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Kibibi NI, Dena I, Cummings PDW, Hicks CD, Bao W, Schweizer ML. Obesity in Refugees post-resettlement in a high-income country: a meta-analysis. J Racial Ethn Health Disparities 2024; 11:2197-2209. [PMID: 37468741 DOI: 10.1007/s40615-023-01688-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/10/2023] [Accepted: 06/18/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND Refugees have a high prevalence of obesity post resettlement, but few studies have compared their risk of obesity to those of the host population. We systematically investigated the association between refugee status and obesity after resettlement in a high-income nation. METHODS We searched PubMed, Embase, OpenGrey and bibliographies of retrieved articles, with no date, location, and language restrictions, for observational studies assessing obesity rates in resettled refugees compared to the host population. RESULTS Nine studies were analyzed. We found no evidence of increased risk of obesity among refugees compared to the host population, with significant heterogeneity across studies. However, the risk of obesity among refugee men were significantly lower than the host population. DISCUSSION The heterogeneity between studies calls for more high-quality research to examine the risk of obesity among refugees compared to the host population in high-income countries. This will enable results to be pooled to provide more decisive evidence about obesity trends among refugees post migration in a high-income nation.
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Affiliation(s)
- Niclette I Kibibi
- Department of Epidemiology, University of Iowa College of Public Health, 145 N. Riverside Dr., S400 CPHB, Iowa City, IA, 52242, USA.
| | - Isabelle Dena
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Precious de-Winton Cummings
- Department of Epidemiology, University of Iowa College of Public Health, 145 N. Riverside Dr., S400 CPHB, Iowa City, IA, 52242, USA
| | - Chelsea D Hicks
- Harborview Injury Prevention and Research Center, Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Wei Bao
- Institute of Public Health Sciences, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026, Anhui, China
| | - Marin L Schweizer
- Division of Infectious Disease, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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Fatima M, Nosheen F, Afzaal M, Islam F, Noreen R, Imran A, Amer Ali Y. Nutritional and health status of Afghan refugee women living in Punjab: A cross-sectional study. Food Sci Nutr 2023; 11:2872-2882. [PMID: 37324867 PMCID: PMC10261817 DOI: 10.1002/fsn3.3267] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/27/2023] [Accepted: 02/03/2023] [Indexed: 03/30/2023] Open
Abstract
Afghan refugees are the world's densely populated community, with 2.6 million registered Afghan refugees living globally, of whom about 2.2 million are in Iran and Pakistan. Pakistan is a densely populated country, and due to its low socioeconomic status, food insecurity, unhygienic conditions, and inadequate access to health care, the Afghan refugees have high chances of being malnourished; the chances of death for these Afghans are 25 times more every year from undernourishment and poverty than those from violence. This study aimed to assess anthropometric and biochemical analyses, their health complications, and the socioeconomic status of Afghan refugee women living in Islamabad Punjab as women are the most vulnerable and highly malnourished group in any community. This cross-sectional study involved 150 Afghan women aged 15-30 years; they were assessed for their nutritional status using Anthropometric, Biochemical, Clinical and Diet (ABCD). The results indicate the prevalence of underweight, normal weight, and overweight at 74.7%, 16.7%, and 8.7%, respectively. Majority of the women have extremely low hemoglobin (Hb) level, which indicates iron deficiency as well as low body mass index for their age. As the results indicate that there are high chances of severe malnutrition among this most vulnerable segment of the population, this situation must be addressed immediately; the main aim of this study is to highlight the current situation of these Afghan refugees in Pakistan. More research is needed to determine how normal body weight women with low hemoglobin levels are compared to women with ideal body mass index ratios.
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Affiliation(s)
- Maleeha Fatima
- Department of Home EconomicsGovernment College UniversityFaisalabadPakistan
| | - Farhana Nosheen
- Department of Home EconomicsGovernment College UniversityFaisalabadPakistan
| | - Muhammad Afzaal
- Department of Food SciencesGovernment College UniversityFaisalabadPakistan
| | - Fakhar Islam
- Department of Food SciencesGovernment College UniversityFaisalabadPakistan
| | - Rabia Noreen
- Department of Home EconomicsGovernment College UniversityFaisalabadPakistan
| | - Ali Imran
- Department of Food SciencesGovernment College UniversityFaisalabadPakistan
| | - Yuosra Amer Ali
- Department of Food Sciences, College of Agriculture and ForestryUniversity of MosulMosulIraq
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Ojo AS, Nnyanzi LA, Giles EL, Ells L, Okeke SR, Ajayi KV, Bolarinwa OA. "I am not really into the government telling me what I need to eat": exploring dietary beliefs, knowledge, and practices among ethnically diverse communities in England. BMC Public Health 2023; 23:800. [PMID: 37131140 PMCID: PMC10152749 DOI: 10.1186/s12889-023-15689-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 04/16/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND Communities with diverse ethnicity in high-income countries are disproportionately affected by poor diet-related health outcomes. In England, the United Kingdom's government's healthy eating dietary resources are not well accepted and are underutilised among this population. Thus, this study explored perceptions, beliefs, knowledge, and practices around dietary intake among communities with African and South Asian ethnicity residing in Medway, England. METHODS This qualitative study generated data from 18 adults aged 18 and above using a semi-structured interview guide. These participants were sampled using purposive and convenience sampling strategies. All the interviews were conducted in English over the telephone, and responses were thematically analysed. RESULTS Six overarching themes were generated from the interview transcripts: eating patterns, social and cultural factors, food preferences and routines, accessibility and availability, health and healthy eating, and perceptions about the United Kingdom government's healthy eating resources. CONCLUSION The results of this study indicate that strategies to improve access to healthy foods are required to improve healthy dietary practices among the study population. Such strategies could help address this group's structural and individual barriers to healthy dietary practices. In addition, developing a culturally responsive eating guide could also enhance the acceptability and utilisation of such resources among communities with ethnic diversity in England.
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Affiliation(s)
- Abimbola S Ojo
- School of Health & Life Sciences, Teesside University, Middlesbrough, UK
| | - Lawrence A Nnyanzi
- School of Health & Life Sciences, Teesside University, Middlesbrough, UK
| | - Emma L Giles
- School of Health & Life Sciences, Teesside University, Middlesbrough, UK
| | - Louisa Ells
- School of Health, Leeds Beckett University, Leeds, UK
| | - Sylvester R Okeke
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | - Kobi V Ajayi
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, Texas, United States
| | - Obasanjo Afolabi Bolarinwa
- Department of Public Health & Well-being, Faculty of Health & Social Care, University of Chester, Castle Drive, Chester, CH1 1SL, UK.
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
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Atayoglu AT, Firat Y, Kaya N, Basmisirli E, Capar AG, Aykemat Y, Atayolu R, Khan H, Guner Atayoglu A, Inanc N. Evaluation of Nutritional Status with Healthy Eating Index (HEI-2010) of Syrian Refugees Living Outside the Refugee Camps. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:849. [PMID: 36613171 PMCID: PMC9819415 DOI: 10.3390/ijerph20010849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/29/2022] [Accepted: 12/09/2022] [Indexed: 06/17/2023]
Abstract
Nutrition is a public health issue. Amongst populations of refugees, unmet nutritional needs have been identified. The aim of this study was to evaluate the nutritional status of Syrian refugees living outside the refugee camps in Kayseri, Turkey. Socio-demographic data and anthropometric measurements of the refugees were collected. The relationship between diet quality, which was assessed through the Healthy Eating Index (HEI-2010), and factors (including the duration of time spent outside the refugee camp, income, obesity, and waist circumference) were measured. Four hundred refugees participated in this study. The majority of refugees (77.8%) reported a 'poor' diet, with the remaining filling into the 'needs improvement' based on HEI-2010 scores. The average consumption of fruits in the study group was 101.9 g per day (g/day), while the average consumption of vegetables was 142.2 g/day. When the relationships were examined between BMI, HEI-2010 score, the time spent as a refugee, and waist circumference, statistically significant relationships were found (p < 0.001). In the linear regression analysis based on these relationships, when the results were adjusted for age and gender factors, it was observed that for every year spent as a refugee, BMI score increased by 0.17 units, and waist circumference increased by 1.14 units (p < 0.05). As a result, this study showed that refugees have low-income-related nutritional risks. In conclusion, ensuring that refugees have access to adequate nutrient-rich food is essential; therefore, analyzing and improving nutritional standards for refugees are suggested to be part of the strategies of the public and primary health care systems.
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Affiliation(s)
- Ali Timucin Atayoglu
- Department of Family Medicine, International School of Medicine, Istanbul Medipol University, Istanbul 34815, Turkey
| | - Yagmur Firat
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Erciyes University, Kayseri 38280, Turkey
| | - Nese Kaya
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Nuh Naci Yazgan University, Kayseri 38170, Turkey
| | - Eda Basmisirli
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Nuh Naci Yazgan University, Kayseri 38170, Turkey
| | - Asli Gizem Capar
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Nuh Naci Yazgan University, Kayseri 38170, Turkey
| | - Yusuf Aykemat
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Nuh Naci Yazgan University, Kayseri 38170, Turkey
| | - Rumeysa Atayolu
- Department of Nutrition and Dietetics, School of Health Sciences, Istanbul Medipol University, Istanbul 34810, Turkey
| | - Hammad Khan
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA 95616, USA
| | - Ayten Guner Atayoglu
- Department of Family Medicine, Beylikduzu State Hospital, Istanbul 34500, Turkey
| | - Neriman Inanc
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Nuh Naci Yazgan University, Kayseri 38170, Turkey
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Shortland T, McGranahan M, Stewart D, Oyebode O, Shantikumar S, Proto W, Malik B, Yau R, Cobbin M, Sabouni A, Rudge G, Kidy F. A systematic review of the burden of, access to services for and perceptions of patients with overweight and obesity, in humanitarian crisis settings. PLoS One 2023; 18:e0282823. [PMID: 37093795 PMCID: PMC10124894 DOI: 10.1371/journal.pone.0282823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 02/23/2023] [Indexed: 04/25/2023] Open
Abstract
INTRODUCTION Excess body weight causes 4 million deaths annually across the world. The number of people affected by humanitarian crises stands at a record high level with 1 in 95 people being forcibly displaced. These epidemics overlap. Addressing obesity is a post-acute phase activity in non-communicable disease management in humanitarian settings. Information is needed to inform guidelines and timing of interventions. The objective of this review was to explore the prevalence of overweight and obesity in populations directly affected by humanitarian crises; the cascade of care in these populations and perceptions of patients with overweight and obesity. METHODS Literature searches were carried out in five databases. Grey literature was identified. The population of interest was non-pregnant, civilian adults who had experience of humanitarian crises (armed conflict, complex emergencies and natural disasters). All study types published from January 1st, 2011, were included. Screening, data extraction and quality appraisal were carried out in duplicate. A narrative synthesis is presented. RESULTS Fifty-six reports from forty-five studies were included. Prevalence estimates varied widely across the studies and by subgroups. Estimates of overweight and obesity combined ranged from 6.4% to 82.8%. Studies were heterogenous. Global distribution was skewed. Increasing adiposity was seen over time, in older adults and in women. Only six studies were at low risk of bias. Body mass index was the predominant measure used. There were no studies reporting cascade of care. No qualitative studies were identified. CONCLUSION Overweight and obesity varied in crisis affected populations but were rarely absent. Improved reporting of existing data could provide more accurate estimates. Worsening obesity may be prevented by acting earlier in long-term crises and targeting risk groups. The use of waist circumference would provide useful additional information. Gaps remain in understanding the existing cascade of care. Cultural norms around diet and ideal body size vary.
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Affiliation(s)
- Thomas Shortland
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Majel McGranahan
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Daniel Stewart
- National Public Health Specialty Training Programme, South West Training Scheme, Bristol, United Kingdom
| | - Oyinlola Oyebode
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Saran Shantikumar
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - William Proto
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Bassit Malik
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Roger Yau
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Maddie Cobbin
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | | | - Gavin Rudge
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Farah Kidy
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
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Nutritional and health status of adult Syrian refugees in the early years of asylum in Germany: a cross-sectional pilot study. BMC Public Health 2022; 22:2217. [PMID: 36447164 PMCID: PMC9706931 DOI: 10.1186/s12889-022-14684-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 11/21/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Migration is usually accompanied by changes in the social, cultural, and religious environment, socioeconomic status, and housing conditions, all of which affect nutritional health. In a cross-sectional study, we assessed the dietary intake as well as nutritional and health situation in a population of Syrian refugees who have resided in Germany for at least six months up to four years since 2015. The primary aim of this pilot study was to evaluate the nutritional and health status in comparison to reference values. METHODS Between December 2018 and March 2020, 114 adult Syrian refugees were included in the study. The subjects filled out questionnaires on sociodemographic variables, exercise, and nutrition behavior (three-day nutrition record). After a fasting blood draw, the subjects were examined for anthropometric parameters (height, weight, body mass index, waist circumference, waist-hip ratio, and body composition via a bioelectrical impedance analyzer). Various blood markers including iron status, hematological parameters, Vitamin D status, lipid metabolism, glucose metabolism, and total homocysteine (tHcy) were measured. RESULTS About half of the participants (71 male, 43 female) had lived in Germany for less than three years. Over 60% of men and 30% of women were overweight (BMI 25-30 kg/m2) or obese (BMI > 30 kg/m2), while 79% of men and 74% of women observed an elevated body fat mass. The evaluation of the three-day nutrition records revealed an unfavorable supply situation for numerous critical nutrients. More than half of the women (53.5%) had depleted iron stores (serum ferritin < 15 µg/l). The 25-OH-Vitamin D blood levels showed a high prevalence of Vitamin D insufficiency (25-49.9 nmol/l: 38% of men and 21% of women) and deficiency (< 25 nmol/l: 44% of men and 70% of women). 83% of men and 67% of women showed tHcy levels in plasma > 10 nmol/l. Fasting insulin levels and the HOMA-IR index indicate a risk for insulin resistance. Hyperlipidemia was prevalent, especially in males with 24% showing hypertriglyceridemia (> 150 mg/dl) and LDL-hypercholesterolemia (> 130 mg/dl). CONCLUSIONS The nutritional and health status of the cohort of Syrian refugees in Germany examined in this study is unsatisfactory, and many of the investigated refugees are at risk for developing cardiovascular disease and type 2 diabetes mellitus. Further studies are required to investigate the nutritional and health situation of refugees. This is obligatory to find ways to avoid malnutrition with all its associated health, sociodemographic, and economic consequences.
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Math SM. Refugee oral health. Br Dent J 2022; 233:587. [DOI: 10.1038/s41415-022-5163-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Ankomah A, Byaruhanga J, Woolley E, Boamah S, Akombi-Inyang B. Double burden of malnutrition among migrants and refugees in developed countries: A mixed-methods systematic review. PLoS One 2022; 17:e0273382. [PMID: 35981085 PMCID: PMC9387835 DOI: 10.1371/journal.pone.0273382] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 08/08/2022] [Indexed: 11/19/2022] Open
Abstract
Migrants and refugees living in high income countries (HICs) have an increased risk of developing non-communicable diseases (NCDs) due to malnutrition at different stages over their life course. This systematic review aims to examine the double burden of malnutrition (DBM) among migrants and refugees in developed countries. This review was informed by the standard Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. Eligible studies were peer-reviewed observational studies that focused on the DBM in refugee or migrant populations; and were written in English with full texts available and accessible. A combination of keywords was used to search 8 electronic bibliographic databases including Ovid MEDLINE, EMBASE, PsycINFO, CINAHL, ProQuest, Scopus, PubMed, and web of science. There is a paucity of research into the DBM among migrants and refugees residing in HICs. Of a total of 2344 articles retrieved from eight databases, 5 studies met the inclusion criteria. All included studies showed the co-existence of some form of undernutrition and overnutrition within the same population. Overnutrition (overweight and obesity) in the studied populations ranged from 11.1% to 42% while undernutrition (stunting, wasting and underweight) ranged from 0.3% to 17%. Standard measures for anthropometry as determined by World Health Organization (WHO) were used for data collection in all included studies. A piloted form informed by the Cochrane Public Health Group Data Extraction and Assessment Template was used in the extraction of data from retrieved studies. Quality assessment of included studies was performed using the study assessment tools of the National Heart, Lung, and Blood Institute of the National Institutes of Health (NIH) and showed that all studies were of fair quality. Interventions that simultaneously target more than one form of malnutrition especially amongst migrant and refugee populations must be implemented for policy solutions to be effective. This review has been registered by the PROSPERO international prospective registry for systematic reviews, reference CRD42020192416.
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Affiliation(s)
- Alex Ankomah
- School of Population Health, University of New South Wales, Sydney, Australia
- Obstetrics and Gynaecology Team, Airport Women’s Hospital, Accra, Ghana
| | - Judith Byaruhanga
- School of Medicine and Public health, The University of Newcastle, Callaghan, Australia
| | - Emma Woolley
- School of Education, Macquarie University, Sydney, Australia
| | - Sheila Boamah
- School of Nursing, McMaster University, Hamilton, Canada
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Khuri J, Wang Y, Holden K, Fly AD, Mbogori T, Mueller S, Kandiah J, Zhang M. Dietary Intake and Nutritional Status among Refugees in Host Countries: A Systematic Review. Adv Nutr 2022; 13:1846-1865. [PMID: 35561746 PMCID: PMC9526844 DOI: 10.1093/advances/nmac051] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 01/21/2022] [Accepted: 05/06/2022] [Indexed: 01/28/2023] Open
Abstract
Refugees remain vulnerable to acute food insecurity, malnutrition, and critically inadequate food and nutrient intake after migration, regardless of the economic level of the host country. We conducted this systematic review to summarize and evaluate the dietary intake and nutritional status among refugees resettled in non-camp settings worldwide. We searched PubMed and Web of Science databases to review relevant studies published between 2009 and 2020 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We also conducted an additional manual search through PubMed and Google Scholar. Studies that evaluated both dietary intake and nutritional status of refugees in host countries were included. A total of 15 articles from 10 countries were included and assessed for study quality and outcomes. Poor dietary diversity and insufficient intake of specific food groups were reported. In addition to these dietary patterns, a high prevalence of stunting, underweight, and anemia was reported, particularly among children. A double burden of malnutrition was also observed across and within studies. Post-resettlement dietary intake and nutritional status of refugees are both influenced by factors at the pre- and post-resettlement stages as refugees transition to their host countries. Those factors, including pre-resettlement experiences, host country resources, socioeconomic status, acculturation, and food security, were summarized and presented in a conceptual model. There is a need for comprehensive dietary and health screening as well as culturally appropriate and sustainable nutrition education resources and interventions for refugees to improve their diet and nutrition. Longitudinal studies and novel methodological approaches are also suggested to measure changes in refugees' food intake and nutritional status as well as to further investigate factors associated with these 2 components.
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Affiliation(s)
- Jacob Khuri
- Lake Erie College of Osteopathic Medicine, Seton Hill University, Greensburg, PA, USA
| | - Youfa Wang
- Global Health Institute, Xi'an Jiaotong University, Xi'an, China
| | | | - Alyce D Fly
- Department of Nutrition and Health Science, Ball State University, Muncie, IN, USA
| | - Teresia Mbogori
- Department of Nutrition and Health Science, Ball State University, Muncie, IN, USA
| | - Sarah Mueller
- Emory University School of Public Health, Atlanta, GA, USA
| | - Jayanhi Kandiah
- Department of Nutrition and Health Science, Ball State University, Muncie, IN, USA
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Food environment interactions after migration: a scoping review on low- and middle-income country immigrants in high-income countries. Public Health Nutr 2021; 25:136-158. [PMID: 34509180 PMCID: PMC8825972 DOI: 10.1017/s1368980021003943] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Objective: To map and characterise the interactions between the food environment and immigrant populations from low- and middle-income countries living in high-income countries. Design: A scoping review was carried out following the framework outlined by Arksey and O’Malley, as well as Levac et al. Peer-reviewed studies in English published between 2007 and 2021 were included. Two reviewers screened and selected the papers according to predefined inclusion criteria and reporting of results follows the PRISMA-ScR guidelines. A ‘Best fit’ framework synthesis was carried out using the Analysis Grid for Environments Linked to Obesity (ANGELO) framework. Setting: High-income countries. Participants: Immigrants from low- and middle-income countries. Results: A total of sixty-eight articles were included, primarily based in the USA, as well as Canada, Australia and Europe, with immigrants originating from five regions of the globe. The analysis identified three overarching themes that interconnected different aspects of the food environment in addition to the four themes of the ANGELO framework. They demonstrate that in valuing fresh, healthy and traditional foods, immigrants were compelled to surpass barriers in order to acquire these, though children’s demands, low incomes, time scarcity and mobility influenced the healthiness of the foods acquired. Conclusion: This study brought together evidence on interactions between immigrant populations and the food environment. Immigrants attempted to access fresh, traditional, healthier food, though they faced structural and family-level barriers that impacted the healthiness of the food they acquired. Understanding the food environment and interactions therein is key to proposing interventions and policies that can potentially impact the most vulnerable.
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