Diet, Physical Activity and Weight-Related Behaviors, Changes and Risks with Newly-Arrived (< 1 Year) Immigrant and Refugee Adolescents (Ages 12–17)

  • Lauren R. SastreEmail author
  • Lauren Haldeman
Original Paper


Adolescent immigrants and refugees are at elevated risk for obesity, however, gaps remain regarding specific diet and lifestyle changes. This study examined: (1) weight status, behaviors and perceptions, (2) diet patterns and changes, (3) sociodemographic and dietary factors associated with BMI. Cross sectional survey, anthropometric measures were conducted at a school for newcomer youth in North Carolina. Data analysis included descriptive, frequency, bivariate and linear regression. Participants (n = 68, 55% female, < 1 year US) included immigrants and refugees ages 12–17. Thirty-one percent were overweight or obese. Forty-seven percent had attempted to lose weight. Positive weight perceptions were associated with normal BMI (p = 0.010). Fruit, milk, fruit juice, soda, and meat consumption increased post-arrival (p = 0.037, p = 0.010, p = 0.003, p = 0.044, p = 0.014, respectively). Dietary change was positively associated with BMI (p = 0.002). Adverse diet and lifestyle changes occur rapidly, are associated with obesity, and weight control behaviors and concerns warrant early intervention.


Adolescent Emigrants and immigrants Refugees Life style Diet Food and nutrition Acculturation Obesity 



  1. 1.
    Baugh R. Annual flow report 2016: US lawful permanent residents.
  2. 2.
    Mossaad N, Baugh R. Annual flow report 2016: refugees and asylees. U.S. Department of Homeland Security Office of Immigration Statistics.
  3. 3.
    US Citizenship and Immigration Services-RAIO-Asylum Division. Asylum Officer Basic Training Course. Eligibility Part I. Definitions; past persecution. Accessed Nov 2015.
  4. 4.
    Colby S, Ortman J. Projections of the size and composition of the U.S. population: 2014 to 2060. Population estimates and projections.
  5. 5.
    Schwartz S, Unger J, Zamboanga B, Szapocznik J. Rethinking the concept of acculturation: implications for theory and research. Am Pyschol. 2010;65(4):237–51. Scholar
  6. 6.
    Pereira C, Larder N, Somerset S. Food acquisition habits in a group of African refugees recently settled in Australia. Health Place. 2010;16(5):934–41. Scholar
  7. 7.
    Adekeye O, Kimbrough J, Obafemi B, Stack R. Health literacy from the perspective of African immigrant youth and elderly: a PhotoVoice project. J Healthcare Poor Underserv. 2014;25(4):1730–47. Scholar
  8. 8.
    Vue W, Wolff C, Goto K. Hmong food helps us remember who we are: perspectives of food culture and health among Hmong women with young children. J Nutr Educ Behav. 2010;43(3):199–204. Scholar
  9. 9.
    Wilson A, Renhazo A. Intergenerational differences in acculturation experiences, food beliefs, and perceived health risks among refugees from the Horn of Africa in Melbourne, Australia. Public Health Nutr. 2014;18(1):176–88. Scholar
  10. 10.
    Rondinelli A, Morris M, Rodwell T, Moser K, Paida P, Popper S, Brouwer K. Under- and over-nutrition among refugees in San Diego County, California. J Immigr Minor Health. 2011;13(1):161–8. Scholar
  11. 11.
    Franzen L, Smith C. Acculturation and environmental change impacts dietary habits among adult Hmong. Appetite. 2009;52(1):173–83. Scholar
  12. 12.
    Garnweidner L, Terragni L, Pettersen K, Mosdol A. Perceptions of the host country’s food culture among female immigrants from Africa and Asia: aspects relevant for cultural sensitivity in nutrition communication. J Nutr Educ Behav. 2012;44(4):335–42. Scholar
  13. 13.
    Peterman J, Silka L, Bermudez O, Wilde P, Rogers B. Acculturation, education, nutrition education, and household composition are related to dietary practices among Cambodian refugee women in Lowell, MA. J Am Diet Assoc. 2011;111(9):1369–74. Scholar
  14. 14.
    Tiedje K, et al. A focus group study of healthy eating knowledge, practices, and barriers among adult and adolescent immigrants and refugees in the United States. Int J Behav Nutr Phys Act. 2014;11:63. Scholar
  15. 15.
    Anderson L, Mah C, Sellen D. Eating well with Canada’s food guide? Authoritative knowledge about food and health among newcomer mothers. Appetite. 2015;91:357–65. Scholar
  16. 16.
    Mannion C, Raffin-Bouchal S, Henshaw C. Navigating a strange and complex environment: experiences of Sudanese refugee women using a new nutrition resource. Int J Womens Health Wellness. 2014;16(6):411–22. Scholar
  17. 17.
    Mulasi-Pokhriyal U, Smith C, Franzen-Castle L. Investigating dietary acculturation and intake among US-born and Thailand/Laos-born Hmong-American children aged 9–18 years. Public Health Nutr. 2012;15(1):176–85. Scholar
  18. 18.
    Hrboticky N, Krondl M. Acculturation to Canadian foods by Chinese immigrant boys: changes in the perceived flavor, health value and prestige of foods. Appetite. 1984;5(2):117–26. Scholar
  19. 19.
    Smith C, Franzen-Castle L. Dietary acculturation and body composition predict American Hmong children’s blood pressure. Am J Hum Biol. 2012;24(5):666–74. Scholar
  20. 20.
    Wieland M, et al. Perspectives on physical activity among immigrants and refugees to a small urban community in Minnesota. J Immigr Minor Health. 2015;17:263–75. Scholar
  21. 21.
    Franzen-Castle L, Smith C. Environmental, personal, and behavioral influences on BMI and acculturation of second generation Hmong children. Matern Child Health J. 2014;18(1):73–89. Scholar
  22. 22.
    Diaz H, Marshak H, Montgomery S, Rea B, Backman D. Acculturation and gender: influence on healthy dietary outcomes for Latino adolescents in California. J Nutr Educ Behav. 2009;41(5):319–26. Scholar
  23. 23.
    Liu J, Chu Y, Frongillo E, Probst J. Generation and acculturation status are associated with dietary intake and body weight in Mexican American adolescents. J Nutr. 2012;142(2):298–305. Scholar
  24. 24.
    Allen M, Elliott M, Morales L, Diamant A, Hambarsoomian K, Schuster M. Adolescent participation in preventive health behaviors, physical activity, and nutrition: differences across immigrant generations for Asians and Latinos compared with Whites. Am J Public Health. 2007;97(2):337–43.CrossRefGoogle Scholar
  25. 25.
    Morris M, Popper S, Rodwell T, Brodine K, Brouwer K. Healthcare barriers of refugees post-resettlement. J Commun Health. 2009;34(6):529–38. Scholar
  26. 26.
    Arcan C, Larson N, Bauer K, Berge J, Story M, Neumark-Sztainer D. Dietary and weight-related behaviors and body mass index among Hispanic, Hmong, Somali, and white adolescents. J Acad Nutr Diet. 2014;114(3):375–83. Scholar
  27. 27.
    Stang J, Kong A, Story M, Eisenberg M, Neumark-Sztainer D. Food and weight-related patterns and behaviors of Hmong adolescents. J Am Diet Assoc. 2007;107(6):936–41.CrossRefGoogle Scholar
  28. 28.
    Kim L, Harrison G, Kagawa-Singer M. Perceptions of diet and physical activity among California Hmong adults and youths. Prev Chronic Dis. 2007;4(4):A93.Google Scholar
  29. 29.
    Renzaho A, McCabe, Swinburn B. Intergenerational differences in food, physical activity, and body size perceptions among African migrants. Qual Health Res. 2012;22(6):740–54.CrossRefGoogle Scholar
  30. 30.
    Hervey K, Vargas D, Klesges L, Fischer PR, Trippel S, Juhn YJ. Overweight among refugee children after arrival in the United States. J Health Care Poor Underserv. 2009;20(1):246–56. Scholar
  31. 31.
    Olson BG, Kurland Y, Rosenbaum PF, Hobart TR. Rapid weight gain in pediatric refugees after US immigration. J Immigr Minor Health. 2017;19(2):263–6. Scholar
  32. 32.
    Dawson-Hahn E, et al. Growth trajectories of refugee and nonrefugee children in the United States. Pediatrics. 2016;138(6):e20160953.CrossRefGoogle Scholar
  33. 33.
    Obesity Facts. Childhood obesity facts. Accessed 15 June 2017.
  34. 34.
    Martin DC, Yankay JE. Annual flow report 2012: refugees and asylees. U.S. Department of Homeland Security Office of Immigration Statistics. (2012).
  35. 35.
    American Immigration Council. New Americans in North Carolina: the political and economic power of immigrants, Latinos, and Asians in the Tar Heel State. (2013).
  36. 36.
    Refugee Council USA. The US resettlement program in North Carolina. (n.d.). Accessed May 2013.
  37. 37.
    Centers for Disease Control and Prevention. Children’s BMI calculator for schools. Atlanta, GA: Centers for Disease Control and Prevention. (n.d.). Accessed Sept 2014.
  38. 38.
    Centers for Disease Control and Prevention. The obesity epidemic and United States students. Atlanta, GA: Centers for Disease Control and Prevention. (n.d.). Accessed Feb 2019.
  39. 39.
    Heney J, Dimock C, Friedman J, Lewis C. Pediatric refugees in Rhode Island: increases in BMI percentile, overweight, and obesity following resettlement. R I Med J. 2015;98(1):43–7.Google Scholar
  40. 40.
    Story M, Harris L. Food habits and dietary change of Southeast Asian refugee families living in the United States. J Am Diet Assoc. 1989;89(6):800–3.PubMedGoogle Scholar
  41. 41.
    Neumark-Sztainer D, Wall M, Haines J, Story M, Eisenberg M. Why does dieting predict weight gain in adolescents? Findings from project EAT-II: a 5-year longitudinal study. J Am Diet Assoc. 2007;107(3):448–55.CrossRefGoogle Scholar
  42. 42.
    Himmelgreen D, Pérez-Escamilla R, Martinez D, Bretnall A, Eells B, Peng Y, Bermúdez A. The longer you stay, the bigger you get: length of time and language use in the U.S. are associated with obesity in Puerto Rican women. Am J Phys Anthropol. 2004;125(1):90–6.CrossRefGoogle Scholar
  43. 43.
    Colby S, Morrison S, Haldeman L. What changes when we move? A transnational exploration of dietary acculturation. Ecol Food Nutr. 2009;48:327–43.CrossRefGoogle Scholar
  44. 44.
    Dharod J. What changes upon resettlement: understanding difference in pre- and post-resettlement dietary habits among South-Asian refugees. Ecol Food Nutr. 2015;54(3):209–23. Scholar
  45. 45.
    Benbenek M, Garwick A. Enablers and barriers to dietary practices contributing to bone health among early adolescent Somali girls living in Minnesota. J Spec Pediatr Nurs. 2012;17(3):205–14. Scholar
  46. 46.
    Beck A, Tschann J, Butte N, Penilla C, Greenspan L. Association of beverage consumption with obesity in Mexican American children. Public Health Nutr. 2014;17(2):338–44. Scholar
  47. 47.
    Cook, et al. Vegetable consumption is linked to decreased visceral and liver fat and improved insulin resistance in overweight Latino youth. J Acad of Nutr Diet. 2014;114(11):1776–83. Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2020

Authors and Affiliations

  1. 1.Department of Nutrition ScienceEast Carolina UniversityGreenvilleUSA
  2. 2.Department of NutritionUniversity of North Carolina at GreensboroGreensboroUSA

Personalised recommendations