Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2017 Dec;4(6):1107-1119.
doi: 10.1007/s40615-016-0316-y. Epub 2016 Dec 7.

Barriers and Facilitators to Healthy Lifestyle Changes in Minority Ethnic Populations in the UK: a Narrative Review

Naina Patel  1 , Harriet Batista Ferrer  2 , Freya Tyrer  3 , Paula Wray  1 , Azhar Farooqi  4 , Melanie J Davies  1 , Kamlesh Khunti  1
Affiliations
Review

Barriers and Facilitators to Healthy Lifestyle Changes in Minority Ethnic Populations in the UK: a Narrative Review

Naina Patel et al. J Racial Ethn Health Disparities. 2017 Dec.

Abstract

Minority ethnic populations experience a disproportionate burden of health inequalities compared with the rest of the population, including an increased risk of type 2 diabetes (T2DM). The purpose of this narrative review was to explore knowledge and attitudes around diabetes, physical activity and diet and identify barriers and facilitators to healthy lifestyle changes in minority ethnic populations in the UK. The narrative review focused on three key research topics in relation to barriers and facilitators to healthy lifestyle changes in minority adult ethnic populations: (i) knowledge and attitudes about diabetes risk; (ii) current behaviours and knowledge about physical activity and diet; and (iii) barriers and facilitators to living a healthier lifestyle. Nearly all of the studies that we identified reported on South Asian minority ethnic populations; we found very few studies on other minority ethnic populations. Among South Asian communities, there was generally a good understanding of diabetes and its associated risk factors. However, knowledge about the levels of physical activity required to gain health benefits was relatively poor and eating patterns varied. Barriers to healthy lifestyle changes identified included language barriers, prioritising work over physical activity to provide for the family, cultural barriers with regard to serving and eating traditional food, different perceptions of a healthy body weight and fear of racial harassment or abuse when exercising. Additional barriers for South Asian women included expectations to remain in the home, fear for personal safety, lack of same gender venues and concerns over the acceptability of wearing 'western' exercise clothing. Facilitators included concern that weight gain might compromise family/carer responsibilities, desire to be healthy, T2DM diagnosis and exercise classes held in 'safe' environments such as places of worship. Our findings suggest that South Asian communities are less likely to engage in physical activity than White populations and highlight the need for health promotion strategies to engage people in these communities. There is a gap in knowledge with regard to diabetes, physical activity, diet and barriers to healthy lifestyle changes among other ethnic minority populations in the UK; we recommend further research in this area.

Keywords: Diabetes; Ethnic minority populations; Healthy lifestyle changes; Narrative review; South Asian; UK.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest

Naina Patel declares that she has no conflict of interest. Dr. Harriet Batista Ferrer declares that she has no conflict of interest. Freya Tyrer declares that she has no conflict of interest. Paula Wray declares that she has no conflict of interest. Azhar Farooqi declares that he has no conflict of interest. Professor Melanie Davies is a member of the National Institute for Health and Clinical Excellence public health guidance on preventing type 2 diabetes and adviser to the UK Department of Health for the NHS Health Checks Programme. She has acted as consultant, advisory board member and speaker for Novo Nordisk, Sanofi-Aventis, Lilly, Merck Sharp and Dohme, Boehringer Ingelheim, AstraZeneca and Janssen and as a speaker for Mitsubishi Tanabe Pharma Corporation. She has received grants in support of investigator and investigator-initiated trials from Novo Nordisk, Sanofi-Aventis and Lilly. Professor Kamlesh Khunti (Chair) is a member of the National Institute for Health and Clinical Excellence public health guidance on preventing type 2 diabetes and adviser to the UK Department of Health for the NHS Health Checks Programme. He has acted as a consultant, served on advisory boards for and speaker for Novartis, Novo Nordisk, Sanofi-Aventis, Lilly, Janssen, Boehringer Ingelheim and Merck Sharp and Dohme. He has received grants in support of investigator and investigator-initiated trials from Novartis, Novo Nordisk, Sanofi-Aventis, Lilly, Roche, Boehringer Ingelheim and Merck Sharp and Dohme.

Research Involving Human Participants and/or Animals

This article does not contain any studies with human participants performed by any of the authors.

Informed Consent

Not applicable—this article does not contain any studies with human participants performed by any of the authors.

Funding

This study was funded by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care-East Midlands (NIHR CLAHRC-EM), with support from the Leicester Clinical Trials Unit and the NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, which is a partnership between University Hospitals of Leicester NHS Trust, Loughborough University and the University of Leicester. The views expressed are those of the authors and are not necessarily those of the NHS, the NIHR or the Department of Health.

References

    1. Fischbacher CM, Bhopal R, Steiner M, Morris AD, Chalmers J. Is there equity of service delivery and intermediate outcomes in south Asians with type 2 diabetes? Analysis of DARTS database and summary of UK publications. Journal of Public Health. 2009;31(2):239–249. doi: 10.1093/pubmed/fdp003. - DOI - PubMed
    1. Simmons D, Williams DR, Powell MJ. Prevalence of diabetes in a predominantly Asian community: preliminary findings of the Coventry diabetes study. Br Med J. 1989;298(6665):18. doi: 10.1136/bmj.298.6665.18. - DOI - PMC - PubMed
    1. Unwin N, Alberti KGMM, Bhopal R, Harland J, Watson W, White M. Comparison of the current WHO and new ADA criteria for the diagnosis of diabetes mellitus in three ethnic groups in the UK. Diabet Med. 1998;15(7):554–557. doi: 10.1002/(SICI)1096-9136(199807)15:7<554::AID-DIA626>3.0.CO;2-E. - DOI - PubMed
    1. Riste L, Khan F, Cruickshank K. High prevalence of type 2 diabetes in all ethnic groups, including Europeans, in a British inner city relative poverty, history, inactivity, or twenty-first century Europe? Diabetes Care. 2001;24(8):1377–1383. doi: 10.2337/diacare.24.8.1377. - DOI - PubMed
    1. Holman N, Forouhi NG, Goyder E, Wild SH. The Association of Public Health Observatories (APHO) diabetes prevalence model: estimates of total diabetes prevalence for England, 2010-2030. Diabet Med. 2011;28(5):575–582. doi: 10.1111/j.1464-5491.2010.03216.x. - DOI - PubMed

LinkOut - more resources