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Ethnic differences in obesity, diet and physical activity. Vanessa Higgins & Angela Dale Centre for Census & Survey Research University of Manchester. Background. In England, almost two-thirds of adults and a third of children are either overweight or obese - PowerPoint PPT Presentation
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Ethnic differences in obesity, diet and physical activity
Vanessa Higgins & Angela Dale
Centre for Census & Survey Research
University of Manchester
Background• In England, almost two-thirds of adults and a third of children are either
overweight or obese
• Government estimates that without action this will rise to almost 9 in 10 adults and two-thirds of children by 2050
• Obesity linked to increased risks of diabetes, heart disease, cancer
• Government strategies – “Healthy Weight, Healthy Lives”, Jan 2008. Identifies 5 areas for tackling
excess weight including promotion of healthier food and physical exercise
– Diet (5 a day; food labelling; restrictions on advertising to children; school-meals)
– Physical activity guidelines– Some recognition of cultural/ethnic differences in these strategies but
need more
Aims of the project• Analyse ethnic differences in three outcomes:
– Obesity– Diet– Physical activity
• Use Health Survey for England from 1999 and 2004 (ethnic boosts)
• Explanatory variables: gender, age, generation, social class, educational level, religion, type of neighbourhood etc (diet and physical activity for obesity)
• Parental diet, physical activity, obesity and other characteristics
• Assess change between 1999 and 2004
% obese by ethnic group by sex
0
5
10
15
20
25
30
35
40
% Men
Women
Aged 16+, Base (unweighted) 11022Source: Health Survey for England 2004
Obesity and ethnicity
• Age: increase in obesity prevalence with age was marked among Black Caribbean, Black African and Indian women.
• Children: Black Caribbean and Pakistani girls at increased risk of obesity and Pakistani and Indian boys are more likely to be overweight. HSE 2004 shows BA boys at risk of obesity.
• Issues of socio-economic confounders – is this a real relationship
• Abdominal obesity in South Asians- Body Mass Index or Waist circumference?- different BMI cut-offs for Asians?
% eating 5 or more portions of fruit or vegetables by ethnic group by sex
0
5
10
15
20
25
30
35
40
45
% Men
Women
Aged 16+, Base (unweighted) 13515Source: Health Survey for England 2004
Diet and ethnicity• All minority ethnic groups have healthier diet than general population.
• Other literature confirms UK South Asian and Afro-Caribbean diets generally healthier than white population. Evidence of high quantities consumed in Caribbean diet
• Heterogeneity of South Asian and Afro-Caribbean: religion, region etc
• Cultural beliefs: mealtime structures, significance of food
• Migration: modification of traditional diet when move to UK, adoption of fast foods, time since immigration
• Age: fruit and veg consumption highest among older groups. Do older people retain traditional eating patterns that may not be followed by younger generations?
% meeting physical activity recommendations by ethnic group by sex
0
5
10
15
20
25
30
35
40
45
% Men
Women
Aged 16+, Base (unweighted) 13482Source: Health Survey for England 2004
Physical activity and ethnicity• Smaller scale studies support HSE findings of low levels of
physical activity among South Asians. Extends to children and young people
• Cultural barriers: language, dress code, modesty and lack of single-sex facilities, concept of physical activity to Bangladeshis. Also non-cultural issues, don’t over-emphasise cultural barriers
• Migration: do British born South Asians do more physical activity than first generation? Does length of time since immigration affect activity levels?
• Lack of literature on physical activity of other ethnic minority groups in UK!
Operationalisation (2004)
• Diet– Summary measure of fruit and vegetable consumption based on the 5-
a-day guidelines (aged 5+)
– Separate components of fruit and vegetable consumption (aged 5+)• Salad, pulses, vegetables, composite dishes, fruit juice, fresh fruit, dried fruit,
frozen or tinned fruit, other dishes made from fruit
– Summary measure of fat scores (aged 16+)
– Separate components of fatty foods consumed (aged 16+)• Milk, cheese, red meat, white meat, fish, fried food, sweet/savoury snacks,
pastries, butter/ghee, reduced fat spreads, oils
– Salt added in cooking and at table (aged 16+)
Operationalisation (2004)• Physical activity of adults (aged 16+)
– Summary measure based on current guidelines of 30+ mins of activity of moderate intensity 5+ days week
• Low activity: less than once a week• High activity: at least 5 days a week
– Separate components: sports/exercise; brisk walks; heavy housework/gardening/DIY; occupational activity
• Physical activity of children (aged 5-15)
– Summary measure based on current guidelines of 1 hour+ of moderate intensity per day
– Separate components: sports/exercise; walking; active play; housework/gardening
• Obesity– Body Mass Index (weight in kgs/height in metres²). WHO cut off points for obesity for
adults and children– Waist Circumference
Summary
• Use HSE to analyse ethnic differences in obesity, diet and physical activity
• Highlighted some of the complexities of measuring outcome variables and some explanations for observed differences
• We will use standard measures but also implement alternatives
• Explanatory work and regression models
Our contact details:
[email protected] for Census and Survey ResearchUniversity of Manchester0161 275 7766
[email protected] for Census and Survey ResearchUniversity of Manchester0161 275 4876