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

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:

Migration, acculturation and environment: determinants of obesity among Iranian migrants in Australia

While migration from low- to high-income countries is typically associated with weight gain, the obesity risks of migration from middle-income countries are less certain. In addition to changes in behaviours and cultural orientation upon migration, analyses of changes in environments are needed to explain post-migration risks for obesity. The present study examines the interaction between obesity-related environmental factors and the pattern of migrant acculturation in a sample of 152 Iranian immigrants in Victoria, Australia. Weight measurements, demographics, physical activity levels and diet habits were also surveyed. The pattern of acculturation (relative integration, assimilation, separation or marginalization) was not related to body mass index, diet, or physical activity behaviours. Three relevant aspects of participants' perception of the Australian environment (physically active environments, social pressure to be fit, unhealthy food environments) varied considerably by demographic characteristics, but only one (physically active environments) was related to a pattern of acculturation (assimilation). Overall, this research highlighted a number of key relationships between acculturation and obesity-related environments and behaviours for our study sample. Theoretical models on migration, culture and obesity need to include environmental factors.

Effect of migration on food habits of Somali women living as refugees in Australia

This study aimed to assess the dietary changes that occur for migrants moving from a low-income to a high-income country. The sample included 45 females who had migrated to Australia from Somalia within the past 5years (1996-2001). The data for the study was derived from structured interviews conducted by a bilingual interviewer and anthropometry. Usual dietary intake and frequency of consumption of 54 foods were determined both for Australia (current home) and for Somalia (previous home). In Australia, subjects maintained the structure of the diet from their country of birth. They did increase their consumption of some processed food, such as instant noodles, crisps, and pizza. However, there was little evidence that the subjects adopted ready or partially prepared meals or takeaway meals. A significant addition to the diet in Australia was the use of breakfast cereals. Significant substitutions were of ready-baked bread for traditional bread and lamb for camel meat. The mean BMI of the sample was 27.4kg/m². Sixty percent of the sample were overweight or obese (BMI>25). Some of the dietary changes observed may be consistent with increased energy intake and altered nutrient density. Given the association between transition to a high-income diet and obesity, it is important that migrants are encouraged to retain the best of their traditional diet while adopting healthy foods from host country.

Finding voices: authentic learning online in the field of public communication and citizenship

A creative re-acculturation of teachers and students is occurring in virtual classrooms as traditional learning resources, pedagogy, and technology intersect in unexpected ways. This paper reports on a case of authentic, experiential, and constructivist learning developed for tertiary public relations  students. A subject titled ‘Public Communication and Citizenship’ (PCC) at  Deakin University in Australia asked students to examine the problematic and contentious areas of self interest, persuasion, power, and ethics in  contemporary contexts of mass media and globalisation. Feedback from  those students suggests that, in this case, online teaching strategies  successfully integrated with the total learning environment to achieve  higher-order learning. PCC is one example of PR pedagogy combining  theory and technology to move beyond ‘skilling for jobs’.

Cultural sustainability of the arts through cross cultural market segmentation

The cultural characteristics attributed to individuals in their country of birth are likely to change through immigration and acculturation processes taking place in the host country. Immigrants are likely to develop their own unique cultural styles through a blending of their old culture and the host culture. With slightly less than half of the population born overseas or with at least one parent born overseas, and with some 200 languages Australia has one of the most cosmopolitan populations in the world, with a relatively small population of 20 million. This paper considers the cross cultural nature of the Australian population and the sustainability of culture through the Arts. This paper also considers the marketing of the arts from a cross cultural segmentation perspective. In so doing the paper identifies segmentation issues associated with cross cultural segmentation.

Diversity, ethnicity and consumption

This paper aims to examine diversity and identity issues from a marketing perspective. The traditional marketing practice of segmenting markets could be viewed as the antithesis of diversity as it relies on identifying  homogenous characteristics of a population. It is uneconomical and  generally less effective to market to a broad range of consumers than to do so for a specific group with homogenous characteristics. However, segmentation is not possible without diversify. Segmentation requires the presence of substantial differences in consumer characteristics and behaviour in a population to be truly effective. Marketing and its relationship to diversity, however, extends beyond segmentation and into issues of an individual's sense of identity and belonging. The literature suggests that an individual's identify is expressed through consumption and this can include ethnic identity. With an increasingly diverse, multicultural society in many countries, it is timely to look more closely at cultural identity and its relationship to consumption. Hofstede's work on cultural characteristics inherent in a particular country, continue to be widely used in international business. How evel; cultural identity and characteristics attributed to individuals in their country of birth may change when they immigrate to another country. Acculturation in a host country affects how immigrants see themselves and wish to be perceived. This can be problematic for marketers attempting to segment and reach consumers on the basis of their ethnicity. If consumption is an expression of identity as the literature suggests, then marketing has a role to play in either influencing or responding to issues of diversity and identity in the population at large. This paper examines the current literature on consumption, consumer behaviour and ethnic identify.

Identity in multicultural societies: who do we think we are?

This paper examines identity issues in multicultural Australia. In its extreme, negative form, assumptions that certain characteristics apply to all members of an ethnic group can be attributed to racism. However, the belief that individuals who share the same ethnic background have similar needs, interests and perceptions is also reflected in business, government policy and academic research. Often, ethnic groupings used for research and policy formulation are very broad and fail to take into account within-group differences. The criteria used to assess an individuals membership of an ethnic group can be problematic. Criteria based purely on objective measures such as country of birth or ethnic ancestry do not take into account acculturation processes or the degree to which individuals consider themselves to be 'ethnic '. These objective measures are complicated further as individuals may have ethnic roots from multiple countries depending on their family composition over several generations. This theory-focused paper proposes that ethnic identity should be viewed as a subjective phenomenon where individuals are likely to align themselves with the ethnic background to which they most identify. This has implications for research and policy making in multicultural societies.

Post-migration food habits of sub-Saharan migrants in Victoria: a cross-sectional study

Objective: (i) To describe sub-Saharan African (SSA) post-migration food habits and eating patterns; and (ii) to examine how the food habits of SSA households in Victoria reflect post-migration acculturation.
Design: A cross-sectional survey using a snowball sampling technique. Data on food habits and eating patterns were obtained using semi-structured, face-to-face interviews from November 2001 to April 2002.
Subjects: A total of 139 households of demographically diverse recent migrants from across sub-Saharan Africa.
Setting: Melbourne metropolitan and Melbourne fringes.
Analysis: Data were summarised using descriptive statistics.
Results: SSA migrants and refugees indicated dietary acculturation characterised by three processes: substitution, supplementation and modification of recipes. They experienced difficulty locating their traditional foods, in particular, African vegetables (34.2%), unprocessed maize meal (29.1%), camel milk (23.1%) and maize grain (13.7%). The new foods adopted since arrival were pizza, breakfast cereals and fast foods, but also included new fruits and vegetables. Takeaway food such as Pizza Hut or McDonalds featured prominently in the SSA post-migration diet. Reasons for eating out were favourite food (48.3%), routine family outing (38.3%), special occasion (33.3%) and no time to cook (25%). A significant change in meal pattern was the inclusion of breakfast, although 21% reported skipping breakfast.
Conclusion: Many of the observed dietary changes were not consistent with good health and may predispose this population to rapid weight gain and chronic disease. Rapid modernisation and the Anglo-Australian culture interact in a complex way with traditional eating and socialisation practices of SSA migrants. Understanding these forces can allow effective health promotion and community development strategies to be developed for the future health of SSA migrants and their communities.

Fat, rich and beautiful: changing socio-cultural paradigms associated with obesity risk, nutritional status and refugee children from sub-Saharan Africa

There has been an increase in Australia's intake of refugees and migrants from sub-Saharan Africa over the last two decades. These refugees have been exposed to nutritional risks prior to migration, which, together with changes associated with acculturation, impact on their health and nutritional status post-migration. However, there is a paucity of data in Australia that has examined the health and nutritional status of this ethnic minority in Australia. Despite basic research assessing the nutritional status of children, none have specifically concentrated on the health and nutritional situation of sub-Saharan refugee children. In the absence of such studies, this paper explores issues relating to obesity in sub-Saharan African refugee children within a cultural and public health framework. We begin by outlining the history of obesity and its cultural meaning. We then move to a consideration of predisposing factors for obesity and how these factors translate into obesity risk contexts of sub-Saharan refugees post-migration. We argue there are a number of key challenges related to culture and the relationship between socio-economic factors post-migration that require addressing by health professionals, dieticians and health educators to ensure the delivery of successful health outcomes.

Smaller steps into longer journeys : experiencing African music and expressing culture

This paper outlines an exploratory research project that draws on survey data from both primary and secondary school music teachers in Victoria. The research stems from a study that I undertook in 2002-2003 with final year Deakin University undergraduate students. That project investigated the potential of African music to enhance the generic musical experiences, learning, motivation, interest, confidence and competence of non-specialist primary teacher education students. The research project being reported in this paper is an extension of the previous study to focus on practising music teachers at both primary and secondary school levels. The research addresses the significance and contribution of African music and culture as a cross-cultural experience for music teachers, their students and the wider community. It further considers my role as an African music practitioner in terms of transformation and acculturation. This paper outlines the progress of, and provides preliminary data about, the emergence of an innovative area of teaching and learning based on African music in Victorian schools. It also explores the notion of why cross-cultural and multi-cultural engagement matters in the contemporary context of educational change.

Arts marketing challenges in multicultural societies

With an increasingly diverse, multicultural society in many countries, it is timely to look more closely at the current literature on arts marketing, ethnic identity and segmentation issues. The growth of diverse, multicultural societies in many countries warrants a closer examination of arts marketing and the use of ethnicity as a basis for segmentation, as these issues have implications for attracting and retaining arts audiences and other consumers of arts related activities. Researchers in the arts industry have stressed the importance of understanding the fundamentals of audience development and the ability to focus on satisfying the needs and wants of their audiences. The focus on marketing activities comes at a time when there is greater pressure on arts organisations to move beyond their traditional role as subsidized non-profit organisations in order to become more self-supporting. Internationally, audience development in the arts industry has focused on segmentation dimensions such as youth, mature aged individuals, geographic location (rural), individuals with disabilities, low income earners, and individuals with culturally diverse backgrounds. Most of these potential segments are under represented in the population of arts consumers in Australia, the United Kingdom, Singapore, and North America. Of those dimensions, segmentation of arts markets by cultural differences such as ethnic identity appears to be a somewhat under researched area. Hofstede's (1980) model of national cultural differences continues to be widely used as a basis for strategic and marketing decisions in international business. However, the cultural characteristics attributed to individuals in their country of birth are likely to change through immigration to another country. In this situation, the ability to predict the consumption behaviour of various ethnic groups is complicated by acculturation processes in which arrivals attempt to adapt to their new environment. Over time, this process has resulted in the emergence of bicultural individuals who are able to switch, at will, between their ethnic identity and an identity aligned with their host country, or a combination of both at any time. Ethnic identity and affiliation with ethnic groups can also change over time, suggesting challenges for arts marketing approaches, and the application of market segmentation theory in particular.

The role of ethnicity and culture in body image and disordered eating among males

An increasing number of researchers have examined body image concerns, disordered eating, and other behaviors associated with increasing muscle size among men from different cultural groups. However, to date there has been no synthesis or evaluation of these studies. In this paper we specifically review studies which have included a comparison between males from different cultural groups with White males on body image concerns or other related behaviors. The groups include Blacks, Hispanic Americans, Asians, Native Americans, Pacific Islanders, and men from Middle Eastern countries. Overall, evidence suggests that males from a range of cultural groups engage in more extreme body change strategies and binge eating than Whites. On the other hand, there is no consistent pattern which summarizes the nature of body image concerns across the different cultures. Mediating and/or moderating variables are proposed to account for the inconsistent findings. These include body build, levels of acculturation, socio-economic status, media exposure, and internalization of the muscular and lean body ideal.

Maintenance of traditional cultural orientation is associated with lower rates of obesity and sedentary behaviours among African migrant children to Australia

Background: Migrants from developing to developed countries rapidly develop more obesity than the host population. While the effects of socio-economic status on obesity are well established, the influence of cultural factors, including acculturation, is not known.

Objective: To examine the association between acculturation and obesity and its risk factors among African migrant children in Australia.

Design and participants: A cross-sectional study using a non-probability sample of 3- to 12-year-old sub-Saharan African migrant children. A bidimensional model of strength of affiliation with African and Australian cultures was used to divide the sample into four cultural orientations: traditional (African), assimilated (Australian), integrated (both) and marginalized (neither).

Main outcome measures: Body mass index (BMI), leisure-time physical activity (PA) and sedentary behaviours (SBs) and energy density of food.

Results: In all, 18.4% (95% confidence interval (CI): 14–23%) were overweight and 8.6% (95% CI: 6–12%) were obese. After adjustment for confounders, integrated (ß=1.1; P<0.05) and marginalized ß(=1.4; P<0.01) children had higher BMI than traditional children. However, integrated children had significantly higher time engaged in both PA (ß=46.9, P<0.01) and SBs (ß=43.0, P<0.05) than their traditional counterparts. In comparison with traditional children, assimilated children were more sedentary (ß=57.5, P<0.01) while marginalization was associated with increased consumption of energy-dense foods (ß=42.0, P<0.05).

Conclusions: Maintenance of traditional orientation was associated with lower rates of obesity and SBs. Health promotion programs and frameworks need to be rooted in traditional values and habits to maintain and reinforce traditional dietary and PA habits, as well as identify the marginalized clusters and address their needs.