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为南亚裔和澳英裔 2 型糖尿病和心血管疾病患者提供的建议:饮食的文化构建是否重要?

Spicing up your advice for South Asian and Anglo-Australians with type 2 diabetes and CVD: Do cultural constructions of diet matter?

机构信息

Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; School of Psychology and Public Health, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC, Australia.

Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Monash Diabetes Unit, Monash Health, Melbourne, Australia.

出版信息

Appetite. 2018 Jan 1;120:679-697. doi: 10.1016/j.appet.2017.10.007. Epub 2017 Oct 7.

Abstract

South Asians are a growing migrant population, both globally and in Australia. This group are at higher risk for both cardiovascular disease and type 2 diabetes. The aim of this qualitative study was to compare dietary practices of South Asians, n = 41 (Indian, n = 25; Sri Lankan, n = 16) and Anglo-Australians, n = 16, with these conditions, using semi-structured in-depth interviews. Findings suggest that both groups had a high level of awareness of dietary practices necessary for optimum disease management, both prior to and post diagnosis. Bi-directional effects of migration were noted in the dietary practices of both groups suggesting hybrid diets are evident in Australia. A key barrier to implementing dietary changes highlighted by both groups of participants was a lack of specific, timely and detailed dietary advice from clinicians. Both groups expressed that advice should be repeated and reinforced throughout the course of their disease. In addition, South Asian participants wanted more culturally relevant advice. Clinicians providing dietary advice need to recognise that preferences for staple food items are resistant to change and may affect adherence. Acculturation was evident in the dietary practices of the South Asian participants. Nevertheless, many maintained traditional food practices which were tied to their cultural identity. It is recommended that clinicians consider these factors when offering advice.

摘要

南亚裔是全球和澳大利亚不断增长的移民群体。这个群体患心血管疾病和 2 型糖尿病的风险更高。本定性研究的目的是比较有这些疾病的南亚裔(印度裔,n = 25;斯里兰卡裔,n = 16)和盎格鲁澳大利亚人(n = 16)的饮食实践,使用半结构化深入访谈。研究结果表明,两组人在疾病管理方面都具有很高的饮食实践意识,无论是在诊断前还是诊断后。两组人的饮食实践都表现出了迁移的双向影响,这表明混合饮食在澳大利亚很明显。两组参与者都强调指出,实施饮食改变的一个主要障碍是临床医生缺乏具体、及时和详细的饮食建议。两组参与者都表示,建议应该在疾病过程中反复和加强。此外,南亚裔参与者希望得到更具文化相关性的建议。提供饮食建议的临床医生需要认识到,对主食的偏好是抵制改变的,可能会影响其坚持性。南亚裔参与者的饮食实践中表现出了文化适应。尽管如此,许多人仍然坚持与他们的文化身份相关的传统饮食实践。建议临床医生在提供建议时考虑这些因素。

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