Childhood Obesity in Bangladeshi Immigrants:
A biocultural investigation

Abstract

Childhood obesity is a problem of increasing concern worldwide. The causes of obesity are complex and varied, but it is clear that there are biological, genetic and social determinants. The Childhood Obesity in Bangladeshi Immigrants project aims to further understand how cultural and biological factors interact in a population at increased risk for obesity-related metabolic diseases.
Research was based in neighbourhood primary schools and was centred on pre-adolescent girls, aged 10-12, in a Bangladeshi migrant community in the city of Sunderland in the northeast England, and white British girls of the same age, socioeconomic status and geographical location. Diet and eating behaviours were assessed using 1) a series of school lunchtime observations 2) a single 24-hour photographic food diary, and 3) researcher-administered questionnaires. Physical health has been assessed through height, weight and waist circumference measurements, health histories (as given by parents) and saliva samples for evaluation of bodily inflammation via CRP assay. In concert with these collected data, interviews with school staff, and further questionnaires and focus groups with children and parents were administered on the topics of eating and health beliefs and behaviour.
A much greater number of study participants in both cohorts were identified as at risk for metabolic disease by waist circumference measurement than identified as overweight or obese by BMI (18/20 vs 6/20 for the Bangladeshi-British cohort, and 17/20 vs 11/20 for the white British cohort). A significant positive correlation was found between CRP levels and waist-to-height ratio in white British participants (p=0.006). Fruit and vegetable intake was markedly lower in the Bangladesh-British cohort during school hours: 15 servings in 40 lunches vs 40 servings in 52 lunches in the white British cohort. However, food diaries reveal that over the whole day intake is similar in both groups (median intake of 1 serving of vegetables and 2 of fruit per day for Bangladeshi British participants, and a median of 0.5 servings of each for white British participants). Cohorts engaged in very different types of physical activity outside of school hours, with Bangladeshi-British subjects engaging primarily in casual play and white British subjects primarily engaged in formal lessons or team sports. It was also found that the school lunchroom environment has significant impact on the amount and types of food consumed during the lunch period, and it appears that certain types of room arrangements are more conducive to healthy eating than others.