Effectiveness of prevention programmes for obesity and chronic diseases among immigrants to developed countries – a systematic review

Andre MN Renzaho, David Mellor, Kelly Boulton, Boyd Swinburn
2009 Public Health Nutrition  
Objective: To determine whether interventions tailored specifically to particular immigrant groups from developing to developed countries decrease the risk of obesity and obesity-related diseases. Design: Databases searched were MEDLINE (), as well as Sociological Abstracts, PsychARTICLES, Science Direct, Web of Knowledge and Google Scholar. Studies were included if they were randomised control trials, 'quasi-randomised' trials or controlled before-and-after studies. Due to the heterogeneity of
more » ... study characteristics only a narrative synthesis was undertaken, describing the target population, type and reported impact of the intervention and the effect size. Results: Thirteen studies met the inclusion criteria. Ten out of thirteen (77 %) studies focused on diabetes, seven (70 %) of which showed significant improvement in addressing diabetes-related behaviours and glycaemic control. The effect on diabetes was greater in culturally tailored and facilitated interventions that encompassed multiple strategies. Six out of the thirteen studies (46 %) incorporated anthropometric data, physical activity and healthy eating as ways to minimise weight gain and diabetes-related outcomes. Of the six interventions that included anthropometric data, only two (33 %) reported improvement in BMI Z-scores, total skinfold thickness or proportion of body fat. Only one in three (33 %) of the studies that included cardiovascular risk factors reported improvement in diastolic blood pressure after adjusting for baseline characteristics. All studies, except four, were of poor quality (small sample size, poor internal consistency of scale, not controlling for baseline characteristics). Conclusions: Due to the small number of studies included in the present review, the findings that culturally tailored and facilitated interventions produce better outcomes than generalised interventions, and that intervention content is more important than the duration or venue, require further investigation. Migration from developing countries to affluent, Westernised countries is associated with an increased risk of chronic disease, especially obesity, diabetes and chronic heart diseases (1-3) . For example, the Ghanaian Health and Nutrition Analysis in Sydney found an increase in selfreported BMI (23?8 (SD 2?2) kg/m 2 for men and 23?4 (SD 4?5) kg/m 2 for women pre-migration v. 27?2 (SD 2?8) kg/m 2 and 27?4 (SD 4?7) kg/m 2 , respectively, post-migration) among Ghanaian migrants (4) . The study also found a high prevalence of both type 2 diabetes mellitus (T2DM) and impaired fasting glucose. The prevalence of T2DM was 20 % in men and 11 % in women, and impaired fasting glucose was 22 % and 20 %, respectively. Only 23 % of study participants were aware of their T2DM status, indicating the lack of awareness and the increased risk of medical conditions related to uncontrolled diabetes. These findings were consistent with those reported in studies of the African Diaspora of West African origin (5, 6) and Ethiopian migrants to Israel (7, 8) .
doi:10.1017/s136898000999111x pmid:19723366 fatcat:24ujfdfsxng6xczwbh4uamcrsq