Obesity Among US Immigrant Subgroups by Duration of Residence

TLDR

Obesity prevalence has risen sharply since the 1980s, and early diet and physical activity interventions could curb weight gain and related chronic diseases. The study aimed to estimate obesity prevalence among US immigrant subgroups, assess how duration of residence influences BMI, and examine reported diet and exercise counseling by birthplace, race, and ethnicity. Using a cross‑sectional design, the authors analyzed 32,374 respondents from the 2000 National Health Interview Survey, measuring BMI from self‑reported height and weight and collecting self‑reported rates of diet and exercise counseling. Among immigrants, obesity prevalence rose from 8 % in those residing less than a year to 19 % after 15 years, with BMI increases of 0.88 and 1.39 for 10–15 and ≥15 years respectively, while immigrants were less likely to report diet and exercise counseling than US‑born peers, and these differences persisted after adjustment.

Abstract

ContextThe prevalence of obesity has increased substantially since the 1980s. While immigrants are the fastest growing segment of the US population, little is known about obesity or clinician counseling about diet and exercise in this group.ObjectivesTo estimate the prevalence of obesity among immigrant subgroups and quantify the magnitude of the association with duration of US residence, and to describe reported diet and exercise counseling by birthplace, race, and ethnicity.Design, Setting, and ParticipantsCross-sectional study using data from the 2000 National Health Interview Survey.Main Outcome MeasuresBody mass index (BMI, measured as weight in kilograms divided by the square of height in meters) based on self-reported height and weight measurements, and self-reported rates of diet and exercise counseling.ResultsOf 32 374 respondents, 14% were immigrants. The prevalence of obesity was 16% among immigrants and 22% among US-born individuals. The age- and sex-adjusted prevalence of obesity was 8% among immigrants living in the United States for less than 1 year, but 19% among those living in the United States for at least 15 years. After adjusting for age, sociodemographic, and lifestyle factors, living in the United States for 10 to 15 and at least 15 years was associated with BMI increases of 0.88 and 1.39, respectively. The association for 15 years or more was significant for all immigrant subgroups except foreign-born blacks. Additionally, immigrants were less likely than US-born individuals to report discussing diet and exercise with clinicians (18% vs 24%, P<.001; 19% vs 23%, P<.001, respectively). These differences were not accounted for by sociodemographic characteristics, illness burden, BMI, or access to care among some subgroups of immigrants.ConclusionsAmong different immigrant subgroups, number of years of residence in the United States is associated with higher BMI beginning after 10 years. The prevalence of obesity among immigrants living in the United States for at least 15 years approached that of US-born adults. Early intervention with diet and physical activity may represent an opportunity to prevent weight gain, obesity, and obesity-related chronic illnesses.