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Being on a 10-hour flight gives you plenty of time to think.
In my dad’s case, his thoughts were consumed by the infinite possibilities of what his life might be like in Canada.
He tried not to think about what he left behind in the Philippines. At 24, he was pursuing his university degree and was ready to propose to his long-term girlfriend (whom he would eventually marry years later). He decided to take a chance on an unfamiliar country far away, one that offered many opportunities for a better quality of life.
Dad was excited but nervous. As the eldest of four children, his parents instilled in him that he had to be a good example for his siblings and show strength. His emotions battled, but Dad knew he couldn’t let his anxiety win. So, he got on that plane in 1995 with his mother and three siblings and travelled over 10,000 kilometres to reunite with his dad, who had immigrated to Winnipeg two years before.
Dad told me that at some point during the flight, he hoped for a comfortable and healthy life in the country he’d soon call home.
My family’s story shares similarities with many other Filipino-Canadian immigrants who choose to leave the sunny, warm islands in pursuit of a better quality of life. Filipinos are the second-highest population of recent immigrants in Canada, but immigrating can be a lonely process.
Like my grandfather, many first-generation immigrants travel alone to establish financial stability before bringing the rest of their family over. Immigrants self-report higher levels of loneliness than people born in Canada, and this feeling doesn’t go away for a long time. Factors such as communicating with a language barrier and acculturation can contribute to mental health issues immigrants face. As the conversation about immigration and mental health gains traction within the Filipino diaspora, I can’t help but wonder how immigration affects physical well-being too.
Then I learned about the Healthy Immigrant Effect.
The Healthy Immigrant Effect is the phenomena of immigrants’ health deteriorating as they spend more time in the country they migrated to, despite initially being healthier than native-born residents. Factors that may contribute to the Healthy Immigrant Effect are again language barriers and difficulty with acculturation, along with other everyday stressors.
Many middle-aged Filipino immigrants share health issues like hypertension, high cholesterol, and Type 2 diabetes. While exercise and lifestyle choices play significant roles in developing these health problems, people tend to point a finger at Filipino cuisine as the main culprit. Filipino food has the reputation of being unhealthy. Many dishes feature meats like pork and beef and are paired with white rice. Eating large portions of white rice can increase the risk of developing Type 2 diabetes, and the risk increases by generation.
Type 2 diabetes occurs when the body can’t regulate glucose properly. One of the main risk factors for this health condition is being overweight. An inactive lifestyle with little to no exercise can increase the chances of getting Type 2 diabetes. These risk factors remain the same for developing high cholesterol levels.
However, calling Filipino food unhealthy is a harmful stereotype — and Filipinos are challenging it.
Adrienne-Rae Velasquez, a Filipino American nutritionist and dietician, reframes this idea by considering other factors. In one post on Instagram, she asks if Filipino food is unhealthy or if Filipinos adjusted to western cuisine during the American occupation in the Philippines.
Closer to home, Jackie Wild — a second-generation Filipina immigrant and the owner of the Tito Boy Restaurant in Winnipeg — said having preconceived notions about Filipino food is “a bit of a narrow view.”
“There are so many amazing, delicious, healthy options that just don’t have as much airtime,” Jackie said.

The Philippines has 17 regions and offers more than the beloved classic dishes like lumpia or egg rolls and pancit, a noodle-based dish with mixed vegetable. Some regions have seafood-based cuisine while others prepare dishes with unprocessed ingredients like coconut milk and freshly harvested vegetables.
“There are way more options than you can ever imagine that can support every type of dietary preference for today’s foodies and everyday eaters,” Jackie said.
And food may not be the sole factor that contributes to health issues Filipino migrants face — immigration may also play a role.
Dad was born in the Province of Tarlac in the 70s. Life in the province was slower than the hustle and bustle of Manila, the capital of the Philippines, but it wasn’t boring. Dad said there were always children laughing, playing, and running after each other. Teenage boys, including my dad, often played basketball on makeshift courts made of soil. Dad said he loved the adrenaline he felt from being active, and this love extended beyond sports. In university, he joined the Reserve Officers’ Training Corps. The drills were exhausting, but the feeling of accomplishment motivated him to finish each one. By the end of the program, he ranked as a sergeant.
In the Philippines, Dad lived a relatively healthy life. He was happy, and he had no health concerns, much like everyone else in his family. He maintained an active lifestyle until he moved to Canada.

When he landed in Winnipeg in April 1995 with his mother and siblings, he said he was stunned by how quiet the city was. Compared to Manila, Winnipeg was so still — and so cold. He worried he would freeze.
“We were wearing nothing but t-shirts, long sleeves and pants, but your grandpa was waiting outside for us, holding our jackets,” he told me.
Dad had another concern: what would he eat? He assumed there would be no Filipino food in a western country, let alone any Asian restaurants. In fear of not being able to eat food he was familiar with, he stuffed his suitcase with his favourite Filipino snacks and hoped he would survive.
When Dad got to his new house, he found two warm, familiar dishes on the table: afritada, which is a tomato-based stew with pork, and pancit. The ingredients were relatively easy to find despite the limited Asian products in the 90s. Dad said he was surprised, but delighted that he didn’t have to adjust his diet. From then on, he ate the same way he did when he was living in the Philippines — except he started frequently having pierogies for breakfast.
One study compared the prevalence of Type 2 diabetes for Filipinas living in the Philippines, Hawaii, and San Diego. It found there was an increased risk for Type 2 diabetes for the women living in Hawaii and San Diego — the ones who’ve “adopted a western lifestyle.” At this point, there aren’t enough studies to make conclusions about how a western lifestyle contributes to the increased prevalence of health conditions, but one theory suggests that access to an abundance of food may play a role.
This access to food can be difficult to obtain in the Philippines. In 2022, the World Food Programme reported that more than one in 10 households in the Philippines were food insecure, with around 20 million Filipinos living below the poverty line.
With these large portions of food readily available when they hadn’t been before, who wouldn’t say no to a plate or two?
Two years after moving to Winnipeg, Dad noticed how much weight he had gained. He was confused, as he hadn’t incorporated anything new into his diet. He ate the same rotation of Filipino dishes every day, with a beer or two every Friday. He hadn’t been exercising and going out as often as before because long winter months made it difficult to do so. Dad recalled feeling like he was always in a sauna back in the Philippines. He would sweat just by standing still. Missing the thrill of playing sports, he started to play basketball at community centres with other Filipinos once a week.
His lifestyle remained the same for decades, even after having my brother and me. He noticed he was eating more meals than ever before. With more money in his pockets, he took advantage of the abundance of food and ate as much as he pleased.
In 2011, he applied to a college program. He figured going back to school would help our family financially. Taking classes, studying, working part-time, and keeping bellies full at home didn’t give him much time to prioritize his health.
Following a general check-up with his doctor later that year, Dad was diagnosed with hypertension and high cholesterol. His doctor prescribed him several medications that regulated these conditions, like rosuvastatin, which helped to lower the “bad” cholesterol in his body. He religiously took these medications for several years.
One February morning in 2016 when he was 40 years old, Dad woke up to pain in his foot. The joint next to his big toe was swollen, tender, and warm to the touch — all signs of gout, a type of inflammatory arthritis. After getting his doctor to squeeze him in for an appointment, he sat in a crowded waiting room with the throbbing pain. He recalled feeling like his suffering was “endless.” He couldn’t do anything but sit with the pain and hope for his name to be called. After waiting for what seemed like hours, Dad’s doctor formally diagnosed him with gout and prescribed two medications he would continue to use for years to come: colchicine for the swelling and narcotics for the pain.
He wasn’t shocked by this diagnosis — he’d seen it coming. He hadn’t been watching his health, and his parents also had gout. Having a family member with gout increases the likelihood of developing it. His mother had developed it shortly after they had immigrated to Winnipeg. He thought that it was only natural that he would get it, too.
After his first gout flare-up, he tried to eat healthier meals and smaller portions, but he couldn’t fully commit to it — he just didn’t have the time. He opted for dishes and snacks that were easy to make and eat but lacked adequate nutritional value.
“That was a big mistake,” Dad said. “I didn’t learn my lesson back then and didn’t change my lifestyle habits.”
The trajectory of his life changed in 2022 when he experienced the most excruciating flare-up he’d ever had.
The pain felt different. It wasn’t a dull, throbbing feeling like the flare-ups before. It was a sharp pain in his ankle joint. Up until that point, he only had flare-ups in his feet, which he could still manage. This time, with his ankle swollen, even the slightest movement would lead to pain, which made walking difficult. He had run out of colchicine and narcotics weeks before, and his doctor was on vacation. Dad was stuck.
He remembered being bedridden, staring at the ceiling and crying. He regretted eating pork rinds the day before, he regretted not putting in more effort in exercising, and most of all, he regretted neglecting his health. He remembered praying to God to make his suffering stop. Dad was sure that if the pain continued, he would die.
I was at home with my dad during this flare-up. Although I was in another room attending class online, I knew when he would move because he would cry out from the pain. When I checked on him, I remember being shocked by the sight of my dad hugging his leg in the fetal position. Seeing your parent in such a vulnerable state isn’t something you easily forget. I eventually left class to get pain relievers for him.
When he finally met with his doctor days later, Dad was able to get his hands on the medicine he needed to alleviate the pain and swelling. His doctor ordered him to get a blood test done and a urinalysis. His doctor advised him to watch the foods he was putting in his body and to come back a month later when the results were in.
The test results weren’t good.
Dad learned that he was in the prediabetes stage and had stage three chronic kidney disease. His kidneys could no longer efficiently filter out the toxins in his body. The estimated glomerular filtration rate (eGFR) indicates the rate of the kidney’s function levels, and having a high eGFR is ideal. The average eGFR is 60, but Dad’s was 46.
Sensing Dad’s anxiety about the results, his doctor calmed him down by assuring him he still had a chance to improve his health. Upon hearing this, Dad went on a strict diet. Although he struggled with hunger, he stopped overindulging in food and used tiny plates to be mindful of his portions. When the swelling and pain from his ankle subsided, he started exercising again. He started playing basketball more frequently. He started cycling everywhere, even biking to places outside of the city.
At his follow-up appointment, Dad’s doctor was shocked at his new appearance. He lost a significant amount of weight from his new routine. His doctor informed him he had increased his eGFR from 46 to 49.
Dad was ecstatic. He was proud of himself for putting his health first, something he had been unable to do before.
It shouldn’t have been a surprise to me when my own doctor told me I had abnormally elevated cholesterol levels, but I was only 19.
The small sterile white room seemed to get smaller after she said that. I was anxious but mainly confused. I was undoubtedly not exercising enough nor eating the healthiest meals, but my poor lifestyle and eating habits didn’t seem like they would be that detrimental to my health — to which my doctor agreed. I remember her frowning at her computer as she studied my blood test results. She said these poor levels were common to see in older people — not in someone in her teens. My doctor immediately put me on rosuvastatin, and she referred me to an internal medicine specialist.
I didn’t want to be on rosuvastatin for the rest of my life, so I tried to cure myself “naturally” by limiting my food intake. I didn’t want to exercise, and on top of being lazy, I was also a university student working part-time. Finding time for a workout was difficult, or so I rationalized. I figured that if I controlled my eating habits I could go back to my life before I had high cholesterol. So I starved myself. I would fast for hours and watch videos of people eating junk food just to satiate my own hunger. Every time I allowed myself to eat, I would think about my cholesterol levels rising, which I imagined would result in my untimely death. These thoughts would be enough to scare me into eating palm-sized portions of food, or only eating once a day.
This disordered eating method worked for a while. I was able to lower my cholesterol levels to a number that was slightly above average, and my doctor was pleased with the work I was putting into becoming a healthier person. However, I knew feeding myself through videos wasn’t sustainable, and this had began to show. I wasn’t skinny, but my face looked gaunt. I was lethargic for most of the day, and I never felt fully present. It felt like I was hanging on a thin piece of thread that anchored me to reality.
Inevitably, I gave in to eating large portions again, and the weight came back. At my next appointment, both my cholesterol and blood sugar levels were high. It was at that same appointment that my doctor told me that I was prediabetic.
I thought of the other young, overweight people in my life who seemed to be doing just fine. I started to wonder why I had to be the one to develop these health issues only older people seemed to have.
After some time, the specialist I had been seeing told me that my health conditions weren’t solely my fault — they were also genetic to some degree. All my paternal aunts, uncles, and grandparents had high cholesterol and were also taking medication to regulate it, but they were in their late 30s and 40s. It seemed like I had gotten the short end of the stick by developing it so young.
It’s been years since I was diagnosed, and since then, I’ve been working to repair my relationship with food. I had antagonized food and grew fearful of it. I didn’t realize I was feeding into diet culture, which diet culture and anti-fat bias author Virginia Sole-Smith says can seep into other aspects of life that we’re passionate about. I never thought of my method of food restriction as a means to be skinny, but rather to prevent further health conditions. In this process, I followed the “all-or-nothing” mindset that diet culture often reinforces. I still have times when I revert to this mindset, but I try to remember that by thinking this way, I am punishing the very body that keeps me alive.
I also try to remember that this body is the one my parents sacrificed so much for — the least I can do is take care of it.
Jackie opened the Tito Boy Restaurant in October 2022. The restaurant’s menu consists of both traditional and fusion Filipino dishes. Jackie wanted to create an intersection between the old and new, and to celebrate all the ways you can be Filipino.
The restaurant isn’t just her dream. It’s also Tito Boy’s — her dad. Tito Boy, otherwise known as Agustin Doming, grew up in the Philippines in the provincial farmlands of Southern Leyte, often helping his mother prepare meals in their kitchen. His passion for cooking didn’t stay in that kitchen. He wanted to open a restaurant.

When Tito Boy first came to Winnipeg, he had to put his dreams on hold. Jackie described this period of her father’s life as “being in survival mode.” Starting a restaurant in a new country with limited resources was off the table. He had to support his family first, so his first job was washing dishes at a hotel. Eventually, he was able to pursue culinary school but realized he wasn’t able to have a healthy work-life balance in the industry and decided to quit. Tito Boy then started a 16-year-long career as a health care aide, and during this time he was able to help his family back home by opening a restaurant in Manila. Jackie said she remembers how the light glimmered in her dad’s eyes when he opened that restaurant. She wanted to help him establish his legacy in the country he immigrated to, leading to the opening of Tito Boy Restaurant — a home away from home.
Like Jackie, I also want to give back to my dad and make him proud. Many second-generation immigrants carry the weight of our parents’ sacrifices — we want to ensure their sacrifices were worth it. When I think about how my dad developed health issues during his pursuit of creating a better life for me, I feel guilty. He neglected his health to put mine first. This is the reality and mindset of many immigrant parents. When the opportunity for their kids to have a better quality of life presents itself, they take it — even if it puts them at a disadvantage.

Although the Healthy Immigrant Effect is a phenomena many Canadian immigrants experience, there isn’t enough research to fully explain why it happens and how to prevent it. In a paper about the HIE, author Mahsa Athari notes that Canada can help by implementing health care policies that support immigrants. Athari suggests three methods to manage the Healthy Immigrant Effect: a migrant sensitive health strategy for healthcare professionals, cultural sensitivity training, and monitoring immigrants’ health.
Immigration and its hidden ramifications are complex, but these suggestions are a start in understanding the Healthy Immigrant Effect.
Shortly after learning his health had improved, my dad and I went for a walk one morning. The sun had just started peeking through the clouds. It was slightly chilly, but we insisted on braving the cold to honour our commitment to “being healthy.” Looking back, I definitely should’ve worn something warmer, but I don’t think I would’ve wanted to experience that morning any other way. My dad and I talked and talked during that two-hour walk, from mundane topics to juicy family gossip.
I struggled to keep up because he’s a fast walker. He often left me trailing him a couple of meters behind, teasing me that a man in his 50s can beat someone much younger. We finished that walk feeling accomplished — we were both taking charge of our health. My dad and I are still in the process of choosing a healthier lifestyle. We still have a long way to go, but doing it together makes it worthwhile.
I’m sure this wasn’t exactly the life or health conditions my dad had dreamed of when he immigrated to Canada, but through his sacrifices he’s helped me get closer to the life I envision for myself — and for that, I am eternally grateful.