Immigrants Show Us why We're Overweight

Summarized by Robert W. Griffith, MD
January 21, 2005

Introduction

The obesity epidemic in the USA has spread to parts of Eastern Europe, the Middle East, and China. However, the situation is more severe in the USA, so that it might be interesting to know if factors in the lifestyle or environment are responsible, and how quickly they take effect. A survey has just been reported that looks at this. The replies from immigrants were compared with those of US-born individuals. The results of this analysis are reported in the Journal of the American Medical Association, and are summarized here.

What was done

The investigators used results from the 2000 National Health Interview Survey (NHIS), which was administered by the US Bureau of the Census for the National Center for Health Statistics. A slightly greater proportion of questionnaires were sent to Latino and black populations, in order to allow for better evaluation of these minority groups.

Respondents gave their height and weight, allowing calculation of the body mass index (BMI); obesity was defined as someone who had a BMI over 30. The participants were also asked about race, birthplace, and years of US residence. There were numerous other questions concerning general health, access to health care, healthy behavior, level of education, and annual household income. In particular, respondents were asked about whether they ever received dietary and exercise counseling.

What the analysis showed

There were over 32,000 respondents, 14% of whom were immigrants. Obesity was diagnosed in 16% of the immigrants and 22% of the US-born individuals.

After adjusting for age and gender, it was found that obesity was seen in 8% of immigrants living in the USA for less than a year, but in 19% of those living in the USA for at least 15 years. Moreover, immigrants were found to be less likely to have been counseled on good diet and exercise habits.

In addition to obesity, the duration of USA residence affected the frequency of overweight (BMI 25 to 30) in immigrants; after 15 years in the USA, 38% of immigrants were overweight, compared with 35% of the US-born.

Because occupation might influence the level of physical activity, an additional analysis was done to estimate its effect. However, the findings were unaltered; i.e. after 15 years in the USA, immigrants had similar rates of overweight and obesity as the US-born respondents.

What this study shows

Clearly, the US lifestyle, or its environment, presents immigrants with features that lead to overweight and obesity, and all the health problems that this entails. By lifestyle, we mean sedentary behavior and/or poor dietary patterns, while the environmental factors include availability of high-calorie foods and more labor-saving technologies leading to inaction.

The lesson to be learned is that new immigrants should be warned of the risks of the USA lifestyle and environment, and counseled accordingly. For those of us already living in the USA, this study provides further proof that our national lifestyle (and environment) is not very healthy, and we should draw the necessary conclusions.

Source

• Obesity among US immigrant subgroups by duration of residence. MS. Goel, EP. McCarthy, RS. Phillips, CC. Wee, JAMA, 2004, vol. 292, pp. 2860--2867

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