Nutritional Status and Obstacles to Healthy Eating Among Refugees in Geneva

Abstract

Refugees face various nutritional challenges during and after migration. This cross-sectional, mixed-methods study seeks to investigate the prevalence of undernutrition and obesity among refugees in Geneva, and to identify barriers to healthy eating. Anthropometric measurements of 354 adult refugees were collected between 2017 and 2019 by trained nurses and dietitians. Seven focus group discussions totaling 51 participants, refugees and social workers, investigated conceptions and needs regarding diet. The mean Body Mass Index is 24.6 ± 4.8 kg/m2. Women are disproportionately affected by obesity compared to men (p < 0.001). Weight gain post-migration is correlated positively with length of stay in Geneva (p < 0.001). Major obstacles to healthy eating are economic and linguistic. For participants, cooking workshops and free physical activities are highly needed interventions. Post-migration lifestyle interventions should be implemented to prevent weight gain in this population. Such interventions must be multi-level, to overcome structural, social and behavioral barriers to healthy eating.

Food environment interactions after migration: a scoping review on low- and middle-income country immigrants in high-income countries

“…Eating out at ethnic restaurants. Amstutzet al, 2020 (90) To investigate the prevalence of undernutrition and obesity among refugees in Geneva and to identify barriers to healthy eating.…”

“…Finally, a total of sixty-eight articles were eligible for inclusion. Out of sixty-eight articles, the vast majority (forty five) studied populations living in the USA ; ten were based in Canada (70)(71)(72)(73)(74)(75)(76)(77)(78)(79) , seven from Australia (80)(81)(82)(83)(84)(85)(86) , three from the UK (87)(88)(89) , one from Switzerland (90) , one from Norway (2) and one from the Netherlands (91) . The immigrant groups were from Asia, Africa, Middle East, South and Central America and the Caribbean.…”

“…Food prices were often high in relation to the income of immigrants (74) , which was a hindrance for buying food (42,64,86) . This was particularly relevant for nutritious food like fruits, vegetables fish and meat that were more expensive (28,29,52,61,65,(84)(85)(86)90) . Culturally specific foods were also considered more expensive (28,40,53,57,58,63,(73)(74)(75)(76)78,80,81,84,85) , particularly in places where there was a low presence of these foods (84) .…”

“…Food values refer to immigrants' desire for high quality, fresh, chemical-free and unprocessed foods, in particular fruits and vegetables, natural foods in their natural state (33,35,41,53,58,64,85,90) , perceived as good for health (41,43,69,75) . Fresh and homemade foods were important to immigrants (65) .…”

“…To afford fruits and vegetables, they frequented market stalls or Pulgas (52) , as well as buying foods on sale (50) or buying seasonal foods (47) . When the budget was tight, quantity was prioritised over quality (25,46,90) . Fresh produce was weighed against more satiating higher energy foods such as fast food and meat when making decisions based on a limited budget (54) .…”