Johal, Gurnam Singh; (2022) A mixed-methods exploration of the behavioural and environmental determinants of overweight and obesity in South Asian Adolescents in England. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Aim: To explore the obesogenic behavioural and environmental determinants of overweight and obesity in South Asian adolescents in England and explore if they differ from other ethnicities. / Methods: A mixed-methods approach comprised a Literature Review, analysis of the WHO Health Behaviour in School-Aged Children (HBSC) data for England (9739 participants) and qualitative interviews with South Asian adolescents enrolled in a weight management programme in London. Qualitative interviews explored insights and lived experiences of 26 overweight and obese South Asian adolescents in London. / Results: Key findings from the quantitative study showed that similar results were found for South Asian compared to White British and South Asian compared to non-South Asians. Compared to White British children, South Asian children had lower fruit and vegetable consumption and were more likely to eat at fast-food restaurants with 29% vs 14% reporting eating at fast food restaurants once a week or more. South Asian children undertook physical activity less frequently compared to White British children. There was a difference in self-perceived body image between South Asian and White British children, with 28% vs 31% reporting being either a bit or much too fat. Slightly more South Asians reported not getting enough sleep compared to White British and non-South Asians. Fewer South Asians reported feeling safe playing outside during the day in the local area compared to White British and non-South Asians. There were similar trends between all groups regarding being taught the importance of health and society more broadly in school. No discernible trends were observed between the Bangladeshi, Indian and Pakistani adolescents in this study, due to the sample size. Key insights from the qualitative study emerged around nutritional behaviours and patterns of eating; some nuanced cultural and behavioural insights were derived from a sub-sample who were partaking in Ramadan. Adolescents also gave rich views into the type and frequency of physical activity and exercise they undertook; the structural barriers to enjoying the local environment and psychosocial aspects of obesogenic behaviours. / Discussion: The findings highlighted some commonalities and differences in health behaviours as determinants of overweight and obesity between South Asian and White British and South Asian and Non-South Asian adolescents in England, which contribute to the limited existing evidence. Further research would be welcomed, including augmented capture of ethnicity and accurate anthropometric measures.

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