Date Published: July 13, 2017
Publisher: Public Library of Science
Author(s): Aymen El Masri, Gregory S. Kolt, Thomas Astell-Burt, Emma S. George, Kerry Sherman.
Little is known regarding the health and lifestyle behaviours of Australians of Lebanese ethnicity. The available evidence suggests that Australians of Lebanese ethnicity who were born in Lebanon reportedly have higher rates of cardiovascular disease-related and type 2 diabetes-related complications when compared with the wider Australian population. The aim of this study is to compare lifestyle behaviours of middle-aged to older adults of Lebanese ethnicity born in Lebanon, Australia, and elsewhere to those of Australian ethnicity. Participants were 37,419 Australians aged ≥45 years, from the baseline dataset of The 45 and Up Study which included 4 groups of interest: those of Australian ethnicity (n = 36,707) [Reference]; those of Lebanese ethnicity born in Lebanon (n = 346); 302 those of Lebanese ethnicity born in Australia (n = 302); and those of Lebanese ethnicity born elsewhere (n = 64). Multilevel logistic regression was used to examine the odds of those of Lebanese ethnicity reporting suboptimal lifestyle behaviours (insufficient physical activity, prolonged sitting, smoking, sleep duration, and various diet-related behaviours) relative to those of Australian ethnicity. Multilevel linear regression was used to examine the clustering of suboptimal lifestyle behaviours through a ‘lifestyle index’ score ranging from 0–9 (sum of all lifestyle behaviours for each subject). The lifestyle index score was lower among Lebanese-born (-0.36, 95% CI -0.51, -0.22, p<0.001) and Australian-born (-0.17, 95% CI -0.32, -0.02, p = 0.031) people of Lebanese ethnicity in comparison to those of Australian ethnicity. Those of Lebanese ethnicity born in Lebanon had higher odds of reporting suboptimal lifestyle behaviours for physical activity, smoking, and sleep duration, and lower odds of reporting optimal lifestyle behaviours for sitting time, fruit, processed meat, and alcohol consumption, when compared with those of Australian ethnicity. Differences in the individual lifestyle behaviours for those of Lebanese ethnicity born in Australia and elsewhere compared with those of Australian ethnicity were fewer. Lifestyle behaviours of those of Lebanese ethnicity vary by country of birth and a lower level of suboptimal lifestyle behaviour clustering was apparent among Lebanese-born and Australian-born middle-aged to older adults of Lebanese ethnicity.
Lower levels of physical activity (PA) [1, 2], sedentary behaviour , poor diet , smoking [2, 5], and suboptimal sleep durations  are all associated with poor health. When suboptimal lifestyle behaviours cluster, however, there is an increased risk of poorer health  and all-cause mortality . Recommended guidelines for many of these lifestyle behaviours were developed based upon empirical evidence [9–12]. Addressing these lifestyle factors has been the focus of many health promotion initiatives and campaigns in Australia, such as the Healthy Communities Initiative  and the National Tobacco Campaign .
Table 1 presents the demographic characteristics and lifestyle behaviour distribution among the sample. The mean (±SD) lifestyle index score was 3.49/9 (±1.42) for those of Australian ethnicity, 3.34/9 (±1.37) for those of Lebanese ethnicity born in Lebanon, 3.30/9 (±1.44) for those of Lebanese ethnicity born in Australia, and 3.48/9 (±1.37) for those of Lebanese ethnicity born elsewhere. There were statistically significant differences for age (χ2 = 33.75, df = 9, p<0.001), gender (χ2 = 17.97, df = 3, p<0.001), education (χ2 = 226.22, df = 12, p<0.001), employment status (χ2 = 32.97, df = 3, p<0.001), SEIFA (χ2 = 51.46, df = 9, p<0.001), ARIA (χ2 = 303.42, df = 3, p<0.001), PA (χ2 = 81.29, df = 3, p<0.001), smoking status (χ2 = 84.43, df = 3, p<0.001), alcohol consumption (χ2 = 72.49, df = 3, p<0.001), fruit consumption (χ2 = 34.60, df = 3, p<0.001), processed meat consumption (χ2 = 142.36, df = 3, p<0.001), and sleep duration (χ2 = 43.86, df = 3, p<0.001) between the four respective groups. This study aimed to examine the lifestyle behaviours of those of Lebanese ethnicity born in Lebanon, Australia, and elsewhere relative to those of Australian ethnicity. The findings of this study suggest that the lifestyle behaviours of those of Lebanese ethnicity vary by country of birth when compared to those of Australian ethnicity. While a lifestyle index score is useful for the examination of the clustering of suboptimal lifestyle behaviours among individuals, it does not provide a complete picture with respect to which key suboptimal lifestyle behaviours are most prominent . This study provides a unique insight into the health of Australians of Lebanese ethnicity. While the lifestyle index suggested that there was a lower level of suboptimal lifestyle behaviour clustering among those of Lebanese ethnicity born in Lebanon and Australia in comparison to those of Australian ethnicity, the examination of the individual lifestyle behaviours showed the potential contributors to these lifestyle index scores. The findings from this study provide important evidence on the lifestyle behaviours of Australians of Lebanese ethnicity, and such evidence could potentially be utilised to develop health promotion initiatives or interventions targeting these key lifestyle behaviours. As lifestyle-related chronic diseases such as cardiovascular disease , T2DM [26, 28], and cancer  are prevalent among Lebanese immigrants, the findings of this study helps underline key lifestyle behaviours that could be targeted by health promotion service providers. Future research among those of Lebanese ethnicity could examine the impact of acculturation on the lifestyle behaviours and the contribution of such lifestyle behaviours on the risk of a range of lifestyle-related chronic diseases. Source: http://doi.org/10.1371/journal.pone.0181217