A culturally adapted lifestyle intervention among Middle-Eastern immigrants in Sweden

In Sweden, there is an increasing immigrant population of which a large proportion originate from the Middle East. Middle East is one of the areas with highest diabetes prevalence in the world. Middle-Eastern immigrants in Sweden have higher rates of obesity and a very strong family history of diabetes. All these risk factors greatly increase their risk of getting diabetes. They tend to get diabetes at a younger age and experience a rapid worsening of the disease. It is therefore of utmost importance to put efforts in diabetes prevention in this group. This will reduce the future burden of disease and save healthcare costs.

With this aim in mind, our research group conducted a culturally-adapted lifestyle intervention among Middle Eastern immigrants residing in Malmo, Sweden. We wanted to study if a culturally appropriate advice on lifestyle changes can actually be helpful in reducing weight and changing diet and physical levels in this group of non-European immigrants. If we can achieve these goals, it will have long term benefits in form of reduced diabetes risk in this group.

We had a total of 96 participants all of which had an increased risk for diabetes. They were either overweight, had a large waist circumference or had abnormal blood glucose levels. A computer program was used to randomly chose half of them to participate in an intervention whereas the other half received usual care in the form of written advice on healthy lifestyle habits. The intervention comprised of seven group sessions including a cooking class. During the sessions, which were led by a diabetes nurse and a community health worker, participants received information on healthy diet and physical activity recommendations. They discussed barriers to adopting healthy lifestyle and ways to overcome them. All the information was adapted to match Middle-Eastern diet and culture and provided in Arabic.

The total duration of the study was four months and the participants were examined at the start, mid and end of the study. Our results indicate that the participants who took part in the intervention, had a reduction in body weight as well as an improvement in insulin sensitivity as compared to those who did not receive the intervention. Insulin sensitivity is involved in glucose regulation and is important in the prevention of type 2 diabetes. They also had a reduction in the so called bad cholesterol, LDL cholesterol levels in their blood.

Our findings suggest that adopting a culturally sensitive approach to lifestyle modification, as in our study, might help to improve metabolic profile of this diabetes prone group.

Faiza Siddiqui
Department of Clinical Sciences, Lund University, Malmö, Sweden

 

Publication

Effects of a culturally adapted lifestyle intervention on cardio-metabolic outcomes: a randomized controlled trial in Iraqi immigrants to Sweden at high risk for Type 2 diabetes.
Siddiqui F, Kurbasic A, Lindblad U, Nilsson PM, Bennet L
Metabolism. 2017 Jan

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