Rationale
From my experience as a Practice Nurse I have identified a deficit in resources available to health professionals when working with Asian Indian patients in New Zealand. The government provides much data in Maori and Pacific languages, but nothing in Hindi, the universal language of most Indians.
Many of these patients have little knowledge or understanding of the principles of nutrition or the need for a variety of foods to ensure a balanced diet. The modern Indian diet increases diabetes risk as it is over represented by highly refined carbohydrates, and contains little fruit, vegetables or fish. To address this deficit in resources available to health professionals I have created this website (www.diabetesdiet.co.nz) outlining how Asian Indians are firstly, genetically predisposed to diabetes, and secondly, how their current diet and lifestyle contributes to increasing obesity leading to type two diabetes. There are recommendations to adapt their cuisine and improve lifestyle choices. The printable resources include a dietary and lifestyle 3-fold pamphlet, a dietary sheet and remodelled food pyramid, available in both English and Hindi.
The resource is primarily intended to enlighten and empower the health professional to be alert for predisposing factors of diabetes when consulting with a person of Asian Indian descent and therefore incorporate appropriate screening, education and interventions into their management. The resources are suitable as a preventive tool and in the management of existing diabetes disease, enabling staff to be able to appropriately collaborate with the patient in creating Care Plans based around patient-centred chronic care models, or give culturally appropriate advice to patients attending General Practitioner or Nurse Clinics. It will also boost confidence in health professionals to act opportunistically.
Current best practice offers little in the way of support or monitoring for those with Insulin Resistance or Metabolic Syndrome, and they tend to fall off the radar until appearing with actual diabetes at a later date. With earlier intervention, some people could be spared the development of diabetes. Established diabetic patients undergo the Annual Get Checked review, thus providing an ideal opportunity to support advice given with a handout in their own Hindi language.
In Hawke's Bay we are fortunate to have a Specialist Doctor in Diabetes, Dr Janet Titchener, on discussion with her, she agrees with the findings here showing that Asian Indians have a genetic predisposition to type two diabetes and their high intake of rice and starchy foods is exacerbating the situation.
The information herein has been approved by Dr. Kamal Karl, MB. BS. FACNEM, FACCS, Fellow of Australasian College of Nutritional and Environmental Medicine from the Hawke's Bay Wellness Centre in Napier, New Zealand
Many of these patients have little knowledge or understanding of the principles of nutrition or the need for a variety of foods to ensure a balanced diet. The modern Indian diet increases diabetes risk as it is over represented by highly refined carbohydrates, and contains little fruit, vegetables or fish. To address this deficit in resources available to health professionals I have created this website (www.diabetesdiet.co.nz) outlining how Asian Indians are firstly, genetically predisposed to diabetes, and secondly, how their current diet and lifestyle contributes to increasing obesity leading to type two diabetes. There are recommendations to adapt their cuisine and improve lifestyle choices. The printable resources include a dietary and lifestyle 3-fold pamphlet, a dietary sheet and remodelled food pyramid, available in both English and Hindi.
The resource is primarily intended to enlighten and empower the health professional to be alert for predisposing factors of diabetes when consulting with a person of Asian Indian descent and therefore incorporate appropriate screening, education and interventions into their management. The resources are suitable as a preventive tool and in the management of existing diabetes disease, enabling staff to be able to appropriately collaborate with the patient in creating Care Plans based around patient-centred chronic care models, or give culturally appropriate advice to patients attending General Practitioner or Nurse Clinics. It will also boost confidence in health professionals to act opportunistically.
Current best practice offers little in the way of support or monitoring for those with Insulin Resistance or Metabolic Syndrome, and they tend to fall off the radar until appearing with actual diabetes at a later date. With earlier intervention, some people could be spared the development of diabetes. Established diabetic patients undergo the Annual Get Checked review, thus providing an ideal opportunity to support advice given with a handout in their own Hindi language.
In Hawke's Bay we are fortunate to have a Specialist Doctor in Diabetes, Dr Janet Titchener, on discussion with her, she agrees with the findings here showing that Asian Indians have a genetic predisposition to type two diabetes and their high intake of rice and starchy foods is exacerbating the situation.
The information herein has been approved by Dr. Kamal Karl, MB. BS. FACNEM, FACCS, Fellow of Australasian College of Nutritional and Environmental Medicine from the Hawke's Bay Wellness Centre in Napier, New Zealand
Objectives
To enlighten health professionals, in particular, Nurses and Doctors to be able to:
1. Describe the prevalence of diabetes among Asian Indian people in New Zealand.
2. Cite statistics illustrating the magnitude of diabetes among Asian Indians in New Zealand.
3. Discuss medical and lifestyle risk factors that increase the chance of developing type 2 diabetes among this population.
4. Discuss various epidemiology studies about diabetes in Asian Indians.
5. Identify factors that increase a person's risk for type 2 diabetes.
6. Advise an Asian Indian patient on the steps he or she can take to reduce the risk of getting diabetes, or control existing disease.
7. Teach a patient about the importance of eating to control diabetes.
8. Explain the food pyramid and encourage appropriate servings of carbohydrates, vegetables, fruit, milk and yogurt, meat and fats.
9. Help an Asian Indian diabetic patient with his or her meal planning.
10. Help an Asian Indian diabetic patient with lifestyle behaviours.
1. Describe the prevalence of diabetes among Asian Indian people in New Zealand.
2. Cite statistics illustrating the magnitude of diabetes among Asian Indians in New Zealand.
3. Discuss medical and lifestyle risk factors that increase the chance of developing type 2 diabetes among this population.
4. Discuss various epidemiology studies about diabetes in Asian Indians.
5. Identify factors that increase a person's risk for type 2 diabetes.
6. Advise an Asian Indian patient on the steps he or she can take to reduce the risk of getting diabetes, or control existing disease.
7. Teach a patient about the importance of eating to control diabetes.
8. Explain the food pyramid and encourage appropriate servings of carbohydrates, vegetables, fruit, milk and yogurt, meat and fats.
9. Help an Asian Indian diabetic patient with his or her meal planning.
10. Help an Asian Indian diabetic patient with lifestyle behaviours.
Strategies
Until recently it was assumed that if people were informed about the risks associated with unhealthy behaviour this would be sufficient for them to change to a healthier pattern. Large investments in the health education movement for relatively little return proved this was not the case. People's beliefs are not based simply on what they are told to believe. Contemporary models of health promotion are more sophisticated and take account of beliefs about health and illness and how those beliefs relate to behaviour. (Bundy 2007)
A number of suggestions to improve South Asian health as reviewed from overseas literature (eg, Macbeth and Shetty 2001) include:
1. Offering culturally-sensitive and appropriate health services
2. Providing appropriate health education and resources
3. Providing medical interpretation and translation service
4. Acknowledging different cultural attitudes and beliefs, eg reinforcing positive traditional dietary habits while encouraging the adaptation of healthy Western food items (Kim et al 2000) and reorienting health services
5. Recognising multi-ethnic culture and collect disaggregated data, utilise over-sampling and allocate more funding for specific studies (Srinivasan and Guillermo 2000)
6. Researching collaboration between universities, community-based organisations and ethnic communities (Chen et al 1997)
7. Supporting community advocacy and raising community awareness (MOH, Asian Public Health Project Report 2003))
A number of suggestions to improve South Asian health as reviewed from overseas literature (eg, Macbeth and Shetty 2001) include:
1. Offering culturally-sensitive and appropriate health services
2. Providing appropriate health education and resources
3. Providing medical interpretation and translation service
4. Acknowledging different cultural attitudes and beliefs, eg reinforcing positive traditional dietary habits while encouraging the adaptation of healthy Western food items (Kim et al 2000) and reorienting health services
5. Recognising multi-ethnic culture and collect disaggregated data, utilise over-sampling and allocate more funding for specific studies (Srinivasan and Guillermo 2000)
6. Researching collaboration between universities, community-based organisations and ethnic communities (Chen et al 1997)
7. Supporting community advocacy and raising community awareness (MOH, Asian Public Health Project Report 2003))
© 2010 De La Haye