Pre-acculturation as a risk factor for obesity: Findings from the Health of Philippine Emigrants Study (HoPES)

Gilbert C. Gee, A. B. de Castro, Catherine Crespi, May Wang, Anna Hing, Adrian Bacong, Karen Llave

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11 Scopus citations

Abstract

Immigrants to the United States may have an advantage in terms of healthier weight, but tend to gain excessive weight after arrival, and may suffer from obesity and related health conditions. Acculturation theory suggests that this increase in obesity risk is due to adoption of unhealthy western dietary behaviors, and assumes that “eastern/traditional” dietary behaviors prior to migration are healthier. While this assumption is supported by studies conducted several decades ago, the phenomenon of globalization that has risen since the 1990s has increased exposure to western ideas and behaviors in communities worldwide. Hence, today's immigrants are more likely to have already adopted less healthy behaviors that increase obesity risk prior to their arrival in the U.S., a phenomenon we term “pre-acculturation.” The present study investigates the role of pre-acculturation in obesity development among immigrants from the Philippines. Data come from the Health of Philippine Emigrants Study, fielded in 2017 (n = 1632). Pre-acculturation was measured with English proficiency, preparation to migrate, receiving care packages, texting, telephone, or internet contact with friends/family in the U.S. Outcomes included the body mass index (BMI, kg/m2), waist circumference (WC, cm), waist-to-height ratio (WHtR) and waist-to-hip-ratio (WHR). Covariates included age, gender, education, financial strain, physical activity, and diet. Migrants reported greater English proficiency, preparation, and a slightly lower WHtR than non-migrants, but did not differ on BMI, WC, or WHR. Preparation was associated with greater BMI, WC, and WHtR, and the effects of preparation status differed by migration status. Among migrants, more preparation was associated with greater BMI, WC, and WtHR. Further, among non-migrants, texting and telephone communications was related to lower BMI, WC, and WHR. In summary, pre-acculturation may be a risk factor for obesity in the Philippines, suggesting that binary notions of “Western” versus “eastern/traditional” cultures may be too simplistic.

Original languageEnglish (US)
Article number100482
JournalSSM - Population Health
Volume9
DOIs
StatePublished - Dec 2019
Externally publishedYes

Bibliographical note

Funding Information:
This study was supported by funding from the U.S. National Institutes of Health (1R01HD083574-01A1). We are grateful to the California Center for Population Research at UCLA (CCPR) for general support. CCPR receives population research infrastructure funding (P2C-HD041022) from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). Partial support for this research came from a Eunice Kennedy Shriver National Institute of Child Health and Human Development research infrastructure grant, P2C HD042828, to the Center for Studies in Demography & Ecology at the University of Washington. We thank the Commission on Filipinos Overseas and their staff, especiallyRegina Galias, Ivy Miravalles, Golda Myra Roma, and Paul Vincent Avecilla,without whom this research would not be possible. We also thank Nanette Lee Mayol, Midea Kabamalan, Anna Vivas, Elma P. Laguna, Christian Joy Cruz, Lorna Perez, Delia Carba, Klarrines Tanalago, Vanessa Medina, and Larry Tagalog for their insights and assistance with this project.

Funding Information:
This study was supported by funding from the U.S. National Institutes of Health ( 1R01HD083574-01A1 ). We are grateful to the California Center for Population Research at UCLA (CCPR) for general support. CCPR receives population research infrastructure funding ( P2C-HD041022 ) from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) . Partial support for this research came from a Eunice Kennedy Shriver National Institute of Child Health and Human Development research infrastructure grant, P2C HD042828 , to the Center for Studies in Demography & Ecology at the University of Washington. We thank the Commission on Filipinos Overseas and their staff, especiallyRegina Galias, Ivy Miravalles, Golda Myra Roma, and Paul Vincent Avecilla,without whom this research would not be possible. We also thank Nanette Lee Mayol, Midea Kabamalan, Anna Vivas, Elma P. Laguna, Christian Joy Cruz, Lorna Perez, Delia Carba, Klarrines Tanalago, Vanessa Medina, and Larry Tagalog for their insights and assistance with this project.

Publisher Copyright:
© 2019 The Authors

Keywords

  • Immigration
  • International
  • Obesity
  • Theory

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