Abstract
Cardiovascular disease (CVD) is the most potent killer in Aotearoa New Zealand (NZ) with South Asians being one of the three high-risk groups. This study aimed to investigate health beliefs, knowledge, and behaviours related to diet among NZ South Asians at risk of CVD, using a mixed-methods approach. Demographics and dietary data were collected via an online Qualtrics survey and qualitative data on health beliefs and knowledge about heart-healthy foods were collected using semi-structured phone interviews. Twenty-one South Asian participants with diagnosed type 2 diabetes and/or hypertension and/or hypercholesterolemia were recruited via stakeholder engagement and advertisements through South Asian cultural and religious organisations.The majority of participants (62%) were aged 35-50 years, 10 were female, 11 were male and 67% were long-term residents of NZ. Most participants were unsure of the recommendations for fruit and vegetable consumption and only 48% and 29% met these guidelines, respectively. This is worrying as NZ Health survey data show a steady decrease in fruit and vegetable consumption among South Asians over 20 years with only 27% meeting the guidelines in 2021. (1) Sixty-two percent of participants consumed milk and yoghurt ≥ 4 times a week; 63% consumed full-fat milk and 45% consumed full-fat yoghurt regularly. These findings are consistent with that found for healthy South Asians in NZ,(2) where dairy, the primary source of saturated fats in South Asian cuisine, increased post-migration. Some participants believed that full-fat dairy increases the risk of heart disease, yet they still preferred to use full-fat milk and ghee as they believed it is healthier than low-fat varieties. Most participants believed that salty foods and pickles increase the risk of heart disease with 33% consuming salted pickles “sometimes” and only 28% choosing “low or reduced salt” food varieties “regularly/always”. More than half (57%) chose reduced-fat varieties of foods deliberately to reduce their risk of CVD. Red meat and deep-fried fatty foods were the most common foods that most participants thought they should avoid; however, some were not sure. Foods that participants considered heart-healthy were green vegetables, lentils and ghee in moderation. Most meat-consuming participants were unaware of healthy cuts of meat with only 38% reporting always choosing low-fat cuts of meat. Most participants believed that they could take some measures to reduce their risk of heart disease. Nevertheless, their health beliefs were not consistent with knowledge of or behaviours concerning heart-healthy measures. Substantial knowledge gaps evident in the reported dietary behaviours need to be addressed to reduce the risk of CVD among at-risk South Asians.