Cultural Variables Underlying Obesity in Latino Men: Design, Rationale and Participant Characteristics from the Latino Men's Health Initiative

Support Provided by Caregivers for Community-Dwelling Obesity Individuals: Focus on Elderly and Hispanics

Obesity is a chronic disease marked by the buildup of extra adipose tissue and a higher chance of developing concomitant illnesses such as heart disease, diabetes, high blood pressure, and some malignancies. Over the past few decades, there has been a global increase in the prevalence of obesity, which now affects around one-third of the world's population. According to recent studies, a variety of factors, including genetics and biology as well as environmental, physiological, and psychosocial factors, may have a role in the development of obesity. The prevalence of obesity is often higher among Hispanic American groups than among White people in the U.S. Obesity is a widespread condition with a high risk of morbidity and death, and it is well-recognized that the prevalence of comorbidities rises with rising levels of obesity or body mass index. To combat the rising prevalence of obesity in the USA, especially among Hispanics, one of the fastest-growing racial/ethnic groups in the country, there is an urgent need for obesity therapies. The exact cause of this disparity is unclear, but some responsible factors are a lack of education, high unemployment rates, high levels of food insecurity, an unhealthy diet, inadequate access to physical activity resources, a lack of health insurance, and constricted access to culturally adequate healthcare. Additionally, managing obesity and giving needed/timely support to obese people is a difficult responsibility for medical professionals and their loved ones. The need for caregivers is increasing with the increased number of individuals with obesity, particularly Hispanics. Our article summarizes the status of obesity, focusing on Hispanic populations, and we also highlight specific factors that contribute to obesity, including genetics, epigenetics, biological, physiological, and psychosocial factors, medication and disease, environment, and socio-demographics. This article also reviews caregiver duties and challenges associated with caring for people with obesity.

Mexican and Puerto Rican Men's Preferences Regarding a Healthy Eating, Physical Activity and Body Image Intervention

This study examined the logistical, practical, and cultural preferences of Latinos regarding the design of a healthy eating, physical activity, and body image intervention. Puerto Rican and Mexican men (n = 203) completed an interview as part of an NIH-funded study. Overall, 66.5% preferred the intervention to be in Spanish only or both Spanish and English; 88.67% said it was moderately, very or extremely important for the intervention leader to be bilingual; and 66.01% considered it moderately to extremely important for the leader to be Hispanic or Latino. Most participants (83.74%) reported they would be willing to attend an intervention that met twice per week and 74.38% said they would be willing to attend an intervention that met for 1.5 to 2 h, twice weekly. Overall, the majority said they would be moderately to extremely interested in attending an exercise program if it consisted of aerobics with Latin or salsa movements (74.88%) and if it consisted of aerobics with Latin or salsa music (70.44%). Some participants were moderately to extremely interested in attending an intervention if it included dichos (Latino sayings) (65.02%) and cuentos (folktales or stories) (69.46%). The findings have implications for lifestyle and body image interventions aimed at preventing cardiometabolic diseases.

Clustering of Health Risk Behaviors in Mexican and Puerto Rican Men: Results from the Latino Men's Health Initiative

Engaging in multiple health risk behaviors simultaneously may increase the risk for cardiometabolic diseases. This study examined the prevalence and clustering of three health behaviors (physical activity, fruit and vegetable consumption, and smoking) among Latino men. The participants were 99 Mexican and 104 Puerto Rican men who participated in a study addressing culture- and obesity-related factors. The health behaviors were obtained from self-reported and anthropometric assessments through objective measurements. Among all participants, 5% had no health risk behaviors, 30% had one, 47% had two, and 18% had all three; their most common health risk behavior cluster was low physical activity and low fruit and vegetable consumption (28%). Among Puerto Rican men, 7% had no health risk behaviors, 24% had one, 51% had two, and 18% had all three; their most common health risk behavior cluster was current smoker and low fruit and vegetable consumption (28%). Among Mexican men, 3% had no health risk behaviors, 36% had one, 43% had two and 19% had all three; their most common health risk behavior cluster was low physical activity and low fruit and vegetable consumption (33%). The findings highlight the need for lifestyle interventions that target multiple health risk behaviors related to cardiometabolic diseases in Latinos.

Associations of Acculturation and Gender with Obesity and Physical Activity among Latinos

Objective: Latinos disproportionately experience overweight/obesity (OWOB) and insufficient physical activity (PA), which are risk factors for numerous health conditions. Whereas numerous studies investigate acculturation as a determinant of OWOB and PA, few have examined acculturation multidimensionally, and none has examined its interaction with gender. Methods: Participants were 140 Latino adults. Primary outcomes were status as OWOB and endorsement of insufficient PA. Acculturation was measured with the Multidimensional Acculturation Scale II. Logistic regression analyses were used to examine the moderating effect of gender on the relationship between each acculturation scale and outcome, controlling for education, nativity, and smoking status. Results: Greater Spanish proficiency was significantly associated with lower odds of insufficient PA. Greater American Cultural Identity was significantly associated with higher odds of OWOB. Women had significantly higher odds of endorsing insufficient PA compared to men. Gender did not moderate the relationship between acculturation and either OWOB or PA. Conclusions: Acculturation is similarly associated with OWOB and insufficient PA for Latino men and women. Cultural identity may need to be considered to target OWOB interventions. Acculturation may be less important, and gender more important, to consider for appropriate targeting of PA interventions.

Misreporting Weight and Height Among Mexican and Puerto Rican Men

Most obesity prevalence data rely on self-report, which typically differs when compared to objectively measured height, weight, and body mass index (BMI). Given that Latino men have high rates of obesity in the United States and demonstrate greater misreporting compared to Caucasian men, examining the factors that contribute to misreporting among Latino men is warranted. This study examined BMI, Latino ethnic background (Mexican or Puerto Rican), and social desirability in relation to misreporting of BMI, as defined as the discrepancy between self-reported and measured height and weight, in Latino men. Participants were 203 adult Mexican and Puerto Rican men, average age 39.41 years, who participated in a larger study. Participants self-reported their weight and height, had their weight and height objectively measured, and completed a measure of social desirability. Measured BMI was the strongest predictor of misreporting BMI, such that the greater the participants' BMI, the greater the discrepancy in BMI (p < .001). Misreporting of BMI did not vary based on ethnic background, and measured BMI did not moderate the relationship between social desirability and misreporting of BMI. When normative error was distinguished from misreporting in post-hoc analyses, results showed that only 34.5% of participants demonstrated misreporting. Findings highlight the importance of identifying normative error when examining misreporting in order to improve the accuracy of self-reported BMI data. Future research on misreporting for Latino men should include weight awareness, acculturation, and length of U.S. residency as these variables may be related to self-reported weight and height.

Mapping Canadian Men's Recent and Intended Health Behavior Changes Through the Don't Change Much Electronic Health Program

Background

Although evaluation studies confirm the strong potential of men’s electronic health (eHealth) programs, there have been calls to more fully understand acceptability, engagement, and behavior change to guide future work. Relatedly, mapping of behavior changes using health promotion theories including the transtheoretical model (or stages of change) has been recommended to build a translatable empirical base to advance design and evaluation considerations for men’s eHealth programs.

Objective

This study aimed to use a benchmark sample as a reference group to map the recent and intended health behavior changes in Canadian men who use the Don’t Change Much (DCM) eHealth program. The hypothesis being tested was that increased exposure to DCM would be positively associated with men’s recent and intended health behavior changes.

Methods

DCM users (n=863) were sampled for demographic data and self-reported recent and intended health behavior changes. Respondents also reported their usage (frequency and duration) for each of the 3 DCM components (web, newsletter, and social media) and were allocated to limited exposure (257/863, 29.8%), low exposure (431/863, 49.9%), and high exposure (175/863, 20.3%) subgroups. A benchmark sample (n=2000), comprising respondents who had not accessed DCM provided a reference group. Bivariate analysis of recent and intended health behavior changes and DCM exposure levels were used to compute the strength of association between the independent variables (exposure levels) and the 10 categorical dependent variables (recent and intended health behavior changes). Binary logistic regression models were computed for each of the 10 recent and intended health behavior changes. Linear regression was used to model the association between the number of recent and intended changes and the level of exposure to DCM.

Results

Compared with the benchmark reference group, DCM high-exposure respondents had significantly increased odds for 9 of the 10 health behavior changes, with the largest effect size observed for Changed diet or Improved eating habits (odds ratio [OR] 5.628, 95% CI 3.932-8.055). High-exposure respondents also had significantly increased odds for 9 intended health changes, with the largest effect sizes observed for Reduce stress level (OR 4.282, 95% CI 3.086-5.941). Moderate effect size (goodness of fit) was observed for increased total number of recent (F_12,2850=25.52; P.001; adjusted R²=.093) and intended health behavior changes (F_12,2850=36.30; P.001; adjusted R²=.129) among high-exposure respondents.

Conclusions

DCM respondents contrasted the predominately precontemplative benchmark sample mapping across the contemplative, preparation, and action stages of the transtheoretical health behavior change model. Almost 10% of variation in the recent and 13% of variation in the intended health behavior changes can be explained by DCM exposure and demographic factors, indicating the acceptability of this men’s eHealth resource.

Body Image, Physical Activity and Cultural Variables Underlying Race and Ethnicity among Latino Men

BACKGROUND

Overweight and obesity is a significant public health concern among Latino men. Common correlates of obesity that have been examined in previous studies are diet, physical activity, and body image.

OBJECTIVES

The aim of this study was to examine whether or not there are differences in body image, physical activity and cultural variables between Mexican and Puerto Rican men.

METHODS

Participants completed a health and culture interview, anthropometric measures, a dietary assessment, and an objective measure of physical activity. The results are from the 203 participants who completed the health and culture interview.

RESULTS

Mexicans and Puerto Ricans did not differ in their current and ideal body image, body image discrepancy, body satisfaction or how they described their weight. Puerto Ricans watched a greater number of hours of television per day than Mexicans (p < .01). There were no significant differences in their participation in any regular activity designed to improve or maintain their physical fitness, the number of times or length they engaged in this activity, or in their perceived exertion during this activity. Puerto Ricans reported a higher level of familism (p < .01) and machismo (p < .05) than Mexicans. There were no ethnic differences in folk illness beliefs, fatalism or personalism, acculturation level, acculturative stress, or ethnic identity.

CONCLUSIONS

Results are discussed in relation to the development of healthy eating, physical activity and body image interventions for Puerto Rican and Mexican men.

Social Support for Exercise as a Predictor of Weight and Physical Activity Status Among Puerto Rican and Mexican Men: Results From the Latino Men's Health Initiative

Social support is an important factor in increasing positive health outcomes and positive health behaviors across a variety of disease states including obesity. However, research examining the relationship between social support for exercise and weight and physical activity status, particularly among Latino men, is lacking. This paper examined whether social support for exercise predicted weight and physical activity status and whether the direction of these relationships differ as a function of Hispanic/Latino background (Puerto Rican/Mexican). Participants were 203 men who participated in a National Institutes of Health (NIH)-funded study addressing culture- and obesity-related variables. Both family participation social support and family rewards and punishment social support predicted higher weight status (p < .005 and p < .05, respectively). Friend participation social support did not predict weight status. The direction of the relationship between weight status and family participation social support, family rewards and punishment social support, and friend participation social support did not significantly differ as a function of Hispanic/Latino background. The direction of the relationship between physical activity status and family participation social support, family rewards and punishment social support, and friend participation social support did not significantly differ as a function of Hispanic/Latino background. Findings suggest that increased social support for exercise from family members may be focused on those who need it most—overweight and obese participants. Additional research is needed to explore sociocultural factors that may promote social support, physical activity, and weight loss and maintenance in Puerto Rican and Mexican men.