Health risks of immigration: the Yemenite and Ethiopian cases in Israel.

Immigration almost always involves major cultural changes in dietary, social and health-related beliefs and behaviour. Two years after the arrival of the earliest Yemenite immigration wave to Israel, about 30 years ago, the prevalence rate of diabetes in that population was almost nonexistent (approximately 0.06%), increasing to approximately 12% 25 years later. Obesity and hyperlipoproteinemia were not always correlated with diabetes. Ethiopians, mainly from the northern regions, first immigrated to Israel ten years ago. At that time, their prevalence rate of diabetes was 0-0.4%. Though it is too early to determine the overall prevalence rate in this population, 5-8% rates have been reported after up to 5 years in Israel. The objective of the present work was to study the effect of the diversity of ethnic food patterns and adaptability on the nutritional status of Ethiopian immigrants. Two groups were studied--teenagers and adults. After 2 and 18 months in Israel, adult Ethiopians who arrived in Israel in 1991 (n = 426) had an average body mass index (BMI) of 20-22 kg/m2, which was below western values; a waist:hip ratio (WHR) of 0.9 suggested abdominal fat accumulation. Fasting serum- glucose levels were within the norm, whereas insulin levels were high (24 micrograms/mL). Plasma triglycerides (TG) increased with age, from about 100 to 150 mg/dL, whereas cholesterol and lipoprotein levels remained stable and normal. The BMI of Ethiopian teenagers (n = 15) 5-7 years in Israel was similar to that found in adults. Fasting serum insulin levels were significantly lower in boys than in girls (approximately 16.6 vs approximately 18.6 microU/mL, respectively). Cholesterol values were significantly higher in girls than in boys (approximately 184 vs approximately 150 mg/dL); TG, high density and low density lipoprotein values were normal. These data indicate the existence of early signs of risk factors for diabetes, which may not manifest itself clinically unless provoked. Several causes, rendered detrimental by progress, could be setting the stage for early manifestation of risk factors for cardiovascular disease and diabetes. Of these, two are of pertinence to this work: a genetic endowment for low-energy output and the thrifty genotype, and maternal undernutrition.