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'Asian' Participants of the 2008/09 Adult National Nutrition Survey

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'Asian' Participants of the 2008/09 Adult National Nutrition Survey Public Health Nutrition: 18(5), 893–904 doi:10.1017/S1368980014001049 A profile of New Zealand ‘Asian’ participants of the 2008/09 Adult National Nutrition Survey: focus on dietary habits, nutrient intakes and health outcomes Sherly M Parackal1,*, Claire Smith2 and Winsome Ruth Parnell2 1School of Population Health, Faculty of Medical and Health Science, The University of Auckland, Bldg 730, 261 Morrin Road, Glen Innes, Pvt Bag 92019, Auckland, New Zealand: 2Department of Human Nutrition, University of Otago, Dunedin, New Zealand Submitted 29 November 2013: Final revision received 27 March 2014: Accepted 28 April 2014: First published online 2 June 2014 Abstract Objective: To investigate similarities and differences in dietary habits, nutrient intakes and health outcomes of South Asians (SA) and East and South-East Asians (ESEA) and the New Zealand European and Other (NZEO) group, and to examine differences within ‘Asian’ subgroups according to duration of residence. Design: Nutrient intake data from 24 h diet recalls and data from the dietary habits questionnaire, anthropometry and biochemical analyses from the cross-sectional 2008/09 Adult National Nutrition Survey in New Zealand were compared for participants categorized as SA, ESEA and NZEO. Subjects: Adults aged 15 years and older (n 2995). Setting: New Zealand households. Results: SA were more likely to ‘never’ eat red meat in comparison to NZEO (P < 0·001) and among females also in comparison to ESEA (P < 0·05). Intakes of fats and some micronutrients (riboflavin, vitamin B6,B12, Se) were lower among SA than NZEO (P < 0·05). Lower intakes of Zn and vitamin B12 were reported by SA females compared with ESEA and NZEO females (P < 0·05). A higher percentage of SA were obese using ethnic-specific cut-offs, had lower indices of Fe status and reported diagnosed diabetes compared with NZEO and ESEA. Keywords β Recent SA male migrants had higher intakes of -carotene, vitamin C and Ca South Asians compared with long-term migrants (P < 0·05). East/South-East Asians Conclusions: The results of the present study indicate that dietary habits, nutrient Dietary habits intakes, blood profile and body size differ significantly between Asian subgroups. Nutrient intakes It also provides some evidence for changes in dietary intakes according to Health outcomes duration of residence especially for SA males. Duration of residence In New Zealand (NZ) it is projected that by 2026, 15 % of risk factor for the development of chronic diseases among – the population will be people of Asian ethnicity, a level South Asian(5,14,19 21) and Chinese(22) migrants. The similar to that projected for the Māori population, the negative consequences of changed dietary patterns and indigenous people of NZ(1). Nutrition-related health issues acculturation have been observed among first-generation – among ‘Asian’ immigrants to Western countries has been a migrants(23 25) and among subsequent generations(26,27). – topic of investigation in recent years(2 8). Research has There is a long history of Asian migration to NZ. However, indicated an elevated risk for type 2 diabetes and CHD few studies have reported dietary patterns and nutrient – among South Asian immigrants(9 14) and cancers among intakes of this growing sector. The 1977 National Diet Chinese immigrants(15,16). Survey(28), the 1989 Life in NZ survey(29) and the 1997 Although migrants can be relatively healthier than the National Nutrition Survey(30) reported dietary intakes of adult resident population on arrival, there is evidence that New Zealanders. However, no attempt was made in these longer duration of residence can mitigate the healthy surveys to provide representative samples to report dietary migrant status(17,18). Numerous factors synergistically intakes of Asians. In NZ the Diabetes Heart and Health Study contribute towards this process, and changes in dietary was probably the first to report dietary intakes for Asian patterns have been identified as an important independent adults and indicated that Asians consumed more dietary Corresponding author: Email [email protected] © The Authors 2014 Downloaded from https://www.cambridge.org/core. 25 Sep 2021 at 07:04:32, subject to the Cambridge Core terms of use. 894 SM Parackal et al. cholesterol and less Ca and alcohol than Europeans(4). Participants reported their highest school-level qualifica- However, reporting results for ‘Asians’ as an ethnic category tion, and if applicable their highest post-school qualification is problematic, as they are a heterogeneous group. Com- (greater than 3 months’ study or training). Four groups bining them in a single ‘Asian’ category averages out sub- were derived: (i) no school or post-school qualifications; group differences and masks important distinctions(31).The (ii) school qualifications only; (iii) trade or technical qua- aims of the present paper were to profile ‘Asian’ participants lifications; and (iv) post-school qualifications (professional of the 2008/09 Adult National Nutrition Survey (NZANS) and or tertiary). report dietary habits, nutrient intakes and health outcomes of The NZ Index of Deprivation (NZDep06) was used Asian subgroups separately to gain some understanding of to measure socio-economic status. This is an area-based similarities and differences between these groups resident in measure and reflects eight dimensions of material NZ. It also aimed to report significant differences within the deprivation(33). For the purposes of the 2008/09 NZANS Asian subgroups according to duration of residence and deprivation scores were divided into quintiles. compare the two Asian subgroups, South Asians (SA) and East and South-East Asians (ESEA), with the New Zealand Duration of residence European and Other (NZEO) group. Participants who reported they were not born in NZ were asked the year they arrived in NZ. Duration of residence was categorized into a dichotomous variable: (i) < 10 Methods years of residence (recent migrants); and (ii) ≥ 10 years of residence and NZ born (long-term migrants). Statistically Study design and sample significant differences in dietary habits and nutrient intakes The 2008/09 NZANS was a cross-sectional survey of according to duration of residence have been reported in fi NZ adults (15 years and older). A three-stage, strati ed, the text but are not included in the respective tables. probability-proportional-to-size sample design was used with an overall response rate of 61 % (n 4721). To ensure Dietary habits ā adequate sample sizes to make comparisons, the M ori and Participants were asked about their frequency of con- fi – Paci cethnicgroupsandtheagegroups1518 years and sumption of selected foods in the ‘past four weeks’. 71 years and older were over-sampled. The study was conducted according to the guidelines laid down in the Nutrient intakes Declaration of Helsinki and all procedures involving human A four-stage 24 h diet recall was administered by trained participants were approved by the Multi-Region Ethics interviewers using LINZ24 (a computer software system)(32). Committee. Written informed consent was obtained from all Of those completing one diet recall a randomly selected participants. A computer-based interviewer-administered sub-sample (25 %) also completed a second 24 h diet recall; questionnaire was used to collect information on dietary however, mean nutrient intakes were calculated from the habits, nutrition-related health and demographics. A full first day of recall only because of inadequate numbers of (32) description of the methods is available elsewhere . repeat recalls in the Asian groups. Energy and nutrient intakes were determined using a tailored and expanded Demographic information and ethnicity version of the New Zealand Food Composition Database(32). Information on ethnicity was collected using the Statistics New Zealand standard ethnicity question. For the present Biochemical/blood indices research, if participants reported belonging to two or more A non-fasting venous blood sample was provided by a total groups they were assigned to a single group using the of 3348 participants (not pregnant) and 3315 provided following order: (i) South Asian (SA); (ii) East and South- a spot urine sample. Full details on the analytical methods East Asian (ESEA); (iii) Māori; (iv) Pacific; and (v) New for all biochemical analyses are available elsewhere(32). Zealand European and Others (NZEO). For example, if a Concentrations of glycated Hb (HbA1c), total cholesterol, participant reported he/she was Māori and East Asian he/ HDL-cholesterol, serum ferritin, Hb, serum Fe, and red she was coded as East Asian. Data from participants coded blood cell (RBC) and serum folate were reported. as Māori and Pacific are not presented in this paper. Inclu- ded in the SA group were participants who self-identified as Iron and folate status Indian, Bangladeshi, Nepalese, Pakistani, Fiji Indian, Afghani Low Hb was defined as: < 136 g/l (15–19 years, males); and Sri Lankan; and in the ESEA group participants who < 137 g/l (20–49 years, males); < 133 g/l (50–69 years, reported they were Chinese (includes Malaysian, Hong males); < 124 g/l (70 + years, males); < 120 g/l (15–69 Kong, Cambodian, Singaporean and Vietnamese Chinese), years, females); and < 118 g/l (70 + years, females). Fe Malaysian, Taiwanese, Filipino, Cambodian, Vietnamese, deficiency with or without anaemia was defined as serum Burmese, Indonesian, Thai, Japanese, Korean and Tibetan. ferritin < 12 μg/l and Zn protoporphyrin > 60 μmol/mol. Fe The ‘Others’ in the NZEO group includes all other ethni- deficiency with anaemia was defined as serum ferritin cities mainly Latin American and African. < 12 μg/l and Zn protoporphyrin > 60 μmol/mol and low Hb. Downloaded from https://www.cambridge.org/core. 25 Sep 2021 at 07:04:32, subject to the Cambridge Core terms of use. The nutrition of Asian New Zealanders 895 Low RBC folate was defined as < 317 nmol/l and low blood and health indices, overweight, obesity and ethnic serum folate as < 6·8 mmol/l.
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