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Undernutrition has been documented in many of these populations. For example, in 2005, populations originating from 10 countries constituted 86% of all newly arrived refugees: Cuban, Ethiopian, Iranian, Laotian, Liberian, Russian, Somali, Sudanese, Ukrainian, and Vietnamese. Since the 1980s, refugee populations arriving in the United States have become more diverse, with increasing numbers of refugees arriving from Africa, Europe, and the Middle East. entries from Southeast Asia during this period likely contributed to the increases observed in overall rates of stunting among the general U.S. For example, during the influx of Southeast Asian refugees in the late 1970s and early 1980s, significant growth and nutritional disorders were reported within these cohorts.

Much of our understanding of the nutritional and developmental status of newly arrived refugees in the United States is based on studies of specific ethnic cohorts during defined periods.

Primary care should be established for ongoing monitoring of growth and development, age-appropriate nutritional screening as well as ongoing counseling and nutrition education.īackground General issues of nutrition in newly arriving refugees.

Culturally appropriate nutritional counseling and social support for food access should be provided.

Children (> 6 years) and adults may benefit from specific supplementation (see text).

All children 6 months-59 months of age should be prescribed an age- appropriate daily multivitamin.

Population-specific testing may be suggested in future guidelines when specific nutritional issues are identified (e.g., vitamin B12 deficiency in Bhutanese refugees).

Complete blood count (CBC) with differential, including red blood cell indices.

Examination for specific physical findings indicating undernutrition/ overnutrition or micronutrient deficiencies (see text).

For children younger than 2 years of age, growth indicators should be compared to WHO standardized growth references while Center for Disease Control and Prevention/National Center for Health Statistics (CDC/NCHS) references may be used for those over 2 years of age.

Body mass index (BMI) calculation for children older than 2 years and all adults –.

Recommended anthropometric indices used to characterize malnutrition include:.

Weight and height/length – to initiate longitudinal growth monitoring.A complete physical examination, including:.Dietary history – including habits, restrictions, and cultural dietary norms food allergies and known current and past nutritional deficiencies.Nutrition Evaluation during the Domestic Medical Examination.Overseas Pre-Departure Nutritional Screening for Refugees.