Paradox of overweight and obesity in children from low-and-middle-income countries: Evidence from Australian Cohort study
02:00pm to 04:00pm

Children whose families originate from low-and-middle-income-countries, with relatively low rates of obesity, consistently show an excess risk for overweight and obesity relative to the host population, including those with high rates such as Australia. Why this occurs is not clear, although some explanations focus on socioeconomic disadvantage as the mechanism.


The current study utilises data of 4606 children from wave 2-6 of the birth cohort of the Longitudinal Study of Australian Children.  Exposure variable was maternal ethnicity classified by the economic development of her family of origin’s country. Outcome variable was proportion of overweight and obese children according to the International Obesity Taskforce, using age-and sex-specific BMI cutoff-points.


The study results show that at baseline 23% children were overweight and obese with no significant differences between children of mothers from low-and-middle-income-countries,  children of Australian-mothers and children of mothers from other high-income-countries. However, overweight and obesity increased significantly from the age of 4-5 years in children of  mothers from low-and-middle-income-countries compared to other groups.  Repeated, cross-sectional multiple logistic regresson modelling indicated that family socioeconomic position does not explain excess overweight and obesity risk in children of mothers from low-and-middle-income-countries at any of the developmental stages. Preliminary examination of the data demonstrated differences in outcomes for sons and daughters. The risk of overweight and obesity in daughters of mothers from low-and-middle-income-countries was significantly higher at 4-5 years (77% p= 0.001) and in sons at 8-9 year (45% p=0.04)) and 10-11 year old (47%, p=0.04) compared to daughters and sons of immigrant mothers from high-income-countries and Australian-born mothers.


Our study concludes that the paradox of excess weight in children is not due to socioeconomic disadvantage alone. There may be other social and cultural processes involved, and possibly interactions between immigrant and host cultures of food, weight, gender and health.

Tehzeeb Zulfiqar
National Centre for Epidemiology and Population Health | Research School of Population Health | The Australian National University

Dr Tehzeeb Zulfiqar is an International Medical graduate, with a background in maternal, child health and nutrition. Her earlier clinical practice involved working with the Afghan refugees based in Pakistan. Later, she worked as a public health specialist in the community health and nutrition programs in Pakistan.


Before moving to Australia, She was a country director of Oxford policy management, a British consultancy firm where she was involved in many surveys and evaluations of health programs in Pakistan.


She did her MPH from the Australian National University with high distinction in 2014. She is now pursuing her PhD with Research school of population health at the Australian National University on a prestigious Australian Endeavour scholarship. Her PhD topic is “overweight and obesity in children of Australian immigrants from low-and-middle-income-countries”.