Obesity in International Migrant Populations.

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childhood obesity 3 endocrinologydiseases
metabolic syndrome 1 endocrinologydiseases
obesity 82 endocrinologydiseases

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childhood obesity 30004 vary between ethnic groups [[]]. There are even more complications when considering thresholds for childhood obesity , given the influence of different ages of growth and sexual maturation on body composition, which can
childhood obesity 33902 some populations, but there is a lack of representation in studies. For example, a Cochrane review of childhood obesity interventions noted that the majority of research in the field had been conducted with ‘motivated,
childhood obesity 34821 cultural focus [[]•].More recently, in the UK, a culturally appropriate intervention for prevention of childhood obesity in the South Asian population was promising in a feasibility study [[]] and is now being examined in
metabolic syndrome 32837 joint scientific statement from a number of US and international bodies, which proposes a definition of metabolic syndrome based on differing thresholds for waist circumference in different populations, some of which correspond
obesity 274 (pmc-release): 7/2017Publication date (ppub): /2017AbstractPurpose of ReviewThis review examines the risk of obesity in migrant groups—specifically migrants from countries with lower prevalence of obesity to countries
obesity 364 the risk of obesity in migrant groups—specifically migrants from countries with lower prevalence of obesity to countries with higher prevalence of obesity. We examine obesity prevalence within migrant groups
obesity 411 groups—specifically migrants from countries with lower prevalence of obesity to countries with higher prevalence of obesity . We examine obesity prevalence within migrant groups compared with native populations and the evidence
obesity 431 countries with lower prevalence of obesity to countries with higher prevalence of obesity. We examine obesity prevalence within migrant groups compared with native populations and the evidence on factors that might
obesity 550 within migrant groups compared with native populations and the evidence on factors that might shape obesity risk in these migrant groups.Recent FindingsMigrants may arrive in new countries with a health advantage
obesity 950 unhealthy weight gain in migrant populations. This unhealthy weight gain leads to similar or greater obesity risk in migrant populations compared with native populations 10–15 years after migration.SummaryMeeting
obesity 1110 populations 10–15 years after migration.SummaryMeeting the challenge of prevention and treatment of obesity in diverse populations will require greater attention to minority groups in research in the future.IntroductionIn
obesity 1253 greater attention to minority groups in research in the future.IntroductionIn 2010, overweight and obesity were estimated to have caused 3.4 million deaths and 94 million disability-adjusted life-years worldwide
obesity 1397 million deaths and 94 million disability-adjusted life-years worldwide [[]]. Worldwide, prevalence of obesity is rising: a systematic analysis for the Global Burden of Disease study examining data on prevalence
obesity 1524 systematic analysis for the Global Burden of Disease study examining data on prevalence of overweight and obesity in children and adults from 1980 to 2013 found that overweight and obesity (based on a body mass index
obesity 1599 prevalence of overweight and obesity in children and adults from 1980 to 2013 found that overweight and obesity (based on a body mass index (BMI) over 25 kg/m2) had risen by 27.5% for adults and 47.1% for children—that
obesity 1892 [[]•]. While this trend is monotonic in populations across the world, the prevalence and risk of obesity vary between and within populations [[]•]. It is likely that the variation in prevalence and risk
obesity 2003 vary between and within populations [[]•]. It is likely that the variation in prevalence and risk of obesity is due to genetic (including ethnic) differences between populations as well as due to the variation
obesity 2208 variation in the degree to which local environments are ‘obesogenic’.This review examines the risk of obesity in migrant groups, focusing on international migration which is often from regions with low prevalence
obesity 2322 migrant groups, focusing on international migration which is often from regions with low prevalence of obesity to regions with higher prevalence of obesity. In this review, we include ‘immigrant’ populations
obesity 2367 migration which is often from regions with low prevalence of obesity to regions with higher prevalence of obesity . In this review, we include ‘immigrant’ populations within our examination of migrants i.e. those
obesity 4136 travelling to start life somewhere new [[]•]. There are certainly many other factors that might shape obesity risk associated with migration status including intrinsic factors related to the genetic background
obesity 4407 wider determinants of health including education, occupation and more. Indeed, it is also likely that obesity risk changes with time of residence in the host country. We examine obesity prevalence within migrant
obesity 4483 it is also likely that obesity risk changes with time of residence in the host country. We examine obesity prevalence within migrant groups compared with native populations, and the evidence on factors that
obesity 4603 within migrant groups compared with native populations, and the evidence on factors that might shape obesity risk in these migrant groups.Obesity PrevalenceThere are two key reasons why we might expect obesity
obesity 4704 obesity risk in these migrant groups.Obesity PrevalenceThere are two key reasons why we might expect obesity prevalence to be lower in migrants than in native populations [[]]. Firstly, migration is stressful
obesity 5680 they would be likely to have a lower BMI on arrival than the native population (although note that obesity is increasing worldwide and in some middle-income countries it is particularly high e.g. Mexico).Consistent
obesity 6440 by migrants generally increases substantially so that 10–15 years post migration, overweight and obesity rates approach or overtake those of the native population [[], []]. There has been debate about cohort
obesity 6814 self-rated health actually improved with a longer duration of residence after accounting for cohort effects, obesity prevalence showed the opposite pattern [[]].The pattern for children is likely to be similar, with slimmer
obesity 7089 analysis of the US National Health and Nutrition Examination Survey (NHANES) 1999–2012 found that obesity prevalence was significantly higher in US-born children/adolescents than in those who had been in the
obesity 7294 the USA for under a year; however, this gap decreased from 1999 to 2011 due to a rapid increase in obesity prevalence among the non-US-born population [[]]. A systematic review of prevalence of overweight and
obesity 7404 prevalence among the non-US-born population [[]]. A systematic review of prevalence of overweight and obesity among European child populations reported that migrant children are at higher risk for overweight and
obesity 7514 among European child populations reported that migrant children are at higher risk for overweight and obesity than children from native populations [[]]. However, most included studies reported differences by ethnic
obesity 8070 discussed why migrant populations are likely to arrive with lower average prevalence of overweight and obesity than resident populations in high-income countries (HICs); however, a number of factors might combine
obesity 8569 physiological factorsLikely that some genetic differences underlie vulnerability of different ethnic groups to obesity . No candidate genes yet identified.Epi-genetic factorsLikely that migrant populations are more often
obesity 8704 identified.Epi-genetic factorsLikely that migrant populations are more often predisposed to increasing obesity risk when exposed to an obesogenic environment.Dietary behaviourAlthough migrants may have an increasingly
obesity 8976 generally healthier than native populations so this is unlikely to be a major contributor to increased obesity risk.Physical activityMigrants generally do more occupational physical activity and physical activity
obesity 9264 Reduced leisure-time physical activity may become an increasingly important determinant of increased obesity risk in the future.Body size preferencePreference or tolerance of larger female body sizes is changing
obesity 9414 preferencePreference or tolerance of larger female body sizes is changing worldwide. This may currently increase obesity risk through reduced motivation to maintain or lose weight in some migrant groups.AcculturationIn general
obesity 9586 some migrant groups.AcculturationIn general migrants who maintain their original culture have reduced obesity risk.Socio-economic statusIt is likely that social and economic disadvantage increase obesity risk in
obesity 9680 reduced obesity risk.Socio-economic statusIt is likely that social and economic disadvantage increase obesity risk in migrants, as with other population groups in HICs.StressIt is plausible that stress experienced
obesity 9814 other population groups in HICs.StressIt is plausible that stress experienced by migrants increases obesity risk.Genetic and Physiological FactorsAnimal and family studies have demonstrated that some of the variation
obesity 10256 genetic control. About 127 sites in the human genome have been reported to link with development of obesity [[]].Given that ethnic groups share common ancestry and therefore have genetic similarities, it is possible
obesity 10444 similarities, it is possible that there are some ethnic groups that are more prone to development of obesity than others. There are some general differences in physiology between groups defined by ethnicity, which
obesity 10855 non-shivering thermogenesis and brown adipose tissue volumes which might underlie high susceptibility to obesity and metabolic disorders [[]]. In a study of Asian Indian, Creole and white Swedish men and women, Asian
obesity 11581 this.Researchers have examined whether genetic differences might underlie differing vulnerability to obesity and metabolic disorders between ethnic groups e.g. [[]]. However, despite this being theoretically possible,
obesity 12677 a calorie-rich, fat-rich, sugar-rich diet, this backfires and the individual becomes vulnerable to obesity and other adult diseases. The percentage of babies born with a low birth weight (one marker of insufficient
obesity 12975 (LMICs) at 27% of live births [[]]. This has been postulated as the cause of increased overweight and obesity in international adoptees living with Swedish families in Sweden [[]] and for the differences between
obesity 13380 337 sub-Saharan African children who had migrated to Australia, higher prevalence of overweight and obesity was associated with lower birth weight [[]]. It is clear that migrants from LMICs to HICs may be more
obesity 13600 have had poor nutrition prenatally or in early life, which may then predispose these individuals to obesity when in the HIC’s obesogenic context.Cultural FactorsDietary BehaviourDietary behaviour varies widely
obesity 17752 that of native populations, it is unlikely that diet alone is responsible for the increasing risk of obesity in settled migrant populations.Physical ActivityAge-standardised prevalence of insufficient physical
obesity 21282 In this scenario, leisure time physical activity may become a more important determinant of rates of obesity in migrant groups.Body Size PreferenceThere has been much research examining whether different cultures
obesity 22053 USA found that ethnicity had no influence on preference for female or male shapes or tolerance for obesity [[]]. In a questionnaire study, the majority of Black Somali mothers living in the UK felt that being
obesity 23408 host culture. A systematic review of evidence on the relationship between acculturation and overweight/ obesity among adult migrants from LMICs to HICs identified nine studies and reported that for men, acculturation
obesity 23754 maintain attitudes and behaviour associated with the country of origin are protected from the increasing obesity risk. In this review, the authors hypothesise that for some women, the adverse dietary and physical
obesity 24589 obese while in low-income countries there is a positive relationship between socio-economic status and obesity , which reverses with increasing economic development [[]–[]]. There are likely to be many mediators
obesity 24753 [[]–[]]. There are likely to be many mediators of the relationship between socio-economic status and obesity including knowledge of the aetiology of disease and causes of obesity, as well as barriers associated
obesity 24823 between socio-economic status and obesity including knowledge of the aetiology of disease and causes of obesity , as well as barriers associated with money, time and opportunities (e.g. within a local neighbourhood)
obesity 25651 wealth [[]].Although many studies examine the contribution of socio-economic status to differences in obesity by ethnic group, very few consider migration status. In terms of ethnicity, studies have reported that
obesity 27062 factors mean that some migrants are likely to experience some degree of stress. Stress has been linked to obesity [[], []], for example through an association between stress and increased food intake, as well as potentially
obesity 27351 of 293 studies found that experience of racism is significantly related to poorer health [[]]. When obesity -related outcomes including BMI, waist circumference and waist-to-hip ratio were examined specifically,
obesity 28723 theory, but without much current evidence.Addressing Obesity in Migrant GroupsThresholds for ActionAdult obesity is a risk factor for type 2 diabetes, cardiovascular disease, cancer, osteoarthritis, chronic kidney
obesity 29002 [[]–[]]. It is associated with reduced life expectancy and reduced healthy life expectancy. Child obesity is a risk factor for adult obesity and associated health consequences [[]], but is also independently
obesity 29037 reduced life expectancy and reduced healthy life expectancy. Child obesity is a risk factor for adult obesity and associated health consequences [[]], but is also independently associated with premature mortality,
obesity 29365 factors including hypertension and hypercholesterolaemia [[]].It is highly likely that the same degree of obesity poses a greater health risk for certain ethnic groups; however, determining this empirically is complex.
obesity 29510 certain ethnic groups; however, determining this empirically is complex. Firstly, common measurements of obesity (such as BMI) may reflect differing accumulations of body fat and in general these may over- or under-predict
obesity 29633 may reflect differing accumulations of body fat and in general these may over- or under-predict true obesity [[]]. Secondly, even with equal amounts of body fat, where this is distributed and given that abdominal
obesity 29745 [[]]. Secondly, even with equal amounts of body fat, where this is distributed and given that abdominal obesity gives rise to greater health risks than subcutaneous obesity, this may result in differing risk. Both
obesity 29806 is distributed and given that abdominal obesity gives rise to greater health risks than subcutaneous obesity , this may result in differing risk. Both these things are likely to be heritable and could vary between
obesity 30014 between ethnic groups [[]]. There are even more complications when considering thresholds for childhood obesity , given the influence of different ages of growth and sexual maturation on body composition, which can
obesity 30245 [[]–[]]. Lastly, even with equal amounts and distribution of body fat, the health consequences of obesity may differ between groups because of underlying differences in physiology (e.g. variations in the blood-circulatory
obesity 30742 European populations [[]]. This was done to determine recommended BMI thresholds for overweight and obesity in Asian populations. The WHO consultation concluded that there was wide variation among Asian populations
obesity 31929 categorisation of ethnic groups was broad. Very little evidence exists on the other health risks associated with obesity , and homogenising ethnic groups may hide important differences between distinct populations. In fact,
obesity 32701 recommend a lower threshold for individuals within these groups.Other attempts at quantifying risk based on obesity and ethnicity include a joint scientific statement from a number of US and international bodies, which
obesity 33080 [[]]. There have been no attempts to officially recommended thresholds for identifying overweight and obesity in children specific to ethnic background, although unofficial thresholds have been proposed [[]].It
obesity 33455 evidence does not adequately quantify this. Best practice is likely to involve using indicators of obesity in the context of other personal information on risk factors when considering clinical action.Specific
obesity 33912 populations, but there is a lack of representation in studies. For example, a Cochrane review of childhood obesity interventions noted that the majority of research in the field had been conducted with ‘motivated,
obesity 34431 eating interventions in these populations [[]]. A recent systematic review of interventions to prevent obesity in US migrant populations identified 20 studies [[]•]. Although the majority of the included studies
obesity 34686 limited in terms of the conclusions that can be drawn, the interventions which showed positive effects on obesity all incorporated some cultural focus [[]•].More recently, in the UK, a culturally appropriate intervention
obesity 34831 [[]•].More recently, in the UK, a culturally appropriate intervention for prevention of childhood obesity in the South Asian population was promising in a feasibility study [[]] and is now being examined in
obesity 35005 [[]] and is now being examined in a definitive cluster randomised controlled trial [[]]. A further obesity treatment intervention for Pakistani and Bangladeshi children is also underway [[]].Taken together,
obesity 35159 Bangladeshi children is also underway [[]].Taken together, the evidence suggests that culturally adapted obesity interventions can be effective—perhaps through increasing the salience, acceptability and uptake of
obesity 35331 salience, acceptability and uptake of these interventions by migrant groups. However, the number of obesity prevention and treatment interventions for migrant populations does not reflect the growing and diverse
obesity 36024 review. These topics were based on an agreed framework for the review and included epidemiology of obesity , factors contributing to obesity prevalence and addressing obesity in migrant groups.Limitations in
obesity 36057 on an agreed framework for the review and included epidemiology of obesity, factors contributing to obesity prevalence and addressing obesity in migrant groups.Limitations in the Evidence BaseBeing repeated throughout
obesity 36091 review and included epidemiology of obesity, factors contributing to obesity prevalence and addressing obesity in migrant groups.Limitations in the Evidence BaseBeing repeated throughout our review, we note a general
obesity 37512 beyond the levels seen in native populations. Meeting the challenge of prevention and treatment of obesity in diverse populations will require greater attention to minority groups in research in the future

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