American Health Habits Influence Immigrants

According to a study, immigrants who have lived in this country for at least 15 years are nearly as obese as their US-born counterparts. The weight gain seems to start after people had been living in the United States for 10 years.

The Study

Although a previous study found that living longer in the United States was associated with obesity, this new study questioned when weight gain happens and how much weight is gained.

Dr. Mita Sanghavi Goel, lead author of a report on the trend and an instructor in medicine at Northwestern University's Feinberg School of Medicine in Chicago, and her colleagues analyzed data on 32,374 people from the 2000 National Health Interview Survey. Of the respondents, 14% were immigrants. The prevalence of obesity was 16% among immigrants and 22% among people born in the US.

Results

Of the immigrants who had lived in the United States for less than one year, only 8% were obese. In contrast, 19% of the immigrants who had been living in the United States for at least 15 years were obese. This association was seen for all immigrant subgroups except for foreign-born black people.

For a typical 5-foot, 4-inch immigrant woman, there was a nine-pound weight gain, and for a typical 5-foot, 9-inch immigrant man, the increase was 11 pounds after 15 years. This weight gain was over and above any gain due to other factors, such as age, income level and race or ethnicity.

"It's amazing how quickly people are changing," says Goel. "Within 15 years, they are more likely to look like someone who is US-born (than to look like a recent immigrant," says Goel. "It's another alarm bell."

Living In America

Although the study was not designed to determine precisely why immigrants gain weight, Goel has a theory. "Imagine you're a recent immigrant coming to the US. You might live in an urban center where there are other immigrants similar to you, shop at a local grocery store, prepare traditional foods. You may not have a car and so you walk around more." Then, imagine that your job changes or you have children and move outside of that original neighborhood. Now you might start picking up more American habits-buying candy at the checkout lane and driving more than walking.

"Immigrants become Americanized rather quickly," adds Maritza Marchante-Henry, a nutritionist with New York City's Visiting Nurse Service, who is originally from Cuba. "They want to be Americanized. They are confronted with a large variety of different foods, including a lot of the fast-food sources, which are very high in fat and high in sodium, and some are also high in sugar."

Changes Afoot

Goel says the results of this study may provide an opportunity, especially with recent immigrants. "Immigrants generally tend to be healthier when they first come to the US," Goel says. "This is the ideal population to talk with about maintaining healthy behaviors."

However, the study found that fewer immigrants (18%) than US-born individuals (24%) discussed diet and exercise with health-care providers.

Goel adds that health-care providers are only a small part of the puzzle. Changes also have to take place in society.

"The larger policy implications are our access to healthy foods. Are they too expensive for people to buy? Or is it harder to find fruits and vegetables?" she speculates. "Is it too easy to get in a car and drive someplace? Maybe we need to create an environment that fosters walking."

More than 127 million American adults are overweight, and almost 70 million are obese or severely obese.