title: Co-occurrence of chronic disease lifestyle risk factors in middle-aged and older immigrants: A cross-sectional analysis of 264,102 Australians.
abstract: BACKGROUND
  The way in which lifestyle risk factors for chronic disease co-occur among people with different cultural backgrounds is largely unknown.
  
  
  METHODS
  This study investigated chronic disease risk among immigrants aged ≥45 years in Australia by combining common lifestyle risk factors into a weighted chronic disease risk index (CDRI). Among 64,194 immigrants and 199,908 Australian-born participants in the 45 and Up Study (2006-2009), Poisson regression was used to derive relative risks (RR) and 95% confidence intervals (CI) for five risk factors (smoking, alcohol use, overweight/obesity, physical activity, diet) by place of birth adjusting for socio-demographic characteristics. Multiple linear regression was used to determine adjusted mean differences (AMDs) in CDRI score by place of birth and years lived in Australia.
  
  
  RESULTS
  Immigrants had higher RRs of smoking than Australian-born participants, lower RRs of excessive alcohol consumption and overweight/obesity, and no difference in RR for physical inactivity and insufficient fruit/vegetable intake. Participants born in the Middle East/North Africa (AMD 3.5, 95% CI 2.7, 4.3), Eastern/Central Europe (1.3, 0.8, 1.9), and Western Europe (0.5, 0.1, 0.8) had higher mean CDRI scores than Australian-born participants, while participants born in East Asia (-7.2, -7.8, -6.6), Southeast Asia (-6.6, -7.2, -6.1), Central/South Asia (-3.1, -4.0, -2.1), Sub-Saharan Africa (-1.9, -2.6, -1.2) and the United Kingdom/Ireland (-0.2, -0.5, 0.0) had lower scores. CDRI score among immigrants generally approximated that of Australian-born participants with greater years lived in Australia.
  
  
  CONCLUSIONS
  This study reveals differences in potential risk of chronic disease among different immigrant groups in Australia.
authors.affiliation: Cancer Research Division, Cancer Council NSW, Postal Address: PO Box 572, Kings Cross, NSW 1340, Australia; Sydney School of Public Health, The University of Sydney, Postal Address: Edward Ford Building (A27), NSW 2006, Australia. Electronic address: peter.sarich@nswcc.org.au.
authors.forename: Peter Eugene Andrew
authors.initials: PE
authors.lastname: Sarich
authors.affiliation: Sydney School of Public Health, The University of Sydney, Postal Address: Edward Ford Building (A27), NSW 2006, Australia. Electronic address: melody.ding@sydney.edu.au.
authors.forename: Ding
authors.initials: D
authors.lastname: Ding
authors.affiliation: Sydney School of Public Health, The University of Sydney, Postal Address: Edward Ford Building (A27), NSW 2006, Australia; School of Public Health and Community Medicine, University of New South Wales UNSW, Sydney, NSW 2052, Australia. Electronic address: freddy.sitas@gmail.com.
authors.forename: Freddy
authors.initials: F
authors.lastname: Sitas
authors.affiliation: Cancer Research Division, Cancer Council NSW, Postal Address: PO Box 572, Kings Cross, NSW 1340, Australia; Sydney School of Public Health, The University of Sydney, Postal Address: Edward Ford Building (A27), NSW 2006, Australia. Electronic address: mariannew@nswcc.org.au.
authors.forename: Marianne Frances
authors.initials: MF
authors.lastname: Weber
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology*; D001315:Australia; D015992:Body Mass Index; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004032:Diet / Q000706:statistics & numerical data; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D015444:Exercise; D005260:Female; D014943:Global Health; D006801:Humans; D008019:Life Style; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*
keywords: Alcohol consumption; Australia; Body mass index; Chronic disease; Fruit; Immigrants; Physical activity; Smoking; Vegetables