title: The effects of acculturation on obesity rates in ethnic minorities in England: evidence from the Health Survey for England.
abstract: OBJECTIVE
  To investigate the extent of generational differences in adult health-related lifestyles and socio-economic circumstances, and explore whether these differences might explain changing patterns of obesity in ethnic minorities in England.
  
  
  METHODS
  Seven ethnic minority groups were selected from the ethnically boosted 1999 and 2004 Health Survey for England (Indian n = 1580; Pakistani n = 1858; Bangladeshi n = 1549; Black Caribbean n = 1472; Black African n = 587; Chinese n = 1559; and Irish n = 889). Age and sex adjusted odds of being obese in the second generation when compared with the first were estimated before and after adjusting for generational differences in health-related behaviours (snacking, eating cakes and fried foods, low levels of physical exercise, any drinking, current smoker, etc.) and socio-economic factors (social class, equivalized income and highest qualification).
  
  
  RESULTS
  Indian [OR: 1.76 (1.14-2.71)] and Chinese [OR: 3.65 (1.37-9.78)] groups were more likely to be obese in the second generation than the first after adjusting for age and sex, with no significant differences observed in all other groups. However, the risk of obesity in all groups converged between generations to the risk observed in the White reference group, with exception to the Black Caribbean group. Adjusting independently for the mixed patterns of acculturative changes and the uniform upward social mobility in all groups increased the risk of obesity in the second generation.
  
  
  CONCLUSIONS
  Obesity converged to the risk in the majority population following acculturation. Future research needs to consider generation and trans-cultural identities as a fundamental variable in determining the causes of ethnic health inequalities.
authors.affiliation: Population Studies Department, London School of Hygiene and Tropical Medicine, London, UK. neil.smith@lshtm.ac.uk
authors.forename: Neil R
authors.initials: NR
authors.lastname: Smith
authors.forename: Yvonne J
authors.initials: YJ
authors.lastname: Kelly
authors.forename: James Y
authors.initials: JY
authors.lastname: Nazroo
mesh_terms: D000069:Acculturation; D000293:Adolescent; D000328:Adult; D044466:Asian People / Q000706:statistics & numerical data; D044383:Black People / Q000706:statistics & numerical data; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004739:England / Q000453:epidemiology; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D015438:Health Behavior; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D009765:Obesity / Q000208:ethnology*; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D044465:White People / Q000706:statistics & numerical data