OBESITY TRENDS AND RISK FACTORS AMONG REFUGEE CHILDREN/YOUTH: A SCOPING REVIEW
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Abstract
BACKGROUND
Overweight and obese children are at a heightened risk of adult-onset health complications including hypertension, cardiovascular disease, type 2 diabetes, certain cancers, and psychosocial complications. These disorders can begin in childhood, which increases the likelihood of early morbidity and mortality. In parallel, over the past two decades, the global population of refugees has grown substantially.
OBJECTIVES
Given the rapid increase of refugee populations in Canada, it is important to understand how obesity and overweight patterns for refugee children and youth differ from those of native-born populations. To date, no review has comprehensively documented weight gain trends and risk factors in paediatric refugee populations.
DESIGN/METHODS
A scoping review of the literature was conducted using Medline, CINAHL, and EMBASE for publications in English from August 1991 to April 2017. A total of 11 articles were identified relating to prevalence and risk factors for becoming overweight/obese in refugee children and youth aged 0 to 18 years old after arrival in a high-income setting.
RESULTS
Paediatric refugees were at increased risk of rapid weight gain after migration. After living in a HIC for 1.5 to 9 years, refugee children demonstrated a prevalence of obesity that ranged from 1.4 to 21%. The prevalence of overweight children and youth ranged from 5.7 to 22.8%. Refugee children and youth had a steeper increase in their BMI compared with non-refugees (P < 0.001). Younger children (< 2 years) experienced an increase in BMI at a slower rate (P = 0.002) than older children and youth. A longer length of stay in HICs was associated with an increase in BMI percentile among refugee children. Populations of Eastern European, African, and Middle Eastern ethnic backgrounds demonstrated a higher risk of becoming overweight/obese in comparison to other paediatric refugees or non-refugee children.
CONCLUSION
This review demonstrates that despite methodological differences between the 11 included studies, 6 of them consistently demonstrate a direct relationship between increased BMI and length of residence in HICs among refugee children. Multiple studies (n=7) emphasize the need for culturally tailored prevention strategies including timely orientation to nutrition in HICs. Preventing the development of obesity among refugee children is crucial for reducing the short and long-term health consequences associated with childhood obesity.
