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移民搬迁后生活方式改变对肥胖及代谢健康的影响
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Abstract:
移民健康是全球公共卫生领域的重要议题。本综述旨在系统阐释移民搬迁后生活方式改变对肥胖及代谢健康的综合影响。研究发现，移民经历通常伴随着明确的“营养与体力活动转型”，其特征表现为饮食结构趋向高能量密度、低营养素密度，体力活动水平全面下降，以及慢性社会心理压力升高。这些多维度的生活方式改变，通过能量代谢失衡、慢性炎症反应、神经内分泌调节紊乱等直接生物医学路径，显著增加肥胖、2型糖尿病及代谢综合征的发生风险。同时，这些行为转变受到迁入地社会文化环境、物理建成环境及移民自身社会经济地位的系统性调节。本文整合了不同移民群体的研究证据，辨析了“健康移民效应”的异质性及方法学挑战，并基于社会生态模型，提出了涵盖个体、社区与环境的多层次干预策略，为制定具有文化敏感性的公共卫生实践与未来研究方向提供理论依据。
Immigrant health is a critical issue in global public health. This review aims to systematically elucidate the comprehensive effects of lifestyle changes following migration on obesity and metabolic health. Studies have consistently shown that the migration experience is typically accompanied by a distinct “nutrition and physical activity transition,” characterized by dietary patterns shifting toward high energy density and low nutrient density, a comprehensive decline in physical activity levels, and increased chronic psychosocial stress. These multidimensional lifestyle changes significantly increase the risk of obesity, type 2 diabetes, and metabolic syndrome through direct biomedical pathways such as energy metabolism imbalance, chronic inflammatory responses, and neuroendocrine regulatory disorders. Meanwhile, these behavioral changes are systematically modulated by the sociocultural environment, physical built environment of the host country, and the migrants’ own socioeconomic status. This review integrates research evidence from different migrant groups, analyzes the heterogeneity and methodological challenges of the “healthy migrant effect,” and proposes multi-level intervention strategies covering individuals, communities, and environments based on the social-ecological model. It provides a theoretical basis for developing culturally sensitive public health practices and future research directions. lth Among Migrants.
| [1] | Markides, K.S. and Rote, S. (2018) The Healthy Immigrant Effect and Aging in the United States and Other Western Countries. The Gerontologist, 59, 205-214. https://doi.org/10.1093/geront/gny136 |
| [2] | Gkiouleka, A. and Huijts, T. (2020) Intersectional Migration-Related Health Inequalities in Europe: Exploring the Role of Migrant Generation, Occupational Status & Gender. Social Science & Medicine, 267, Article ID: 113218. https://doi.org/10.1016/j.socscimed.2020.113218 |
| [3] | Popkin, B.M., Adair, L.S. and Ng, S.W. (2012) Global Nutrition Transition and the Pandemic of Obesity in Developing Countries. Nutrition Reviews, 70, 3-21. https://doi.org/10.1111/j.1753-4887.2011.00456.x |
| [4] | Isasi, C.R., Ayala, G.X., Sotres-Alvarez, D., Madanat, H., Penedo, F., Loria, C.M., et al. (2015) Is Acculturation Related to Obesity in Hispanic/Latino Adults? Results from the Hispanic Community Health Study/study of Latinos. Journal of Obesity, 2015, Article ID: 186276. https://doi.org/10.1155/2015/186276 |
| [5] | Pan, F., Zhang, T., Mao, W., Zhao, F., Luan, D. and Li, J. (2023) Ultra-Processed Food Consumption and Risk of Overweight or Obesity in Chinese Adults: Chinese Food Consumption Survey 2017-2020. Nutrients, 15, Article 4005. https://doi.org/10.3390/nu15184005 |
| [6] | Monteiro, C.A., Cannon, G., Levy, R.B., Moubarac, J., Louzada, M.L., Rauber, F., et al. (2019) Ultra-Processed Foods: What They Are and How to Identify Them. Public Health Nutrition, 22, 936-941. https://doi.org/10.1017/s1368980018003762 |
| [7] | Sun, Q., Li, X. and Rahut, D.B. (2021) Urbanicity and Nutrition: Evidence from Rural-Urban Migrants in China. China Agricultural Economic Review, 13, 673-704. https://doi.org/10.1108/caer-02-2020-0016 |
| [8] | Varre, J.V., Dustin, M. and Van Vliet, S. (2025) Dietary Transformations and Health Implications in Migrant Populations: A Global Perspective. Frontiers in Nutrition, 12, Article 1623556. https://doi.org/10.3389/fnut.2025.1623556 |
| [9] | Hills, A.P., Arena, R., Khunti, K., Yajnik, C.S., Jayawardena, R., Henry, C.J., et al. (2018) Epidemiology and Determinants of Type 2 Diabetes in South Asia. The Lancet Diabetes & Endocrinology, 6, 966-978. https://doi.org/10.1016/s2213-8587(18)30204-3 |
| [10] | Katzmarzyk, P.T., Friedenreich, C., Shiroma, E.J. and Lee, I. (2021) Physical Inactivity and Non-Communicable Disease Burden in Low-Income, Middle-Income and High-Income Countries. British Journal of Sports Medicine, 56, 101-106. https://doi.org/10.1136/bjsports-2020-103640 |
| [11] | Sallis, J.F., Bull, F., Guthold, R., Heath, G.W., Inoue, S., Kelly, P., et al. (2016) Progress in Physical Activity over the Olympic Quadrennium. The Lancet, 388, 1325-1336. https://doi.org/10.1016/s0140-6736(16)30581-5 |
| [12] | Ickes, M.J. and Sharma, M. (2012) A Systematic Review of Physical Activity Interventions in Hispanic Adults. Journal of Environmental and Public Health, 2012, Article ID: 156435. https://doi.org/10.1155/2012/156435 |
| [13] | Franssen, W.M.A., Nieste, I., Verboven, K. and Eijnde, B.O. (2025) Sedentary Behaviour and Cardiometabolic Health: Integrating the Potential Underlying Molecular Health Aspects. Metabolism, 170, Article ID: 156320. https://doi.org/10.1016/j.metabol.2025.156320 |
| [14] | Ng, S.W. and Popkin, B.M. (2012) Time Use and Physical Activity: A Shift Away from Movement across the Globe. Obesity Reviews, 13, 659-680. https://doi.org/10.1111/j.1467-789x.2011.00982.x |
| [15] | Harris, R., Tobias, M., Jeffreys, M., Waldegrave, K., Karlsen, S. and Nazroo, J. (2006) Racism and Health: The Relationship between Experience of Racial Discrimination and Health in New Zealand. Social Science & Medicine, 63, 1428-1441. https://doi.org/10.1016/j.socscimed.2006.04.009 |
| [16] | Çimşir, E. and Ünlü Kaynakçı, F.Z. (2024) Acculturative Stress and Depressive Symptoms among International University Students: A Meta-Analytic Investigation. International Journal of Intercultural Relations, 102, Article ID: 102041. https://doi.org/10.1016/j.ijintrel.2024.102041 |
| [17] | Hatzenbuehler, M.L., Phelan, J.C. and Link, B.G. (2013) Stigma as a Fundamental Cause of Population Health Inequalities. American Journal of Public Health, 103, 813-821. https://doi.org/10.2105/ajph.2012.301069 |
| [18] | Powell-Wiley, T.M., Baumer, Y., Baah, F.O., Baez, A.S., Farmer, N., Mahlobo, C.T., et al. (2022) Social Determinants of Cardiovascular Disease. Circulation Research, 130, 782-799. https://doi.org/10.1161/circresaha.121.319811 |
| [19] | Tomiyama, A.J. (2019) Stress and Obesity. Annual Review of Psychology, 70, 703-718. https://doi.org/10.1146/annurev-psych-010418-102936 |
| [20] | Chao, A.M., Jastreboff, A.M., White, M.A., Grilo, C.M. and Sinha, R. (2017) Stress, Cortisol, and Other Appetite‐Related Hormones: Prospective Prediction of 6‐Month Changes in Food Cravings and Weight. Obesity, 25, 713-720. https://doi.org/10.1002/oby.21790 |
| [21] | Saint-Fort, L. and Choi, K. (2019) Heterogeneity in Tobacco-Use Behaviors among U.S. Blacks per Global Region of Origin. Journal of Immigrant and Minority Health, 21, 1185-1189. https://doi.org/10.1007/s10903-019-00865-x |
| [22] | Lui, P.P. and Zamboanga, B.L. (2018) Acculturation and Alcohol Use among Asian Americans: A Meta-Analytic Review. Psychology of Addictive Behaviors, 32, 173-186. https://doi.org/10.1037/adb0000340 |
| [23] | Heymsfield, S.B. and Wadden, T.A. (2017) Mechanisms, Pathophysiology, and Management of Obesity. New England Journal of Medicine, 376, 254-266. https://doi.org/10.1056/nejmra1514009 |
| [24] | Hotamisligil, G.S. (2017) Inflammation, Metaflammation and Immunometabolic Disorders. Nature, 542, 177-185. https://doi.org/10.1038/nature21363 |
| [25] | McEwen, B.S. (2017) Neurobiological and Systemic Effects of Chronic Stress. Chronic Stress, 1, 127-140. https://doi.org/10.1177/2470547017692328 |
| [26] | McEwen, B.S. (1993) Stress and the Individual. Archives of Internal Medicine, 153, 2093-2101. https://doi.org/10.1001/archinte.1993.00410180039004 |
| [27] | Rigolon, A., Browning, M. and Jennings, V. (2018) Inequities in the Quality of Urban Park Systems: An Environmental Justice Investigation of Cities in the United States. Landscape and Urban Planning, 178, 156-169. https://doi.org/10.1016/j.landurbplan.2018.05.026 |
| [28] | Miller, G.E., Chen, E. and Parker, K.J. (2011) Psychological Stress in Childhood and Susceptibility to the Chronic Diseases of Aging: Moving toward a Model of Behavioral and Biological Mechanisms. Psychological Bulletin, 137, 959-997. https://doi.org/10.1037/a0024768 |
| [29] | Williams, D.R. and Kavanagh, J. (2020) Special Issue Introduction: Place, Migration and Health. Social Science & Medi-cine, 256, Article ID: 112968. |
| [30] | Cerin, E., Nathan, A., van Cauwenberg, J., Barnett, D.W. and Barnett, A. (2017) The Neighbourhood Physical Environment and Active Travel in Older Adults: A Systematic Review and Meta-analysis. International Journal of Behavioral Nutrition and Physical Activity, 14, Article No. 15. https://doi.org/10.1186/s12966-017-0471-5 |
| [31] | Drewnowski, A. (2012) The Economics of Food Choice Behavior: Why Poverty and Obesity Are Linked. In: Nestlé Nutrition Institute Workshop Series, S. Karger AG, 95-112. https://doi.org/10.1159/000341303 |
| [32] | Gong, C., Yang, R. and Li, S. (2024) The Role of Urban Green Space in Promoting Health and Well-Being Is Related to Nature Connectedness and Biodiversity: Evidence from a Two-Factor Mixed-Design Experiment. Landscape and Urban Planning, 245, Article ID: 105020. https://doi.org/10.1016/j.landurbplan.2024.105020 |
| [33] | Hamilton, T.G. (2015) The Healthy Immigrant (Migrant) Effect: In Search of a Better Native-Born Comparison Group. Social Science Research, 54, 353-365. https://doi.org/10.1016/j.ssresearch.2015.08.008 |
| [34] | Goel, M.S. (2004) Obesity among US Immigrant Subgroups by Duration of Residence. JAMA, 292, 2860-2867. https://doi.org/10.1001/jama.292.23.2860 |
| [35] | Grundy, S.M., Stone, N.J., Bailey, A.L., Beam, C., Birtcher, K.K., Blumenthal, R.S., et al. (2019) 2018 AHA/ ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APHA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol. Journal of the American College of Cardiology, 73, e285-e350. https://doi.org/10.1016/j.jacc.2018.11.003 |
| [36] | Singh, G.K., Kogan, M.D. and Yu, S.M. (2009) Disparities in Obesity and Overweight Prevalence among US Immigrant Children and Adolescents by Generational Status. Journal of Community Health, 34, 271-281. https://doi.org/10.1007/s10900-009-9148-6 |
| [37] | McCullough, M.B. and Marks, A.K. (2014) The Immigrant Paradox and Adolescent Obesity: Examining Health Behaviors as Potential Mediators. Journal of Developmental & Behavioral Pediatrics, 35, 138-143. |
| [38] | Roura, M., Dias, S., LeMaster, J.W. and MacFarlane, A. (2021) Participatory Health Research with Migrants: Opportunities, Challenges, and Way Forwards. Health Expectations, 24, 188-197. https://doi.org/10.1111/hex.13201 |
| [39] | Tao, Y., Ma, J., Shen, Y. and Chai, Y. (2022) Neighborhood Effects on Health: A Multilevel Analysis of Neighborhood Environment, Physical Activity and Public Health in Suburban Shanghai. Cities, 129, Article ID: 103847. https://doi.org/10.1016/j.cities.2022.103847 |
| [40] | Alegría, M., NeMoyer, A., Falgàs Bagué, I., Wang, Y. and Alvarez, K. (2018) Social Determinants of Mental Health: Where We Are and Where We Need to Go. Current Psychiatry Reports, 20, Article No. 95. https://doi.org/10.1007/s11920-018-0969-9 |
| [41] | Lam, T.M., Vaartjes, I., Grobbee, D.E., Karssenberg, D. and Lakerveld, J. (2021) Associations between the Built Environment and Obesity: An Umbrella Review. International Journal of Health Geographics, 20, Article No. 7. https://doi.org/10.1186/s12942-021-00260-6 |
| [42] | Yoon, E., Chang, C., Kim, S., Clawson, A., Cleary, S.E., Hansen, M., et al. (2013) A Meta-Analysis of Acculturation/enculturation and Mental Health. Journal of Counseling Psychology, 60, 15-30. https://doi.org/10.1037/a0030652 |
| [43] | Loi, S., Li, P. and Myrskylä, M. (2025) Unequal Weathering: How Immigrants’ Health Advantage Vanishes over the Life-Course. Journal of Migration and Health, 11, Article ID: 100303. https://doi.org/10.1016/j.jmh.2025.100303 |
