1. Ethnic differences in obesity, diet and physical activity Vanessa Higgins & Angela Dale Centre for Census & Survey Research University of Manchester

2. Background In England, almost two-thirds of adults and a third of children are either overweight or obese Government estimates that without action this will rise to almost 9 in 10 adults and two-thirds of children by 2050 Obesity linked to increased risks of diabetes, heart disease, cancer Government strategies –“Healthy Weight, Healthy Lives”, Jan 2008. Identifies 5 areas for tackling excess weight including promotion of healthier food and physical exercise –Diet (5 a day; food labelling; restrictions on advertising to children; school-meals) –Physical activity guidelines –Some recognition of cultural/ethnic differences in these strategies but need more

3. Aims of the project Analyse ethnic differences in three outcomes: –Obesity –Diet –Physical activity Use Health Survey for England from 1999 and 2004 (ethnic boosts) Explanatory variables: gender, age, generation, social class, educational level, religion, type of neighbourhood etc (diet and physical activity for obesity) Parental diet, physical activity, obesity and other characteristics Assess change between 1999 and 2004

4. Aged 16+, Base (unweighted) 11022 Source: Health Survey for England 2004

5. Obesity and ethnicity Age: increase in obesity prevalence with age was marked among Black Caribbean, Black African and Indian women. Children: Black Caribbean and Pakistani girls at increased risk of obesity and Pakistani and Indian boys are more likely to be overweight. HSE 2004 shows BA boys at risk of obesity. Issues of socio-economic confounders – is this a real relationship Abdominal obesity in South Asians -Body Mass Index or Waist circumference? -different BMI cut-offs for Asians?

6. Aged 16+, Base (unweighted) 13515 Source: Health Survey for England 2004

7. Diet and ethnicity All minority ethnic groups have healthier diet than general population. Other literature confirms UK South Asian and Afro-Caribbean diets generally healthier than white population. Evidence of high quantities consumed in Caribbean diet Heterogeneity of South Asian and Afro-Caribbean: religion, region etc Cultural beliefs: mealtime structures, significance of food Migration: modification of traditional diet when move to UK, adoption of fast foods, time since immigration Age: fruit and veg consumption highest among older groups. Do older people retain traditional eating patterns that may not be followed by younger generations?

8. Aged 16+, Base (unweighted) 13482 Source: Health Survey for England 2004

9. Physical activity and ethnicity Smaller scale studies support HSE findings of low levels of physical activity among South Asians. Extends to children and young people Cultural barriers: language, dress code, modesty and lack of single-sex facilities, concept of physical activity to Bangladeshis. Also non-cultural issues, don’t over-emphasise cultural barriers Migration: do British born South Asians do more physical activity than first generation? Does length of time since immigration affect activity levels? Lack of literature on physical activity of other ethnic minority groups in UK!

10. Operationalisation (2004) Diet –Summary measure of fruit and vegetable consumption based on the 5- a-day guidelines (aged 5+) –Separate components of fruit and vegetable consumption (aged 5+) Salad, pulses, vegetables, composite dishes, fruit juice, fresh fruit, dried fruit, frozen or tinned fruit, other dishes made from fruit –Summary measure of fat scores (aged 16+) –Separate components of fatty foods consumed (aged 16+) Milk, cheese, red meat, white meat, fish, fried food, sweet/savoury snacks, pastries, butter/ghee, reduced fat spreads, oils –Salt added in cooking and at table (aged 16+)

11. Operationalisation (2004) Physical activity of adults (aged 16+) –Summary measure based on current guidelines of 30+ mins of activity of moderate intensity 5+ days week Low activity: less than once a week High activity: at least 5 days a week –Separate components: sports/exercise; brisk walks; heavy housework/gardening/DIY; occupational activity Physical activity of children (aged 5-15) –Summary measure based on current guidelines of 1 hour+ of moderate intensity per day –Separate components: sports/exercise; walking; active play; housework/gardening Obesity –Body Mass Index (weight in kgs/height in metres²). WHO cut off points for obesity for adults and children –Waist Circumference

12. Summary Use HSE to analyse ethnic differences in obesity, diet and physical activity Highlighted some of the complexities of measuring outcome variables and some explanations for observed differences We will use standard measures but also implement alternatives Explanatory work and regression models

13. Our contact details: vanessa.higgins@manchester.ac.uk Centre for Census and Survey Research University of Manchester 0161 275 7766 angela.dale@manchester.ac.uk Centre for Census and Survey Research University of Manchester 0161 275 4876