A cross-cultural examination of physical activity and healthy food consumption among Ethiopian immigrants in Israel and the general population in regard to type 2 diabetes

Abstract

The global rise in type 2 diabetes mellitus (T2DM) highlights the need for effective preventive health behaviors, such as maintaining a nutritious diet, optimal body weight, and regular physical activity. Ethiopian immigrants (EIs) in Israel, an ethnic minority, are vulnerable to T2DM, with a risk significantly higher than the general population. This study aims to assess and compare health behaviors, specifically physical activity and healthy food consumption, between EIs and Israeli-born individuals (IBs). Utilizing an expanded theory of planned behavior framework, the study incorporates perceived susceptibility to T2DM and perceived health status as additional determinants of these behaviors. A cross-sectional study design was employed, involving a convenience sample of 110 EIs and 97 IBs. Data collection involved questionnaires administered via email or hard-copy. Key variables included attitudes, subjective norms, perceived control, intention, perceived susceptibility, and perceived health status, with logistic regression used to identify significant predictors of health behaviors. Results revealed no significant differences in the rates of physical activity (60.9% for EIs, 60.8% for IBs; p = 0.99) and in healthy food consumption (66.4% for EIs, 78.4% for IBs; p = 0.05). Significant predictors of physical activity differed between the groups. For EIs, intention (OR = 1.35, 95%CI [0.71,1.99], p < 0.001) had a significant effect, while for IBs, this effect was not observed. Perceived health status (OR = 1.63, 95%CI [1.07,2.48], p = 0.023) was a significant predictor across both groups. For healthy food consumption, significant predictors included marital status (OR = 4.25, 95%CI [1.92, 9.44], p < 0.001), BMI (OR = 0.61, 95%CI [0.39, 0.95], p = 0.029), and intention (OR = 2.86,95%CI [1.40,5.86], p = 0.004), with no significant group interaction effects found for these variables. The findings highlight the importance of culturally tailored health interventions that consider both individual and communal beliefs. The study fills a critical gap in preventive health practices among high-risk populations, providing insights for developing effective strategies to promote healthy behaviors in diverse cultural contexts.