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Open Access Highly Accessed Research article

Acculturation and obesity among migrant populations in high income countries – a systematic review

Maryam Delavari1*, Anders Larrabee Sønderlund2, Boyd Swinburn13, David Mellor4 and Andre Renzaho5

Author Affiliations

1 WHO Collaborating Centre for Obesity Prevention, Department of Health, Deakin University, Melbourne, Australia

2 School of Psychology, College of Life and Environmental Sciences, University of Exeter, Exeter, UK

3 School of Population Health, University of Auckland, Auckland, New Zealand

4 School of Psychology, Faculty of health, Deakin University, Melbourne, Australia

5 Global Health and Society Unit, School of Public Health and Preventive Medicine, Monash University; and Centre for International Health, Burnet Institute, Melbourne, Australia

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BMC Public Health 2013, 13:458  doi:10.1186/1471-2458-13-458

Published: 10 May 2013

Abstract

Background

There is evidence to suggest that immigrant populations from low or medium-income countries to high income countries show a significant change in obesogenic behaviors in the host society, and that these changes are associated with acculturation. However, the results of studies vary depending on how acculturation is measured. The objective of this study is to systematically review the evidence on the relationship between acculturation - as measured with a standardized acculturation scale - and overweight/obesity among adult migrants from low/middle countries to high income countries.

Methods

A systematic review of relevant studies was undertaken using six EBSCOhost databases and following the Centre for Reviews and Dissemination’s Guidance for Undertaking Reviews in Health Care.

Results

The initial search identified 1135 potentially relevant publications, of which only nine studies met the selection criteria. All of the studies were from the US with migrant populations from eight different countries. Six studies employed bi-directional acculturation scales and three used uni-directional scales. Six studies indicated positive general associations between higher acculturation and body mass index (BMI), and three studies reported that higher acculturation was associated with lower BMI, as mainly among women.

Conclusion

Despite the small number of studies, a number of potential explanatory hypotheses were developed for these emerging patterns. The ‘Healthy Migrant Effect’ may diminish with greater acculturation as the host culture potentially promotes more unhealthy weight gain than heritage cultures. This appears particularly so for men and a rapid form of nutrition transition represents a likely contributor. The inconsistent results observed for women may be due to the interplay of cultural influences on body image, food choices and physical activity. That is, the Western ideal of a slim female body and higher values placed on physical activity and fitness may counteract the obesogenic food environment for female migrants.

Keywords:
Acculturation; Acculturation scale; Immigration; BMI; Diet