Obesity and cardiovascular disease risk among Turkish and Moroccan migrant groups in Europe: a systematic review

Migrants from Turkey and Morocco are among the largest ethnic minority groups in several European countries. In this review, we aimed to systematically search, assess and describe the available literature on cardiovascular disease (CVD), obesity and other endogenous cardiovascular risk factors among these groups. Although the number of publications covering this topic among Turkish and Moroccan migrants has increased in the past decades, studies among these groups, especially the Moroccan, are still limited. There is a particular lack of information on CVD mortality and morbidity rates. Furthermore, studies are often hampered by low participation rates, small sample sizes and self‐reported data. This further complicates drawing sound conclusions on CVD and risk factors among these migrant groups. The results with regard to CVD morbidity and mortality rates are inconclusive. With regard to CVD risk factors, we tentatively conclude that obesity and diabetes are more common among Turkish and Moroccan migrant groups in Europe than the western European population. In the Turkish population there is also a fair amount of evidence for unfavourable high‐density lipoprotein cholesterol levels. However, more research on this topic among these major ethnic minorities is of high importance.

[1]  C. Agyemang,et al.  Prevalence and management of hypertension among Turkish, Moroccan and native Dutch ethnic groups in Amsterdam, the Netherlands: the Amsterdam Health Monitor Survey , 2006, Journal of hypertension.

[2]  N. Chaouki,et al.  Prevalence of the main cardiovascular risk factors in Morocco: results of a National Survey, 2000 , 2003, Journal of hypertension.

[3]  J. Seidell,et al.  Underreporting of BMI in Adults and Its Effect on Obesity Prevalence Estimations in the Period 1998 to 2001 , 2006, Obesity.

[4]  J. Mackenbach,et al.  Differences in avoidable mortality between migrants and the native Dutch in the Netherlands , 2006, BMC public health.

[5]  A. Hoes,et al.  Rotterdam general practitioners report (ROHAPRO): a computerised network of general practices in Rotterdam, The Netherlands. Rotterdam's HuisArtsen Project. , 1995, Journal of Epidemiology and Community Health.

[6]  S. Yusuf,et al.  Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study , 2004, The Lancet.

[7]  S. Johansson,et al.  Country of birth and body mass index: A national study of 2,000 immigrants in Sweden , 2004, European Journal of Epidemiology.

[8]  J. Mackenbach,et al.  Ethnic inequalities in age- and cause-specific mortality in The Netherlands. , 2004, International journal of epidemiology.

[9]  S. Yusuf,et al.  Stemming the global tsunami of cardiovascular disease , 2011, The Lancet.

[10]  S. Humphries,et al.  C-reactive protein and coronary heart disease: predictive test or therapeutic target? , 2009, Clinical chemistry.

[11]  N. Hammar,et al.  Acute myocardial infarction incidence in immigrants to Sweden. Country of birth, time since immigration, and time trends over 20 years , 2007, European Journal of Epidemiology.

[12]  R. Bhopal,et al.  Exclusion and Inclusion of Nonwhite Ethnic Minority Groups in 72 North American and European Cardiovascular Cohort Studies , 2006, PLoS medicine.

[13]  A. Verhoeff,et al.  Life expectancy and mortality differences between migrant groups living in Amsterdam, The Netherlands. , 2002, Social science & medicine.

[14]  M. Khlat,et al.  Mortality and causes of death of Moroccans in France, 1979-91. , 1996, Population. English selection.

[15]  M. Nicolaou,et al.  Risk groups for overweight and obesity among Turkish and Moroccan migrants in The Netherlands. , 2008, Public health.

[16]  K. Stronks,et al.  Body size preference and body weight perception among two migrant groups of non-Western origin , 2008, Public Health Nutrition.

[17]  Gretchen A. Stevens,et al.  National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9·1 million participants , 2011, The Lancet.

[18]  R. Mahley,et al.  Turkish Heart Study: lipids, lipoproteins, and apolipoproteins. , 1995, Journal of lipid research.

[19]  J. Mackenbach,et al.  Socioeconomic inequalities in mortality within ethnic groups in the Netherlands, 1995–2000 , 2005, Journal of Epidemiology and Community Health.

[20]  B. Gersh National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9·1 million participants , 2012 .

[21]  J. Kastelein,et al.  Are high-density lipoprotein genes and their products targets for therapy? , 2010, Current opinion in lipidology.

[22]  W. Verschuren,et al.  RISICOFACTOREN VOOR HART- EN VAATZIEKTEN BIJ TURKEN IN AMSTERDAM EN IN ANKARA , 1997 .

[23]  A. Hoes,et al.  Prevalence of type 2 diabetes mellitus, other cardiovascular risk factors, and cardiovascular disease in Turkish and Moroccan immigrants in North West Europe: a systematic review. , 2004, Preventive medicine.

[24]  J. Sundquist,et al.  Morbidity in cardiovascular diseases in immigrants in Sweden , 2003, Journal of internal medicine.

[25]  B. Vessby,et al.  Dietary fat intake, fat sources and fatty acid composition in serum among immigrant women from Iran and Turkey compared with women of Swedish ethnicity , 2005 .

[26]  David W. Williamson,et al.  Polymorphisms in the hepatic lipase gene affect plasma HDL-cholesterol levels in a Turkish population[S] , 2010, Journal of Lipid Research.

[27]  K. Sundquist,et al.  Coronary heart disease risks in first‐ and second‐generation immigrants in Sweden: a follow‐up study , 2006, Journal of internal medicine.

[28]  Jonathan D. Smith,et al.  Alcohol Consumption Raises HDL Cholesterol Levels by Increasing the Transport Rate of Apolipoproteins A-I and A-II , 2000, Circulation.

[29]  L. Berglund,et al.  Risk factors for coronary heart disease among immigrant women from Iran and Turkey, compared to women of Swedish ethnicity. , 2005, Ethnicity & disease.

[30]  H. Garretsen,et al.  Religious, cultural and social cognitive correlates of alcohol use among Turks and Moroccans in The Netherlands , 2006 .

[31]  H. Zeeb,et al.  Cardiovascular mortality of Turkish nationals residing in West Germany. , 1998, Annals of epidemiology.

[32]  I. Dalen,et al.  Ethnic differences in obesity among immigrants from developing countries, in Oslo, Norway , 2006, International Journal of Obesity.

[33]  A. Larsson,et al.  Antioxidant intake, oxidative stress and inflammation among immigrant women from the Middle East living in Sweden: associations with cardiovascular risk factors. , 2007, Nutrition, metabolism, and cardiovascular diseases : NMCD.

[34]  H. Meyer,et al.  Ethnic differences in SCORE cardiovascular risk in Oslo, Norway , 2009, European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology.

[35]  A. Hoes,et al.  No evidence for marked ethnic differences in accuracy of self-reported diabetes, hypertension, and hypercholesterolemia. , 2007, Journal of clinical epidemiology.

[36]  S. Sue,et al.  Ethnic and Racial Health Disparities Research: Issues and Problems , 2006, Health education & behavior : the official publication of the Society for Public Health Education.

[37]  R. von Georgi,et al.  Prevalence of risk factors of coronary heart disease in Turks living in Germany: The Giessen Study. , 1999, Atherosclerosis.

[38]  J. Sundquist,et al.  Do immigrants have an increased prevalence of unhealthy behaviours and risk factors for coronary heart disease? , 2005, European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology.

[39]  H. Meyer,et al.  Cardiovascular disease risk factors among five major ethnic groups in Oslo, Norway: the Oslo Immigrant Health Study , 2006, European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology.

[40]  H. Vermeulen,et al.  The Second Generation in Europe , 2003 .

[41]  C. Bouchard,et al.  Ethnic Differences in Self‐reported and Measured Obesit , 2009, Obesity.

[42]  T. Lauritzen,et al.  Diabetes prevalence and quality of diabetes care among Lebanese or Turkish immigrants compared to a native Danish population. , 2007, Primary care diabetes.

[43]  K. Haks,et al.  Veranderingen in etnische gezondheidsverschillen in de stad Utrecht in de periode 1995-2003 , 2007 .

[44]  K. Stronks,et al.  Ethnic differences in the effect of environmental stressors on blood pressure and hypertension in the Netherlands , 2007, BMC public health.

[45]  G. V. van Montfrans,et al.  [Risk factors for cardiovascular diseases in Turks in Amsterdam and in Ankara]. , 1997, Nederlands tijdschrift voor geneeskunde.

[46]  K. Stronks,et al.  Behavioural risk factors in two generations of non-Western migrants: do trends converge towards the host population? , 2007, European Journal of Epidemiology.

[47]  S. Johansson,et al.  Diabetes mellitus in Turkish immigrants in Sweden. , 2003, Diabetes & metabolism.

[48]  A. Verhoeff,et al.  Diabetes prevalence and risk factors among ethnic minorities. , 2009, European journal of public health.

[49]  A. Onat Risk factors and cardiovascular disease in Turkey. , 2001, Atherosclerosis.

[50]  M. Hochleitner,et al.  The Mosque Campaign: a cardiovascular prevention program for female Turkish immigrants , 2006, Wiener klinische Wochenschrift.

[51]  J. Mackenbach,et al.  Duration of residence was not consistently related to immigrant mortality. , 2007, Journal of clinical epidemiology.

[52]  S. Reijneveld Reported health, lifestyles, and use of health care of first generation immigrants in The Netherlands: do socioeconomic factors explain their adverse position? , 1998, Journal of epidemiology and community health.

[53]  J. Cornelisse-Vermaat,et al.  Ethnic Differences in Lifestyle and Overweight in The Netherlands , 2007, Obesity.