June 10, 2003
(American Heart Association) -- Modifying lifestyle and
diet reduced stroke incidence among Chinese immigrants to the
United States, according to a study presented at the American
Heart Association's Second Asia Pacific Scientific Form.
"The incidence of stroke is higher in China than in the
United States," says Jing Fang, M.D., assistant professor,
department of epidemiology, Albert Einstein College of
Medicine in the Bronx, New York. "But when individuals migrate
to the United States, their stroke mortality is lower than in
China."
A two-year study compared 134 Chinese immigrant stroke
patients with 132 Chinese immigrants who had not suffered
stroke. Half were men and their average age was 74.
Participants provided detailed information about behavioral
characteristics, socioeconomic and medical status and changes
in these factors after immigration.
The preliminary results show that changes in diet, exercise
and job status after immigration reduced stroke risk in the
control group.
"People in the control group were more likely to reduce the
salt and sugar intake in their diet once they immigrated to
the United States," Fang says. "In China, the food is very
salty. Salt often is used as a preservative for fish and
meat."
The high-salt diet can result in hypertension, a risk
factor for stroke. When dietary habits were established from a
list of 49 food items, non-stroke controls were more likely to
eat fish at least three times a week (65 percent versus 49
percent) and twice as likely to eat more fish after
immigration. More than half of the controls drank fruit juice
at least once a week, but less than 31 percent of the stroke
survivors did.
Even though meat preserved with salt could be purchased in
Chinatown, Chinese immigrant non-stroke controls were more
inclined to buy fresh fish and meat, Fang says.
Although exercise in the past 12 months was similar between
stroke cases and controls, those in the control group were
more likely to have participated in exercise 20 years earlier
and to have increased the amount of exercise after
immigration. Almost twice as many stroke-free immigrants
increased their exercise level compared to the stroke
patients.
Thirty-one percent of the controls reported better jobs in
the United States compared to 21 percent of the stroke
patients. Also, twice as many stroke patients thought their
job status had worsened after coming to the United States
compared to the controls.
Lower job status with the problems of language,
communication and isolation in the Chinese community can
create stress among the immigrants, Fang says. "These are all
stressful factors to immigrants."
In addition, people in the control group were more likely
than stroke patients to find and see a doctor regularly.
Cigarette smoking and drinking alcohol were similar between
the two groups.
The study is preliminary, but the researchers plan to
continue following the immigrants and add more people to the
study. "We would like to do more follow-up and conduct another
risk behavior study not only with older immigrants, but with
younger immigrants," Fang says. "If you want to do
intervention, you have to know what risk factors are there."