title: Factors associated with childhood overweight and obesity among acculturated and new immigrants.
abstract: OBJECTIVE
  To examine the relationship between acculturation and obesity among low socioeconomic status (LSES) children.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Children from 12 preschools in LSES neighborhoods were recruited.
  
  
  METHODS
  Anthropometric measurements were obtained from 238 children (aged 4-7 years) and 224 mothers. Sociodemographic characteristics and perceptions of child's weight were collected from mothers. We compared native Israelis and immigrants for risk factors for obesity, using a 9-year cut-off to define new and acculturated immigrants.
  
  
  RESULTS
  The combined prevalence of overweight and obesity (OWOB) among children was 29.8% (71/238) using the World Health Organization (WHO) growth standard. Mean age, sleeping hours, sex distribution and poverty level were similar between immigrants and natives. Prevalence of OWOB and current parental smoking were significantly lower among children of new immigrants (P = .02). More than 82% of mothers underestimated their child's weight status, 74.2% of OWOB children were perceived as normal-weight (NW) and 8% as thin. In a multivariable logistic-regression analysis comparing NW to OWOB children, maternal underestimation of the child's weight status (OR = 7.5; 95%CI: 3.4-16.5, P < .0001) and being born to acculturated immigrants (OR = 2.3 95% CI: 1.1-4.7, P = .03) were associated with OWOB. Ethiopian children were at lower risk for obesity. Paternal smoking increased the risk for obesity by 2-fold in non-Ethiopian, and 5-fold in Ethiopian children (OR = 2.0 and 5.0, respectively; P for interaction = .026).
  
  
  CONCLUSIONS
  Acculturation, perception of child's weight status and parental smoking are associated with childhood OWOB. Immigration status should be considered when programs to prevent childhood obesity are implemented in mixed populations.
authors.affiliation: Department of Epidemiology and Health Services Evaluation, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. kaufmanshriv@smh.ca
authors.forename: Vered
authors.initials: V
authors.lastname: Kaufman-Shriqui
authors.forename: Drora
authors.initials: D
authors.lastname: Fraser
authors.forename: Michael
authors.initials: M
authors.lastname: Friger
authors.forename: Natalya
authors.initials: N
authors.lastname: Bilenko
authors.forename: Hillel
authors.initials: H
authors.lastname: Vardi
authors.forename: Kathleen
authors.initials: K
authors.lastname: Abu-Saad
authors.forename: Naama
authors.initials: N
authors.lastname: Elhadad
authors.forename: Karen
authors.initials: K
authors.lastname: Mor
authors.forename: Zvi
authors.initials: Z
authors.lastname: Feine
authors.forename: Danit R
authors.initials: DR
authors.lastname: Shahar
mesh_terms: D000069:Acculturation; D000328:Adult; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D004522:Educational Status; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005002:Ethiopia / Q000208:ethnology; D005220:Fathers; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009035:Mothers; D015999:Multivariate Analysis; D009765:Obesity / Q000208:ethnology*; D016017:Odds Ratio; D050177:Overweight / Q000208:ethnology; D010465:Perception; D011203:Poverty; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000208:ethnology*; D055815:Young Adult