Goel Mita Sanghavi, McCarthy Ellen P, Phillips Russell S, Wee Christina C
Division of General Internal Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Ill.
JAMA. 2004 Dec 15;292(23):2860-7. doi: 10.1001/jama.292.23.2860.
The 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.
To 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 PARTICIPANTS: Cross-sectional study using data from the 2000 National Health Interview Survey.
Body 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.
Of 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.
Among 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.
自20世纪80年代以来，肥胖症的患病率大幅上升。虽然移民是美国人口中增长最快的群体，但对于该群体中的肥胖情况或临床医生关于饮食和运动的咨询了解甚少。
估计移民亚组中的肥胖患病率，并量化与在美国居住时间的关联程度，以及按出生地、种族和族裔描述报告的饮食和运动咨询情况。
设计、地点和参与者：使用2000年全国健康访谈调查数据进行的横断面研究。
根据自我报告的身高和体重测量值计算的体重指数（BMI，以千克为单位的体重除以以米为单位的身高的平方），以及自我报告的饮食和运动咨询率。
在32374名受访者中，14%为移民。移民中的肥胖患病率为16%，美国本土出生的人为22%。在美国居住不到1年的移民中，经年龄和性别调整后的肥胖患病率为8%，但在美国居住至少15年的移民中为19%。在调整年龄、社会人口学和生活方式因素后，在美国居住10至15年以及至少15年分别与BMI增加0.88和1.39相关。除外国出生的黑人外，居住15年或更长时间的关联在所有移民亚组中均具有显著性。此外，移民比美国本土出生的人报告与临床医生讨论饮食和运动的可能性更小（分别为18%对24%，P<0.001；19%对23%，P<0.001）。这些差异在某些移民亚组中不能由社会人口学特征（社会人口统计学特征）、疾病负担、BMI或获得医疗服务的情况来解释。
在不同的移民亚组中，在美国居住的年限在10年后与较高的BMI相关。在美国居住至少15年的移民中的肥胖患病率接近美国本土出生的成年人。对饮食和身体活动进行早期干预可能是预防体重增加、肥胖症以及与肥胖相关的慢性疾病的一个机会。
