Insights from South Asian Dietary Interventions: providing culturally appropriate advice for diabetes

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1 Insights from South Asian Dietary Interventions: providing culturally appropriate advice for diabetes Azmina Govindji RD MBDA Registered Dietitian & Consultant Nutritionist on.fb.me/aznutrition

2 The menu British Heart Foundation Social cooking intervention ( , 2011 to date) The Ismaili Nutrition Centre website (2009 to date) based on DH S Asian Food Survey Change4life BME Campaign ( ) FSA Indian restaurants research Learnings and recipe for success

3 Why this group? South Asians living in the UK have a 40-50% higher death rate from heart disease than the general population (1). South Asians also have a high premature death rate from stroke 55% higher for men and 41% higher for women (2). 5-6 times higher risk of diabetes than the general population (3). South Asians, particularly Sikhs add more salt during cooking than the general population (2). less likely to meet with physical activity recommendations. [1] BHF coronary heart disease statistics (2005). British Heart Foundation Health Promotion Research Group, Department of public Health, University of Oxford [ 2] Health Survey For England The Health of Minority Ethnic Groups 1999, Department of Health, July 2000 [3] Diabetes UK

4 Pockets of Settlement e.g. Brent, Harrow, Leicester - Gujarati Hindus Southall, Birmingham - Punjabi Sikhs Tower Hamlets, Bradford - Bangladeshi Muslims

5 EXT-E-ND-ED FAMILY

6 British Heart Foundation intervention Temples Gurdwaras

7 Rationale Volunteer cooks in gurdwaras and temples prepare communal meals for large numbers of people on a regular basis (social cooking). Working with cooks allows us to demonstrate how salt/sat fat reduction needn t impact taste Enables learning to be transferred to the home (word of mouth +++) Focuses on what you can change Talks to congregations (importance of salt/fat reduction, labels etc)

8 How much reduction? What is practical, achievable, realistic? Aim to reduce salt (& fat) by 5% Educate the chefs and the head cook on healthy cooking and how to reduce salt & fat Talk to volunteers & congregations - increasing awareness on the importance of salt and saturated fat reduction

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10 Cooks corner Ghee makes you strong & gives you strong bones The older generation used to have ghee with every thing and they do not suffer from heart disease? People won t eat the food if there is not enough salt in it The food will go off if a lot of oil is not added to the food If food is not tasty, it will not be eaten and will waste If you don t add enough butter to chapattis they will go rock hard

11 6g SALT maximum recommended daily amount

12 So, what did we achieve? Original target: 5% salt reduction Result: 5-10% achieved in all places of worship, 10% in most of them!!!!!

13 Read all about it wwwfoodvision.gov.uk/pages/reducing-salt-insocial-cooking-in-temples-and-gurdwaras Food Vision Local Government Group, UK, article on Cooking with Auntiji, October

14 Local project with global impact The Ismaili Nutrition Centre Launch 2009 Based on research at Kings College London Online resource for S Asians - aim to risk of NCDs Preserve traditional dishes & eating habits

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22 The Ismaili Nutrition Centre is supported by:

23 Change4life BME initiative

24 Reaching the Community Stakeholder Conferences Gatekeepers cookery demos Family pressure to have chubby children. Children doubling up on meals. Western food can often be consumed as snacks Often unhealthy choices (chips, pizza and burgers) School work v activity Healthy Weight, Healthy Lives: Consumer Insight Story (2008)

25 UK Food Standards Agency Indian Restaurants Research

26 A recipe for success Understand your audience Use their language e.g. roti, dahl Build rapport Get the stakeholders involved Use all levels of communication Seek out the ring leader Be aware of internal pressures It takes time to create any change Cultural, social, religious factors Notice what happens behind your back Press the pause button!