Dietary intake, lifestyles and risk of nutrition-related non-communicable diseases in a Punjabi south Asian male population in Kent, United Kingdom
Chronic nutrition related non-communicable diseases (NR-NCDs) are more prevalent in south Asians living in the United Kingdom compared to the general UK population. Observed differences have been attributed to inter-generational nutritional experiences and pattern of lifestyle changes which affect the risk of adult disease in later life. The aim of this research is to investigate socio-demographic variables, their food culture, dietary intakes, lifestyles, physical activity and experiences that contribute to the risk factor of NR-NCDs. Therefore, this study was designed in three phases. Phase I: A focus group study involving male participants (n=40) were used to collect sample population-wide data about food-related attitudes, habits and choices, methods of recipe formulation, food preparation and eating behaviours. Phase II: A randomly selected sample of adult males (n=137) of Punjabi origin were used to collect population-wide data using modified a pre-validated food frequency questionnaire (FFQ) previously used in Europe and a 24-hour recall dietary intake questionnaire. A modified version of the validated WHO Global Physical Activity Questionnaire (GPAQ) was used to assess physical activity. Anthropometric and blood pressure measurements were also taken to examine physical and physiological indicators of risk. Phase III: a quasi-randomly selected sub-group (n=30) then undertook physiological and biochemical tests including blood pressure, fasting serum lipid and glucose measurements. Later data from phase II and phase III were analysed based on first and second generation migrant status. Statistical comparisons including non-parametric qualitative analysis of focus group data; qualitative and quantitative tests comparing within and between first and second generation migrant groups, analysis of variances and multiple regression analysis were used to establish relationships to the risk factors for NR-NCDs. Overall data suggest this Punjabi migrant population analysed in phase II and III have significantly high energy intake, low physical activity, elevated blood pressure and fasting serum glucose level compared to recommend energy intake, physical activity level, blood pressure and fasting serum glucose cut-off. Significant differences were observed between first and second generation migrants. A significant higher intake of energy was seen among the second generation (p=0.045). Low level of energy expenditure with a physical activity level of 1.55 was seen across both generations of migrants. Reported fruits and vegetable consumption was low compared to 400g per day proposed intake for UK general population. Overall fibre intake among first and second generation migrants (15.23 g/day) was below the RNI of 18 g in the UK. This population reported low to moderate income of Â£15,999-Â£24,999 annually. Among the Punjabi migrant population the rate of OW+OB was 91% compared to 62.3% in UK general population. Physical measurements among first and second generation migrant indicate a pre-hypertensive state with mean SBP of 138 mm/Hg. SBP and DBP were significantly influenced by age (p=0.016; p=0.018 ) respectively. Overall there was no significant difference among first and second generation BMI. However, BMI was higher among young (21-25 years) people compared to other age groups. The following dietary and biochemical parameters were observed among phase II and phase III of the research: overall SFAs contributed >2-fold of the recommended intake; Sugar contributed nearly 1/3 of total energy intake; Sodium intake exceeded recommended intakes by >400 mg/day; excess protein intake of 32.62 g / day exceeding above recommended intake for weight and level of activity; serum fasting glucose and total cholesterol (TC) levels were raised above upper limit of normal cut-off ; TC and non-HDL cholesterol showed significant inter-generational differences (p=0.016 and p=0.015) respectively with first generation being higher than second generation migrants. This population has provided evidence that supports the nutrition transition and indicates high risk of NR-NCDs which merits further investigation and may lead to interventions aimed at awareness, lifestyle, behaviour change and increase in physical activity.
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