Diabetes and cancer in South Asian communities

Diabetes, its impact including the risk of cancer, and lifestyle practices for the prevention of diabetes: a community health seminar

Pay for your food – through physical activity.

When eminent endocrinologist Dr Soji Swaraj says we must ‘earn’ our food with exercise, the penny drops immediately.

He repeated this recently at an informative health session for Indian subcontinental communities, held by Diabetes Australia in conjunction with Pink Sari Inc. and Healthy Living Toongabbie.

Dr Swaraj urged his audience to eat when hungry, to lose fat (especially waist fat) and gain muscle, and to empower themselves to improve their insulin resistance through healthy eating and portion control.

Urging them to better understand the diabetes-obesity relationship, he also stressed the connection between various cancers – most notably breast, endometrial and bowel cancer and insulin resistance in diabetic conditions.

Cancer. Diabetes. These two words often evoke anxiety and fear in a person, cancer perhaps even more so than diabetes. Both these conditions can seriously affect a person’s health, quality of life and can lead to serious life-threatening complications. Most people of Indian subcontinental origin are unfortunately affected by either one or sometimes both conditions. The impact may be direct on themselves or indirect through affected family members, friends or even an acquaintance.

At the recent health session held at the Wentworthville Community Centre, the topic was diabetes, its impact including the risk of cancer, and lifestyle practices for the prevention of diabetes.

The event was backed and supported by the National Diabetes Service Scheme (NDSS).

What made the session so special was the excellent team of health professionals who came from varied specialities relevant to diabetes care and control. The experts provided informative and interesting presentations; their insights and in-depth knowledge keeping the audience engaged and glued to their seats – well, almost, except for when the exercise physiologists prodded them to perform impromptu exercises in their spots.

Diabetes educator Jenet Thevarajah from Prince of Wales Hospital emphasised how the NDSS supports people diagnosed with diabetes or at risk of diabetes. NDSS is an initiative of the Australian Government to enhance the capacity of people living with diabetes to understand and self-manage their life with diabetes and to access services, support and subsidised diabetes products.

Dr Soji Swaraj’s expertise and experience in managing patients living with diabetes was obvious. His messages revolved around the common misconceptions and wellestablished dogmas in diabetes care and control.

Nisha Thacker, an accredited practising dietitian, reinforced Dr Swaraj’s messages about healthy eating. Her talk ‘Making Healthy Eating Easy’ was relevant and in keeping with the Indian cultural food context. Nisha’s practical tips on healthy cooking and meal plans, snack ideas and portion sizing were welcomed by a very receptive audience.

Accredited exercise physiologists David Inglis and Bianca Kwok from Sydney Physios spoke about the benefits of exercise, and followed it up with a practical demonstration of a simple and effective exercise routine for older persons.

Following the presentations, the speakers, as a collective panel, took numerous questions from the audience, clarified their queries, and left them hungry for food and more information.

The organisers, in keeping with the theme of the afternoon, provided a delicious healthy afternoon tea.

Well done, Diabetes Australia and partnering local organisations, for organising this session. Our communities need more of such sessions to improve their health and well-being.

Dr Usha Salagame is an advisor with Pink Sari Inc

According to the Heart Foundation, heart disease kills one Australian every 18 minutes. It’s been the leading cause of death in Australia for the last three years.

South Asians, however, are more susceptible to chronic diseases than the general Australian population. Numerous studies point to underlying genetic and physiological factors, including BMI and lipoprotein concentration levels.

But it’s not all genetic: our actions and mindset around areas such as diet, exercise, smoking and alcohol and health care (also known as our health behaviours) can exacerbate or reduce chronic disease.

Dr Mehwish Nisar, a PhD researcher at the University of Queensland, has found the South Asian community exhibit many negative health behaviours which increase their risk of chronic disease. These include favouring a sedentary lifestyle, using high amounts of oil and sodium in food, and prioritising other facets of life, particularly education and work, over health.

Her findings show such health behaviours are linked to South Asian cultural beliefs, social circumstances, and economic situations.

“I call this my three Cs model: cost, culture and circumstances,” she says. “Cost relates to the price of healthy foods and the cost of facilities. Culture is understanding our needs with facilities, doctors understanding cultural background and language. Circumstances are about environment, the opportunity to exercise - own circumstances as well as those provided by the system.”

Frighteningly, the trend shows that heart disease is more severe and appearing earlier on in South Asians, with 50% of heart attacks happening before the age of 50. Dr Nisar notes how negative health behaviours can be passed intergenerationally.

“In school, kids might learn one thing, but at home, their parents might not have the mindset or be able to provide opportunities,” she says.

Cultivating positive health behaviours is crucial to positive health outcomes within the South Asian community.

“Health behaviours are modifiable, you can change them with intervention,” she says. “If you have genetic susceptibility, negative health behaviours will aggravate it: the condition might present sooner in life, or with more complications. This is not only a burden for the person, but the Australian healthcare system. Positive health behaviours will achieve several things, including delaying gene presentation.”

Dr Nisar notes that misinformation within the community is a key barrier to positive health behaviours.

“There are two types of misinformation: one is the myths that go from generation to generation, cultural misconceptions like we won’t screen for disease because ‘if we’re digging for something, it will come’, or ‘if you are walking instead of driving, it is a sign of poverty’,” says Dr Nisar.

The second, is dubious health advice shared via social media platforms such as