P19 An Examination of the Immigrant Paradox and Unhealthy Eating Behaviors

Abstract

Background Childhood obesity is a growing health concern in the US, affecting about 13.7 million children in 2016. Latino children have the highest incidence of obesity. According to the “immigrant paradox” immigrant families face higher levels of health risks with each subsequent generation in the US. Disparities may be due to lifestyle or buildup of acculturative stress. Previous research has ignored unhealthy eating behaviors that may be linked to behavioral health, such as sneaking food or emotional eating. Objective This study assessed two competing hypotheses for the immigrant paradox. We examine differences in body mass index (BMI) and health behaviors across ethnicity and acculturative status (operationalized as parent language). We also examine the potential moderational role of child gender. Study Design, Settings, Participants This study used baseline data from the Family Check Up 4 Health randomized control trial. Two hundred and forty families with children aged 5-12 years at elevated BMI (≥ 85th%) were recruited from three primary care clinics serving primarily Latino and low income families. Seventy three percent of children received Medicaid. Thirty three percent of parents spoke Spanish. Measurable Outcome/Analysis Parents reported on child health behaviors using the Family Health Behavior Scale and the HABITS Questionnaire. Tanita scales were used to measure BMI percentile. Hypotheses were tested via multivariate analysis of variance (MANOVA). Results Ethnicity did not predict BMI or health behaviors. Males had higher BMI and engaged in more unhealthy eating behaviors. Acculturation was not related to BMI, but children with less acculturated parents engaged in more unhealthy eating behaviors and less physical activity. A trend was found for an interaction of gender and acculturation on emotional eating, with less acculturated males engaging in the highest levels of emotional eating. Conclusion Gender and acculturation are important predictors of unhealthy eating. The next step is to conduct mediational analyses to understand links with BMI. Funding Center for Disease Control and Prevention.