Migrating increases diabetes risk for South Asians

A study finds that South Asians who migrate face greater risk of developing lifestyle diseases as their exercise patterns change.

The stress of migrating to a new country can take its toll on an individual. There is the need to adapt to a new society and culture, and many struggle to establish links within their own ethnic community. The strain can have a detrimental effect on mental and physical health and impair the management of conditions such as type-2 diabetes and cardiovascular disease (CVD).

Dr Sabrina Gupta, a lecturer in the School of Psychology and Public Health at La Trobe University, has been researching the effects of migration stress when it comes to the development of lifestyle diseases. Her work has focused on South Asian populations that have migrated to Australia, primarily Indian and Sri Lankan.

Working with Dr Rosalie Aroni of the Australian National University and Professor Helena Teede of Monash University, Dr Gupta’s recent study focused on the experience and perception of physical exercise amongst South Asian migrants in managing these diseases.

“Researchers studying the physical activity levels amongst South Asian migrant groups in developed nations have found that they take part in less structured exercise,” says Dr Gupta. “It’s important to work out why this is the case, not just for their individual health and well-being, but for the potential impact on the healthcare system.”

Dr Gupta interviewed South Asian individuals with either type 2 diabetes or CVD and compared the results with those of a similar cohort of Anglo-Australian participants that she also interviewed. Designing the study this way allowed a direct comparison between participation and attitudes towards physical activity, diet, and lifestyle choices associated with disease management.

The researchers found different practices and attitudes when it came to approaching physical activity, despite both groups showing awareness and acknowledgement of its benefits. Anglo-Australian participants reported dedicating time for exercise, while South Asians largely described their physical activity as ‘unplanned’.

“South Asian migrants do not prioritise physical exercise, and their approach is to treat it as a social experience,” says Dr Gupta. “When they migrate to Australia the social aspect of their life can suffer. Their diet can change dramatically, and they undertake worryingly low levels of physical activity when compared with Anglo-Australians with type 2 diabetes and/or cardiovascular disease (CVD).”

Anglo-Australians perceived exercise and organised sport as the primary forms of physical activity to be undertaken to prevent disease and maintain health. It was often a planned event, with dedicated time, and at times a solitary practice.

In contrast, South Asians sought little dedicated time for exercise. They construed all movement as physical activity and viewed taking “time out” to exercise as selfish as it was viewed as taking time away from the family which did not accord with their cultural norms.

“The data showed clear divides between perceptions of exercise and socio-cultural priorities,” says Dr Gupta. “South Asians considered themselves more family oriented than Anglo-Australians, with many commenting that they had less time for personal pursuits and felt guilty about taking their time away from family if they exercised.”

“For South Asians exercise is very much tied to their ethnic identities, through communities and families setting group goals,” says Dr Gupta. “Once they come to Australia they desire to retain these cultural norms but can have trouble making connections in the community. Their diet is also adapted to some extent to accommodate what is available domestically.”

Similar studies about South Asians have been carried out in the United Kingdom and Canada and participants in those studies reported similar levels of exercise and attitudes to physical activity, but a very different level of knowledge regarding benefits. South Asians in Australia were aware of the need for sufficient physical activity in maintaining health with type-2 diabetes and CVD, but this had little impact on the levels of activity undertaken.

“The differences in knowledge levels between migrants to Australia and other countries could be explained by the effectiveness of health promotion campaigns and the strong presence of exercise as an Australian cultural value,” says Dr Gupta. “Despite this exercise levels among South Asians remain unchanged and this is a matter of significant  concern.”

Respondents to Dr Gupta’s study expressed a desire for more detailed advice from healthcare providers, with culturally tailored programs specifying the type, duration and intensity of physical activities presented in appropriate formats for different ethnic groups.

“A number of South Asian respondents acknowledged a general lack of motivation to be active or eat healthily,” says Dr Gupta. “Clinicians need to provide advice that recognises the need to conduct physical activity with family. If there is greater alignment between exercise and cultural values it may make health promotion activities more successful. This could be an area for future research.”

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