Guided grocery store trips, menu labeling at restaurants, community gardens, and video-game-based exercise programs are among several promising, culturally appropriate ways to prevent obesity among Latino children, according to a new collection of studies from Salud America! The Robert Wood Johnson Foundation Research Network to Prevent Obesity Among Latino Children published in a supplement to the March issue of the American Journal of Preventive Medicine.
Salud America! is a national network of researchers, advocates, and policymakers established in 2007 that seeks environmental and policy solutions to Latino childhood obesity, an American epidemic.
The supplement focuses on Salud America! achievements over the past five years, including 19 papers of groundbreaking research. It also features three commentaries authored by a range of political and medical leaders—such as San Antonio Mayor Julián Castro and Harvey V. Fineberg, President of the Institute of Medicine.
Each paper considers the context of Latino culture, health conditions, and/or policies in places where Latino children and families live, work, learn, play, and pray.
“This supplement is the culmination of several years of diligence, passion, and hard work in identifying and examining the most promising policy-relevant strategies to reduce and prevent obesity among Latino children,” say supplement editors Amelie G. Ramirez, DrPH, MPH, director of Salud America! and the Institute for Health Promotion Research at The University of Texas Health Science Center at San Antonio, and Guadalupe X. Ayala, PhD, MPH, of the Division of Health Promotion and Behavioral Sciences in the Graduate School of Public Health at San Diego State University. “In addition to fueling new research findings, Salud America! helped to increase the skills and experience of researchers working in the field, and further expand the national Salud America! research network. The ranks of those working to reverse the country’s obesity epidemic are getting stronger each day.”
In the United States, Latinos are currently the most populous and fastest-growing ethnic minority. About 44 percent of Latino boys and 38 percent of Latino girls are either overweight or obese, compared with an average rate of 31 percent. Children who are overweight or obese are more likely to remain so later in life, which can put them at greater risk for long-term health conditions, such as high blood pressure, type 2 diabetes, and some forms of cancer.
According to the National Council of La Raza, there are more than 16 million Latino children under the age of 18 living in the United States. The number of Latino children has increased by 30 percent since 2000 and doubled since 1990, making them one of the fastest growing segments of the U.S. population. And as of May 2010, 38.2 percent of Hispanic children ages 2 to 19 were overweight or obese, compared with 31.7 percent of all children, according to the Leadership for Healthy Communities.
The National Council of La Raza reports that one out of two Latino children born in the year 2000 will develop diabetes. “That is the statistic that should be our wake-up call,” said Jennifer Ng’andu, deputy director of the council’s health policy project, where she oversees efforts to improve the health status and outcomes of Latinos through national policy change.
Latinos are especially at risk because their communities often lack access to affordable healthy foods, according to the Leadership for Healthy Communities. Hispanic neighborhoods have one-third as many chain supermarkets as other neighborhoods.
“This is not just a health and exercise issue. This is an academic and social justice issue. This is about making sure people have access to information and resources so that they can make healthy choices,” said Ng’andu.
The supplement presents Salud America! studies that sought effective approaches for preventing and controlling obesity among Latino children. The studies represent work conducted in eleven states and a variety of participants, research methodologies, and outcomes.
Within the Latino community, studies concluded that:
Owners of small, independent restaurants can improve access to healthy menu options and continue to publish calorie information on their menus
Tending community gardens or attending nutrition and cooking workshops improved or maintained children’s body mass indices and increased the presence of fruits and vegetables in the home
Capitalizing on the interconnectedness of one’s faith and health, religious communities can serve as conduits for obesity prevention programs that offer faith-oriented cooking classes, health education, and physical activity opportunities
A child’s participation in an afterschool fitness program can increase the likelihood of subsequent fitness over a two-year period
Barriers related to transportation, language, and school communication can negatively affect families’ physical activity
Policy development and environmental change are possible to stimulate physical activity, based on a study administered within the United States – Mexico border colonias
Exercise also poses tricky problems for Latino children struggling with weight, as many live in disadvantaged areas may make it tough for them to play outside or walk to school.
From a physical point of view - in terms of sidewalks and litter - those areas tend to be in worse shape than an average neighborhood, Franzini said. But her research also suggests that the social component of a neighborhood affects children’s physical activity levels.
“It’s not sufficient to just clean up the neighborhood - pick up the trash and build sidewalks,” said Franzini, whose study on the impact of neighborhoods’ social characteristics was published earlier this year in the American Journal of Public Health. “It also needs to be a neighborhood where people feel safe and they feel that they can go out and walk and run and exercise and do whatever they want to do.”
To that end, Franzini’s research indicates that those Latinos living in tight-knit communities often get more exercise than those in more mixed neighborhoods.
“Having a neighborhood which is more connected, where people feel safe - I think it’s all a matter of feeling empowered in a way. And so those who feel that they have this stronger neighborhood from a social point of view, they are also more likely to be physically active,” Franzini said.
Within schools, a team of investigators concluded that using active video games can increase cardiorespiratory endurance and math scores over time among Latino students.
Within the Latino family, studies focused on the effectiveness of a variety of interventions:
An intervention involving nutrition education about food selection and a guided trip to the grocery store resulted in a decrease in the total number of calories per dollar spent, challenging the common perception that purchasing healthy foods costs more money
A summertime intervention of parental training and guidance to support healthy lifestyle choices among mothers, combined with a program of exercise, nutrition education, and behavioral counseling for their daughters, produced a significant reduction in the percentage of body fat and waist circumference for the girls
Among migrant workers, parents were not as concerned about overweight children as they were obese children, indicating the need for more community education and prevention programs
In his commentary, George R. Flores, MD, MPH, asserts, “Research represented in the Salud America! supplement is noteworthy because it represents good science and new information about a population and problem that deserve much greater attention, was produced with a minimum of resources, and provided opportunities for professional growth to a number of early career scientists. For its foresight and support of Salud America!, The Robert Wood Johnson Foundation merits acclaim.”
Elsevier Health Sciences