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BackgroundImmigrants from low-income countries comprise an increasing proportion of the population in Europe. Higher prevalence of obesity and nutrition related diseases, such as type 2 diabetes (T2D) and cardiovascular disease (CVD) is found in some immigrant groups, especially in South Asians.AimTo review dietary changes after migration and discuss the implication for health and prevention among immigrants from low-income countries to Europe, with a special focus on South Asians.MethodSystematic searches in PubMed were performed to identify relevant high quality review articles and primary research papers. The searches were limited to major immigrant groups in Europe, including those from South Asia (India, Pakistan, Bangladesh, Sri Lanka). Articles in English from 1990 and onwards from Europe were included. For health implications, recent review articles and studies of particular relevance to dietary changes among South Asian migrants in Europe were chosen.ResultsMost studies report on dietary changes and health consequences in South Asians. The picture of dietary change is complex, depending on a variety of factors related to country of origin, urban/rural residence, socio-economic and cultural factors and situation in host country. However, the main dietary trend after migration is a substantial increase in energy and fat intake, a reduction in carbohydrates and a switch from whole grains and pulses to more refined sources of carbohydrates, resulting in a low intake of fiber. The data also indicate an increase in intake of meat and dairy foods. Some groups have also reduced their vegetable intake. The findings suggest that these dietary changes may all have contributed to higher risk of obesity, T2D and CVD.Implications for preventionA first priority in prevention should be adoption of a low-energy density – high fiber diet, rich in whole grains and grain products, as well as fruits, vegetables and pulses. Furthermore, avoidance of energy dense and hyperprocessed foods is an important preventive measure.

To develop effective intervention strategies, it is vital to understand both how changes do occur and how different factors influence dietary habits. The Koctürk model was useful to structure the various foods and changes that may occur. Strategies for dietary counselling should not only include dietary advice but also focus on the multitude of factors causing dietary changes.

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Objectives: To compare ethnic and gender differences in generalized and central obesity and to investigate whether these differences persisted after adjusting for socio-demographic and lifestyle factors. Design: In 2002, the population-based cross-sectional, Oslo Immigrant Health study was conducted. Subjects: A total of 7890 Oslo residents, born between 1942 and 1971 in Turkey, Iran, Pakistan, Sri Lanka and Vietnam, were invited and 3019 attended. Measurements: Participants completed a health questionnaire and attended a clinical screening that included height, weight, waist and hip measurements. Results: Generalized obesity (BMIX30 kg/m 2 ) was greatest among women from Turkey (51.0%) and least among men from Vietnam (2.7%). The highest proportions of central obesity (waist hip ratio (WHR)X0.85) were observed among women from Sri Lanka (54.3%) and Pakistan (52.4%). For any given value of BMI, Sri Lankans and Pakistanis had higher WHR compared to the other groups. Despite a high mean BMI, Turkish men (27.9 kg/m 2 ) and women (30.7 kg/m 2 ) did not have a corresponding high WHR. Ethnic differences in BMI, waist circumference and WHR persisted despite adjusting for socio-demographic and lifestyle factors. Conclusion: We found large differences in generalized and central obesity between immigrant groups from developing countries. Our data find high proportions of overweight and obese subjects from Pakistan and Turkey, but low proportions among those from Vietnam. Subjects from Sri Lanka and Pakistan had the highest WHR for any given value of BMI. Our findings, in light of the burgeoning obesity epidemic, warrant close monitoring of these groups.

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