Chinese immigrants living in Australia show more cardiovascular risk factors the earlier they move and the longer they stay, according to research published Oct. 24 in the European Journal of Preventative Cardiology.

“Acculturation to western lifestyles includes adopting an unhealthy diet, with increasing consumption of processed food, saturated fat, sugars and soft drinks,” lead author Kai Jin, a PhD student at the University of Sydney, said in a press release. “These changes, as well as exposure to western lifestyles at an early age, may predispose immigrants to obesity and diabetes.”

Jin and colleagues studied a sample of 3,220 Chinese immigrants living in Australia, where they are the third-largest foreign-born group. Individuals in the study were an average of 59 years old and 56 percent were women.

Those who moved before the age of 18 were 71 percent more likely to have diabetes, 49 percent more likely to be overweight or obese and 47 percent more likely to have at least three cardiovascular risk factors than immigrants who moved as an adult. The researchers assessed six risk factors: hypertension, diabetes, high cholesterol, smoking, physical inactivity and being overweight or obese.

Immigrants in the study who had lived in Australia for at least 30 years were 84 percent more likely to have diabetes and three or more cardiovascular risk factors than those who had lived in Australia for less than a decade.

“Our study shows that a greater level of acculturation is associated with a worse cardiovascular risk profile, particularly overweight, obesity, and diabetes,” Jin said. “Chinese people who migrate as children or adolescents are more susceptible to acquiring risk factors, and susceptibility increases with length of residence.”

Jin et al. noted their findings were consistent with previous studies on Asian immigrants in North America. More than two million Chinese immigrants lived in the U.S. in 2014, while more than 500,000 lived in Australia in 2016, according to the authors.

“With the rapid increase in Chinese immigrants to Western countries, an understanding of links between risk factors and acculturation could help predict future burden of cardiovascular disease (CVD) among this group,” the researchers wrote. “These findings highlight the importance of both clinicians and policymakers proactively developing and implementing interventions to ameliorate CVD risk among Chinese immigrants. Future longitudinal studies with sensitive and specific acculturation measures could better inform the development of culturally-specific interventions to lower the burden of CVD risk-factors among Chinese immigrants.”