Sedentary Behavior and Consumption of Sugar Sweetened Beverages Across Immigrant Generation Among Urban Adolescents in Boston, MA
Methods: We conducted secondary analysis on data from the 2008 Boston Youth Survey, a representative sample of 9th-12th-graders in public high schools in Boston, MA. Outcomes of interest were sedentary behaviors (n=1409), and consumption of soda or other sweetened fruit drinks (n=1438). The main predictor was immigrant generation: 1st (foreign-born in US <4 years); 1.5 (foreign-born in US >4 years); 2nd (US-born with >1 foreign-born parent) and 3rd (US- born with 2 US-born parents). We used generalized estimated equation models and accounted for clustering of students within schools to generate the relative risk (RR) of SSB consumption and sedentary behaviors among each immigrant generation group relative to 3rd generation youth.
Results: 1st and 1.5 generation youth were significantly less likely to consume soda (RR=0.57, 95% CI=0.36, 0.91 and RR=0.69, 95% CI=0.54, 0.90) and other SSB (RR=0.43, 95% CI=0.27, 0.69 and RR=0.53, 95% CI=0.36, 0.78) relative to 3rd generation; risk of SSB consumption among 2nd generation was indistinguishable from the referent group. Only 1st generation youth were significantly less likely than 3rd generation to view >2 hours of TV per day (RR= 0.65, 95% CI=0.45, 0.93); risk among 1.5 and 2nd generation youth were equal to 3rd generation. For video game and computer use, there were no significant differences in risk across immigrant generation groups.
Conclusions: Consumption of SSB may help explain the increase in obesity among immigrant youth shortly after arrival in the US. Adolescence is a critical period for establishing dietary and behavior patterns which endure into adulthood. The first few years after immigrant youth arrive in the US are crucial for the adoption of obesogenic behaviors, especially SSB consumption. Targeted marketing of SSB to poor, racial/ethnic minority youth, many of whom are immigrants, needs to be challenged. There is a window of opportunity when social workers in schools and communities can intervene to prevent an impending burden of obesity, and the associated adverse health and social sequelae among immigrant youth.