Department of Medicine, Cambridge Health Alliance, Revere, Massachusetts.
Am J Prev Med. 2020 Mar;58(3):378-385. doi: 10.1016/j.amepre.2019.10.003. Epub 2019 Dec 10.
Little is known about the longitudinal trends and factors associated with obesity and overweight among U.S. immigrants and ethnic minorities.
At a large safety net health system in Massachusetts, 7,973 adults were followed retrospectively for 42.0 months on average from 2011 to 2016. Multivariate analyses were performed to identify factors associated with obesity (BMI ≥30 kg/m) and overweight (BMI ≥25 kg/m). Data were collected and analyzed in 2018-2019.
Obesity prevalence and trends were highest among Mexican/Central American men (32.6% in 2011 to 42.5% in 2016, p=0.03) and Haitian/black Caribbean women (37.5% to 51.5%, p<0.01). Mexican/Central American men had 564% (OR=5.64, 95% CI=4.02, 7.91) and women had 432% (OR=4.32, 95% CI=2.99, 6.23) higher odds of obesity compared with white, non-Hispanic men and women, respectively. Baseline age, weight, and duration of follow-up were associated with obesity among men (OR=1.02, 95% CI=1.02, 1.03; OR=1.16, 95% CI=1.15, 1.17; and OR=1.17, 95% CI=1.06, 1.30, respectively) and women (OR=1.01, 95% CI=1.01, 1.02; OR=1.18, 95% CI=1.17, 1.19; and OR=1.44, 95% CI=1.29, 1.61, respectively). East/Southeast Asians had the lowest obesity burdens. Most weight gains (63% among men and 75% among women) took place within 3 years.
Longitudinal obesity and overweight trends increased among all immigrants and ethnic minorities, primarily within the first 3 years, but significant variations existed. Mexican/Central American men and Haitian/black Caribbean women were disproportionately affected, approaching or exceeding U.S. rates. Targeted early prevention and treatment strategies are needed to reduce health disparities in obesity and unhealthy weight gain among immigrants.
关于美国移民和少数族裔的肥胖和超重的纵向趋势和相关因素知之甚少。
在马萨诸塞州的一个大型医疗保障系统中，2011 年至 2016 年期间，对 7973 名成年人进行了平均 42.0 个月的回顾性随访。采用多变量分析来确定与肥胖（BMI≥30kg/m）和超重（BMI≥25kg/m）相关的因素。数据于 2018-2019 年进行收集和分析。
肥胖的患病率和趋势在墨西哥/中美洲男性（2011 年为 32.6%，2016 年为 42.5%，p=0.03）和海地/黑加勒比裔女性（37.5%至 51.5%，p<0.01）中最高。与白人、非西班牙裔男性和女性相比，墨西哥/中美洲男性肥胖的几率高 564%（OR=5.64，95%CI=4.02，7.91），女性肥胖的几率高 432%（OR=4.32，95%CI=2.99，6.23）。男性（OR=1.02，95%CI=1.02，1.03；OR=1.16，95%CI=1.15，1.17；OR=1.17，95%CI=1.06，1.30）和女性（OR=1.01，95%CI=1.01，1.02；OR=1.18，95%CI=1.17，1.19；OR=1.44，95%CI=1.29，1.61）的基线年龄、体重和随访时间与肥胖有关。东亚/东南亚人群的肥胖负担最低。大多数体重增加（男性为 63%，女性为 75%）发生在 3 年内。
所有移民和少数族裔的肥胖和超重的纵向趋势都有所增加，主要是在前 3 年内，但存在显著差异。墨西哥/中美洲男性和海地/黑加勒比裔女性受影响最大，接近或超过美国的水平。需要采取有针对性的早期预防和治疗策略，以减少移民中肥胖和体重不健康增加的健康差距。
