Top

BMC Public Health

Published in:

Open Access 01-12-2016 | Research article

Ethnic differences in overweight and obesity and the influence of acculturation on immigrant bodyweight: evidence from a national sample of Australian adults

Authors: Karen Menigoz, Andrea Nathan, Gavin Turrell

Published in: BMC Public Health | Issue 1/2016

Abstract

Background

Despite growing international migration and documented ethnic differences in overweight and obesity in developed countries, no research has described the epidemiology of immigrant overweight and obesity at a national level in Australia, a country where immigrants comprise 28.1 % of the population. The aim of this study was to examine ethnic differences in body mass index (BMI) and overweight/obesity in Australia and the influence of acculturation on bodyweight among Australian immigrants.

Methods

Data from the national Household Income and Labour Dynamics in Australia (HILDA) survey were used to examine mean BMI and odds of overweight/obesity comparing immigrants (n = 2 997) with Australian born (n = 13 047). Among immigrants, acculturation differences were examined by length of residence in Australia and age at migration. Data were modelled in a staged approach using multilevel linear and logistic regression, controlling for demographic and socioeconomic variables.

Results

Relative to Australian born, men from North Africa/Middle East and Oceania regions had significantly higher BMIs, and men from North West Europe, North East Asia and Southern and Central Asia had significantly lower BMIs. Among women, the majority of foreign born groups had significantly lower BMIs compared with Australian born. Male and female immigrants living in Australia for 15 years or more had significantly higher BMIs and increased odds of being overweight/obese respectively, compared with immigrants living in Australia for less than 5 years. Male immigrants arriving as adolescents were twice more likely to be overweight/obese and had significantly higher BMIs than immigrants who arrived as adults. Male and female immigrants who arrived as children (≤11 years) had significantly higher odds of adult overweight/obesity and BMIs.

Conclusions

This study provides evidence of ethnic differences in overweight and obesity in Australia with male immigrants from North Africa/Middle East and Oceania regions being particularly vulnerable. In addition, this study suggests that greater acculturation may negatively impact immigrant bodyweight and recently arrived immigrants as well as those who arrive as children or adolescents may benefit from obesity prevention intervention. Public health policy targeted at and tailored to these immigrant cohorts will assist in the multi-pronged approach required to address the obesity epidemic.

Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384:766–81. http://dx.doi.org/10.1016/S0140-6736(14)60460-8.

United Nations Department of Economic and Social Affairs Population Division. Trends in International Migration, 2015. In: Population Facts. vol. 2015/4: United Nations; 2015: 1–4.

Kumar BN, Meyer HE, Wandel M, Dalen I, Holmboe-Ottesen G. Ethnic differences in obesity among immigrants from developing countries, in Oslo. Norway Int J Obes. 2006;30(4):684–90. doi:10.1038/sj.ijo.0803051;.CrossRef

Wang Y, Beydoun MA. The obesity epidemic in the United States - gender, age, socioeconomic, racial/ethnic, and geographic characteristics: a systematic review and meta-regression analysis. Epidemiol Rev. 2007;29(1):6–28. doi:10.1093/epirev/mxm007.CrossRefPubMed

McDonald JT, Kennedy S. Is migration to Canada associated with unhealthy weight gain? Overweight and obesity among Canada’s immigrants. Soc Sci Med. 2005;61(12):2469–81. doi:10.1016/j.socscimed.2005.05.004.CrossRefPubMed

El-Sayed A, Scarborough P, Galea S. Ethnic inequalities in obesity among children and adults in the UK: a systematic review of the literature. Obes Rev. 2011;12(5):e516–34. doi:10.1111/j.1467-789X.2010.00829.x.CrossRefPubMed

El-Sayed A, Scarborough P, Galea S. Unevenly distributed: a systematic review of the health literature about socioeconomic inequalities in adult obesity in the United Kingdom. BMC Public Health. 2012;12(1):18. doi:10.1186/1471-2458-12-18.CrossRefPubMedPubMedCentral

Gearon E, Backholer K, Stevenson C, Magliano DJ, Keating C, Ball K, et al. Trends in body mass index according to educational attainment for urban Australian adults between 1980 and 2007. Int J Obes. 2015;39(6):1019–26. doi:10.1038/ijo.2015.27.CrossRef

McLaren L. Socioeconomic status and obesity. Epidemiol Rev. 2007;29(1):29–48. doi:10.1093/epirev/mxm001.CrossRefPubMed

10.

Ball K, Crawford D. Socioeconomic status and weight change in adults: a review. Soc Sci Med. 2005;60(9):1987–2010. doi:10.1016/j.socscimed.2004.08.056.CrossRefPubMed

11.

Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. JAMA. 2012;307(5):491–7. doi:10.1001/jama.2012.39.CrossRefPubMed

12.

Krueger PM, Coleman‐Minahan K, Rooks RN. Race/ethnicity, nativity and trends in BMI among US adults. Obesity. 2014;22(7):1739–46. doi:10.1002/oby.20744.CrossRefPubMedPubMedCentral

13.

Zilanawala A, Davis-Kean P, Nazroo JY, Sacker A, Simonton S, Kelly YJ. Race/ethnic disparities in early childhood BMI, obesity and overweight in the United Kingdom and United States. Int J Obes. 2014;39:520–9. doi:10.1038/ijo.2014.171.CrossRef

14.

Smith NR, Kelly YJ, Nazroo JY. The effects of acculturation on obesity rates in ethnic minorities in England: evidence from the Health Survey for England. Eur J Public Health. 2012;22(4):508–13. doi:10.1093/eurpub/ckr070.CrossRefPubMed

15.

Alkerwi AA, Sauvageot N, Pagny S, Beissel J, Delagardelle C, Lair M-L. Acculturation, immigration status and cardiovascular risk factors among Portuguese immigrants to Luxembourg: findings from ORISCAV-LUX study. BMC Public Health. 2012;12(1):1–10. doi:10.1186/1471-2458-12-864.CrossRef

16.

Australian Bureau of Statistics: Australian Health Survey: first results, 2011–12. 2012. http://www.ausstats.abs.gov.au/ausstats/subscriber.nsf/0/1680ECA402368CCFCA257AC90015AA4E/$File/4364.0.55.001.pdf. Accessed 19 Aug 2015.

17.

Australian Bureau of Statistics: Australia’s population by country of birth. 2012. http://www.abs.gov.au/ausstats/abs@.nsf/Products/84074889D69E738CCA257A5A00120A69?opendocument. Accessed 19 Aug 2015.

18.

United States Census Bureau: Statistical Abstract of the United States: 2012. http://www.census.gov/library/publications/2011/compendia/statab/131ed.html. Accessed 5 Sept 2015.

19.

Achat HM, Stubbs JM. Socio-economic and ethnic differences in the prevalence of overweight and obesity among school children. J Paediatr Child Health. 2012;50:E77–84. doi:10.1111/j.1440-1754.2012.02474.x.CrossRefPubMed

20.

Hardy LL, King L, Hector D, Baur LA. Socio-cultural differences in Australian primary school children’s weight and weight-related behaviours. J Paediatr Child Health. 2013;49(8):641–8. doi:10.1111/jpc.12263.CrossRefPubMed

21.

O’Dea JA. Gender, ethnicity, culture and social class influences on childhood obesity among Australian schoolchildren: implications for treatment, prevention and community education. Health Soc Care Community. 2008;16(3):282–90. doi:10.1111/j.1365-2524.2008.00768.x.CrossRefPubMed

22.

Waters E, Ashbolt R, Gibbs L, Booth M, Magarey A, Gold L, et al. Double disadvantage: the influence of ethnicity over socioeconomic position on childhood overweight and obesity: findings from an inner urban population of primary school children. Int J Pediatr Obes. 2008;3(4):196–204. doi:10.1080/17477160802141846.CrossRefPubMed

23.

Astell-Burt T, Feng X, Croteau K, Kolt GS. Influence of neighbourhood ethnic density, diet and physical activity on ethnic differences in weight status: a study of 214,807 adults in Australia. Soc Sci Med. 2013;93:70–7. doi:10.1016/j.socscimed.2013.06.006.CrossRefPubMed

24.

Hauck K, Hollingsworth B, Morgan L. BMI differences in 1st and 2nd generation immigrants of Asian and European origin to Australia. Health & Place. 2011;17(1):78–85. doi:10.1016/j.healthplace.2010.08.016.CrossRef

25.

Guo S, Lucas RM, Joshy G, Banks E. Cardiovascular disease risk factor profiles of 263,356 older Australians according to region of birth and acculturation, with a focus on migrants born in Asia. PLoS One. 2015;10(2), e0115627. doi:10.1371/journal.pone.0115627.CrossRefPubMedPubMedCentral

26.

Redfield R, Linton R, Herskovits MJ. Memorandum for the study of acculturation. Am Anthropol. 1936;38(1):149–52.CrossRef

27.

Schwartz SJ, Unger JB, Zamboanga BL, Szapocznik J. Rethinking the concept of acculturation: implications for theory and research. Am Psychol. 2010;65(4):237–51. doi:10.1037/a0019330.CrossRefPubMedPubMedCentral

28.

Sanchez-Vaznaugh EV, Kawachi I, Subramanian S, Sánchez BN, Acevedo-Garcia D. Differential effect of birthplace and length of residence on body mass index (BMI) by education, gender and race/ethnicity. Soc Sci Med. 2008;67(8):1300–10. doi:10.1016/j.socscimed.2008.06.015.CrossRefPubMed

29.

Barcenas CH, Wilkinson AV, Strom SS, Cao Y, Saunders KC, Mahabir S, et al. Birthplace, years of residence in the United States, and obesity among Mexican‐American adults. Obesity. 2007;15(4):1043–52.CrossRefPubMed

30.

Albrecht SS, Diez-Roux AV, Aiello AE, Schulz AJ, Abraido-Lanza AF. Secular trends in the association between nativity/length of US residence with body mass index and waist circumference among Mexican-Americans, 1988–2008. Int J Public Health. 2013;58(4):573–81. doi:10.1007/s00038-012-0414-5.CrossRefPubMed

31.

Bennett GG, Wolin KY, Askew S, Fletcher R, Emmons KM. Immigration and obesity among lower income blacks. Obesity. 2007;15(6):1391–4.CrossRefPubMed

32.

Delavari M, Sønderlund AL, Swinburn B, Mellor D, Renzaho AMN. Acculturation and obesity among migrant populations in high income countries: a systematic review. BMC Public Health. 2013;13(1):458. doi:10.1186/1471-2458-13-458.CrossRefPubMedPubMedCentral

33.

Oza‐Frank R, Cunningham SA. The weight of US residence among immigrants: a systematic review. Obes Rev. 2010;11(4):271–80. doi:10.1111/j.1467-789X.2009.00610.x.CrossRefPubMed

34.

Salant T, Lauderdale DS. Measuring culture: a critical review of acculturation and health in Asian immigrant populations. Soc Sci Med. 2003;57(1):71–90. doi:10.1016/S0277-9536(02)00300-3.CrossRefPubMed

35.

Wan-Ping L, Lingard J, Bermingham M. Change in diet and body mass index in Taiwanese women with length of residence in Australia. Asia Pac J Clin Nutr. 2007;16(1):56–65.

36.

Albrecht SS, Osypuk TL, Kandula NR, Gallo LC, Lê-Scherban F, Shrager S, et al. Change in waist circumference with longer time in the United States among Hispanic and Chinese immigrants: the modifying role of the neighborhood built environment. Ann Epidemiol. 2015;25(10):767–72. http://dx.doi.org/10.1016/j.annepidem.2015.07.003.CrossRefPubMedPubMedCentral

37.

Ro A, Bostean G. Duration of U.S. stay and body mass index among Latino and Asian immigrants: a test of theoretical pathways. Soc Sci Med. 2015;144:39–47. doi:10.1016/j.socscimed.2015.09.001.CrossRefPubMed

38.

Gray L, Harding S, Reid A. Evidence of divergence with duration of residence in circulatory disease mortality in migrants to Australia. Eur J Public Health. 2007;17(6):550–4. doi:10.1093/eurpub/ckm008.CrossRefPubMed

39.

Guven C, Islam A. Age at migration, language proficiency and socio-economic outcomes: evidence from Australia. In: Discussion Paper 18/13. Melbourne: Department of Economics, Monash University; 2013.

40.

Roshania R, Narayan K, Oza‐Frank R. Age at arrival and risk of obesity among US immigrants. Obesity. 2008;16(12):2669–75. doi:10.1038/oby.2008.425.CrossRefPubMed

41.

Watson N, Wooden M. The Household, Income and Labour Dynamics in Australia (HILDA) survey: wave 1 survey methodology. 2002. http://www.melbourneinstitute.com/downloads/hilda/Bibliography/HILDA_Technical_Papers/htec102.pdf. Accessed 26 Apr 2015.

42.

Watson N. Methodology for the HILDA top-up Sample. 2011. http://www.melbourneinstitute.com/hilda/biblio/HILDA_technical_papers.html. Accessed 22 Jul 2016.

43.

Watson N. Longitudinal and Cross-Sectional Weighting Methodology for the HILDA Survey. 2012. http://www.melbourneinstitute.com/hilda/biblio/HILDA_technical_papers.html. Accessed 22 Jul 2016.

44.

Wooden M, Watson N, Agius P, Friedin S. Assessing the quality of the height and weight data in the HILDA survey. 2008. http://www.melbourneinstitute.com/hilda/biblio/HILDA_technical_papers.html. Accessed 24 Aug 2015.

45.

World Health Organisation: Global database on body mass index. 2013. http://apps.who.int/bmi/index.jsp?introPage=intro_3.html. Accessed 19 Jul 2015.

46.

Australian Bureau of Statistics: Standard Australian Classification of Countries (SACC). 2011. http://www.abs.gov.au/ausstats/abs@.nsf/mf/1269.0. Accessed 21 Apr 2015.

47.

Australian Bureau of Statistics: Socio-Economic Indexes for Areas. 2013. http://www.abs.gov.au/websitedbs/censushome.nsf/home/seifa?opendocument&navpos=260. Accessed 22 July 2016.

48.

Australian Bureau of Statistics: Australian Standard Geographical Classification (ASGC). 2001. http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/1216.02001?OpenDocument. Accessed 21 Apr 2015.

49.

Cleland V, Hume C, Crawford D, Timperio A, Hesketh K, Baur LA, et al. Urban-rural comparison of weight status among women and children living in socioeconomically disadvantaged neighbourhoods. Med J Aust. 2010;192(3):137.PubMed

50.

Lau R, Morse CA. Health and wellbeing of older people in Anglo‐Australian and Italian‐Australian communities: a rural-urban comparison. Aust J Rural Health. 2008;16(1):5–11.CrossRefPubMed

51.

Browne WJ. MCMC Estimation in MLwiN Version 2.13. United Kingdom: Centre for Multilevel Modelling, University of Bristol; 2009.

52.

Leckie G, Charlton C. Runmlwin-a program to run the MLwiN multilevel modelling software from within Stata. J Stat Softw. 2013;52(11):1–40.

53.

Bates LM, Acevedo-Garcia D, Alegria M, Krieger N. Immigration and generational trends in body mass index and obesity in the United States: results of the National Latino and Asian American Survey, 2002–2003. Am J Public Health. 2008;98(1):70–7. doi:10.2105/AJPH.2006.102814.CrossRefPubMedPubMedCentral

54.

Anikeeva O, Bi P, Hiller JE, Ryan P, Roder D, Han G-S. The health status of migrants in Australia: a review. Asia Pac J Public Health. 2010;22(2):159–93. doi:10.1177/1010539509358193.CrossRefPubMed

55.

Krueger P, Reither E. Mind the gap: race/ethnic and socioeconomic disparities in obesity. Current Diabetes Reports. 2015;15(11):1–9. doi:10.1007/s11892-015-0666-6.CrossRef

56.

Kennedy S, McDonald JT, Biddle N. The healthy immigrant effect and immigrant selection: evidence from four countries. In: SEDAP Research Paper #164. Ottawa: Social and Economic Dimensions of an Ageing Population (SEDAP) Research Program; 2006.

57.

Antecol H, Bedard K. Unhealthy assimilation: why do immigrants converge to American health status levels? Demography. 2006;43(2):337–60. doi:10.1353/dem.2006.0011.CrossRefPubMed

58.

Kaplan MS, Huguet N, Newsom JT, McFarland BH. The association between length of residence and obesity among Hispanic immigrants. Am J Prev Med. 2004;27(4):323–6. doi:10.1016/j.amepre.2004.07.005.CrossRefPubMed

59.

Abouzeid M, Bhopal RS, Dunbar JA, Janus ED. The potential for measuring ethnicity and health in a multicultural milieu: the case of type 2 diabetes in Australia. Ethn Health. 2013;19(4):424–39. doi:10.1080/13557858.2013.828828.CrossRefPubMed

60.

Ford CL, Harawa NT. A new conceptualization of ethnicity for social epidemiologic and health equity research. Soc Sci Med. 2010;71(2):251–8. doi:10.1016/j.socscimed.2010.04.008.CrossRefPubMedPubMedCentral

61.

Gorber SC, Tremblay MS, Moher D, Gorber B. A comparison of direct vs. self‐report measures for assessing height, weight and body mass index: a systematic review. Obes Rev. 2007;8(4):307–26. doi:10.1111/j.1467-789X.2007.00347.x.CrossRefPubMed

62.

Richmond TK, Thurston I, Sonneville K, Milliren CE, Walls CE, Austin SB. Racial/ethnic differences in accuracy of body mass index reporting in a diverse cohort of young adults. Int J Obes. 2015;39(3):546–8. doi:10.1038/ijo.2014.147.CrossRef

63.

Stella SY, Kwon SC, Wyatt L, Islam N, Trinh-Shevrin C. Weighing in on the hidden Asian American obesity epidemic. Prev Med. 2015;73:6–9. http://dx.doi.org/10.1016/j.ypmed.2015.01.007.CrossRef

64.

Albrecht SS, Roux AVD, Kandula NR, Osypuk TL, Ni H, Shrager S. Immigrant assimilation and BMI and waist size: a longitudinal examination among hispanic and chinese participants in the multi-ethnic study of atherosclerosis. Obesity. 2013;21(8):1695–703. doi:10.1002/oby.20104.CrossRefPubMedPubMedCentral

Title: Ethnic differences in overweight and obesity and the influence of acculturation on immigrant bodyweight: evidence from a national sample of Australian adults
Authors: Karen Menigoz
Andrea Nathan
Gavin Turrell
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-016-3608-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Ethnic differences in overweight and obesity and the influence of acculturation on immigrant bodyweight: evidence from a national sample of Australian adults

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2016

Prevalence of hardcore smoking in the Netherlands between 2001 and 2012: a test of the hardening hypothesis

Study protocol for a multi-component kindergarten-based intervention to promote healthy diets in toddlers: a cluster randomized trial

Service evaluation of an educational intervention to improve sexual health services in primary care implemented using a step-wedge design: analysis of chlamydia testing and diagnosis rate changes

The Effect of Energy Labelling on Menus and a Social Marketing Campaign on Food-Purchasing Behaviours of University Students

A systematic review on the clustering and co-occurrence of multiple risk behaviours

Born in Bradford’s Better Start: an experimental birth cohort study to evaluate the impact of early life interventions