Improved social integration shapes female body composition in Turkish migrants

Background Turkish migrants in Western Europe exhibit higher adiposity than non-migrants, yet how integration policies shape body composition beyond body mass index (BMI) remains underexplored. Objectives To examine how contrasting integration regimes — integration-oriented (Germany) versus multicultural (Netherlands) — shape body composition in Turkish adults, focusing on sex-specific biocultural adaptations. Sample and Methods Cross-sectional study of 478 Turkish adults (aged 18–65 years) across Türkiye, Germany, and the Netherlands. Standardised anthropometry assessed BMI, detailed body composition, and frame index. Analyses comprised regression modelling and St. Nicolas House Analysis (SNHA). Results Germany and the Netherlands independently predicted elevated arm fat area (AFA) relative to Türkiye (β=0.061–0.073, p<0.05). Country independently predicted AFA variance in females (ΔR²=0.025, p=0.017), with Germany predicting higher arm muscle area (AMA; β=0.128, p=0.031). Principal component regression identified a country-of-residence dimension, which may reflect differences in integration policy context, explaining 12.0% of variance in both outcomes (p<0.001). In males, cross-country differences were largely accounted for by age. SNHA revealed sex-specific network organization in Türkiye. In migrant subgroups, the education/income association was restructured or absent, negatively mediated through return intention in Dutch males, and partially embedded in the body composition cluster in Dutch females. Conclusions Country of residence — interpreted as a partial, indirect proxy for integration policy context alongside other unmeasured factors — was independently associated with body composition in female migrants. Sex-responsive public health interventions are needed to address structural determinants of migrant well-being.