Weight and Obesity The Prevalence of Overweight and Obesity in Immigrant Women from Sub-Saharan Africa Living in Grande Prairie, Alberta

In spite of the increased prevalence of overweight and obesity in the general population, little attention has been paid to immigrant communities, which are at a greater risk of weight gain compared to the majority. This is quite disturbing given the increased rate of migration from low-income countries. Lack of epidemiological data relating to overweight and obesity is particularly true for women of sub-Saharan African origin living in Grande Prairie, Alberta, Canada. This study will involve a cross-sectional survey, to fill this gap in literature. A sample of 100 subjects is deemed to be representative of the target population. Knowledge of the prevalence of overweight and obesity in this population will be important for designing weight management interventions for this group, thereby reducing the risk of overweight and obesity as well as associated co-morbidities.

Introduction and Background

The prevalence of overweight and obesity has been on the rise in the last few decades, with physical inactivity and other lifestyle factors playing a crucial role (Singh, Kogan & Yu, 2009). Measured by body mass index (BMI) (body weight divided by the square of body height in metres), overweight and obesity generally denote an imbalance between energy intake and expenditure in the body (Labree et al., 2015). The ideal body weight should be 18.5-25 kg/m2 (Menigoz, Nathan & Turrell, 2016). Anything beyond this is considered overweight or obesity.

Overweight and obese immigrants bear a greater burden compared to the rest of the population (Choi, 2012; Gele & Mbalilaki, 2013). Regrettably, most developed countries lack substantive documentation of the epidemiology of overweight and obesity among immigrants (Menigoz, Nathan & Turrell, 2016). This imposes significant morbidity, mortality, economic, and psychological burden on such immigrants. More importantly, immigrants increasingly comprise a significant portion of the population in developed countries, especially North America (Menigoz, Nathan & Turrell, 2016).

The scarcity of epidemiological data relating to overweight and obesity in immigrants is particularly true for women in Canada. The few studies in Canada pay attention to immigrants in general, with little or no information about variations in overweight and obesity by gender, ethnic background, and region (e.g. McDonald & Kennedy, 2005; Adhikari, 2014). Kirchengast & Kilaf (2014) show that immigrant women are at a greater risk of developing overweight and obesity compared to immigrant men and the rest of the population. Furthermore, women from certain ethnic backgrounds face a greater risk of overweight and obesity compared to others (Choi, 2012).

The researcher found that so far no research has been conducted to document the prevalence of overweight and obesity in women of sub-Saharan African origin living in Grande Prairie, Alberta, Canada. The present study proposes to fill this gap in literature. The study will specifically seek to answer the following question: Are immigrant women from sub-Saharan Africa, 25 to 50 years old, who have lived in Grande Prairie, Alberta, Canada for 5 years and above at increased risk of excessive weight gain due to inactive lifestyle, compared to immigrant women from sub-Saharan Africa of the same age group who have lived in Grande Prairie for 2 years and below?

Pertaining to the above, five important variables are evident: overweight, obesity, immigrant (migrant status), duration of residence, and physical activity. Denoting weight gain, overweight and obesity comprise the dependent variables, while migrant status, duration of residence, and physical activity will represent the independent variables. In this study, overweight will be defined as BMI in the range of 25 to 29 kg/m2, while obesity will be defined as BMI in the range of 30 kg/m2 and above. An immigrant will be defined as an individual born outside and...

This will particularly relate females of sub-Saharan African origin aged 25-50 years living in Grande Prairie, Alberta, Canada. Duration of residence denote the length in years the individual has lived in the host country. Finally, physical activity will be defined as moderate to vigorous physical movement of the body that consumes energy, such as brisk walking, jogging, cycling, dancing, aerobics, swimming, as well as sports such as tennis and basketball.
Theoretical Framework

Though there are numerous theories underpinning research on overweight and obesity within the context of immigration, acculturation model provides an appropriate theoretical foundation. Acculturation generally denotes changes in an individual's cultural patterns as a result of interaction with the environment, lifestyle, and culture of the host country (Menigoz, Nathan & Turrell, 2016). Studies conducted in most developed countries have extensively demonstrated that immigrants have lower BMI, overweight, and obesity upon arrival compared to natives (McDonald & Kennedy, 2005; Choi, 2012; Gele & Mbalilaki, 2013; Goulao, Santos & Carmo, 2015). Nonetheless, as they become acculturated into the host country, their BMI and prevalence of overweight and obesity increase. They change their lifestyle behaviours and become more exposed to obesogenic environments, consequently increasing the risk of weight gain (Kirchengast & Kilaf, 2014).

Literature Review

Literature has extensively documented the prevalence of obesity and overweight in immigrants. A study involving a nationally representative sample of Australian adults (n = 13,047) found that immigrants had substantially higher BMIs compared to the majority population (Menigoz, Nathan & Turrell, 2016). The large sample used is a major strength of the study. A systematic review of 39 articles further found a consistent positive link between immigration and weight gain (Goulao, Santos & Carmo, 2015). Other studies have also reported similar findings (McDonald & Kennedy, 2005; Choi, 2012; Gele & Mbalilaki, 2013; Adhikari, 2014).

Overweight and obesity mainly result from an enduring energy balance in the body (Goulao, Santos & Carmo, 2015). The consumption of high-calorie foods results in high intake of energy, a problem compounded by physical inactivity and a sedentary life. A sedentary life often means low energy expenditure, which creates an imbalance between the excess energy taken in and the low energy consumed by the body. It is, however, important to note that other factors may also increase the risk of overweight and obesity: socioeconomic background, age, psychological factors, ethnicity, genetics, environmental factors (obesogenic environments), and immigrant status (Kirchengast & Kilaf, 2014; Labree et al., 2015).

Immigrant status may be a particularly important risk factor for overweight and obesity (Adhikari, 2014). Migrating from low-income to high-income countries is often a risk factor for overweight and obesity as majority of immigrants are usually characterised by lower educational attainment and poorer socioeconomic status compared to the majority population (Kirchengast & Kilaf, 2014). These factors predispose immigrants to unhealthy weight gain. For instance, low income hinders access to healthy food, compelling most immigrants to resort to fast foods and other unhealthy dietary habits. In fact, low socioeconomic status is significantly associated with health risks (Choi, 2012).

The increased risk…