Should Physical Activity Recommendations for South Asian Adults Be Ethnicity-Specific? Evidence from a Cross-Sectional Study of South Asian and White European Men and Women.

Stamatina Iliodromiti,Jason M R Gill,Carlos A Celis-Morales,Naveed Sattar,Mary Ann Lumsden,Nazim Ghouri,Shahrad Taheri

doi:10.1371/journal.pone.0160024

Abstract

International public health guidelines recommend that adults undertake at least 150 min.week−1 of moderate-intensity physical activity. However, the underpinning evidence has largely been obtained from studies of populations of white European descent. It is unclear whether these recommendations are appropriate for other ethnic groups, particularly South Asians, who have greater cardio-metabolic risk than white Europeans. The objective of our study was to determine the level of moderate-intensity physical activity required in South Asians adults to confer a similar cardio-metabolic risk profile to that observed in Europeans of similar age and body mass index (BMI) undertaking the currently recommended levels of 150 min.week−1. 148 South Asians and 163 white Europeans aged 18 to 70 years were recruited. Physical activity was measured objectively via vertical axis accelerations from hip-worn accelerometers. Factor analysis was used to summarize the measured risk biomarkers into a single underlying latent “factor” describing overall cardio-metabolic risk. Sex did not modify the association between physical activity and the cardio-metabolic risk factor, so data for both sexes were combined and models adjusted for age, sex, BMI and accelerometer wear time. We estimated that South Asian adults needed to undertake 232 (95% Confidence interval: 200 to 268) min.week−1 in order to obtain the same cardio-metabolic risk factor score as a white European undertaking 150 minutes of moderate-equivalent physical activity per week. The present findings suggest that South Asian men and women need to undertake ~230 minutes of moderate intensity physical activity per week. This equates to South Asians undertaking an extra 10–15 minutes of moderate intensity physical activity per day on top of existing recommendations.

Highlights

There is overwhelming evidence suggesting that migrant South Asians living in high income countries develop type 2 diabetes (T2D) and cardiovascular disease (CVD) almost five to 10 years younger and at lower levels of adiposity than people of white European descent [1,2,3,4]
The analyses suggest that South Asian adults need to undertake 232 min.week-1 of moderate-equivalent physical activity to achieve the same cardio-metabolic risk factor value as European adults undertaking 150 min.week-1 moderate-equivalent physical activity, in analyses adjusted for age, body mass index (BMI) and accelerometer wear time
The present findings suggest that South Asian men and women need to undertake ~230 minutes of moderate intensity physical activity per week to confer a similar cardio-metabolic risk profile to adults of white European descent achieving current physical activity recommendations of 150 minutes per week

Summary

Introduction

There is overwhelming evidence suggesting that migrant South Asians living in high income countries develop type 2 diabetes (T2D) and cardiovascular disease (CVD) almost five to 10 years younger and at lower levels of adiposity than people of white European descent [1,2,3,4]. We recently used the approach adopted for the calculation of ethnicity-specific obesity cut-points [18,19] to approximate the level of physical activity needed in South Asian men to confer a similar cardio-metabolic disease risk profile as white European men undertaking 150 minutes of moderate physical activity per week [20] [21] It is not known whether these findings extend to South Asian women, who have high T2D and CVD risk [22,23,24,25] and are typically highly inactive [26,27]

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Discussion

Conclusion