Vol.:(0123456789) 1 3 Journal of Immigrant and Minority Health https://doi.org/10.1007/s10903-020-00970-2 ORIGINAL PAPER Diet, Physical Activity and Weight‑Related Behaviors, Changes and Risks with Newly‑Arrived (< 1 Year) Immigrant and Refugee Adolescents (Ages 12–17) Lauren R. Sastre 1  · Lauren Haldeman 2 © Springer Science+Business Media, LLC, part of Springer Nature 2020 Abstract Adolescent immigrants and refugees are at elevated risk for obesity, however, gaps remain regarding specifc diet and life- style changes. This study examined: (1) weight status, behaviors and perceptions, (2) diet patterns and changes, (3) sociode- mographic and dietary factors associated with BMI. Cross sectional survey, anthropometric measures were conducted at a school for newcomer youth in North Carolina. Data analysis included descriptive, frequency, bivariate and linear regression. Participants (n = 68, 55% female, < 1 year US) included immigrants and refugees ages 12–17. Thirty-one percent were over- weight or obese. Forty-seven percent had attempted to lose weight. Positive weight perceptions were associated with normal BMI (p = 0.010). Fruit, milk, fruit juice, soda, and meat consumption increased post-arrival (p = 0.037, p = 0.010, p = 0.003, p = 0.044, p = 0.014, respectively). Dietary change was positively associated with BMI (p = 0.002). Adverse diet and lifestyle changes occur rapidly, are associated with obesity, and weight control behaviors and concerns warrant early intervention. Keywords Adolescent · Emigrants and immigrants · Refugees · Life style · Diet · Food and nutrition · Acculturation · Obesity Background Over one-third of the immigrants and refugees that arrived in the United States (US) in 2016 were children and adoles- cents [1–3]. The under-eighteen, foreign-born population is projected to increase by 29.8% between 2014 and 2060 [4]. The ongoing infux of immigrant and refugee “newcomers” is reshaping the US population. There is scant research on immigrant and refugee children and adolescents, despite increases in number and documented risks. Although research is limited, some nutrition and health risks have been identifed for newcomer households, children, and adoles- cents. Exposure to the host country and resulting adaptations have been associated with the “immigrant paradox” in which the newcomer’s health declines as they acculturate [5]. The Multidimensionality of Acculturation Model proposed by Schwartz and colleagues expands the concept of accultura- tion, suggesting that the process is highly variable and infu- enced by ethnicity, cultural similarity, discrimination, and the context of reception [5]. The acculturation process and its complexities also vary by generation. Younger generations have been found to adopt and/or increase consumption of less healthful foods [e.g. sugar-sweetened beverages (SSB), convenience (e.g. fast foods, pre-prepared foods], resulting in parental frus- tration [6–16]. These rapid changes likely occur as children and adolescents are exposed to new foods at school. Dietary changes or acculturation can also result in improved nutrient acquisition with the adoption of some foods, like increased calcium; however, increases in fat and total caloric intake also occur and are associated with increases in body-mass index (BMI) and blood pressure [17–21]. Adolescents and children who report less dietary changes also report better diet quality and higher consumption of fruits and vegetables [22–24]. Limited changes and maintenance of traditional foods may ofer a protective efect on diet quality. Although * Lauren R. Sastre sastrel18@ecu.edu Lauren Haldeman lahaldem@uncg.edu 1 Department of Nutrition Science, East Carolina University, Greenville, NC 27858, USA 2 Department of Nutrition, University of North Carolina at Greensboro, Greensboro, NC 27412, USA