane-Anderson, N, Bennett, F, Wilks, R. Standardised comparison of glucose intolerance in west African-origin populations of rural and urban Cameroon, Jamaica, and Caribbean megrants to Britain. Diabetes Care 1999; 22: 434–40.CrossRefGoogle Scholar
27Sharma, S, Cade, J, Mbanya, JC, et al. Development of food frequency questionnaires in 3 populations of African origin from Cameroon, Jamaica, and Caribbean migrants to Britain. Eur. J. Clin. Nutr. 1996; 50: 179–86.Google Scholar
28Sharma, S, Cade, J, Griffiths, S, Cruickshank, JK. Nutrient intakes among UK African-Caribbeans: changing risk of coronary heart disease. Lancet. 1998; 352: 114–5.Google ScholarPubMed
29Mennen, LI, Jackson, M, Sharma, S, Mbanya, JC, Cade, J, Walker, S, Wilks, R, Balkau, B, Forrester, T, Cruickshank, JK. Habitual Diet in 4 Populations of African origin: Nutrient Intakes in rural and urban Cameroon, Jamaica and Caribbean Migrants in Britain. Publ. Hlth. Nutr. in the press.Google Scholar
30Cruickshank, JK, Alleyne, SA. Black West Indian and match white diabetics in Britain compared with diabetics in Jamaica: blood pressure, body mass and vascular disease. Diabetes Care 1987; 10: 170–9.CrossRefGoogle ScholarPubMed
31Chaturvedi, N, Fuller, JH. Ethnic differences in mortality from cardiovascular disease in the UK: do they persist in people with diabetes? J. Epidemiol. Comm. Hlth. 1996; 50: 137–9.CrossRefGoogle ScholarPubMed
32Mather, HM, Chaturvedi, N, Kehely, AM. Comparison of prevalence and risk factors for microalbuminuria in South Asians and Europeans with type 2 diabetes mellitus. Diabetic Med. 1995; 15: 672–7.3.0.CO;2-3>CrossRefGoogle Scholar
33Poulter, N, Cappuccio, F, Chaturvedi, N, Cruickshank, JK. High blood pressure and the African-Caribbean community in the UK. Birmingham: MediNews, 1997.Google Scholar
34Cruickshank, JK, Mbanya, JC, Wilks, R, Balkau, B, Forrester, T, Anderson, SG, Mennen, L, Forhan, A, Riste, L, McFarlane-Anderson, N. Hypertension in 4 African-origin populations: current 'rule of halves', quality of blood pressure control and attributable risk of cardiovascular disease. J. Hypertension 2000; In the press.Google Scholar
35Cruickshank, JK, Mbanya, JC, Wilks, R, Balkau, B, McFarlane-Anderson, N, Forrester, T. Sick genes, sick individuals or sick populations? The emergence of diabetes and high blood pressure in African origin populations. Internat. J. Epidemiol. 2001; In the press.CrossRefGoogle ScholarPubMed
36Cooper, RS, Rotimi, CN, Kaufman, JS, Owaje, EE, Fraser, H, Forrester, T, Wilks, R, Riste, LK, Cruickshank, JK. The prevalence of hypertension in seven populations of west African origin. Amer. J. Publ. Hlth. 1997a; 87: 160–8.CrossRefGoogle ScholarPubMed
37Raleigh, VS. Diabetes and hypertension in Britain's ethnic minorities implications for the future of renal services. Brit. Med. J. 1997; 314: 209–13.CrossRefGoogle ScholarPubMed
38Shaukat, N, de Bono, DP, Cruickshank, JK. Clinical features, risk factors and referral delay in British patients of Indian and European origin with angina, matched for coronary atheroma. Brit. Med. J. 1993; 307: 717–8.CrossRefGoogle ScholarPubMed
39Cruickshank, JK, Anderson N, McFarlane, Wadsworth, J, McHardy Young, S, Jepson, E. Treating hypertension in black compared with white non-insulin dependent diabetics: a double blind trial of verapamil and metoprolol. Brit. Med. J. 1988; 297: 1155–9.CrossRefGoogle ScholarPubMed
40Riste, L. Risk factors associated with glucose tolerance and high blood pressure among African Caribbeans and white populations in Manchester: opportunities for prevention. PhD Thesis. University of Manchester, 1997.Google Scholar
41Cruickshank, JK, Jackson, S, Beevers, DG, Osbourne, VL, Corlett, D, Selby, S. Similarity of blood pressure in Blacks, Whites and Asians in England: the Birmingham factory study. J. Hypertension 1985; 3: 365–71.CrossRefGoogle ScholarPubMed
42Cruickshank, JK. Cardiovascular disease in black and Indian origin populations outside the USA. In: Cruickshank, JK, Beevers, DG, eds. Ethnic factors in health and disease. Rushden, Northants: Wright, 1989.Google Scholar
43Pomerleau, J, McKeigue, PM, Chaturvedi, N. Factors associated with obesity in South Asian, African-Caribbean and European women. Internat. J. Obesity-rel. Metabolic Dis. 1999; 23: 2533.CrossRefGoogle Scholar
44McKeigue, PM. Metabolic consequences of obesity and body fat pattern: lessons from migrant studies. Ciba Foundation Symposium 1996; 201: 5464.Google ScholarPubMed
45Abbotts, J, Williams, R, Ford, G, Hunt, K, West, P. Morbidity and Irish Catholic descent in Britain: an ethnic and religious minority 150 years on. Soc. Sci. Med. 1997; 45: 314.CrossRefGoogle Scholar
46Rudat, K. Health and Lifestyles: Black and Minority Ethnic Groups in England. London: Health Education Authority, 1994.Google Scholar
47Wilks, R, McFarlane-Anderson, N, Bennett, F, Fraser, H, McGee, D, Cooper, R, Forrester, T. Obesity in peoples of African diaspora. Ciba Foundation Symposium 1996; 201: 3748.Google ScholarPubMed
48Cooper, RS, Rotimi, CN, Kaufman, JS, Owaje, EE, Fraser, H, Forrester, T, Wilks, R, Riste, LK, Cruickshank, JK. Prevalence of NIDDM among populations of the African diaspora. Diabetes Care. 1997b; 20: 343–8.CrossRefGoogle ScholarPubMed
49Deurenberg, P, Yap, M, van Stavaren, WA. Body mass index and percent body fat: a meta analysis among different ethnic groups. Int. J. Obesity-rel. Metab. Disorders 1998; 22: 1164–71.CrossRefGoogle ScholarPubMed
50Williams, R, Bhopal, R, Hunt, K. Health of a Punjabi ethnic minority in Glasgow: a comparison with the general population. J. Epidemiol. Comm. Hlth. 1993; 47: 96102.CrossRefGoogle Scholar
51Chinn, S, Cole, TJ, Preece, MA, Rona, RJ. Growth charts for ethnic populations in UK. Lancet. 1996; 347: 839–40.CrossRefGoogle ScholarPubMed
52Mennen, LI, Jackson, M, Cade, J, Mbanya, JC, Lafay, L, Sharma, S, Walker, S, Wilks, R, Balkau, B, Forrester, T, Cruickshank, JK. Under-reporting of energy intake in four populations of African origin. Int. J. Obesity 2000; 24: 882–7.CrossRefGoogle Scholar
53Sevak, L, McKeigue, P, Marmot, M. Relationship of hyperinsulinaemia to dietary intake in South Asian and European Men. Amer. J. Clin. Nutr. 1994; 59: 1069–74.CrossRefGoogle ScholarPubMed
54Smith, Z, Knight, T, Sahota, P, Kernohan, E, Baker, M. Dietary patterns in Asian and Caucasian men: differences and implications for health education. J. H. Nutr. Dietet. 1993; 6: 323–34.CrossRefGoogle Scholar
55Silman, A, Loysen, E, deGraaf, W, Sramek, M. High dietary fat intake and cigarette smoking as risk factors for ischaemic heart disease in Bangladeshi male immigrants in East London. J. Epidemiol. Comm. Hlth. 1985; 39: 301–3.CrossRefGoogle ScholarPubMed
56Thompson, RL, Cruickshank, JK. Dietary fatty acid intakes and P:S ratios in a population sample of women with differing risks of coronary heart disease. Clin. Sci. 1990; 78(suppl. 22): 25.CrossRefGoogle Scholar
57Reddy, S, Sanders, TA. Lipoprotein risk factors in vegetarian women of Indian descent are unrelated to dietary intake. Atherosclerosis 1992; 95: 223–9.CrossRefGoogle ScholarPubMed
58Reddy, S, Sanders, TA. Haematological studies on pre-menopausal Indian and Caucasian vegetarians compared with Caucasian omnivores. Brit. J. Nutr. 1990; 64: 331–8.CrossRefGoogle ScholarPubMed
59Anderson, A, Lean, M. Healthy change? Observation on a decade of dietary change in a sample of Glaswegian South Asian migrant women. J. H. Nutr. Dietet. 1995; 8: 129–36.CrossRefGoogle Scholar
60Anderson, A, Lean, M, Bush, H, Bradby, H, Williams, R. Macronutrient intake in South Asian and Italian women in the West of Scotland. Proc. Nutr. Soc. 1995; 54: 203A.Google Scholar
61Kassam-Khamis, T, Judd, P, Thomas, JE, Sevak, L, Reddy, S, Ganatra, S. Frequency of consumption of composite dishes commonly consumed by South Asians originating from Gujerat and the Punjab. J. H. Nutr. Dietet. 1995; 8: 265–77.CrossRefGoogle Scholar
62Tan, SP, Wenlock, R, Buss, D. Immigrant Foods. Second supplement to McCance & Widdowson's The Composition of Foods. 4th edition. London: HMSO, 1985.Google Scholar
63Holland, B, Welch, AA, Unwin, ID, Buss, D, Paul, AA, Southgate, DAT. McCance & Widdowson's The Composition of Foods. 5th revised and extended edition. London: Royal Society of Chemistry & Ministry of Agriculture, Fisheries & Food, 1991.Google Scholar
64West, C, van Stavaren, W. Food consumption, nutrient intake, and the use of food composition tables. In: Margetts, B, Nelson, M, eds. Design Concepts in Nutritional Epidemiology. 2nd edition. Oxford: Oxford University Press, 1997.Google Scholar
65Paul, A, Southgate, DAT. Conversion into nutrients. In: Cameron, M, van Stavaren, W, eds. Manual on Methodology for Food Consumption Studies. Oxford: Oxford University Press, 1988.Google Scholar
66McKeigue, P, Sevak, L. Coronary Heart Disease in South Asian Communities, A manual for health promotion. London: Health Education Authority, 1994.Google Scholar
67Landman, J, Wyke, S. Healthy eating and South Asians in Scotland. Report of a research project for the Health Education Board for Scotland, Edinbourgh, 1995.Google Scholar
68Wyke, S, Landman, J. Healthy eating? Diet and cuisine amongst Scottish South Asian people. Brit. Food J. 1997; 99: 2734.CrossRefGoogle Scholar
69Lip, GY, Malik, I, Luscombe, C, McCarry, M, Beevers, G. Dietary fat purchasing habits in whites, blacks and Asian peoples in England-implications for heart disease. Internat. J. Cardiol. 1995; 48: 287–93.CrossRefGoogle ScholarPubMed
70Williams, R, Bush, H, Lean, M, Anderson, A, Bradby, H. Food choice and culture in a cosmopolitan city: South Asians, Italians and other Glaswegians. In: Murcott, A, ed. The Nation's Diet: the Social Science of Food Choice. London: Sage, 1998.Google Scholar
71Caplan, P. Approaches to the study of food health and identity. In: Caplan, P, ed. Food Health and Identity. London: Routledge, 1997.Google Scholar
72Caplan, P, Keane, A, Willetts, A, Williams, J. Studying food choice in its social and cultural contexts: approaches from a social and anthropological perspective. In: Murcott, A, ed. The Nations' Diet: The social science of food choice. Edited, London: Longman, 1998.Google Scholar
73Bradby, H. Health, eating and heart attacks: Glaswegian Punjabi women's thinking about everyday food. In: Caplan, P, ed. Food Health and Identity. London: Routledge, 1997.Google Scholar
74Marshall, D. Eating at home: meals and food choice. In: Marshall, D, ed. Food Choice and the Consumer. Glasgow: Blackie Academic and Professional, 1995.CrossRefGoogle Scholar
75James, A. How British is British food? In: Caplan, P, ed. Food Health and Identity. London: Routledge, 1997.Google Scholar
76Buisson, D. Developing new products for the consumer. In: Marshall, D, ed. Food Choice and the Consumer. Glasgow: Blackie Academic and Professional, 1995.Google Scholar
77Dowler, E, Calvert, C. Looking for 'fresh' food: diet and lone parents. Proc. Nutr. Soc. 1995; 54: 759–69.CrossRefGoogle ScholarPubMed
78Barker, DJP. Mothers, Babies and Disease in Later Life. London: BMJ Publishing Group, 1994.Google Scholar
79Godfrey, K, Forrester, T, Barker, DJP, Jackson, AA, Landman, JP, Hall, J, Cox, V, Osmond, C. Maternal nutritional status in pregnancy and blood pressure in childhood. Brit. J. Obstet. Gynaecol. 1994; 101: 398403.CrossRefGoogle ScholarPubMed
80Forrester, T, Wilks, R, Bennett, F, Simeon, D, Osmond, C, Allen, M, et al. Fetal growth and cardiovascular risk factors in Jamaican schoolchildren. Brit. Med. J. 1996; 312: 156–60.CrossRefGoogle ScholarPubMed
81Stein, CE, Fall, CHD, Kumaran, K, Osmond, C, Cox, V, Barker, DJP. Fetal growth and coronary heart disease in South India. Lancet. 1996; 348: 1269–73.CrossRefGoogle ScholarPubMed
82Gregory, J, Foster, K, Tyler, H, Wiseman, M. The Dietary and Nutritional Survey. London: HMSO, 1990.Google Scholar