Risk factors for obesity and high blood pressure in Chinese American children: maternal acculturation and children's food choices

Self-Care Behaviors and Associated Factors Among Hypertensive Patients at Dessie Referral Hospital, Northeast Ethiopia

Introduction: Hypertension poses a significant global health challenge, leading to serious health conditions and premature death. Effective blood pressure control is often hindered by patients' nonadherence to self-care behaviors. This study evaluates these behaviors and their influencing factors among hypertensive patients at Dessie Referral Hospital, Ethiopia. Methods: Conducted from October 20 to November 30, 2019, this mixed-methods study involved 370 hypertensive patients from the hospital's outpatient clinic. Data were collected via structured questionnaires and analyzed using multivariable logistic regression. Additionally, 14 in-depth interviews provided qualitative insights, analyzed thematically. Results: Only 29.4% of patients fully adhered to self-care recommendations. Urban dwellers showed 70% less adherence than rural counterparts. Adherence varied with the duration since diagnosis, with medium-duration patients being less likely to adhere. Interviews revealed personal strategies for managing diet, exercise, medication, and lifestyle, highlighting the struggle with adherence and innovative solutions to challenges. Conclusion: Adherence to self-care among hypertensive patients is alarmingly low, influenced by diagnosis duration, residency, and BMI. Addressing hindrances like living conditions, work, cultural norms, and peer influence is vital. Healthcare providers must focus on education that promotes behavior change and support. Patient engagement in self-care is essential. Future research should investigate healthcare organizational and provider influences. Implementing these strategies could markedly improve hypertension management and patient outcomes.

Prevalence and associated factors of overweight and obesity among Afghan school children: A cross-sectional analytical study from Kandahar City, Afghanistan

BACKGROUND

Childhood overweight and obesity is an emerging public health problem in developing countries. This is the first school-based study of its type from Afghanistan to estimate the prevalence and associated factors of overweight and obesity among Afghan school children aged 6-18 years in Kandahar City of Afghanistan.

METHODS

This cross-sectional analytical study was conducted among 2281 school children from January 10-April 15, 2024. Sociodemographic properties, anthropometric measurements, and other data were collected from all the participants. Data were analyzed using descriptive statistics, Chi-square test, and multiple logistic regression analysis.

RESULTS

Among the 2281 enrolled children, 72.5% were boys, 65.1% going to private schools, and 53.8% poor. The prevalence of overweight and obesity was 11.5% (6.6% were overweight and 4.9% were obese). The mean (SD) age was 12.7 (2.1) years. By logistic regression analysis, statistically significant risk factors associated with overweight and obesity were being boy (AOR 1.5 and 95% CI 1.1-2.0), student of private school (AOR 2.2 and 95% CI 1.5-2.8), belonging to a rich family (AOR 1.9 and 95% CI 1.3-2.7), and parental obesity (AOR 1.5 and 95% CI 1.1-2.0).

CONCLUSION

School children of Kandahar city are suffering from overweight/obesity. Overweight/obesity should be dealt with as an emerging problem in school children of Kandahar city. It is recommended that Afghanistan ministries of education and public health, with the help of international donor agencies, such as WHO and UNICEF, work together in controlling overweight and obesity in school children of Kandahar city. Periodic special awareness programs on the prevention and control of overweight/obesity should be conducted in schools, radio, television, and other sources of social media.

Obesity among Asian American people in the United States: A review

Standard measures of obesity, i.e., body weight and BMI, suggest that Asian American people have a lower obesity prevalence than other racial groups in the United States. However, Asian American people face a unique challenge in their pattern of adiposity with central obesity, which raises the risk for multiple comorbidities, such as type 2 diabetes, metabolic syndrome, and cardiovascular disease, at a lower BMI compared with other populations. Several organizations recommend lower BMI cutoffs for obesity in Asian people (BMI ≥25.0 or ≥27.5 kg/m² ) instead of the standard ≥30.0 kg/m² threshold. The risks of obesity and related comorbidities in this population are further influenced by diet, physical activity, perceptions of health, and access to information and therapies. Asian-specific parameters for assessing obesity should become a standard part of clinical practice. Asian American people should equally be offered subgroup-specific tailored interventions owing to heterogeneity of this population. Access to medications and surgery should be improved, in part by updating US indications for therapies to reflect race-specific obesity thresholds and through inclusion of Asian American people of all subtypes with lower BMI values in clinical trials.

A qualitative investigation of the health behaviours of young children from refugee families using photo elicitation interviews

Objectives

To explore the experiences and perspectives of refugee parents regarding health behaviour changes among their children (i.e. changes in diet, levels of physical activity) and the impact of these changes on the health of their children aged 2–12 years.

Design

A qualitative approach using semi-structured interviews supported by photo-elicitation.

Methods

Parents of 2–12 years old children who had relocated to the UK within the past three or more years were recruited from two refugee organisations in the UK. Semi-structured face-to-face interviews and photo-elicitation were used to stimulate face-to-face in-depth discussions with participants. Data were analysed using an inductive and latent thematic analysis approach.

Results

Twenty-seven parent refugees were recruited. Participants were primarily mothers (85%) and from Syria (70%). Other countries of origin were Sudan, Eritrea, Iraq, Kuwait, Libya and Tunisia. Twenty-six interviews were conducted in Arabic and one in English. The analysis identified three themes: (1) Reflection on acculturation, (2) Changed parental role, and (3) Environmental barriers to being healthy. Participants described facing substantial changes to their lifestyle and personal context, including a restricted living space, restricted neighbourhood/community and inclement weather. These differences in the environment required parents to adjust their roles, and practices around their own and their child’s eating habits. These changes influenced refugee children’s health behaviours. Of particular concern to parents were increased sedentary behaviour and consumption of unhealthy snacks.

Conclusions

Multiple factors were identified relating to changes in family circumstances and environments that influenced refugee children’s health behaviours. Targeting these behaviours in tailored interventions may help improve refugee children’s health.

Obesity and Obesogenic Behaviors in Asian American Children with Immigrant and US-Born Mothers

Child obesity is understudied in Asian Americans, which include a growing population of recent immigrants. We examined the relationship between maternal nativity and time in the US, and obesity and obesogenic behaviors among Asian American children. We analyzed public-use data from the 2013-2016 California Health Interview Survey for Asian American children ages 2 to 11 years. We used logistic regression to determine the odds of obesity and obesogenic behaviors associated with maternal nativity and time in the US. This study included n = 609 children. Children of US-born mothers had lower odds of obesity (adjusted odds ratio, AOR, 0.12; 95% CI 0.02 to 0.91) and lower fruit intake (AOR 0.15, 95% CI 0.03 to 0.81) than children of recent immigrants (< 5 years in the US). Asian American children with recent immigrant mothers are more likely to be obese and eat less fruit than children with US-born mothers. Efforts to prevent obesity and increase fruit consumption are particularly important for this vulnerable population of children of recent immigrants.

"Food is Environmentally and Culturally Specific!": A Preliminary Qualitative Study on U.S. Immigrant Parents' Perceptions of School Lunch

Children spend most of their day hours in school, so the dietary choices they make during school days are important for their childhood development and later life. This research examined food choices among immigrant families with school-age children in Indiana, USA. Open-ended questions were answered by 52 immigrant parents in 2017. Parents who answered the questions had children in classes ranging from kindergarten to grade 12. NVivo 11 was used for the initial analysis of the dataset, and several themes were identified. After the initial analysis, the data were categorized into major themes to condense the themes. Thirty-eight (73%) of the respondents indicated that their children ate school lunch, 14 (27%) indicated that they prepared lunch for their children to eat at school, and 39 (75%), mostly from non-industrialized countries, indicated that their children ate their home-country staple foods for dinner and on non-school days. Parents indicated that schools are serving the needs of immigrant children by serving varieties of foods during lunchtime.

State-of-the-Science Review of Non-Chemical Stressors Found in a Child's Social Environment

Background: Children are exposed to chemical and non-chemical stressors from their built, natural, and social environments. Research is needed to advance our scientific understanding of non-chemical stressors, evaluate how they alter the biological response to a chemical stressor, and determine how they impact children’s health and well-being. To do this, we conducted a state-of-the-science review of non-chemical stressors found in a child’s social environment. Methods: Studies eligible for inclusion in this review were identified through a search of the peer-reviewed literature using PubMed and PsycINFO. Combinations of words associated with non-chemical stressors and children were used to form search strings. Filters were used to limit the search to studies published in peer-reviewed journals from 2000–2016 and written in English. Publications found using the search strings and filters went through two rounds of screening. Results: A total of 146 studies met the inclusion criteria. From these studies, 245 non-chemical stressors were evaluated. The non-chemical stressors were then organized into 13 general topic areas: acculturation, adverse childhood experiences, economic, education, family dynamics, food, greenspace, neighborhood, social, stress, urbanicity, violence, and other. Additional information on health outcomes, studies evaluating both chemical and non-chemical stressors, and animal studies are provided. This review provides evidence that non-chemical stressors found in a child’s social environment do influence their health and well-being in both beneficial (e.g., salutatory effects of greenspace and social support) and adverse (e.g., poor relationships between health and selected non-chemical stressors such as economics, educational attainment, exposure to violence, stress) ways. Conclusions: This literature review identified a paucity of studies addressing the combined effects of chemical and non-chemical stressors and children’s health and well-being. This literature review was further complicated by inconsistencies in terminology, methodologies, and the value of non-chemical stressor research in different scientific disciplines. Despite these limitations, this review showed the importance of considering non-chemical stressors from a child’s social environment when addressing children’s environmental health considerations.

Healthy Living Behaviors Among Chinese-American Preschool-Aged Children: Results of a Parent Survey

Associations between diet, physical activity, parenting, and acculturation among Chinese-American children are understudied. Parents/caregivers of children attending child-care programs in Boston Chinatown completed a self-administered survey on demographics, child's diet, physical activities, anthropometrics, and parenting practices. Associations were evaluated in multivariable regression analysis, stratified by survey language preference, a proxy for acculturation. Responding Asian families = 132; 86.4% were immigrants; 75.8% completed the Chinese-version survey. Children (mean ± SD: 4.9 ± 1.1 years) did not eat vegetables (31.8%), or play actively outside (45.4%) daily, 64.8% watched television/screens daily; 32.6% were overweight/obese (based on parent report). Parenting practices associated with obesity were apparent. Although healthy-living behavioral outcomes were less prevalent among less acculturated parents; multivariable adjustment attenuated the observed significant differences. Findings suggest opportunities for improvement in study children's diet and healthy-living behaviors, and underscore the need for further research on acculturation, and parenting styles in this population.

Socio-demographic factors associated with overweight and obesity among primary school children in semi-urban areas of mid-western Nigeria

BACKGROUND

Many developing countries are in a state of nutritional transition from prevalent under-nutrition to the emergent problem of over-nutrition (overweight and obesity), which is associated with increased morbidity and mortality, and whose complications can persist into adulthood with long-term consequences. However, data are limited on the risk factors for overweight and obesity (O&O) among primary school children, particularly those in rural and semi-urban areas in these countries.

AIM AND OBJECTIVES

To determine the socio-demographic factors associated with overweight and obesity among primary school children in semi-urban areas.

SUBJECTS AND METHODS

1187 school pupils aged 6-11 years recruited from semi-urban areas using multistage sampling were interviewed for risk factors of overweight and obesity using a structured questionnaire. Nutritional status was assessed using body mass index and this was classified using a standard method. The proportions were compared using Pearson's chi-squared. Multivariate logistic regression analysis was also carried out with overweight and obesity as the dependent variable and socio demographic factors as independent variables. The level of statistical significance was set at p <0.05 in all the statistical analyses.

RESULTS

Fifty-eight pupils (4.9%) had overweight and obesity while 1129 (95.1%) were either of normal nutritional status (1088, 91.6%) or were thin/severely thin (41, 3.5%). Among those with overweight and obesity, 41 (3.5%) were overweight and 17 (1.4%) obese. A higher prevalence of overweight and obesity was significantly associated (in unadjusted analysis) with female gender [unadjusted Odds Ratio, OR (95% CI) = 2.42 (1.37, 4.28)], attendance at private schools [OR (95% CI) = 3.34 (1.86, 6.00)], higher socio-economic status families [OR (95% CI) = 2.32 (1.65, 5.80)] and presence of a television in the pupil's bedrooms [OR (95% CI) = 2.22 (1.02, 4.82)] on bivariate analyses. However, only gender, school type and family socioeconomic status were independently associated with overweight and obesity on multivariate logistic regression analysis.

CONCLUSION

We conclude that overweight and obesity among primary school pupils in semi-urban areas is associated with female gender, attendance at private schools and higher socioeconomic status families. Preventive programmes should accordingly be more directed at children from affluent families; particularly those who are females and those attending private schools.

An integrated experiential training programme with coaching to promote physical activity, and reduce fatigue among children with cancer: A randomised controlled trial

OBJECTIVE

This study examined the effectiveness of an integrated programme in promoting physical activity, reducing fatigue, enhancing physical activity self-efficacy, muscle strength and quality of life among Chinese children with cancer.

METHODS

A randomised controlled trial was conducted in a Hong Kong public hospital. Seventy eligible children were randomly assigned to an experimental group (n = 37) or a control group (n = 33). The experimental group received an integrated programme with 28 home visits from coaches over a 6-month period. The control group received a placebo intervention. The primary outcome was fatigue at 9 months (3 months after intervention completion). Secondary outcomes were physical activity levels, physical activity self-efficacy, muscle strength and quality of life at 9 months, assessed at baseline, and 6 and 9 months after starting the intervention.

RESULTS

The experimental group reported significantly lower levels of cancer-related fatigue, higher levels of physical activity and physical activity self-efficacy, greater right- and left-hand grip strength and better quality of life than the control group at 9 months.

CONCLUSION

The programme is effective and feasible to implement among children with cancer and offers an alternative means of ameliorating the healthcare burden.

PRACTICE IMPLICATIONS

Healthcare professionals should build multidisciplinary partnerships to sustain such programmes.

Correlates of elevated blood pressure in healthy children: a systematic review

The prevalence of hypertension in children is increasing globally. Addressing this will require a robust understanding of associated risk factors. To this end, we conducted a systematic review to identify correlates of elevated blood pressure (BP) in children. Literature searches were conducted using pre-defined search terms from three academic databases. The abstract and full text of identified studies were screened for eligibility by two independent reviewers. A total of 100 studies were included in this systematic review. An assessment tool was first used to assess study quality; a narrative synthesis was then performed. We found a broad range of physiological, social and behavioural factors associated with elevated BP in children. The most common correlate observed was adiposity, suggesting that childhood obesity may be implicated in the increased prevalence of hypertension observed in children. However, the broad range of other factors identified underscores the multi-factorial aetiology of hypertension. Data from a broad range of studies showed that the correlates of hypertension in children are multi-factorial. Therefore, approaches aimed at preventing hypertension must in turn be multi-factorial to ensure that the burden of hypertension in childhood is addressed.

Association between acculturation and body weight status among migrant children in Guangzhou, China: a cross-sectional study

OBJECTIVE

To assess the association between acculturation and body weight status among internal migrant children in China.

DESIGN, SETTING AND PARTICIPANTS

A cross-sectional study was conducted among 1154 pairs of migrant children aged 11-17 years and their primary caregivers in Guangzhou, China, from April to May 2016.

MEASURES

Migrant children's body weight status was measured by body mass index. Acculturation was measured by a questionnaire, developed and validated by the research team. The questionnaire had three dimensions with five factors, namely language, social interaction, custom, dressing and diet. Social anxiety was measured by Social Anxiety Scale for Children. Food intake was measured by the food frequency table that was developed from a previous study. Logistic regression was performed to examine the association between acculturation and overweight/obesity while controlling for migrant children's and their caregivers' demographic characteristics, children's social anxiety and food intake.

RESULTS

Seventy-six out of 1154 (6.6%) migrant children were overweight, and 36 (3.1%) were obese. The overall prevalence of overweight/obesity was 12.5% in boys, and 6.1% in girls (p<0.001), respectively. The mean scores of acculturation were 41.8 (SD=14.6). Migrant children had the highest level of acculturation in the aspect of dressing (mean=61.7, SD=16.6), followed by language (mean=47.9, SD=22.3), diet (mean=45.0, SD=18.5), social interaction (mean=42.4, SD=21.3) and custom (mean=27.6, SD=19.2). After controlling for confounding factors, the levels of acculturation was negatively associated with overweight/obesity (adjusted OR (aOR)=0.98, 95% CI 0.97 to 1.00, p=0.030). Furthermore, migrant children who had urban-to-urban migrant caregivers were more likely to be overweight/obese (aOR=2.07, 95% CI 1.16 to 3.69, p=0.014) than their counterparts living with rural-to-urban migrant caregivers.

CONCLUSIONS

The low levels of acculturation was associated with overweight/obesity among migrant children in Guangzhou, China. Promoting healthy acculturation and social campaign on healthy body weight may help prevent childhood overweight/obesity. Young migrant children, boys and children living with urban-to-urban migrant caregivers should be the target subgroups.

Adventure-based training to promote physical activity and reduce fatigue among childhood cancer survivors: A randomized controlled trial

BACKGROUND

Cancer-related fatigue is one of the most distressing symptoms reported by childhood cancer survivors. Despite the body of evidence that regular physical activity helps alleviate cancer-related fatigue, insufficient participation in physical activity is frequently observed among childhood cancer survivors.

OBJECTIVES

This study examined the effectiveness of an adventure-based training programme in promoting physical activity, reducing fatigue, and enhancing self-efficacy and quality of life among Hong Kong Chinese childhood cancer survivors.

DESIGN

A prospective randomised controlled trial.

SETTINGS

A paediatric oncology outpatient clinic, a non-governmental organisation, and a non-profit voluntary organisation.

PARTICIPANTS

Hong Kong Chinese childhood cancer survivors aged 9-16 years who reported symptoms of fatigue and had not engaged in regular physical exercise in the past 6 months.

METHODS

The experimental group underwent a 4-day adventure-based training programme. The control group received a placebo intervention. The primary outcome was fatigue at 12 months. Secondary outcomes were physical activity levels, self-efficacy and quality of life at 12 months. Data collection was conducted at baseline, and 6 and 12 months after the intervention began. We performed intention-to-treat analyses.

RESULTS

From 6 January, 2014 to 8 June, 2015, we randomly assigned 222 eligible childhood cancer survivors to either an experimental (n = 117) or a control group (n = 105). The experimental group showed statistically significantly lower levels of cancer-related fatigue (P < 0.001), higher levels of self-efficacy (P < 0.001) and physical activity (P < 0.001), and better quality of life (P < 0.01) than the control group at 12 months.

CONCLUSIONS

This study provides evidence that adventure-based training is effective in promoting physical activity, reducing cancer-related fatigue, and enhancing self-efficacy and quality of life among Hong Kong Chinese childhood cancer survivors. These results may help inform parents and healthcare professionals that regular physical activity is crucial for the physical and psychological wellbeing and quality of life of childhood cancer survivors.

Acculturation and weight change in Asian-American children: Evidence from the ECLS-K:2011

Despite relatively low rates of overweight and obesity among Asian-American children, disparities exist based on acculturation, socioeconomic status, and Asian ethnicity. The purpose of this study was to examine the association between acculturation and weight change in Asian-American children. Secondary aims were to compare changes by Asian ethnic group and acculturation x socioeconomic status. Participants included 1200 Asian-American children from the Early Childhood Longitudinal Study, Kindergarten Class of 2010-11, a longitudinal study of U.S. children attending kindergarten in 2010-2011. Multinomial logistic regressions were conducted to predict weight change based on body mass indices in kindergarten (spring 2011) and second grade (spring 2013): consistently healthy weight, consistently overweight/obese, healthy weight change, and unhealthy weight change. Models included demographic, household, socioeconomic status, and acculturation measures, specifically mother's English proficiency and percentage of life spent in the U.S. Overall, 72.3% of children were at healthy weights in kindergarten and second grade. Of all Asian ethnic groups, Filipino children had the highest rate of being consistently overweight/obese (24.8%) and the lowest rate of being consistently healthy weight (62.9%). In addition, mother's English proficiency predicted unhealthy weight change (OR: 0.83; 95% CI: 0.75-0.92) and healthy weight change (OR: 0.75; 95% CI: 0.65-0.86), relative to "consistently healthy weight." English proficiency also predicted being consistently overweight/obese for children with less educated mothers. Findings enhance our understanding of obesity disparities within Asian Americans and highlight the need to disaggregate the population. Obesity interventions are needed for Filipino children and families with low socioeconomic status but high English proficiency.

Dietary Patterns among Vietnamese and Hispanic Immigrant Elementary School Children Participating in an After School Program

Immigrants in the U.S. may encounter challenges of acculturation, including dietary habits, as they adapt to new surroundings. We examined Vietnamese and Hispanic immigrant children’s American food consumption patterns in a convenience sample of 63 Vietnamese and Hispanic children in grades four to six who were attending an after school program. Children indicated the number of times they consumed each of 54 different American foods in the past week using a food frequency questionnaire. We ranked each food according to frequency of consumption, compared the intake of foods to the USDA Healthy Eating Pattern, and performed dietary pattern analysis. Since the data were not normally distributed we used two nonparametric tests to evaluate statistical significance: the Kruskal–Wallis tested for significant gender and ethnicity differences and the Wilcoxon signed-rank test evaluated the food consumption of children compared with the USDA recommended amounts. We found that among USDA categories, discretionary food was most commonly consumed, followed by fruit. The sample as a whole ate significantly less than the recommended amount of grains, protein foods, and dairy, but met the recommended amount of fruit. Boys ate significantly more grains, proteins, and fruits than did girls. Dietary pattern analysis showed a very high sweet snack consumption among all children, while boys ate more fast food and fruit than girls. Foods most commonly consumed were cereal, apples, oranges, and yogurt. Ethnicity differences in food selection were not significant. The high intake of discretionary/snack foods and fruit, with low intake of grains, vegetables, protein, and dairy in our sample suggests Vietnamese and Hispanic immigrant children may benefit from programs to improve diet quality.

Ethnic-group socioeconomic status as an indicator of community-level disadvantage: A study of overweight/obesity in Asian American adolescents

Asian American children and adolescents are an under-investigated subpopulation in obesity research. Informed by a wide socioeconomic diversity among Asian American ethnic groups, this study explored ethnic-group socioeconomic status (SES) as an indicator of community-level disadvantage that may influence overweight/obesity in Asian American adolescents. We hypothesized that ethnic-group SES was inversely associated with overweight/obesity in Asian American adolescents. Multiple logistic regression models were fitted using a sample of 1525 Asian American adolescents ages 12-17 from pooled 2007-2012 California Health Interview Survey (CHIS) data. Age, gender, nativity, individual-level SES (income and education), and two lifestyle variables (fast food consumption and physical activity) were controlled for. We found that adolescents in high- or middle-level SES ethnic groups were far less likely to be overweight/obese than those in low-SES ethnic groups. Further, these relationships were more pronounced for foreign-born adolescents but not significant for U.S.-born adolescents. Ethnic-group SES may be a meaningful indicator of community-level socioeconomic disparities that influence the health of Asian Americans and, potentially, other populations with high proportions of immigrants of diverse socioeconomic and ethnic backgrounds.

What are Asian-American youth consuming? A systematic literature review

Numerous studies have explored dietary practices among children, but there are limited studies on children of Asian background in the US. This review had three aims: (a) review literature regarding Asian-American youth's dietary behaviors, (b) critically evaluate the methodological quality of such research, and (c) provide recommendations for future nutrition-related research on Asian-American youth. The authors conducted a systematic literature review through MEDLINE (EBSCO), CINAHL Plus with Full Text (EBSCO), and Embase (Ovid); extracted descriptive data; and evaluated methodological quality. Thirteen articles were included. Major findings included: (a) frequent consumption of milk, fruit, meat, unenriched white rice, vegetables, and high-fat and high-sugar items among Asian-American children and (b) acculturation's influences on diet, resulting in Asian-American youth consuming diets characterized by both Asian and American foods. Findings from this review may inform education and promotion programs and services for Asian Americans in the US.

Psychosocial aspects of type 1 diabetes in Latino- and Asian-American youth

Latino and Asian-Americans represent the fastest growing immigrant populations in the United States. We aimed to review the current knowledge on the psychosocial factors that influence type 1 diabetes (T1D) care, education, and outcomes in Latino and Asian-American youth immigrants in the United States, as well as culturally sensitive programs to address health disparities. We conducted a narrative, conceptual review of studies on T1D in Latino and Asian-American youth and relevant studies in type 2 diabetes and adults. Approximately 50% of both Latino and Asian-American youth with T1D are in suboptimal glycemic control. Socioeconomic status, literacy, English proficiency, acculturation, access to health care, family functioning, mental health, and nutrition influence T1D care and outcomes. However, the degree to which these complex, inter-related and dynamic factors affect long-term T1D outcomes is largely unknown. Culturally sensitive programs for Latino or Asian-American youth with T1D are scarce in the United States. Research is needed among Latino and Asian-American youth with T1D so that comprehensive, culturally sensitive diabetes education, and care programs can be developed to decrease disparities in the health burden of these groups.

Ethnicity, socioeconomic status, and overweight in Asian American adolescents

Asian American children and adolescents are an under-investigated subpopulation in obesity research. This study aimed to identify specific profiles of Asian subgroups at high risk of adolescent overweight with special attention to Asian ethnicity, socioeconomic status (SES), and their interaction. Multiple logistic regression models were fitted using a sample of 1533 Asian American adolescents ages 12–17 from the 2007–2012 California Health Interview Survey (CHIS). In addition to Asian ethnicity and socioeconomic status (assessed by family income and parental education level), age, gender, nativity, and two lifestyle variables, fast food consumption and physical activity, were also controlled for in these models. Key predictors of overweight in Asian American adolescents included certain Asian ethnicities (Southeast Asian, Filipino, and mixed ethnicities), low family income (< 300% of the Federal Poverty Level), and being male. Multiplicative interaction terms between low family income and two ethnicities, Southeast Asian and Vietnamese that had the lowest SES among Asian ethnic groups, were significantly associated with greatly elevated odds of being overweight (ORs = 12.90 and 6.67, respectively). These findings suggest that high risk of overweight in Asian American adolescents associated with low family incomes may be further elevated for those in low-income ethnic groups. Future research might investigate ethnic-group SES as a meaningful indicator of community-level socioeconomic disparities that influence the health of Asian Americans.

•

Southeast Asian and Filipino ethnicities were associated with adolescent overweight.

•

Low family income was positively associated with Asian adolescent overweight.

•

Ethnicity and low family income interacted to increase risk of adolescent overweight.

Maternal Cultural Orientation and Child Growth in New Zealand Pacific Families

BACKGROUND

In New Zealand (NZ), children of Pacific heritage are generally born heavier and gain weight more quickly than non-Pacific children. Immigrants' health is commonly expected to converge with the host population through acculturation. The aim of this analysis was to examine whether mothers' acculturation is associated with less-rapid weight gain in NZ Pacific children, and whether this differs by mothers' nativity.

METHODS

In a birth cohort of 1249 children followed 2000-2011, birth weight and weight and standing height, measured at years 2, 4, 6, 9, and 11, were quantified as sex- and age-specific weight (weight-for-age; WFA) and BMI z-scores. Maternal acculturation (range, 11-54) was assessed at baseline and years 4, 6, and 11.

RESULTS

In adjusted models using generalized estimating equations to account for repeated measures, maternal acculturation was not significantly associated with children's WFA or BMI z-scores overall. In stratified analyses, change in maternal acculturation score was inversely associated with WFA z-score change among children of NZ-born, but not immigrant, mothers (beta=-0.021; 95% confidence interval, -0.036 to -0.007; p=0.006; interaction, p=0.005).

CONCLUSIONS

Our study provides the first evidence in a longitudinal sample that changes in maternal acculturation can influence children's growth, suggesting the importance of lifestyle or behavioral factors related to a mother's cultural orientation. Given the high risk of obesity and its related conditions in the NZ Pacific population, critical next steps are to identify mediating factors, as well as to understand the processes influencing growth among children of immigrant mothers.

Effect of Internet-based Intervention on Obesity among Adolescents in Kuala Lumpur: A School-based Cluster Randomised Trial

BACKGROUND

Co-morbidities in adulthood is a significant problem and is associated with obesity during adolescent.

METHODS

This 3-months randomised controlled trial was aimed at determining the effectiveness of having internet-based intervention (obeseGO!) toward obesity among adolescents in Kuala Lumpur. Forty seven students were assigned randomly to the obeseGO! (intervention) group for internet-based intervention i.e., information on healthy lifestyle and diet were provided via the internet. Fifty students were assigned to the control group, where pamphlets containing health education were provided to these students. The measurement of body mass index (BMI), waist circumference, and the body fat percentage was taken at baseline and after 12 weeks of intervention.

RESULTS

The multivariate analysis of variance (MANOVA) analysis found that obeseGO! had a small effect in reducing BMI, waist circumference and body fat percentage.

CONCLUSION

The internet-based obesity intervention program may be an effective medium for promoting healthy diet and physical activity among the obese adolescents.

Obesogenic Dietary Practices of Latino and Asian Subgroups of Children in California: An Analysis of the California Health Interview Survey, 2007-2012

OBJECTIVES

We examined obesogenic dietary practices among Latino and Asian subgroups of children living in California.

METHODS

We analyzed 2007, 2009, and 2011-2012 California Health Interview Survey data to examine the differences in dietary practices among Mexican and non-Mexican Latino children and 7 ethnic subgroups of Asian children. We used multivariable regression to examine the sociodemographic factors associated with specific dietary practices.

RESULTS

Latino subgroups of children had few differences in obesogenic dietary practices, whereas Asian subgroups of children exhibited significant differences in several obesogenic dietary practices. Korean and Filipino children were more likely than Chinese children to consume fast food and have low vegetable intake. Filipino children, followed by Japanese children, had the most obesogenic dietary practices compared with Chinese children, who along with South Asian children appeared to have the least obesogenic dietary practices. In general, income, education, and acculturation did not explain the dietary differences among Asian groups.

CONCLUSIONS

Our findings suggest the need to disaggregate dietary profiles of Asian and Latino children and to consider nontraditional sociodemographic factors for messaging and counseling on healthy dietary practices among Asian populations.