Trajectories of dietary change and the social context of migration: a qualitative study

The Role of Food Literacy in Managing Nutritional Precarity in the Migrant Experience: Dietary Lifestyles of Cambodia Migrants in Thailand

The paper explores the dietary lifestyles of young Cambodian migrants in Thailand to illuminate the role of food literacy in determining nutritional outcomes and well-being, including during crises, such as the COVID-19 pandemic. In this context, food literacy is defined as food skills and abilities to plan, select, and prepare to achieve adequate consumption under new or adverse social and culinary contexts of the migrant experience. In this paper, we consider both how nutritional precarity arises in the migrant experience, and to what extent food literacy can mitigate it under various conditions. The research approach involves a combination of qualitative and quantitative approaches that were adjusted to address the limited mobility for social science research during the COVID-19 pandemic in Thailand. Data collection was conducted through hybrid (online and in-person) ethnography, focus group discussions, food literacy questionnaires, and key informant interviews, often facilitated through internet messaging clients. The findings indicate that, while generally high food literacy may facilitate the transition to the foreign food systems found in migration destinations, optimizing nutrition and well-being requires reinforcement by context-specific food literacy, such as openness to foreign flavors and recipes. Contextual food literacy most directly leads to positive social and health outcomes while simultaneously expanding universal food literacy in the long-term.

Segmented assimilation as a mechanism to explain the dietary acculturation paradox

Latinos have disproportionately high rates of diet-related diseases which are associated with acculturation to the U.S. This negative shift in dietary quality is paradoxical in light of gains in income and education that would be expected to lead to better diet. We examined the extent to which the dietary acculturation paradox among Mexican Americans can be explained by segmented assimilation, a theory that considers how immigrants' and their descendants' trajectories of integration are influenced by a complex interplay of individual, social, and structural factors. First, we performed confirmatory cluster analysis to identify three assimilation segments (classic, underclass, and selective) based on education, income, and an acculturation proxy derived from language, nativity, and time in the U.S. among Mexican-origin participants (N = 4475) of the 2007-2016 National Health and Nutrition Examination Survey (NHANES). These segments were then used as independent variables in linear regression models to estimate the relationship between cluster and dietary quality (assessed by the Health Eating Index (HEI)) and the interaction between cluster and gender, controlling for marital status. There were strong effects of cluster on dietary quality, consistent with hypotheses per segmented assimilation theory. The classic assimilation segment had the poorest diet, despite having higher income and education than the underclass segment. The selective segment had higher or similar dietary quality to the underclass segment. Consistent with expectations, this difference was driven by the relatively higher consumption of greens and beans and whole grains of those in the selective and underclass segments. Overall, women had better diets than men; however, the strongest gender contrast was in the underclass segment. This study advances understanding of dietary acculturation and potential disparities in diet-related health outcomes.

Migrants on the Move and Food (In)security: A Call for Research

Food insecurity contributes to negative outcomes for health and wellbeing, and its impact may be exacerbated during periods of vulnerability. While food insecurity is both a driver and a consequence of migration, anecdotal evidence indicates that it is also common during migration when people are ‘on the move’, although its prevalence and severity during these periods are largely undocumented. Food security monitoring is critical to ensuring the universal right to food for migrants, and instruments must be designed which capture the unique challenges faced during these ‘extra-ordinary’ periods of mobility, including in the context of emergencies such as the COVID-19 pandemic. This paper reviews knowledge on food security in migrants on the move and examines how active mobility intersects with food security and its measurement. Considering the potential consequences on health and wellbeing, we call for interdisciplinary research using standard instruments to document food insecurity in migrants on the move.

Factors influencing the nutritional behavior of Syrian migrants in Germany - results of a qualitative study

Background

Syrian migrants represent the third-largest group of foreigners in Germany and are therefore potential users of health promotion initiatives, including nutrition programs. It is little known how (healthy) nutrition is understood and implemented by this group and which factors influence their experiences related to food and eating in the host country. Thus, this study aimed to explore the importance of (healthy) nutrition, facilitators, and barriers of a preferred diet; nutritional changes in relation to the country of origin; and how nutrition may change with increasing length of stay.

Methods

Thirty semi-structured qualitative interviews with Syrian migrants (male = 16, female = 14, 18–35 years, length of stay 10–68 months) were conducted in 2018. Seventeen migrants could be followed-up after 12 months and were interviewed in 2019 again and were asked for changes in their nutritional behavior. Interviews were conducted in German, English, or Arabic, transcribed and translated into English if necessary. For analysis, an abbreviated version of the Grounded Theory was used.

Results

We identified six overarching themes that described influencing factors on a favored diet in Germany over the course of stay: (1) managing everyday life; (2) intercultural contact with local residents; (3) social context of cooking and eating; (4) ambiguity toward Arabic food; (5) mistrust toward certain types of food; and (6) influence of postmigration stressors. In general, the importance of nutrition is high among Syrian migrants. However, daily stressors, the lack of practical knowledge of how to cook favored dishes, and food insecurity in the new food environment make it difficult to obtain a preferred diet. With increasing stay, many developed a higher awareness of healthy eating, mainly due to a new independence or influences from the social environment in Germany.

Conclusion

Results highlight the need for health promotion interventions to be more responsive to the specific needs of Syrian migrants, including nutrition. Syrian migrants differ in their capabilities, needs, and aims, and they should be addressed differently by health professionals, social services or migrant specific services. Future research should continue to focus on the living conditions of Syrian migrants and its influence on nutrition.

Lifestyle Habits and Health Indicators in Migrants and Native Schoolchildren in Chile

In Chile, the migrant population has increased in the last years. Migrants adopt behaviors of this new culture, which can have an effect on their health. Contradictory results regarding differences between migrant and native children have been reported. The aim of this study was to explore the associations between nationality with health indicator and lifestyle habits among schoolchildren in Chile. A cross-sectional and observational study with a non-probabilistic sample was conducted in 1033 children (86.4% Chilean and 13.6% migrant) from second to fourth grade of seven public schools from low-income municipalities from the Metropolitan Region, Chile. Anthropometric measurements (weight, height, waist circumference, triceps and subscapular folds), handgrip strength, and standing long jump measurements, physical activity, self-esteem and food guidelines accomplishments were determined. Migrant children presented lower body mass index (BMI), Z-BMI, body fat% and waist circumference values; and higher handgrip strength, standing long jump, and more satisfactory compliance with food guidelines than natives (p < 0.05). No significant difference for physical activity and self-esteem was observed. In the adjusted models, migrants presented lower odds for overweight/obesity, risk of abdominal obesity, low handgrip strength and unsatisfactory food guidelines accomplishment in all models (p < 0.05). The nutritional and muscular fitness of migrant children was better than that of the Chilean ones.

Relative Severity of Food Insecurity During Overland Migration in Transit Through Mexico

Despite anecdotal reports of food insufficiency in the overland migration through Mexico, little is known about the frequency and extent of food insecurity during this transit. In a shelter in north central Mexico, we interviewed 95 Central American migrants traveling overland to the US regarding their experiences of food insecurity in transit. 74% experienced some degree of food insecurity, ranging from having only one meal to no food at all in one or several consecutive 24 h periods. Factors associated with relatively more severe food insecurity included more days in active transit, more severe illness impacting mobility, or travel companion illness in the prior 2 weeks. Illness was predicted by a pre-migration diagnosis of chronic disease. Understanding the factors associated with relative severity of food insecurity during overland migration can inform policies for prioritizing assistance and prevention.

The biohabitus of scarcity: bio-social dispositions and the "obesity epidemic" in Mexico

In this article, we explore the potential of Warin et al.'s concept of biohabitus (a set of embodied biological and social dispositions) as a conceptual tool for the understanding of mechanisms behind the "obesity epidemic." Elaborating on this concept, we argue that a context of food scarcity gives rise to a biohabitus geared to energy-saving, expressed in both biological (the thrifty genotype/phenotype hypotheses) and symbolic dispositions (Bourdieu's "taste of necessity"), and the interaction between this type of biohabitus and changes in the food-related environment results in increased body mass index. We exemplify the use of this framework by applying it to the case of Mexico, a middle-income Latin American country with one of the highest prevalences of obesity worldwide. The example shows how the concept of biohabitus can help researchers move beyond disciplinary explanations, towards a more complex understanding of the conjunction of social and biological processes that result in differential patterns of health and disease.

Cardiometabolic risk profile and diet quality among internal migrants in Brazil: a population-based study

PURPOSE

Studies of migrants can improve understanding of the environmental influence on the risk of chronic diseases. In continental countries, internal migration has been associated with changes in diet and health status. The objective of this study is to assess differences in diet quality and the cardiometabolic risk profile between migrants and the host population.

METHODS

A cross-sectional, population-based study was conducted in the city of São Paulo. The study population included internal migrants, defined as individuals born outside São Paulo city who had lived in the city for ten years or longer. The final population (n = 537) was divided into three groups: natives of São Paulo (45.5%), migrants from the Southeast (26.9%) and migrants from the Northeast (27.5%). The joint interim statement consensus criteria were used for diagnosing MetSyn. Diet quality was estimated using the revised version of the Brazilian Healthy Eating Index (BHEI-R). Comparisons between the data of BHEI-R, cardiometabolic risk factors and MetSyn in migrants and natives were performed using generalized linear models adjusted for confounding factors, respectively.

RESULTS

Southeastern and Northeastern migrants younger than 60 years had a higher average of for whole fruit and oil components, respectively. Northeastern migrants older than 60 years had higher systolic and diastolic blood pressure, atherogenic ratio concentrations, lower HDL-C and were more likely to present metabolic syndrome compared to those born in São Paulo of the same age group.

CONCLUSION

Native and internal migrants from Brazil resident in São Paulo exhibited differences in diet quality and cardiometabolic risk factors.

Food Knowledge and Migrant Families in Argentina

This article presents an analysis of different aspects of the migration process of a large group of people in Argentina, who originally come from the rural uplands (Jujuy Province) but who currently dwell in a lowlands peri-urban area (Buenos Aires Metropolitan Area). In particular, it presents some of the results of a long-term research project on food practices deployed in both geographical zones, which are united by a considerable migrant flow that intensified during the last three decades. From an anthropological perspective, it analyses the features of the nutritional transition of this social group regard to changes in its food knowledge and cultural heritage. It suggests that this qualitative factor can contribute to a better understanding of the health issues that have been faced by this group.

Dementia in immigrant groups: A cohort study of all adults 45 years of age and older in Sweden

OBJECTIVE

To study the association between country of birth and incident dementia in several immigrant groups in Sweden.

METHODS

The study population included all adults (n = 3,286,624) aged 45 years and older in Sweden. Dementia was defined as having at least one registered diagnosis of dementia in the National Patient Register. The incidence of dementia in different immigrant groups, using Swedish-born as referents, was assessed by Cox regression, expressed in hazard ratios (HRs) and 95% confidence intervals (CI). All models were stratified by sex and adjusted for age, geographical residence in Sweden, educational level, marital status, and neighbourhood socioeconomic status.

RESULTS

A total of 136,713 individuals had a registered dementia event, i.e. 4.2%; 3.6% among men and 4.9% among women. After adjusting for confounders, in general, there was a lower incidence of dementia among both male immigrants (HR 0.85, 0.83-0.88) and female immigrants (HR 0.93, 0.91-0.95) compared to their Swedish-born counterparts. Among immigrant groups, a higher incidence (HR, 95%CI) of dementia was observed among men from Finland (1.14, 1.08-1.20), Bosnia (1.61, 1.18-2.20), Estonia (1.25, 1.10-1.43) and Russia (1.37, 1.12-1.69), and women from Finland (1.20 1.15-1.24) and Norway (1.14, 1.07-1.22).

CONCLUSIONS

Risk of dementia was lower in immigrants in general compared to the Swedish-born population; however there were substantial differences among immigrant groups in risk of dementia. Developing dementia in a new country with a different language could cause problems for both patients and the health care staff.

International migration and dietary change in Mexican women from a social practice framework

Migration from lower- and middle-income to high-income countries is associated with dietary change, and especially with the adoption of a modern, less healthy diet. In this article we analyze the dietary changes experienced by Mexican migrants, employing as a theoretical framework the concept of social practice. According to this framework, practices integrate material elements, meanings and competences that provide their conditions of possibility. Practices are shared by members of social groups, and interact with other competing or reinforcing practices. Between 2014 and 2015, we conducted semi-structured interviews with 27 women, international return migrants living in Tijuana, Mexico. The interview guide asked about history of migration and dietary change. We found three main areas of dietary change: from subsistence farming to ready meals, abundance vs. restriction, and adoption of new food items. The first one was associated with changes in food procurement and female work: when moving from rural to urban areas, participants substituted self-produced for purchased food; and as migrant women joined the labor force, consumption of ready meals increased. The second was the result of changes in income: participants of lower socioeconomic position modified the logic of food acquisition from restriction to abundance and back, depending on the available resources. The third change was relatively minor, with occasional consumption of new dishes or food items, and was associated with exposure to different cuisines and with learning how to cook them. Public health efforts to improve the migrants' diets should take into account the constitutive elements of dietary practices, instead of isolating individuals from their social contexts.

Retaining Traditional Dietary Practices among Greek Immigrants to Australia: The Role of Ethnic Identity

This article explores why some Greek immigrants to Australia continue to adhere to a traditional Mediterranean diet whereas others have adopted eating behaviors characteristic of a less healthy "Australian" diet. Twelve qualitative interviews were conducted and comparisons made between individuals consuming more (n = 6) and less traditional diets (n = 6). The level of adherence to the diet was previously assessed by a diet score in a separate quantitative study (MEDIS-Australia) from which the subset of 12 participants for the present study was recruited. Analysis revealed that maintenance of a strong ethnic identity offers a pathway through which individuals retain dietary practices of their homeland.

Dietary energy density was associated with diet quality in Brazilian adults and older adults

Cross-sectional and longitudinal studies present association of low dietary energy density with higher intake of vitamins, minerals and dietary fiber, lower intake of fat, and better balance of macronutrients. The objective of this study was to verify the relationship between dietary energy density and diet quality measured by an index of diet quality. This study used data from 496 adults and 445 older adults of cross-sectional population-based survey from São Paulo conducted in 2008-2009, Brazil. Dietary intake data was assessed by two 24-h dietary recalls. Dietary energy density values were calculated based on foods only method. Dietary energy density and revised Brazilian Health Eating Index and its components, were estimated by usual intake using Multiple Source Method. The relationship between dietary energy density and the total revised Brazilian Health Eating Index and its components were assessed by Gaussian family log-link model for each age group. The analyses showed an inverse association between dietary energy density and total revised Brazilian Health Eating Index in adults (T2:β = 0.96, p < 0.001; T2:β = 0.86, p < 0.001) and older adults (T2:β = 0.96, p < 0.001; T2:β = 0.90, p < 0.001), and an inverse association between dietary energy density and nine of twelve revised Brazilian Health Eating Index components in adult and/or older adults groups. Dietary energy density was associated with diet quality in Brazilian adults and older adults regardless of sex, per capita household income, body mass index, physical activity level, current smoking habits status, alcohol beverage drinking status and usual energy intake (kilocalories) from beverages.