South Asian Males Research Articles

Anthropometric indices in predicting 10-year cardiovascular risk among males and females aged 40–74 years in south and southeast Asia: analysis of 12 WHO STEPS survey data

The relevance of anthropometric indices in predicting cardiovascular disease (CVD) or CVD risk factors is established across different countries, particularly in the high-income countries. However, past studies severely lacked representation from the south and southeast Asian countries. The main aim of this study was to determine the performance of conventional and new anthropometric indices to best predict 10-year cardiovascular disease (CVD) risk in south Asian and southeast Asian populations. The present study examined data from 14,532 participants in three south Asian and 13,846 participants (all aged between 40 and 74 years) in six southeast Asian countries, drawn from twelve cross-sectional studies (WHO STEPwise approaches to NCD risk factor surveillance [STEPS] survey data from 2008 to 2019). A Predictive performance of ten anthropometric indices were examined for predicting 10-year CVD risk ≥ 10% (CVD-R ≥ 10%). The 10-year CVD-R ≥ 10% was calculated by utilising the WHO CVD risk non-laboratory-based charts. Receiver operating characteristic (ROC) curve analysis was used to identify the optimal anthropometric index. Among the ten anthropometric indices, a body shape index (ABSI), body adiposity index (BAI), body roundness index (BRI), hip index (HI), and waist-height ratio (WHtR) performed best in predicting 10-year CVD risk among south Asian males and females. Improved performances were found for ABSI, BRI, conicity index (CI), WHtR, and waist-hip ratio (WHR) for 10-year CVD-R ≥ 10% predictions among southeast Asian males. Contrastingly, among southeast Asian females, ABSI and CI demonstrated optimal performance in predicting 10-year CVD-R ≥ 10%. The performance of anthropometric indices in predicting CVD risk varies across countries. ABSI, BAI, BRI, HI, and WHtR showed better predictions in south Asians, whereas ABSI, BRI, CI, WHtR, and WHR displayed enhanced predictions in southeast Asians. None.

Alanine aminotransferase elevation varies by ethnicity among Asian and Pacific Islander children with overweight or obesity.

Limited research on alanine aminotransferase (ALT) screening for metabolic dysfunction-associated steatotic liver disease (MASLD) among US Asian/Pacific Islander (PI) children necessitates investigation in this heterogeneous population. Examine ALT elevation among Asian/PI children with overweight or obesity. Elevated ALT prevalence (clinical threshold) and association with body mass index ≥85th percentile were compared among 18 402 Asian/PI and 25 376 non-Hispanic White (NHW) children aged 9-17 years using logistic regression. ALT elevation was more prevalent among Asian/PI (vs. NHW) males with overweight (4.0% vs. 2.7%), moderate (7.8% vs. 5.3%) and severe obesity (16.6% vs. 11.5%), and females with moderate (5.1% vs. 3.0%) and severe obesity (10.2% vs. 5.2%). Adjusted odds of elevated ALT were 1.6-fold and ~2-fold higher for Asian/PI (vs. NHW) males and females (with obesity), respectively. Filipino, Chinese and Southeast Asian males had 1.7-2.1-fold higher odds, but Native Hawaiian/PI (NHPI) and South Asian males did not significantly differ (vs. NHW). Filipina and Chinese females with obesity had >2-fold higher odds, Southeast and South Asian females did not differ and NHPI findings were mixed (vs. NHW). High elevated ALT prevalence among Asian/PI children with overweight and obesity emphasizes the need for MASLD risk assessment and examination of ethnic subgroups.

Inverse association between total bilirubin and type 2 diabetes in U.S. South Asian males but not females.

United States South Asians constitute a fast-growing ethnic group with high prevalence of type 2 diabetes (T2D) despite lower mean BMI and other traditional risk factors compared to other races/ethnicities. Bilirubin has gained attention as a potential antioxidant, cardio-protective marker. Hence we sought to determine whether total bilirubin was associated with prevalent and incident T2D in U.S. South Asians. We conducted a cross-sectional and prospective analysis of the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study. Total bilirubin was categorized into gender-specific quartiles (Men: <0.6, 0.6, 0.7-0.8, >0.8; Women: <0.5, 0.5, 0.6, >0.6 mg/dl). We estimated odds of type 2 diabetes as well as other cardiovascular (CV) risk factors using multivariable logistic regression. Among a total 1,149 participants (48% female, mean [SD] age of 57 [9] years), 38% had metabolic syndrome and 24% had T2D. Men and women in the lowest bilirubin quartile had 0.55% and 0.17% higher HbA1c than the highest quartile. Men, but not women, in the lowest bilirubin quartile had higher odds of T2D compared to the highest quartile (aOR [95% CI]; Men: 3.00 [1.72,5.23], Women: 1.15 [0.57,2.31]). There was no association between bilirubin and other CV risk factors. Total bilirubin was inversely associated with T2D in SA men but not women. Longitudinal studies are needed to understand temporality of association.

Ethnic differences in cardiac structure and function assessed by MRI in healthy South Asian and White European people: A UK Biobank Study

BackgroundEchocardiographic studies indicate South Asian people have smaller ventricular volumes, lower mass and more concentric remodelling than White European people, but there are no data using cardiac MRI (CMR). We aimed to compare CMR quantified cardiac structure and function in White European and South Asian people. MethodsHealthy White European and South Asian participants in the UK Biobank Imaging CMR sub-study were identified by excluding those with a history of cardiovascular disease, hypertension, obesity or diabetes. Ethnic groups were matched by age and sex. Cardiac volumes, mass and feature tracking strain were compared. Results121 matched pairs (77 male/44 female, mean age 58 ± 8 years) of South Asian and White European participants were included. South Asian males and females had smaller absolute but not indexed left ventricular (LV) volumes, and smaller absolute and indexed right ventricular volumes, with lower absolute and indexed LV mass and lower LV mass:volume than White European participants. Although there were no differences in ventricular or atrial ejection fractions, LV global longitudinal strain was higher in South Asian females than White European females but not males, and global circumferential strain was higher in both male and South Asian females than White European females. Peak early diastolic strain rates were higher in South Asian versus White European males, but not different between South Asian and White European females. ConclusionsContrary to echocardiographic studies, South Asian participants in the UK Biobank study had less concentric remodelling and higher global circumferential strain than White European subjects. These findings emphasise the importance of sex- and ethnic- specific normal ranges for cardiac volumes and function.

P wave indices, heart rate variability and anthropometry in a healthy South Asian population

BackgroundSouth Asians have a low prevalence of atrial fibrillation (AF) in comparison with White Europeans despite a higher burden of hypertension, diabetes mellitus and coronary artery disease. The reason for this disparity is unclear but may relate to electrophysiological or structural differences within the atria or variations in autonomic function. We aimed to assess these areas using a range of non-invasive cardiac investigations.MethodsA prospective cohort study was performed on 200 South Asian and 200 Caucasian healthy volunteers aged 18–40 years. All subjects underwent electrocardiography (ECG), echocardiography and anthropometric measurements. Eighty subjects in each cohort underwent 24 hour ambulatory ECG and fifty subjects in each cohort underwent exercise testing.ResultsCompared with White Europeans, South Asians were of a smaller height with lower lean body mass and smaller left atrial size. They had reduced P wave dispersion and P wave terminal force in lead V1. South Asians had a lower burden of supraventricular ectopy. They had a higher mean heart rate and South Asian males had lower heart rate variability, suggestive of sympathetic predominance. Exercise capacity was lower in South Asians.ConclusionsSouth Asians have differences in left atrial size, P wave indices, burden of supraventricular ectopy, heart rate, heart rate variability and anthropometric measurements. These differences may relate to variations in atrial morphology, atrial electrophysiology and autonomic function and might help to explain why South Asians are less susceptible to developing AF.

Caucasian and south Asian men show equivalent improvements in surrogate biomarkers of cardiovascular and metabolic health following 6-weeks of supervised resistance training

Background: The South Asian population have greater cardiovascular risk than their age-matched Caucasian counterparts, characterized by unfavorable biomarkers. South Asians may also be partially resistant to the pleiotropic benefits of physical activity on cardiovascular health. There is a current absence of studies that compare markers of cardio-metabolic health between Caucasians and South Asians employing resistance exercise. This study set out to compare the response in biomarkers of cardio-metabolic health in Caucasians and South Asians in response to resistance exercise.Methods: Caucasian (n=15, 25.5 ± 4.8 yrs) and South Asian (n=13, 25.4 ± 7.0 yrs) males completed a 6-week progressive resistance exercise protocol. Fasting blood glucose, insulin, and their product insulin resistance (HOMA-IR), triglycerides (TRIGS), low density lipoprotein (LDL), high density lipoprotein (HDL), total cholesterol (TC), vascular endothelial growth factor (VEGF), asymmetric dimythylarginine (ADMA), L-arginine (L-ARG) and C-reactive protein (CRP) were established at baseline and following resistance exercise.Results: There were significant improvements in fasting glucose, TC, LDL, HDL and VEGF in both groups following resistance exercise (p&lt;0.05, for all). No change was observed in insulin, HOMA-IR, TRIGS, ADMA, L-ARG following resistance exercise (p&gt;0.05, in both groups). CRP increased in the South Asian group (p&lt;0.05) but not the Caucasian group (p&gt;0.05)Conclusions: The cardio-metabolic response to resistance exercise is comparable in young Caucasian and South Asian males though inflammatory response to exercise may be prolonged in South Asians.

Caucasian and south Asian men show equivalent improvements in surrogate biomarkers of cardiovascular and metabolic health following 6-weeks of supervised resistance training

Background: The South Asian population have greater cardiovascular risk than their age-matched Caucasian counterparts, characterized by unfavorable biomarkers. South Asians may also be partially resistant to the pleiotropic benefits of physical activity on cardiovascular health. There is a current absence of studies that compare markers of cardio-metabolic health between Caucasians and South Asians employing resistance exercise. This study set out to compare the response in biomarkers of cardio-metabolic health in Caucasians and South Asians in response to resistance exercise. Methods: Caucasian (n=15, 25.5 ± 4.8 yrs) and South Asian (n=13, 25.4 ± 7.0 yrs) males completed a 6-week progressive resistance exercise protocol. Fasting blood glucose, insulin, and their product insulin resistance (HOMA-IR), triglycerides (TRIGS), low density lipoprotein (LDL), high density lipoprotein (HDL), total cholesterol (TC), vascular endothelial growth factor (VEGF), asymmetric dimythylarginine (ADMA), L-arginine (L-ARG) and C-reactive protein (CRP) were established at baseline and following resistance exercise. Results: There were significant improvements in fasting glucose, TC, LDL, HDL and VEGF in both groups following resistance exercise ( p<0.05, for all). No change was observed in insulin, HOMA-IR, TRIGS, ADMA, L-ARG following resistance exercise ( p>0.05, in both groups). CRP increased in the South Asian group ( p<0.05) but not the Caucasian group ( p>0.05) Conclusions: The cardio-metabolic response to resistance exercise is comparable in young Caucasian and South Asian males though inflammatory response to exercise may be prolonged in South Asians.

Caucasian and south Asian men show equivalent improvements in surrogate biomarkers of cardiovascular and metabolic health following 6-weeks of supervised resistance training.

Background: The South Asian population have greater cardiovascular risk than their age-matched Caucasian counterparts, characterized by unfavorable biomarkers. South Asians may also be partially resistant to the pleiotropic benefits of physical activity on cardiovascular health. There is a current absence of studies that compare markers of cardio-metabolic health between Caucasians and South Asians employing resistance exercise. This study set out to compare the response in biomarkers of cardio-metabolic health in Caucasians and South Asians in response to resistance exercise. Methods: Caucasian (n=15, 25.5 ± 4.8 yrs) and South Asian (n=13, 25.4 ± 7.0 yrs) males completed a 6-week progressive resistance exercise protocol. Fasting blood glucose, insulin, and their product insulin resistance (HOMA-IR), triglycerides (TRIGS), low density lipoprotein (LDL), high density lipoprotein (HDL), total cholesterol (TC), vascular endothelial growth factor (VEGF), asymmetric dimythylarginine (ADMA), L-arginine (L-ARG) and C-reactive protein (CRP) were established at baseline and following resistance exercise. Results: There were significant improvements in fasting glucose, TC, LDL, HDL and VEGF in both groups following resistance exercise ( p<0.05, for all). No change was observed in insulin, HOMA-IR, TRIGS, ADMA, L-ARG following resistance exercise ( p>0.05, in both groups). CRP increased in the South Asian group ( p<0.05) but not the Caucasian group ( p>0.05) Conclusions: The cardio-metabolic response to resistance exercise is comparable in young Caucasian and South Asian males though inflammatory response to exercise may be prolonged in South Asians.

Prevalence and characteristics of supernumerary teeth in patients from Ras Al Khaimah: A retrospective study from a Teaching Dental Hospital in the UAE

Context: Supernumerary teeth are teeth that exceed the normal dental formula. They have variable characteristics and may cause a number of clinical complications. In the Middle East, a prevalence of 0.3%–2.14% has been observed; however, the number of studies of this condition is limited in the region. Aims: This study aimed to examine the prevalence and characteristics of supernumerary teeth in patients from Ras Al Khaimah with consideration of demographic variations. Setting and Design: The study was performed at RAK College of Dental Sciences Dental Clinic. The radiographic database from two consecutive years was used as study sample. Subjects and Methods: A total of 2925 panoramic radiographs were analyzed to identify supernumerary teeth, and demographic-clinical data were extracted from patient files. Statistical Analysis: Data were analyzed using nonparametric tests. P ≤ 0.05 was considered statistically significant. Results: A prevalence of 0.75% was observed. Affected patients were predominantly South Asian males. The teeth were mostly supplemental, para-premolars, and impacted with low incidence of distomolars and no difference in occurrence in the maxilla or mandible. Occurrence of multiple supernumerary teeth was low and restricted to one jaw. Conclusions: This study suggests that one of every 133 patients will have impacted supernumerary teeth that can be expected in the premolar area of the maxilla/mandible, which should be considered when planning community oral health diagnosis and dental treatment strategies.

Lipid droplet dynamics and insulin sensitivity upon a 5-day high-fat diet in Caucasians and South Asians

A 5-day High-Fat High-Calorie diet (HFHC-diet) reduces insulin-stimulated glucose disposal (Rd) in South Asian, but not Caucasian healthy lean males. We aimed to investigate if differences in myocellular lipid handling are underlying this differential response. A two-step hyperinsulinemic-euglycemic clamp and muscle biopsies were performed in 12 healthy lean Caucasian and South Asian males (BMI < 25 kg/m2, 19–25 years) before and after a 5-day HFHC-diet (regular diet + 375 mL cream/day; 1275 kcal/day; 94% fat). Triglyceride extractions and Western Blots for lipid droplet and mitochondrial proteins were performed. Intramyocellular lipid content and HFHC-diet response were similar between ethnicities (group effect: P = 0.094; diet effect: +~30%, P = 0.044). PLIN5 protein content increased upon the HFHC-diet (P = 0.031) and tended to be higher in South Asians (0.87 ± 0.42 AU vs. 1.35 ± 0.58 AU, P = 0.07). 4-HNE tended to increase in South Asians upon the HFHC-diet (interaction effect: P = 0.057). In Caucasians ΔPLIN5 content correlated with ΔRd (Caucasians: r = 0.756, P = 0.011; South Asians: r = −0.085, P = 0.816), while in South Asians Δ4-HNE associated with ΔPLIN5 content (Caucasians: r = 0.312, P = 0.380; South Asians: r = 0.771, P = 0.003). These data indicate that in Caucasians, PLIN5 may be protective against HFHC-diet induced insulin resistance, which for reasons not yet understood is not observed in South Asians, who possess increased lipid peroxidation levels.

Ethnic inequalities in acute myocardial infarction hospitalization rates among young and middle-aged adults in Northern Italy: high risk for South Asians.

The knowledge of ethnic-specific health needs is now essential to design effective health services and population-based prevention strategies. However, data on migrant populations living in Southern Europe are limited. The study is designed to investigate ethnic inequalities in hospitalization for acute myocardial infarction (AMI) in the Veneto region (Italy). Hospital admissions for AMI in Veneto for the whole resident population aged 20-59years during 2008-2013 were studied. Age and gender-specific AMI hospitalization rates for immigrant groups (classified by country of origin according to the United Nations geoscheme) and Italians were calculated. The indirect standardization method was used to estimate standardized hospitalization ratios (SHR) for each immigrant group, with rates of Italian residents as a reference. Overall, 8200 AMI events were retrieved, 648 among immigrants. The highest risk of AMI is seen in South Asians males (SHR 4.2, 95% CI 3.6-4.9) and females (SHR 2.5, 95% CI 1.4-4.5). AMI rates in South Asian males sharply increase in the 30-39years age class. Other immigrant subgroups (Eastern Europe, North Africa, Sub-Saharan Africa, other Asian countries, Central-South America, high-income countries) displayed age- and gender-adjusted hospitalization rates similar to the native population. Present findings stress the urgent need for implementation of ethnic-specific health policies in Italy. The awareness about the high cardiovascular risk in subjects from South Asia must be increased among general practitioners and immigrant communities.

The association between physical activity and sexual dysfunction in patients with diabetes mellitus of European and South Asian origin: The Oxford Sexual Dysfunction Study.

BackgroundThe present study aims to evaluate the relationship between physical activity and sexual dysfunction amongst an ethnic South Asian population living in the United Kingdom and compare the association with that of the native Caucasian population.MethodsTwenty-five general practitioner clinics from eight primary care trusts in the United Kingdom collaborated in the Oxford Sexual Dysfunction Study. In each practice, a sample of diabetic and non-diabetic patients of European/Europid and South Asian origin were invited for the study. Erectile dysfunction (ED) was assessed using a five-item version of the International Index of Erectile Function. Premature ejaculation (PE) was diagnosed using the premature ejaculation diagnostic tool. Libido was assessed by asking participants to grade their desire for sexual activity. Physical activity during the past week was assessed using the short version of the International Physical Activity Questionnaire (IPAQ). A binary logistic regression analysis was performed in all adults, Europids and South Asians with ‘presence of ED’ as the dichotomous dependent variable (0 = ED absent; 1 = ED present) and age, diabetes status, physical activity, ethnicity, current smoking and use of antihypertensive medications as the independent variables.ResultsSample size was 510, and mean age was 56.9 ± 9.7 years. There were 63.9 % (n = 326) Europid males in the study population. The prevalence of ED was 64.5 % and it was significantly higher in men with diabetes than in those without diabetes (84.4 vs. 49.0 %, p < 0.001). The overall prevalence of PE was 28.8 %, (with diabetes 32.6 %, without diabetes 25.8 %; p = 0.109). Reduced libido was reported by 26.9 % of study participants (with diabetes 32.8 %, without diabetes 22.0 %; p < 0.01). The median (IQR) total physical activity of the study population was 2373 (3612) MET-min/week. In the IPAQ categorical score, 36.8 % (n = 184/434) males were ‘highly active’, and 17.8 % (n = 89/434) were ‘inactive’. In all adults, age (OR: 1.06), South Asian ethnicity (OR: 1.40), physical inactivity (OR: 1.62) and presence of diabetes (OR: 3.90) all were associated with significantly increased risk of developing ED. A similar result was observed in Europids but not in South Asians.ConclusionsErectile dysfunction was associated with physical inactivity, mainly in Europid males, irrespective of diabetes status. This association was not observed in South Asian males with or without diabetes.

Temporal trends in cardiovascular disease risk factors among white, South Asian, Chinese and black groups in Ontario, Canada, 2001 to 2012: a population-based study

ObjectivesTo determine ethnic-specific temporal trends in cardiovascular risk factors in Ontario between 2001 and 2012.DesignA population-based repeated cross-sectional study.SettingOntario, Canada.Participants219 276 participants of the Canadian Community Health Survey (205 326...

PTU-019 Pain, perception and reality – comparison of comfort scores of south asian and white british patients undergoing bowel cancer screening colonoscopy:

<h3>Introduction</h3> There have been several studies suggesting South Asian patients have differing pain perception to White British patients.¹Watson <i><i>et al</i>.</i>compared hot and cold pain perception in 20 age-matched South Asian and White British volunteers, with significantly increased heat pain scores and reduced pain threshold.² Recently, Al-Hashimi <i><i>et al</i></i>showed no significant differences in post-operative pain scores and analgesia consumption in 60 South Asian patients undergoing total abdominal hysterectomy versus 60 age-matched White British controls.³ Sedation and analgesia administration is well regulated in colonoscopy practice and comparing comfort scores in similar aged South Asian and White British screening patients is of interest to bowel cancer screening programme (BCSP) centres in ethnically diverse areas. <h3>Method</h3> In 2014, colonoscopy screened individuals (BCSP) in Leicester and Kettering had their self-selected ethnic origin recorded. Comfort scores of 713 patients recorded in the Exeter online database was correlated to ethnic origin data and analysed. <h3>Results</h3> Total number of patients: 713 Difference between means: 0.26 (95% CI: 0.05–0.47) <h3>Conclusion</h3> This analysis shows mean comfort scores are significantly <i>lower</i>in South Asian patients (p = &lt;0.02). This is counter to what published literature might suggest. We reported in 2014 that South Asian patients undergoing BCSP colonoscopy have significantly lower adenoma detection rates when compared to White British patients (31.68% vs 48.09% p = &lt;0.02). ⁴Perhaps fewer adenomas requiring polypectomy lead to more straightforward colonoscopy and lower comfort scores. Whatever the explanation, this analysis shows that pain perception is complex. The interaction of patient ethnicity factors (behavioural, cultural, social and psychological) are not easily predicted and requires further study. <h3>Disclosure of interest</h3> None Declared. <h3>References</h3> Edwards CL, Fillingim RB, Keefe F. Race, ethnicity and pain. Pain 2001; 94: 133–137 Watson PJ, Latif RK, Rowbotham DJ. Ethnic differences in thermal pain responses: a comparison of South Asian and White British healthy males. Pain 2005;118:194–200 Al-Hashimi M, Scott S, Griffin-Teall N, Thompson J. Influence of ethnicity on the perception and treatment of early post-operative pain. Pain 2014. doi: 10.1177/2049463714559254 Verma AM, Lewin V, Chilton AP, de Caestecker J, Dixon A, Jameson J, Wurm P, Robinson RJ. Variations in adenoma detection rate and cancer detection rate in individuals from different ethnic groups undergoing bowel cancer screening colonoscopy. Gut 2014;<b>63</b>(Suppl 1):A122

Hypertension prevalence, awareness, treatment, and control, in male South Asian immigrants in the United Arab Emirates: a cross-sectional study.

BackgroundSouth Asian males constitute the largest proportion of the United Arab Emirates (UAE) population. Minimal data is available on the prevalence of hypertension among South Asian immigrants in the UAE. We determined the prevalence, associated factors, awareness, treatment, and control of hypertension among male South Asian immigrants from India, Pakistan and Bangladesh residing in the UAE.MethodsWe recruited a representative sample (n = 1375; 76.4 % participation rate) of South Asian adult (≥18 years) immigrant males, including Indian (n = 433), Pakistani (n = 383) and Bangladeshi (n = 559) nationalities in Al Ain, UAE (January-June 2012). Blood pressure, height, body mass, waist and hip circumference data were obtained using standard protocols. Information related to socio-demographics, lifestyle factors, history of diagnosis and treatment of hypertension was collected through a pilot-tested adapted version of the STEPS instrument, developed by the World Health Organization for the measurement of non-communicable disease risk factors at the country level .ResultsMean age of participants was 34.0 years (95 % confidence interval (CI): 33.4, 34.5 years) and the overall prevalence of hypertension was 30.5 % (95 % CI 28.0, 32.8). In this study, 62 % of study participants had never had their blood pressure measured. Over three quarters (76 %) of the sample classified as hypertensive were not aware of their condition. Less than half (48.5 %) of the sample that were aware of their hypertension reported using antihypertensive medication and only 8.3 % had their hypertension under control (<140/90 mmHg). Hypertensive participants were more likely to be overweight (adjusted odds ratio (AOR) = 1.43; 95 % CI 1.01, 2.01); obese (AOR = 2.49; 95 % CI: 1.51, 4.10); have central obesity (AOR = 2.01; 95 % CI 1.37, 2.92); have a family history of hypertension (AOR = 1.51; 95 % CI 1.05, 2.17); and were less likely to walk 30 minutes daily (AOR = 1.79; 95 % CI 1.24, 2.60).ConclusionsThe prevalence of hypertension in a representative sample of young male South Asian immigrants living in the UAE was relatively high. However, the awareness, treatment, and control of hypertension within this population were very low. Strategies are urgently needed to improve the awareness and control of hypertension in this large population of migrant workers in the UAE.

An exploratory study of image and performance enhancement drug use in a male British South Asian community

BackgroundConsumerism of image and performance enhancement drugs (IPEDs) is a world-wide public health concern. Given anecdotal reporting of increased normalisation of IPED use and uptake of British South Asian male IPED users at UK needle and syringe exchange services, the study aimed to explore use of IPEDs among this under-researched ethnic group. Methods20 in depth interviews were conducted with a purposive sample of British South Asian males attending harm reduction outreach in the North East of England. The interviews explored motives for use of IPEDs, sourcing routes, information seeking, injecting behaviours and cultural and community sensitivities around IPED use among this group. The data was collected and analysed using the Interpretative Phenomenological Analysis approach (IPA). ResultsMotives for use centred on the achievement of enhanced definition and density of muscle, and improved recovery from training and injuries. All participants reported initial stimulation of interest and triggers to seek information on IPEDs due to social media, community and peer messages. Diverse forms of IPED use were described, with rational and moderated use common among older participants. In contrast younger participants adopted more excessive use in seeking short cuts to attaining muscle size. Sourcing of androgenic–anabolic steroids (AAS) and growth hormones from originating countries (Pakistan, India) was reported, along with diversification of entrepreneurial activity into IPED dealing networks. Sellers were generally reported to provide effective and reliable products and mentoring to inexperienced users. Group injecting practices were common. IPED use was observed by some as health promotion medium within religious contexts. Crime deterrence and drug abstinence occurred for some while involved in AAS cycles. ConclusionsThe study is intended to contribute to health policy and practice debate around the targeting of dedicated education, outreach and harm reduction for ethnic groups engaged in IPED use.

Predictors of eating disturbances in South Asian American females and males: A look at negative affectivity and contingencies of self-worth.

In the present study, we looked at sex differences in negative affectivity and contingencies of self-worth as predictors of eating disturbances (viz., drive for thinness, bulimic symptoms, and body dissatisfaction) in a South Asian American sample of 97 females and 83 males. Females, compared with males, were found to report greater self-worth involving others’ approval, appearance, academic competition, and greater drive for thinness and body dissatisfaction. Results of conducting hierarchical regression analyses indicated that for females, negative affectivity accounted for significant variance in each of the three eating disturbance outcomes. Furthermore, the inclusion of contingencies of self-worth was found to account for additional unique variance in eating disturbances within this group. In contrast, regression results obtained for males generally failed to support the utility of a prediction model of eating disturbances involving negative affectivity and contingencies of self-worth. Implications of the present findings for understanding sex differences in eating disturbances in South Asian Americans are discussed.

Comparison of coronary calcification among South Asians and Caucasians in the UK

Most of the published studies have shown racial differences in the prevalence and severity of coronary artery calcification (CAC) [1–3]. Although individuals of South Asian origin (India, Pakistan, Sri Lanka, Nepal & Bangladesh) represent 20% of the world population and considered as one of the largest ethnic groups at risk of coronary heart disease (CHD), they are under-represented in studies investigating the presence of CAC [4,5]. Therefore, we compared the prevalence of CAC in Caucasians and South Asians who underwent electron beam computed tomography (EBCT) at the European Scanning Centre, London, UK. CAC score (CACS) was performed on an Imatron C300 Ultrafast EBCT scanner (GE Healthcare), using a standard method with calcium deposition scored according to Agatston method [6]. Demographic information and the presence of risk factors were abstracted from referral letters and questionnaires completed by the patients prior to their test. Individuals with previously documented CHD or chronic kidney disease were not included in the study. CACSwas assessed in 935 South Asians (739males and 196 females) and 13,501 Caucasians (10,232 males and 3269 females). Gender distribution between Caucasians and South Asians was similar (p= 0.1); conversely, the Caucasians group was older to its South Asians counterpart (52.8 ± 9.6 vs. 50.6 ± 10.3, respectively; p b 0.001); while on the other hand, South Asians appeared to have a higher prevalence of diabetes mellitus (17.5% vs. 4.3%; p b 0.0001). Interestingly, therewas no difference in the prevalence of smoking between the 2 groups (15% vs. 12.1%; p = 0.06), of hypertension (31.3% vs. 25.3%; p b 0.4), family history of CHD (22.8% vs. 16.1%; p = 0.3), and hyperlipidemia (24.5% vs. 17.3%; p = 0.3). The prevalence of CAC (CACS N 0) was similar between Caucasians and South Asians (50.9% vs. 50.8%; p= 0.9), although a statistically significant difference in the prevalence of CAC in South Asians N50 years should be noted (p= 0.01). South Asian males showed a higher mean CACS as compared to Caucasians (179.6 ± 545.1 vs. 144.1 ± 420.1; p= 0.03). Although, in malesb50 years, therewasno statistically significantlydifference inmean CACS between South Asians and Caucasians (36.1 ± 277.8 vs. 23.8 ± 104.2; p= 0.06), inmales N50 years old thedifference inmeanCACSwas significant (South Asians, 339.1 ± 702.9 vs. Caucasians 232.3 ± 528.7; p b 0.0001). On the other hand, no difference was observed in the mean CACS between South Asian and Caucasian females (South Asians 59.2 ± 224.9 vs. Caucasians 56.6 ± 219.2; p = 0.86). South Asian females b50 years and South Asian females N50 years had similar mean CACS compared to Caucasians. CACS subgroups for age, gender and racial subgroups are tabulated in Table 1. We observe that in South Asian males N50 years old, the mean CACS was significantly higher than the Caucasians (p b 0.0003) and there was significant difference in the proportion of the population in any CACS range (p= 0.01). South Asians seem more prone to extensive calcification, as South Asians had higher mean CACS than Caucasians in both sex and all age groups (Fig. 1). Furthermore, age seems to play an important

Birth Weight Curves Tailored to Maternal World Region

BackgroundNewborns of certain immigrant mothers are smaller at birth than those of domestically born mothers. Contemporary, population-derived percentile curves for these newborns are lacking, as are estimates of their risk of being misclassified as too small or too large using conventional rather than tailored birth weight curves. MethodsWe completed a population-based study of 766 688 singleton live births in Ontario from 2002 to 2007. Smoothed birth weight percentile curves were generated for males and females, categorized by maternal world region of birth: Canada (63.5%), Europe/Western nations (7.6%), Africa/Caribbean (4.9%), Middle East/North Africa (3.4%), Latin America (3.4%), East Asia/Pacific (8.1%), and South Asia (9.2%). We determined the likelihood of misclassifying an infant as small for gestational age (≤ 10th percentile for weight) or as large for gestational age (≥ 90th percentile for weight) on a Canadian-born maternal curve versus one specific to maternal world region of origin. ResultsSignificantly lower birth weights were seen at gestationspecific 10th, 50th, and 90th percentiles among term infants born to mothers from each world region, with the exception of Europe/Western nations, compared with those for infants of Canadian-born mothers. For example, for South Asian babies born at 40 weeks’ gestation, the absolute difference at the 10th percentile was 198g (95% CI 183 to 212) for males and 170g (95% CI 161 to 179) for females. Controlling for maternal age and parity, South Asian males had an odds ratio of 2.60 (95% CI 2.53 to 2.68) of being misclassified as small for gestational age, equivalent to approximately 116 in 1000 newborns; for South Asian females the OR was 2.41 (95% CI 2.34 to 2.48), equivalent to approximately 106 per 1000 newborns. Large for gestational age would be missed in approximately 61 per 1000 male and 57 per 1000 female South Asian newborns if conventional rather than ethnicity-specific birth weight curves were used. ConclusionsBirth weight curves need to be modified for newborns of immigrant mothers originating from non-European/Western nations.

The New Politics of Hate? An Assessment of the Appeal of the English Defence League Amongst Disadvantaged White Working- Class Communities in England

Since the summer of 2009 in the United Kingdom there have been a number of violent clashes amongst white and south Asian males, antifascist demonstrators, and the police. These disturbances have centred around the activities of a new far-right grouping, the English Defence League (EDL), which claims to oppose ‘radical Islam’. This article charts the growth of the EDL and examines its motivations and ideologies. It argues that the increasing influence of this organisation reflects wider socio-economic and political processes, and in particular needs to be understood in light of the contemporary state of ‘post-politics’ in which the UK is embroiled. Drawing on our own empirical research, we argue that the growth in popularity of the EDL amongst some segments of England’s marginalised and disenfranchised white working class must be understood in the context of the failure of mainstream political discourses to reach out to these communities, who have instead turned to the EDL as an organisation through which they can vent their anger at the ‘Islamic other’ rather than at the political and financial classes that are the real source of their disadvantage.