By Amy Harris
Unlike the average U.S.-born person, many immigrants arriving in the U.S. fall within healthy weight ranges. However, as newcomers adopt the calorie, sugar, and fat-dense American diet and sedentary lifestyle of the U.S., they may start to put on excess weight. This can lead to obesity, a medical term used to describe a person who weighs too much for their height. Obesity is associated with many diseases, and is most dangerous when stored as fat, especially around the waistline.
The U.S. Centers for Disease Control and Prevention (CDC) blames excessive calorie intake and inadequate physical inactivity for the country’s rising obesity rates, and calls the U.S. food environment “obesigenic,” which means “promoting excess weight gain.” Current research identifies as causal factors in the obesity epidemic micronutrient deficiencies, overconsumption of sugary beverages, the low intakes of certain foods such as vegetables, whole fruits, legumes, and healthy fats, a sedentary lifestyle, and greater exposure to endocrine-disrupting pollutants.
Associated with obesity are common chronic diseases such as heart disease, stroke, type 2 diabetes, some cancers, and some mental health problems. Excess weight raises blood pressure, cholesterol, and triglyceride levels, and lowers HDL (good) cholesterol levels. Pre-pandemic data collected by the National Health and Nutrition Examination Survey from 2017-2020 indicate that 16% – 39% of Americans are obese, which endangers their health.
Causes of obesity
The social determinants of health in the U.S. influence obesity rates, and are generational. Research has shown that children born to women who are obese or who gain excess weight in pregnancy are twice as likely to have obesity themselves, and that obesity or excessive weight gain during pregnancy are associated with complications like gestational diabetes and preeclampsia, which can increase the child’s disease risk later in life.
Looking at all Americans, the CDC has calculated that pre-pregnancy obesity rates were higher for non-Hispanic Black and Hispanic women from 2017-2019. In addition, immigration status is considered a risk factor. Dr. Carrie Gordon, Medical Director of Let’s Go, MaineHealth’s obesity prevention program, said that migration itself is an important determinant of health. This is because of the economic, physical, and mental burden of uprooting and traveling to start life somewhere new. “For individuals experiencing poverty and psychosocial stress, their environment is really the dominant contributor to their obesity. Immigrating to the U.S. affects people’s obesity risk,” Gordon said.
Maxine Lindsay, who emigrated from Jamaica to Maine 30 years ago and talks about “keeping the American weight off,” compared her experience in Maine with Jamaica: “In Jamaica, I used to wake up every morning and walk to get water – I started every day moving and never stopped.”
Selma Tinta has “noticed a huge difference in diet between my country [of Angola] and Maine … we eat more healthy food because we like to cook every day in Angola.” As a strategy for keeping her family healthfully nourished, Tinta tries to make larger portions of home-cooked family meals that will last her family of four more than one day. “It’s harder to keep healthy here because we have to work longer hours to be financially stable … this makes us resort to food that is not healthy, such as fast food,” she said.
One in five children in the U.S. currently has obesity. The temptations of “high-sugar, high-calorie, highly-processed foods are everywhere you look,” said Courtney Kennedy, Food and Nutrition Education Manager of the nonprofit Good Shepherd Food Bank. She also noted that immigrant children, who are often trying hard to fit into their new peer group, may learn unhealthy eating habits from them.
The need for a community response
Cooking family-friendly, affordable, healthy meals is particularly challenging for many of Maine’s newest immigrants and refugees who live in shelters or hotel rooms, with no tools other than hot plates or rice cookers. Preble Street’s Director of Food Programs Natalie Varrallo, who coordinates the provision of 2,000 meals a day, half of which she estimates feed new Mainer communities, uses the term “food apartheid” to describe the racialized shortage of affordable, culturally appropriate, fresh, and nutritious foods available to those most at risk for food insecurity and obesity. Foods such as halal meats, cassava, or fresh African vegetables like eggplant are prohibitively expensive for those who want to cook familiar, healthy meals for their families.
“Cultural diets are most often more nutritious than the American diet,” Kennedy said, adding that service providers and healthcare providers “need to listen, hear, learn, and understand” from the community. For example, after Good Shepherd learned that the typical African diet does not “involve consumption of many canned vegetables, fruits, or meats” as they previously had been offering, they began coordinating with local farmers, Hannaford supermarkets produce and fish departments, and halal meat distributors to provide the types of culturally appropriate foods their clients eat.
A coordinated, community-based, culturally focused response like that, delivered through Let’s Go, Good Shepherd Food Bank, Maine Immigrants’ Rights Coalition, Preble Street, and more is one way to protect Maine’s growing immigrant and refugee population from the obesogenic American environment. People born in Maine may, in fact, stand to learn a thing or two from our newest neighbors about healthy eating.
Healthy Living Tips
● Eat three meals per day, and don’t skip meals
● Control portion sizes, but eat a variety of foods (eat foods in all the colors of the rainbow)
● Plan meals ahead of time
● Drink water and limit beverages like juices and soda
● Choose meals high in fiber and complex carbohydrates, and low in sugars
● Limit foods high in fat
● Limit consumption of processed, packaged, or fast foods
● Increase physical activity and exercise (150 minutes per week recommended, strength training twice a week)
● Limit screen time
● Use the stairs when possible
● Take breaks to walk throughout the day