| 1. |
- Ahmadi, Nasser, 1958, et al.
(författare)
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Clinical characteristics of asymptomatic left ventricular diastolic dysfunction and its association with self-rated health and N-terminal B-type natriuretic peptide: a cross-sectional study
- 2016
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Ingår i: Esc Heart Failure. - : Wiley. - 2055-5822. ; 3:3, s. 205-211
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Tidskriftsartikel (refereegranskat)abstract
- Aims Left ventricular hypertrophy, obesity, hypertension, and N-terminal B-type natriuretic peptide (Nt-proBNP) predict left ventricular diastolic dysfunction with preserved systolic function (DD-PSF). Self-rated health (SRH) is shown to be associated with chronic diseases, but the association of SRH with DD-PSF is unclear. In light of the clinical implications of DD-PSF, the following goals are of considerable importance: (1) to determine the role of SRH in patients with DD-PSF in the general population and (2) to study the association between Nt-proBNP and DD-PSF. Methods and results The current study is a cross-sectional study conducted on a random sampling of a rural population. Individuals 30-75 years of age were consecutively subjected to conventional echocardiography and tissue velocity imaging. Data were collected on 500 (48%) men and 538 (52%) women (n = 1038). DD-PSF was the main outcome, and SRH and Nt-proBNP were the primary indicators. Diabetes mellitus, hypertension, and obesity were accounted for as major confounders of the association with SRH. DD-PSF was identified in 137 individuals, namely, 79 men (15.8%) and 58 women (10.8%). In a multivariate regression model, SRH (OR 2.95; 95% CI 1.02-8.57) and Nt-proBNP (quartile 4 vs. quartile 1 OR 4.23; 95% CI 1.74-10.26) were both independently associated with DD-PSF. Conclusions SRH, evaluated based on a descriptive question on general health, should be included in the diagnostic process of DD-PSF. In agreement with previous studies, our study confirms that Nt-proBNP is a major indicator of DD-PSF.
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| 2. |
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| 3. |
- Andersson, Susanne, et al.
(författare)
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Attitudes Regarding Participation in a Diabetes Screening Test among an Assyrian Immigrant Population in Sweden
- 2016
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Ingår i: Nursing Research and Practice. - : Hindawi Limited. - 2090-1429 .- 2090-1437.
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Tidskriftsartikel (refereegranskat)abstract
- Immigrants from the Middle East have higher prevalence and incidence of type 2 diabetes (T2D) compared with native Swedes. The aim of the study was to describe and understand health beliefs in relation to T2D as well as attitudes regarding participation in a screening process in a local group of Assyrian immigrants living in Sweden. A qualitative and quantitative method was chosen in which 43 individuals participated in a health check-up and 13 agreed to be interviewed. Interviews were conducted, anthropometric measurements and blood tests were collected, and an oral glucose tolerance test was performed. In total, 13 of the 43 participants were diagnosed with impaired glucose metabolism, 4 of these 13 had TD2. The interviewed participants perceived that screening was an opportunity to discover more about their health and to care for themselves and their families. Nevertheless, they were not necessarily committed to taking action as a consequence of the screening. Instead, they professed that their health was not solely in their own hands and that they felt safe that God would provide for them. Assyrians' background and religion affect their health beliefs and willingness to participate in screening for TD2.
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| 4. |
- Arvidsson, Daniel, et al.
(författare)
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Vigorous Physical Activity may be Important for the Insulin Sensitivity in Immigrants From the Middle East and Native Swedes
- 2015
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Ingår i: Journal of Physical Activity & Health. - : Human Kinetics. - 1543-3080 .- 1543-5474. ; 12:2, s. 273-281
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To compare physical activity measures and their associations with insulin sensitivity, beta-cell function and body mass index (BMI) between Iraqi immigrants and native Swedes. Methods: A cross-sectional study of 493 Iraqis (58% men) and 469 Swedes (54% men) aged 30 to 75 years living in the city of Malmo, Sweden. Accelerometry was used for physical activity measures (sedentary time, breaks in sedentary time, moderate and vigorous physical activity, total counts). Insulin sensitivity index and oral disposal index were determined from an oral glucose tolerance test and BMI by body weight and height. Results: Iraqi men were less physically active than Swedish men, while the physical activity was more similar in the women. BMI was a strong predictor of insulin sensitivity and beta-cell function and frequently associated with the physical activity measures. BMI modified the associations of insulin sensitivity and beta-cell function with the physical activity measures to such extent that only VPA and total counts show direct associations with insulin sensitivity in addition to the indirect associations via BMI. Iraqi women demonstrated weaker associations compared with Swedish women. Conclusions: Physical activity and performed at vigorous intensity may be important mainly for the insulin sensitivity in Iraqi immigrants and native Swedes.
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| 5. |
- Bennet, Louise, et al.
(författare)
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A family history of diabetes determines poorer glycaemic control and younger age of diabetes onset in immigrants from the Middle East compared with native Swedes
- 2015
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Ingår i: Diabetes & Metabolism. - : Elsevier BV. - 1262-3636 .- 1878-1780. ; 41:1, s. 45-54
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Tidskriftsartikel (refereegranskat)abstract
- Aims. - Immigrant populations from the Middle East develop diabetes earlier than indigenous European populations; however, the underlying etiology is poorly understood. This study looked at the risk factors associated with early diabetes onset and, in non-diabetics, glycaemic control in immigrants from Iraq compared with native Swedes. Methods. - This cross-sectional population-based study comprised 1398 Iraqi immigrants and 757 Swedes (ages 30-75 years) residing in the same area of Malmo, Sweden. Outcomes were age at diabetes onset and glycaemic control (HbA(1c)) as assessed by Cox proportional hazards and linear regression, respectively. Results. - In Iraqis vs Swedes, clustering in the family history (in two or more relatives) was more prevalent (23.2% vs 3.6%, P<0.001) and diabetes onset occurred earlier (47.6 years vs 53.4 years, P=0.001). Having an Iraqi background independently raised the hazard ratio (HR) for diabetes onset. Diabetes risk due to family history was augmented by obesity, with the highest HRs observed in obese participants with clustering in the family history (HR: 5.1, 95% CI: 3.2-8.2) after adjusting for country of birth and gender. In participants without previously diagnosed diabetes (Iraqis: n=1270; Swedes: n=728), HbA(1c), levels were slightly higher in Iraqis than in Swedes (4.5% vs 4.4%, P=0.038). This difference was explained primarily by clustering in the family history rather than age, obesity, lifestyle or socioeconomic status. Conclusion. - The study shows that the greater predisposition to diabetes in Middle Eastern immigrants may be explained by a more extensive family history of the disorder; clinical interventions tailored to Middle Eastern immigrants with such a family history are thus warranted.
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| 6. |
- Bennet, Louise, et al.
(författare)
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BMI and waist circumference cut-offs for corresponding levels of insulin sensitivity in a Middle Eastern immigrant versus a native Swedish population - The MEDIM population based study
- 2016
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this study was to identify corresponding body mass index (BMI) and waist circumference cut-offs for equivalent levels of insulin sensitivity in a Middle Eastern immigrant population compared with native Swedes. Methods: Citizens of Malmö, Sweden aged 30 to 75 years, who were born in Iraq or Sweden, were in 2010-2012 invited to participate in a health examination including anthropometrics, oral glucose tolerance test, fasting samples and interviews concerning sociodemographic factors and lifestyle behaviours. Results: In total, 1176 individuals born in Iraq and 688 born in Sweden, without previously diagnosed type 2 diabetes, participated in the study. In normal weight participants (BMI < 25 kg/m2), 21.2% of Iraqis vs 9.3% of Swedes were insulin resistant. Corresponding figures in participants without abdominal obesity (waist circumference, men < 94 cm, women < 80 cm) were 28.2% of Iraqis vs 9.4% of Swedes. The age-adjusted insulin sensitivity index (ISI) for obese Swedes (BMI 30 kg/m2) corresponded in Iraqi men with BMI of 28.5 kg/m2, and in Iraqi women with BMI of 27.5 kg/m2. The ISI level in abdominally obese Swedes corresponded with waist circumference cut-offs of 84.0 cm and 71.0 cm in Iraqi men and women, respectively. In men only, larger waist circumference (P interaction = 0.026) presented a stronger association with impaired ISI in Iraqis as compared to Swedes. Conclusions: Our data shows that the impact of BMI and waist circumference on ISI is ethnic- and gender-specific, indicating a disturbed fat metabolism in Iraqi males in particular. Our data suggests that 10 cm lower cut-off values for abdominal obesity, than is currently recommended by major organisations, should be considered when estimating diabetes risk in Middle Eastern populations.
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| 7. |
- Bennet, Louise, et al.
(författare)
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Country of birth modifies the association of fatty liver index with insulin action in Middle Eastern immigrants to Sweden
- 2015
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Ingår i: Diabetes Research and Clinical Practice. - : Elsevier BV. - 0168-8227 .- 1872-8227. ; 110:1, s. 66-74
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Non-alcohol fatty liver disease (NAFLD) is a strong risk factor for insulin resistance and type 2 diabetes. The prevalence of NAFLD varies across populations of different ethnic backgrounds but the prevalence in Middle Eastern populations, which are at high risk of type 2 diabetes, is largely unknown. Using fatty liver index (FLI) as a proxy for NAFLD the aim was to calculate the odds of NAFLD (FLI >= 70) given country of origin and further to investigate the associations between ISI and FLI. Methods: In 2010-2012 we conducted a population-based study of individuals aged 30-75 years born in Iraq or Sweden, in whom anthropometrics, fasting blood samples and oral glucose tolerance tests were performed and sociodemography and lifestyle behaviors characterized. Results: A higher proportion of Iraqis (N = 1085) than Swedes (N = 605) had a high probability of NAFLD (FLI >= 70, 32.5 vs. 22.6%, p < 0.001, age-and sex-adjusted data) and ISI was more severely impaired (70.7 vs. 95.9%, p < 0.001). Independently of traditional risk factors for NAFLD, being born in Iraqi increased the risk of FLI >= 70 (OR 1.59: 95% CI 1.15, 2.20). Furthermore, country of birth presented a stronger association between ISI and FLI >= 70 in Iraqis than in Swedes (P-interaction = 0.019). Conclusions: Our data indicate that immigrants from Iraq are at higher risk of NAFLD. The finding that country of birth modifies the relationship of FLI with ISI, suggests that liver fat may be a stronger determinant of impaired insulin action and increased risk of type 2 diabetes in Iraqis than in Swedes.
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| 8. |
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| 9. |
- Bennet, Louise, et al.
(författare)
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Dubbelt så hög risk för diabetes typ 2 hos svenskar födda i Irak
- 2015
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Ingår i: Läkartidningen. - 0023-7205. ; 112:16, s. 1-4
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The MEDIM study reports that Immigrants from the Middle East to Sweden – independently of other diabetes related risk factors – have a twice as high type 2 diabetes risk as compared to non-immigrated Swedes. Diabetes onset occurs 6 years earlier in this group and is partly explained by family history and/or obesity. But the MEDIM study has identified that Middle Eastern background per se is an independent risk factor for earlier disease onset. Immigrants from the Middle East free of diabetes have a more pronounced insulin resistance and worse glycaemic control than non-immigrated Swedes independently of age, obesity or other risk factors for diabetes. To be able to reduce the risk of diabetes and offer an equal health care, glucose/HbA1c should be controlled on wide indications, and risk evaluation and preventive actions provided earlier for this population at high risk for type 2 diabetes. © 2015, Swedish Medical Association. All rights reserved.
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| 10. |
- Bennet, Louise, et al.
(författare)
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Family history of diabetes and its relationship with insulin secretion and insulin sensitivity in Iraqi immigrants and native Swedes : a population-based cohort study
- 2018
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Ingår i: Acta Diabetologica. - : Springer Milan. - 0940-5429 .- 1432-5233. ; 55:3, s. 233-242
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Tidskriftsartikel (refereegranskat)abstract
- Aims Middle Eastern immigrants to western countries are at high risk of developing type 2 diabetes. However, the heritability and impact of rst-degree family history (FH) of type 2 diabetes on insulin secretion and action have not been adequately described. Methods Citizens of Malmö, Sweden, aged 30–75 years born in Iraq or Sweden were invited to participate in this population- based study. Insulin secretion (corrected insulin response and oral disposition index) and action (insulin sensitivity index) were assessed by oral glucose tolerance tests.Results In total, 45.7% of Iraqis (616/1348) and 27.4% of native Swedes (201/733) had FH in parent(s), sibling(s) or single parent and sibling, i.e., FH+. Approximately 8% of Iraqis and 0.7% of Swedes had ≥ 3 sibling(s) and parent(s) with diabetes, i.e., FH++. Irrespective of family size, prediabetes and diabetes increased with family burden (FH− 29.4%; FH+ 38.8%; FH++ 61.7%) without signi cant di erences across ethnicities. With increasing level of family burden, insulin secretion rather than insulin action decreased. Individuals with a combination of ≥ 3 siblings and parents with diabetes presented with the lowest levels of insulin secretion.Conclusions The Iraqi immigrant population often present with a strong familial burden of type 2 diabetes with the worst glycemic control and highest diabetes risk in individuals with ≥ 3 siblings and parents with diabetes. Our data show that in a population still free from diabetes familial burden in uences insulin secretion to a higher degree than insulin action and may be a logical target for intervention.
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| 11. |
- Bennet, Louise
(författare)
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Hög diabetesrisk bland icke-västerländska invandrare : Riktad och strukturerad prevention behövs
- 2018
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Ingår i: Läkartidningen. - 0023-7205. ; 115:8, s. 354-354
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Tidskriftsartikel (refereegranskat)abstract
- Political instability the last decades has forced millions of people to migrate from their homelands. In Sweden today, 1.6 million are born abroad, of which the largest immigrant groups originate from the Middle East. Immigrants from these areas represent high risk populations for type 2 diabetes with prevalence of type 2 diabetes twice as high compared to the native Swedish population. The mechanisms behind this increased diabetes risk are not fully unraveled but are likely connected to lifestyle, socioeconomic situation, genetics and epigenetics. A large proportion still free from diabetes are likely to develop diabetes within the coming decade. To prevent this epidemic, increased awareness of risk factors, lifestyle habits, potential barriers and of success factors for lifestyle change in immigrant populations is important. Examples of such preventive actions are culturally adapted lifestyle interventions addressing cultural barriers and behavioral change, which are described in this article.
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| 12. |
- Bennet, Louise, et al.
(författare)
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Self-rated health and social capital in Iraqi immigrants to Sweden : The MEDIM population-based study
- 2018
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; , s. 194-194
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Poor self-rated health is an estimator of quality of life and a predictor of mortality seldom studied in immigrant populations. This work aimed to study self-rated health in relation to social capital, socioeconomic status, lifestyle and comorbidity in immigrants from Iraq - one of the largest non-European immigrant group in Sweden today - and to compare it with the self-rated health of native Swedes.DESIGN: The study was a cross-sectional population-based study conducted from 2010 to 2012 among citizens of Malmö, Sweden, aged 30-65 years and born in Iraq or Sweden. All participants underwent a health examination and answered questionnaires on self-rated health, social capital, comorbidity, lifestyle and socioeconomic status.RESULTS: In total, 1348 Iraqis and 677 Swedes participated. Poor self-rated health was identified in 43.9% of Iraqis and 21.9% of native Swedes ( p<0.001), with the highest prevalence (55.5%) among Iraqi women. Low social capital was highly prevalent in the immigrants. Female gender showed higher odds of poor self-rated health in Iraqis than in Swedes (OR 1.8, 95% CI 1.4-2.5, pinteraction=0.024), independent of other risk factors connected to social capital, socioeconomic status, lifestyle or comorbidity.CONCLUSIONS: Although public health initiatives promoting social capital, socioeconomic status and comorbidity in immigrants are crucial, the excess risk of poor self-rated health in Iraqi women is not fully attributed to known risk factors for self-rated health, but remains to be further explored.
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| 13. |
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| 14. |
- Memon, Ashfaque, et al.
(författare)
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Circulating HER2 is associated with hyperglycaemia and insulin resistance.
- 2015
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Ingår i: Journal of Diabetes. - : Wiley. - 1753-0407 .- 1753-0393. ; 7:3, s. 369-377
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Tidskriftsartikel (refereegranskat)abstract
- Type 2 diabetes mellitus (T2DM) and HER2 are associated with cancer although the role of HER2 in T2DM is not well defined. Our aim was to investigate the association between HER2 levels and T2DM and whether that association was different in Swedish people born in Iraq or Sweden.
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| 15. |
- Modesti, Pietro Amedeo, et al.
(författare)
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Panethnic Differences in Blood Pressure in Europe : A Systematic Review and Meta-Analysis
- 2016
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 11:1, s. 0147601-0147601
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Forskningsöversikt (refereegranskat)abstract
- BACKGROUND: People of Sub Saharan Africa (SSA) and South Asians(SA) ethnic minorities living in Europe have higher risk of stroke than native Europeans(EU). Study objective is to provide an assessment of gender specific absolute differences in office systolic(SBP) and diastolic(DBP) blood pressure(BP) levels between SSA, SA, and EU.METHODS AND FINDINGS: We performed a systematic review and meta-analysis of observational studies conducted in Europe that examined BP in non-selected adult SSA, SA and EU subjects. Medline, PubMed, Embase, Web of Science, and Scopus were searched from their inception through January 31st 2015, for relevant articles. Outcome measures were mean SBP and DBP differences between minorities and EU, using a random effects model and tested for heterogeneity. Twenty-one studies involving 9,070 SSA, 18,421 SA, and 130,380 EU were included. Compared with EU, SSA had higher values of both SBP (3.38 mmHg, 95% CI 1.28 to 5.48 mmHg; and 6.00 mmHg, 95% CI 2.22 to 9.78 in men and women respectively) and DBP (3.29 mmHg, 95% CI 1.80 to 4.78; 5.35 mmHg, 95% CI 3.04 to 7.66). SA had lower SBP than EU(-4.57 mmHg, 95% CI -6.20 to -2.93; -2.97 mmHg, 95% CI -5.45 to -0.49) but similar DBP values. Meta-analysis by subgroup showed that SA originating from countries where Islam is the main religion had lower SBP and DBP values than EU. In multivariate meta-regression analyses, SBP difference between minorities and EU populations, was influenced by panethnicity and diabetes prevalence.CONCLUSIONS: 1) The higher BP in SSA is maintained over decades, suggesting limited efficacy of prevention strategies in such group in Europe;2) The lower BP in Muslim populations suggests that yet untapped lifestyle and behavioral habits may reveal advantages towards the development of hypertension;3) The additive effect of diabetes, emphasizes the need of new strategies for the control of hypertension in groups at high prevalence of diabetes.
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| 16. |
- Nilsson, Christopher, et al.
(författare)
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Renal function and its association with blood pressure in Middle Eastern immigrants and native Swedes
- 2017
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Ingår i: Journal of Hypertension. - 0263-6352. ; 35:12, s. 2493-2500
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:: Iraqi-born immigrants residing in Sweden are at high risk for type 2 diabetes, obesity and hyperlipidemia compared with native Swedes. Paradoxically, hypertension is less prevalent in this immigrant population. The aim of this study was to investigate differences in renal function and further if differences in blood pressure (BP) levels were associated with differences across ethnicities in renal function as a possible explanation to the paradox. METHODS:: A population-based, cross-sectional study of men and women, born in Iraq or Sweden, aged 30–75 years was conducted in Malmö, Sweden, from 2010 to 2012. Blood samples were drawn, physical examinations performed and self-administrated questionnaires were assessed. Estimated glomerular filtration rate (eGFR) was calculated from the Caucasian Asian Pediatric Adult cohort formula based on cystatin C. RESULTS:: Participants without history of cardiovascular disease born in Iraq (n?=?1214), irrespective of age and sex, presented with higher eGFR than participants born in Sweden (n?=?659), (96.5?ml/min per 1.73?m vs. 93.6, P?=?0.009). Furthermore, eGFR showed weaker association with BP in Iraqis than in Swedes, especially for SBP. The relationship was confirmed by a significant interaction between eGFR and country of birth (Pinteraction country of birth?×?eGFRcystatinC?=?0.004). CONCLUSION:: The current study shows differences across ethnicities in renal function and its associations with BP. More studies are needed to understand mechanisms contributing to BP regulation and renal function in populations of different ethnic backgrounds.
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| 17. |
- Nilsson, Peter M., et al.
(författare)
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Diabetes : The cost of globalization
- 2017
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Ingår i: Heart and Metabolism. - 1566-0338. ; :73, s. 4-8
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Tidskriftsartikel (refereegranskat)abstract
- The epidemic of type 2 diabetes mellitus (T2DM) on a global scale is a matter of concern, not only from a public health perspective, but also with consideration of societal costs. The increased call on health care resources to treat and monitor T2DM and its complications could put a heavy burden on national health care systems and financing. An important contributing factor for development of T2DM is lifestyle, reflecting increasing affluence and exposure to increased calorie intake in combination with sedentary lifestyle and less human energy expenditure. More detailed glucometabolic studies have been conducted in high-risk migrant populations, eg, from the Middle East. Recently, intervention programs have also been tested to improve lifestyle and reduce the risk of developing T2DM in at-risk individuals. There are many obstacles to success for such programs, which should be tailored not only to the individual in a culture-sensitive way, but also to families and local ethnic communities.
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| 18. |
- Olaya-Contreras, Patricia, 1964, et al.
(författare)
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Perceptions, experiences and barriers to lifestyle modifications in first-generation Middle Eastern immigrants to Sweden : A qualitative study
- 2019
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 9:10, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Objective The prevalence of type 2 diabetes (T2D) among Iraqi immigrants to Sweden is high and partly related to sedentary physical activity and calorie dense food. The aim of the present study was to explore perceptions, experiences and barriers concerning lifestyle modifications (LSM) in Iraqi immigrants to Sweden at risk for T2D. Design A qualitative thematic analysis was conducted on data collected from gender-specific focus group interviews which took place during a culturally adapted randomised controlled intervention study addressing motivation to lifestyle change, self-empowerment, behavioural modifications and sociocultural barriers to LSM. Seven focus groups were held, with an interval of 1-4 weeks between January and May of 2015; each session lasted approximately 1.5 hours. Setting The city of Malmö, Sweden. Participants Out of 27 women and 23 men assigned to the intervention group, 19 women and 14 men who attended at least one focus group session were included in the study. Results Participants expressed awareness of the content of healthy lifestyle practices. They also expressed numerous social and cultural barriers to LSM connected to irregular meals, overeating, food and drinking preferences and family expectations. Overeating was described as a consequence of social and cultural norms and expectations and of poor mental well-being. Facilitators for reaching successful LSM were connected to family involvement and support. Conclusion Our study reports that facilitators for LSM are connected to presence of family support. Preventive actions addressing family involvement may benefit Middle Eastern immigrants at high risk for T2D to consider healthier lifestyles practices. Identification of sociocultural barriers and facilitators for LSM are crucial for successful health promotion in minority populations at risk for T2D. Trial registration Trial registration number: NCT01420198 for the MEDIM-study; Pre-results.
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| 19. |
- Saha, Sanjib, et al.
(författare)
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Valuing a Lifestyle Intervention for Middle Eastern Immigrants at Risk of Diabetes
- 2018
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601. ; 15:3
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Tidskriftsartikel (refereegranskat)abstract
- Willingness-to-pay (WTP) techniques are increasingly being used in the healthcare sector for assessing the value of interventions. The objective of this study was to estimate WTP and its predictors in a randomized controlled trial of a lifestyle intervention exclusively targeting Middle Eastern immigrants living in Malmö, Sweden, who are at high risk of type 2 diabetes. We used the contingent valuation method to evaluate WTP. The questionnaire was designed following the payment-scale approach, and administered at the end of the trial, giving an ex-post perspective. We performed logistic regression and linear regression techniques to identify the factors associatedwith zero WTP value and positive WTP values. The intervention group had significantly higher average WTP than the control group (216 SEK vs. 127 SEK; p= 0.035; 1 U.S.$ = 8.52 SEK, 2015 price year) per month. The regression models demonstrated that being in the intervention group, acculturation, and self-employment were significant factors associated with positive WTP values. Male participants and lower-educated participants had a significantly higher likelihood of zero WTP. In this era of increasedmigration, our findings can help policy makers to take informed decisions to implement lifestyle interventions for immigrant populations.
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| 20. |
- Siddiqui, Faiza, et al.
(författare)
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Changes in dietary intake following a culturally adapted lifestyle intervention among Iraqi immigrants to Sweden at high risk of type 2 diabetes : a randomised trial
- 2017
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Ingår i: Public Health Nutrition. - 1368-9800. ; 20:15, s. 2827-2838
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the effectiveness of a culturally adapted lifestyle intervention for changing dietary intake, particularly energy, fat and fibre intakes, in the intervention group (IG) compared with the control group (CG). Design: Randomised controlled trial. Setting: IG (n 50) and CG (n 46). The IG was offered seven group sessions, including one cooking class, over a period of 4 months. The participants filled out 4 d food diaries at the start, mid and end of the study. Subjects: Iraqi-born residents of Malmö, Sweden, at increased risk for developing diabetes. Results: At baseline, participants’ fat intake was high (40 % of total energy intake (E%)). The predefined study goals of obtaining <30 E% from fat and ≥15 g fibre/4184 kJ (1000 kcal) were met by very few individuals. In the IG v. the CG, the proportion of individuals obtaining <40 E% from fat (48·4 v. 34·6 %, P=0·65), <10 E% from saturated fat (32·3 v. 11·5 %, P=0·14) and ≥10 g fibre/4184 kJ (45·2 v. 26·9 %, P=0·46) appeared to be higher at the last visit, although the differences were statistically non-significant. A trend towards decreased mean daily intakes of total energy (P=0·03), carbohydrate (P=0·06), sucrose (P=0·02) and fat (P=0·02) was observed within the IG. Differences in changes over time between the groups did not reach statistical significance. Conclusions: Although no significant differences were observed in the two groups, our data indicate that this culturally adapted programme has the potential to modify dietary intake in Middle Eastern immigrants. The high fat intake in this group should be addressed.
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| 21. |
- Siddiqui, Faiza, et al.
(författare)
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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
- 2017
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Ingår i: Metabolism: Clinical and Experimental. - : Elsevier BV. - 0026-0495 .- 1532-8600. ; 66, s. 1-13
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Tidskriftsartikel (refereegranskat)abstract
- Background andAims Middle-Eastern immigrants constitute a growing proportion of the Swedish population and are at high risk for Type 2 diabetes. This calls for a more proactive preventive approach for dealing with diabetes risk in this target group. The aim was to test the effect of a culturally adapted lifestyle intervention programme on changes in lifestyle habits and cardio-metabolic outcomes comparing an intervention group with a control group receiving usual care. Methods Citizens of Malmö, Sweden born in Iraq and at high risk for Type 2 diabetes (n=636) were invited. Participation rate was 15.1%. In all, 96 participants were randomized to the intervention group (n=50) or to the control group (n=46). The intervention group was offered seven group sessions addressing healthy diet and physical activity including one cooking class. Changes in body weight, physical activity levels and cardio-metabolic outcomes were evaluated using linear mixed-effects models. Results The mean follow-up time was 3.9 and 3.5months in the intervention and control groups, respectively. The drop-out rate from baseline to the last visit was 30.0% in the intervention group (n=15) and 30.4% in the control group (n=14). The mean insulin sensitivity index increased significantly at follow-up in the intervention group compared to the control group (10.9% per month, p=0.005). The intervention group also reached a significant reduction in body weight (0.4% per month, p=0.004), body mass index (0.4% per month, p=0.004) and LDL-cholesterol (2.1% per month, p=0.036) compared to the control group. In total, 14.3% in the intervention group reached the goal to lose ≥5% of body weight versus none in the control group. Conclusions This culturally adapted lifestyle intervention programme shows a beneficial effect on insulin action, body weight reduction, as well as LDL-cholesterol reduction, in Middle-Eastern immigrants. The programme adapted to resources in primary health care provides tools for improved primary prevention and reduced cardio-metabolic risk in this high-risk group for Type 2 diabetes. © 2016 The Authors
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| 22. |
- Siddiqui, Faiza, et al.
(författare)
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Effects of a randomized, culturally adapted, lifestyle intervention on mental health among Middle-Eastern immigrants
- 2019
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Ingår i: European Journal of Public Health. - : Oxford University Press (OUP). - 1101-1262 .- 1464-360X. ; 29:5, s. 888-894
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Tidskriftsartikel (refereegranskat)abstract
- Background Middle-Eastern immigrants in Sweden are at increased risk for type 2 diabetes (T2D) and poor mental health. Physical activity not only prevents/delays onset of T2D but also shows favorable effects on mental health. However, the effects of a culturally adapted lifestyle intervention on mental health among Middle-Eastern immigrants have not been explored before. We aimed to study the effects of a randomized controlled, culturally adapted lifestyle intervention on anxiety and depression levels in diabetes-prone Iraqi immigrants. Methods Participants (n = 96) were randomized to intervention group, IG (n = 50) or control group, CG (n = 46). The IG received seven group sessions addressing lifestyle change and the CG received treatment as usual. Montgomery–Åsberg Depression Rating Scale (MADRS-S) and Hospital Anxiety and Depression Scale (HADS) assessed mental health at start, mid (2 months) and end of the study (4 months). Proportional odds ratio (OR) model was used to study the effect of the intervention. Results The odds of scoring lower on MADRS-S and HADS depression scale at visit 3 vs. baseline were higher in the IG compared to the CG (MADRS-S OR 5.9, 95% CI: 1.6–22.5; HADS OR 4.4, 95% CI: 0.9–20.3). The findings persisted after adjustment for age, sex, body mass index, time since migration, sedentary lifestyle and language spoken at home. Group differences were non-significant at visit 2 vs. baseline. Conclusion A culturally adapted lifestyle intervention addressing T2D prevention in Middle-Eastern immigrants has favorable effects on mental health. The effect was more pronounced at the 4 months than at 2 months follow-up, indicating beneficial effect of longer study duration. Trial registration www.clinicaltrials.gov NCT01420198.
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| 23. |
- Siddiqui, Faiza, et al.
(författare)
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Physical Activity in a Randomized Culturally Adapted Lifestyle Intervention
- 2018
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Ingår i: American Journal of Preventive Medicine. - : Elsevier BV. - 0749-3797. ; 55:2, s. 187-196
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Middle Eastern immigrants exhibit high levels of physical inactivity and are at an increased risk for Type 2 diabetes. The primary aim of this study was to examine the changes in objectively assessed physical activity levels following a culturally adapted lifestyle intervention program. The secondary aim was to examine the association between objectively assessed physical activity and insulin sensitivity. Participants: Iraqi immigrants residing in Malmo, Sweden, exhibiting one or more risk factors for Type 2 diabetes. Intervention: The intervention group (n=50) was offered a culturally adapted lifestyle intervention comprising seven group sessions including a cooking class. The control group (n=46) received usual care. Main outcome measures: Raw accelerometry data were processed by validated procedures and daily mean physical activity intensity, vector magnitude high-pass filtered (VM-HPF), was inferred. Further inferences into the number of hours/day spent in sedentary (VM-HPF <48 milli-Gs [mGs] where G=9.8 m/sec(2)) and light- (48- <163 mGs); moderate- (163- <420 mGs); and vigorous-intensity (>= 420 mGs) activities were also calculated (year of analysis was 2016-2017). Results: No difference was observed between the two groups in terms of change over time in VM-HPF. There was a significant increase in the number of hours/day spent in light intensity physical activity in the intervention group compared with the control group (beta=0.023, 95% CI=0.001, 0.045, p=0.037). The intervention group also increased the time spent in sedentary activities, with the highest VM-HPF (36- < 48 mGs) within the sedentary behavior (B=0.022, 95% CI=0.002, 0.042, p=0.03). Higher VM-HPF was significantly associated with a higher insulin sensitivity index (beta=0.014, 95% CI=0.0004, 0.025, p=0.007). Conclusions: The findings favor the culturally adapted intervention approach for addressing low physical activity levels among Middle Eastern immigrants. Replacing sedentary time with light-intensity activities could be an achievable goal and will have potential beneficial effects for diabetes prevention among this sedentary group of immigrants. Trial registration: This study was registered at www.clinicaltrials.gov NCT01420198. Am J Prev Med 2018;55(2):187-196. (C) 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
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| 24. |
- Siddiqui, Faiza, et al.
(författare)
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The Effect of Family History of Diabetes and Middle Eastern Background on Abdominal Obesity is Modified by Gender: A Population based Cross-Sectional Study
- 2018
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Ingår i: Current Research in Diabetes & Obesity Journal (CRDOJ). - 2476-1435. ; 6:1, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Background: Abdominal obesity is on the increase worldwide and ethnic minority groups are at high risk. However, studies of the underlying causes are scarce. The aims of this study were to investigate the prevalence of abdominal obesity and to identify metabolic, lifestyle and socio-demographic risk factors associated with abdominal obesity in male and female residents of Malmö, a city in southern Sweden, comparing those born in Iraq with those born in Sweden.Method: We conducted a population-based, cross-sectional study from 2010 to 2012. Both male and female residents of Malmö, aged 30-75 years, born in Iraq (n=1387) or Sweden (n=749), underwent a physical examination. Fasting blood samples were drawn and socio-demography and lifestyle were characterized using questionnaires. Associations with abdominal obesity were assessed by logistic regression analysis.Results: Abdominal obesity (waist circumference ≥80 cm in women and ≥94 cm in men) was highly prevalent and was most common in Iraqi-born women (Iraqi-born women 89.2% vs. Swedish women 73.1%, p<0.001, Iraqi-born men 70.2% vs. Swedish men 63.6%, p<0.003). Furthermore, family history of diabetes was more prevalent in participants born in Iraq than those born in Sweden (53.6% vs.28.5%, p<0.001). Based on the total study population, female gender, Middle Eastern background, family history of diabetes and depression conveyed higher odds of abdominal obesity. Family history of diabetes and Middle Eastern origin conveyed higher odds of abdominal obesity in females than in males (Pinteraction: Female gender*Family history=0.023; Pinteraction: Female gender*Middle Eastern origin =0.011).Conclusion: Abdominal obesity is highly prevalent irrespective of Middle Eastern or Caucasian background but most prevalent in Iraqi-born women. Our findings suggest that factors related to heritage such as genetics and traditional lifestyles, influence excess risk in Middle Eastern females in particular, which should be taken into consideration when planning preventive actions.Keywords: Abdominal obesity; Migration; Middle East; Family history of diabetes; GenderAbbreviations: BMI: Body Mass Index; CVD: Cardiovascular Disease; FPG: Fasting Plasma Glucose; HAD scale: Hospital Anxiety and Depression Scale; IDF: International Diabetes Federation; OGTT: Oral Glucose Tolerance Test; PA: Physical Activity; The MEDIM study: The Impact of Migration and Ethnicity on Diabetes in Malmö; T2D: Type 2 Diabetes; WHO: World Health Organization
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| 25. |
- Wemrell, Maria, et al.
(författare)
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Understanding the complexity of socioeconomic disparities in type 2 diabetes risk : a study of 4.3 million people in Sweden
- 2019
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Ingår i: BMJ Open Diabetes Research & Care. - : BMJ Publishing Group Ltd. - 2052-4897. ; 7:1
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Tidskriftsartikel (refereegranskat)abstract
- Objective Investigating demographic and socioeconomic factors as intersecting rather than as separate dimensions may improve our understanding of the heterogeneous distribution of type 2 diabetes in the population. However, this complexity has scarcely been investigated and we still do not know the accuracy of these factors for predicting type 2 diabetes. Improved understanding of the demographic and socioeconomic disparities predicting type 2 diabetes risk in the population would contribute to more precise and effective public health interventions.Research design and methods We analyzed the risk of type 2 diabetes among 4 334 030 individuals aged 40–84 years who by 2010 had resided in Sweden for at least 5 years. We stratified the study population into 120 strata defined by categories of age, gender, income, education, and immigration status. We calculated measures of absolute risk (prevalence) and relative risk (prevalence ratio), and quantified the discriminatory accuracy of the information for predicting type 2 diabetes in the population.Results The distribution of type 2 diabetes risk in the population was highly heterogeneous. For instance, immigrated men aged 70–79 years with low educational achievement and low income had a risk around 32 times higher than native women aged 40–49 years with high income and high educational achievement (ie, 17.6% vs 0.5%). The discriminatory accuracy of the information was acceptable.Conclusion A more detailed, intersectional mapping of socioeconomic and demographic distribution of type 2 diabetes can assist in public health management aiming to reduce the prevalence of the disease.
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