Abstract
High prevalence of type 2 diabetes (T2D) is seen in some immigrant groups in Western countries, particularly in those from the Indian subcontinent. Our aims were to increase the physical activity (PA) level in a group of Pakistani immigrant men, and to see whether any increase was associated with reduced serum glucose and insulin concentrations. The intervention was developed in collaboration with the Pakistani community. It used a social cognitive theory framework and consisted of structured supervised group exercises, group lectures, individual counselling and telephone follow-up. One- hundred and fifty physically inactive Pakistani immigrant men living in Oslo, Norway, were randomised to either a control group or an intervention group. The 5-month intervention focused on increasing levels of PA, which were assessed by use of accelerometer (Actigraph MTI 7164) recordings. Risk of diabetes was assessed by serum glucose and insulin concentrations determined in a fasted state, and after an oral glucose tolerance test (OGTT). ANCOVA was used to assess differences between groups. There was a mean difference in PA between the two groups of 49 counts per minute per day, representing a 15 % (95 % CI = 8.7–21.2; P = 0.01) higher increase in total PA level in the intervention group than in the control group. Insulin values taken 2 h after an OGTT were reduced in the intervention group by 27 % (95 % CI = 18.9–35.0; P = 0.02) more than those in the control group. There were no differences in fasting or postprandial glucose values between the groups at the follow-up test. This type of intervention can increase PA and reduce serum insulin in Pakistani immigrant men, thereby presumably reducing their risk of T2D.
Highlights
Immigrants comprise an increasing proportion of many Western populations
Physical inactivity seems more prevalent among South Asian (SA) immigrants than in the native population [8,9,10,11] and is, together with central obesity [12], highly likely to contribute to insulin resistance [13]
A higher prevalence of type 2 diabetes (T2D) and other cardiovascular disease (CVD) risk factors among immigrants living in their new country compared with those from their country of origin may support the hypothesis that a change in lifestyle, such as lowered physical activity, is a causative factor [2, 14]
Summary
Immigrants comprise an increasing proportion of many Western populations. In Norway, the immigrant population is predicted to increase from currently 11 % of the population, to 22–28 % of the population in 2060 [1]. A higher prevalence of type 2 diabetes (T2D), which is a main risk factor for cardiovascular disease (CVD), is seen in some immigrant groups. It seems that those who have migrated from the Indian subcontinent (Pakistan, India and Bangladesh) to Western countries, and their descendants, are vulnerable to this disease [2,3,4,5]. The reason for this apparent higher disease risk is not known, but is probably attributed in part to an excess of insulin resistance [4, 6, 7].
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