Diet and Metabolic Risk Factors in Immigrant Women from the Middle East and Swedish-Born Women : A Cross-Sectional Study of Women from Iran, Turkey and Sweden

Sammanfattning: The increasing number of immigrants in Sweden during the past decades has brought the health of different ethnic groups into focus. Many groups of immigrants in Sweden have a higher risk of cardiovascular disease (CVD) and coronary heart disease (CHD) than a Swedish reference group. The objective of this thesis was to study the health status and prevalence of metabolic risk factors among immigrant women from Iran and Turkey in comparison with native-Swedish women. The analyses are based on a cross-sectional study of first-generation immigrant women and women born in Sweden aged 35-64. The women underwent a clinical examination, including blood sampling and anthropometric measurements. Dietary intake was assessed by four repeated 24-hour food intake recalls. The results show important ethnic differences in risk factors for CHD and the metabolic syndrome between the immigrant and the Swedish-born women. Immigrant women from Iran and Turkey are heavier, with a higher prevalence of abdominal obesity and an unfavourable lipid profile and a high degree of physical inactivity during leisure-time, which may predispose for a higher incidence of diabetes and atherosclerotic CVD. The associations between dietary variables and metabolic risk factors were generally relatively weak. The degree of underreporting of the energy was significant, especially among immigrant women, which might have attenuated possible associations. The fatty acid profile of the diet and in serum among the immigrant women indicated both favourable and unfavourable features, despite a higher prevalence of obesity and dyslipidemia compared to the Swedish-born women. Signs of oxidative stress and inflammation are evident in the immigrant women from the Middle East. With reference to ethnical differences in metabolic risk factors, as demonstrated in this thesis, increased emphasis should be given to modifying the underlying factors such as overweight/obesity and physical inactivity associated with the metabolic syndrome in various immigrant groups.