Ethnic Differences in Correlates of Obesity between Latin-American and Black Women

Latina Women, Obesity, and Culture: Design, Rationale, and Participant Characteristics of the ¡Viva la Cultura Latina! Community-Based Study

OBJECTIVES

Due to the high rates of overweight and obesity in Mexican and Puerto Rican women, interventions that target these groups are in great need. The purpose of this cross-sectional study is to explore the role of four cultural variables (acculturation, acculturative stress, ethnic identity, and cultural values) that may help to explain ethnic disparities in correlates of obesity (diet, physical activity, and body image) among Mexican and Puerto Rican women. This paper describes the study design, measures, and initial analyses of participant characteristics, as well as implications for the development of an obesity intervention.

METHODS

A total of 552 participants contacted the study staff, with 368 completing the oral script and initial eligibility interview. From these, 227 completed the written consent, 199 completed the "Health and Culture" interview, and 186 completed all study components; 42 women completed the qualitative interview. Data for the current study is from the 199 participants who completed the "Health and Culture" interview.

RESULTS

Mexican women were younger, more likely to have completed less than a 9th grade education, and more likely to prefer to complete the interview in Spanish (vs. English) compared to Puerto Rican women. In addition, Mexican women were more likely to be in the normal-weight group, be a non-smoker, and not have health insurance compared to Puerto Rican women.

CONCLUSION

Results revealed key initial differences between Puerto Rican and Mexican women which should be considered when developing interventions that address overweight and obesity.

Consumption of Sugary Drinks among Urban Adults in Colombia: Association with Sociodemographic Factors and Body Adiposity

INTRODUCTION

Calories from sugar-sweetened beverages (SSBs) contribute to the development of noncommunicable diseases. There is limited knowledge of the intake of SSBs and their correlates in developing countries. Thus, this study aimed to estimate the consumption of multiple SSBs and their sociodemographic correlates in an urban adult population from Colombia, South America.

METHODS

This was a probabilistic, population-level study of adults aged 18 to 75 from five cities representing different regions of Colombia. Dietary intake was assessed employing a 157-item semiquantitative food frequency questionnaire that inquired about intake over the last year. The consumption of regular soda, low-calorie soda, homemade and industrialized fruit juices, energy drinks, sport drinks, malt drinks and traditional sugar cane infusion ("agua de panela") was analyzed for the total sample and subgroups defined by sociodemographic and clinical factors of interest.

RESULTS

The study included 1491 individuals (female: 54.2%, mean age: 45.3, overweight: 38.0%, obese: 23.3%). Sugary beverages contributed, on average, 287 Cal/d among women and 334 Cal/d among men, representing 8.9% of total daily calories (TDC). Women in the lowest SEL consumed 10.6% of their TDC from sugary drinks, as opposed to 6.6% for those in a high SEL. For men, this difference was not present (p-value for interaction = 0.039). Interestingly, a higher educational level correlated with a lower consumption of calories from sugary drinks only among men. Fruit juices were by far the main source of sugary drinks, and their consumption did not change sizably by sex and socioeconomic or educational level. Among women, there was a negative association between socioeconomic level (SEL) and consumption of regular soda, a 50% difference between extreme levels. The intake of low-calorie soda was much higher among men than women, and it more than tripled in the highest vs. lowest SEL among men. The consumption of energy drinks was heavily concentrated in men of low SEL.

CONCLUSION

Colombian urban adults obtain a considerable proportion of their calories from sugary drinks, especially vulnerable groups such as women with lower education. Given the recent acceleration of the obesity epidemic in Latin America, strategies to limit the intake of such liquid calories may provide important public health benefits.

Racial variations of adverse perinatal outcomes: A population-based retrospective cohort study in Ontario, Canada

Introduction

Racial differences in adverse maternal and birth outcomes have been studied in other countries, however, there are few studies specific to the Canadian population. In this study, we sought to examine the inequities in adverse perinatal outcomes between Black and White pregnant people in Ontario, Canada.

Methods

We conducted a population-based retrospective cohort study that included all Black and White pregnant people who attended prenatal screening and had a singleton birth in any Ontario hospital (April 1^st, 2012-March 31^st, 2019). Poisson regression with robust error variance models were used to estimate the adjusted relative risks of adverse perinatal outcomes for Black people compared with White people while adjusting for covariates.

Results

Among 412,120 eligible pregnant people, 10.1% were Black people and 89.9% were White people. Black people were at an increased risk of gestational diabetes mellitus, preeclampsia, placental abruption, preterm birth (<37, <34, <32 weeks), spontaneous preterm birth, all caesarean sections, emergency caesarean section, low birth weight (<2500g, <1500g), small-for-gestational-age (<10th percentile, <3^rd percentile) neonates, 5-minute Apgar score <4 and <7, neonatal intensive care unit admission, and hyperbilirubinemia requiring treatment but had lower risks of elective caesarean section, assisted vaginal delivery, episiotomy, 3rd and 4th degree perineal tears, macrosomia, large-for-gestational-age neonates, and arterial cord pH≤7.1, as compared with White people. No difference in risks of gestational hypertension and placenta previa were observed between Black and White people.

Conclusion

There are differences in several adverse perinatal outcomes between Black and White people within the Ontario health care system. Findings might have potential clinical and health policy implications, although more studies are needed to further understand the mechanisms.

Adherence to the Mediterranean Lifestyle and Desired Body Weight Loss in a Mediterranean Adult Population with Overweight: A PREDIMED-Plus Study

Background. Body weight dissatisfaction is a hindrance to following a healthy lifestyle and it has been associated with weight concerns. Objectives. The aim of this study was to assess the association between the adherence to the Mediterranean lifestyle (diet and exercise) and the desired body weight loss in an adult Mediterranean population with overweight. Methods. Cross-sectional analysis in 6355 participants (3268 men; 3087 women) with metabolic syndrome and BMI (Body mass index) between 27.0 and 40.0 kg/m² (55–75 years old) from the PREDIMED-Plus trial. Desired weight loss was the percentage of weight that participants wished to lose. It was categorized into four cut-offs of this percentage (Q1: <10%, n = 1495; Q2: 10–15%, n = 1804; Q3: <15–20%, n = 1470; Q4: ≥20%, n = 1589). Diet was assessed using a validated food frequency questionnaire and a 17-item Mediterranean diet questionnaire. Physical activity was assessed by the validated Minnesota-REGICOR and the validated Spanish version of the Nurses’ Health Study questionnaire. Results. Participants reporting higher percentages of desired weight loss (Q3 and Q4) were younger, had higher real and perceived BMI and were more likely to have abdominal obesity. Desired weight loss correlated inversely to physical activity (Q1: 2106 MET min/week; Q4: 1585 MET min/week. p < 0.001) and adherence to Mediterranean diet (Q1: 8.7; Q4: 8.3. p < 0.001). Conclusions. In older Mediterranean individuals with weight excess, desired weight loss was inversely associated with Mediterranean lifestyle adherence. Deeply rooted aspects of the MedDiet remained similar across groups. Longitudinal research is advised to be able to establish causality.

Study of the Relationship between Body Mass Index, Body Image, and Lifestyle Behaviors: A Community Survey in Fiji

Introduction:

Public health promotion efforts aimed at overweight and obesity prevention often proceed from the premise that the first step should be losing weight. Appropriate perceptions of body image may be important for improving weight loss awareness. Therefore, we aimed to examine the relationship between body mass index and body image perception in Fiji, where increasing obesity is currently the most important health-related issue.

Methods:

Using the resident register based on the governmental census, one household member, aged between 18 and 69 years, was randomly selected from each household in two areas. There were 1,014 participants in the study. The questionnaire items were related to body image, dietary behaviors, physical activity, smoking habits, and alcohol consumption habits. Moreover, information regarding height, weight, blood pressure, and hemoglobin A1c were measured, and questions about social status (age, ethnicity, education, marital status, and employment), and subjective living status were asked. A multivariate logistic regression analysis was performed to analyze the relationship between body mass index (BMI) and body image perception.

Results:

Data from 391 men and 537 women were analyzed. Men within higher BMI quartiles smoked less (p = 0.0004) and drank less alcohol (p = 0.042). Women in higher BMI quartiles engaged in less physical activity (p = 0.022). Among the assessed data, both men and women in the higher BMI quartiles underestimated their body image compared with their actual physique (p < 0.0001). The higher BMI was associated with underestimated body image (men: odds ratio [OR] = 3.22, 95% confidence interval [CI], 1.94–5.35; p < 0.0001; women: OR = 18.11, 95% CI, 10.10–32.47; p < 0.0001).

Conclusions:

Higher BMI is strongly associated with underestimated body image among Fiji residents. Health-related counseling should be included within programs that aim to increase recognition of one’s actual physical size.

Relationship between Body Image and Body Weight Control in Overweight ≥55-Year-Old Adults: A Systematic Review

Objective: To assess the scientific evidence on the relationship between body image and body weight control in overweight ≥55-year-old adults. Methods: The literature search was conducted on MEDLINE database via PubMed, using terms related to body image, weight control and body composition. Inclusion criteria were scientific papers, written in English or Spanish, made on older adults. Exclusion criteria were eating and psychological disorders, low sample size, cancer, severe diseases, physiological disorders other than metabolic syndrome, and bariatric surgery. Results: Fifty-seven studies were included. Only thirteen were conducted exclusively among ≥55-year-old adults or performed analysis adjusted by age. Overweight perception was related to spontaneous weight management, which usually concerned dieting and exercising. More men than women showed over-perception of body image. Ethnics showed different satisfaction level with body weight. As age increases, conformism with body shape, as well as expectations concerning body weight decrease. Misperception and dissatisfaction with body weight are risk factors for participating in an unhealthy lifestyle and make it harder to follow a healthier lifestyle. Body image disturbance also made it more likely to underreport calorie intake. Conclusions: Aging is associated with a decrease in weight concerns and lower overweight perception, especially in women. However, when designing a program to improve body image in overweight ≥55-year-old adults, three items ought to be considered: physical activity, dietary and behavioral treatments.

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 network body size is associated with body size norms of South Asian adults

Aims

To examine the association between social network body size and body size norms in South Asian adults.

Methods

Participants (n = 766) from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study (2014-2018) provided detailed information about their five closest network members. Participants' perceptions of their network members' body sizes, their own body size (self-body size), and a healthy body size for men and women (body size norms) were assessed using the Stunkard 9-figure scale. Adjusted hierarchical linear regression models were used to examine associations between the average body size of network members and perceived body size norms.

Results

Participants' average age was 59.1 years (SD = 9.2) and 44.1% were women. Participants reported an average network body size of 4.0 (SD = 1.1). The average body size norm for male and female Stunkard images was 3.6 (SD = 1.0) and 3.4 (SD = 0.8), respectively. Social network body size was positively associated with increasing body size norms (β-coefficient = 0.31, 95% CI: 0.26, 0.36), independent of self-body size.

Discussion

Social networks may influence body size norms in South Asian adults. Long-term follow up of the MASALA cohort will determine if social network body size and body size norms are associated with weight- control behaviors and weight change.

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

Overweight and obesity are associated with significant health problems and rates of obesity are high among Latino men. This paper describes the design, rationale and participant characteristics of the key demographic variables assessed in an NIH-funded study (R21-CA143636) addressing culture and several obesity-related variables (diet, physical activity, and body image) among Mexican and Puerto Rican men using a community-based participatory research framework. Participants completed objective measures (height, weight, body fat, hip, waist), a health and culture interview, a diet questionnaire, and used an accelerometer to measure their level of physical activity. A total of 203 participants completed the measures and the health and culture interview and 193 completed all study components. Puerto Ricans were older than Mexicans (p < .0001) and there were significant differences in marital status (p < .05), country of birth (p < .05), smoking (p < .05) and work status (p < .001). There were no significant differences in religion, education, health insurance, Body Mass Index, body fat, hip and waist measurements, and the language preference of the interview. Results have implications for the development of a future intervention that incorporates the role of cultural factors into a community participatory obesity intervention for Latino men.

Cardiovascular Disease Risk Among Young Urban Women

BACKGROUND

Although young women are presumed to have low cardiovascular disease (CVD) risk and mortality, the mortality benefits secondary to ischemic heart disease have plateaued among young women, <50 years.

MATERIALS AND METHODS

Women, 18-49 years (n = 595) among all participants (n = 1,045) in the Columbia University Heart Health in Action Study, were assessed for CVD risk burden, that is, presence of hypertension, diabetes mellitus, current tobacco use, hyperlipidemia, physical inactivity, and/or obesity. Anthropometrics (height, weight, waist circumference, and body mass index [BMI]); demographics; socioeconomic status, CVD risk factors, body size perception; knowledge and awareness of CV disease; and attitudes toward lifestyle perception were determined.

RESULTS

Most were Hispanic (64.0%); non-Hispanic white (20.0%); or non-Hispanic black (8.7%), age = 35.9 ± 8.0 years. BMI was categorized as obese (≥30 kg/m2, 27.0%; 160/592); overweight (25.0-29.1 kg/m2, 29.1%; 172/592); normal weight (18.5-24.9, 41.7%; 247/592); and underweight (≤18.4; 2.2%; 13/592). More than half (57.9%; 337/582) had CVD risks: 45.9% (267/582) had >1 CVD risk factor exclusive of obesity, including physical inactivity (18.4%), hypertension (17.2%), hyperlipidemia (11.3%), current tobacco use (9.8%), and diabetes (5.6%). Regardless of CVD risk burden, most knew blood pressure, blood sugar, and cholesterol. Women with increased CVD risk burden, however, were less likely to correctly identify body size (53.3% vs. 66.1%, p = 0.002). Obese and overweight women with CVD risk factors exclusive of obesity were more likely to cite cost (23.4% vs. 10.7%, p = 0.003) and fatigue (32.2% vs. 18.8%, p = 0.006) as barriers to weight loss.

CONCLUSION

Among these young women, the majority had CVD risks and the CVD risk burden is high among young women, particularly among the overweight and obese and physically inactive. Strategies to encourage healthy lifestyles and reduce CVD risk factors among this vulnerable at-risk population are vital.

[Latin American consensus on hypertension in patients with diabetes type 2 and metabolic syndrome]

The present document has been prepared by a group of experts, members of cardiology, endocrinology, internal medicine, nephrology and diabetes societies of Latin American countries, to serve as a guide to physicians taking care of patients with diabetes, hypertension and comorbidities or complications of both conditions. Although the concept of metabolic syndrome is currently disputed, the higher prevalence in Latin America of that cluster of metabolic alterations has suggested that metabolic syndrome is a useful nosography entity in the context of Latin American medicine. Therefore, in the present document, particular attention is paid to this syndrome in order to alert physicians on a particular high-risk population, usually underestimated and undertreated. These recommendations result from presentations and debates by discussion panels during a 2-day conference held in Bucaramanga, in October 2012, and all the participants have approved the final conclusions. The authors acknowledge that the publication and diffusion of guidelines do not suffice to achieve the recommended changes in diagnostic or therapeutic strategies, and plan suitable interventions overcoming knowledge, attitude and behavioural barriers, preventing both physicians and patients from effectively adhering to guideline recommendations.

The Relationship between Social Network Body Size and the Body Size Norms of Black and Hispanic Adults

Objective

To examine the relationship between the body size norms of Black and Hispanic adults and the body sizes of their social network members.

Methods

Egocentric network data were examined for 245 adults recruited from 2012–2013 in New York City. A multivariable regression model was used to examine the relationship between participants' perception of normal body size and the body sizes of their network members adjusted for participant age, education, race/ethnicity and network size. Participants' body size norms were also examined stratified by the following characteristics of obese network members: frequency of contact, living proximity, relationship, and importance of relationship.

Results

Index participants were 89% female with mean body mass index 33.5 kg/m². There were 2571 network members identified (31% overweight, 10% obese). In the fully adjusted multivariable model, perception of normal body size increased as the number of network members with obesity increased (p < 0.01). Larger body size norms were associated with increased frequency of contact with obese network members (p = 0.04), and obese members living in the home (p = 0.049).

Conclusions

These findings support a relationship between the body size norms of Black and Hispanic adults and their social network body size.

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Participants reported a larger body size as normal as the number of social network members with obesity increased.

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Participants' perception of normal body size increased as frequency of contact with obese members increased.

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Participants with obese network members living in the home perceived a larger body size as normal.

Life cycle development of obesity and its determinants in six European countries

This paper empirically examines the effect of parents' and individuals' own socioeconomic status on overweight and obesity, and investigates how this effect changes over the life cycle. The impact of individuals' health behaviours on their obesity status later in life is also studied. We use data from Denmark, Finland, France, Greece, the Netherlands and the U.K. in which 4595 individuals aged 50-65 are surveyed and where individuals' height and weight at different ages (25, 35, 45 and current age) are available. We perform "repeated cross-sections" analyses as well as dynamic probit analyses of the individuals' obesity histories. We contribute to the literature by examining the role of a variety of obesity determinants over the whole life cycle, not only over a certain portion of individuals' lives. Key findings are: (i) parents' socioeconomic status predicts obesity in early adulthood whereas the individual's own socioeconomic status as adult is more important in explaining obesity at later stages of the life cycle, (ii) changes in obesity status are associated with changes in health behaviours, (iii) obesity in late adulthood is strongly and positively correlated with overweight and obesity in younger ages, and (iv) cross-country differences in obesity and overweight largely remain after controlling for parental and childhood factors and individuals' health behaviours.

Cardiovascular disease knowledge and weight perception among Hispanic and non-Hispanic white women

BACKGROUND

While knowledge of cardiovascular disease (CVD) has improved, it remains low among minority women, thereby contributing to disparities and posing health challenges. Moreover, substantial numbers of women do not recognize that excess weight imposes CVD risk and increases morbidity and decreases survival. In order to test the hypothesis that CVD knowledge is reduced among overweight and obese women, CVD knowledge and weight perception was compared among Hispanic and non-Hispanic white (NHW) women.

METHODS

Data from 382 Hispanic and 301 NHW women, participants in the Heart Health in Action database (n=829), were analyzed from a structured behavioral risk factor surveillance system (BRFSS) questionnaire to assess demographics, risk factors, and CVD knowledge. Multivariable logistic regression analysis was utilized to test for differences between Hispanic and NHW women regarding knowledge with covariates of age, education, and body mass index (BMI).

RESULTS

Hispanics (27%) were less likely than NHW (88%) to correctly identify the leading cause of death among women, (p<0.0001). Years living in the United States did not relate to the percentage of respondents who correctly identified the leading cause of death among women or knew the symptoms of a heart attack. Differences between Hispanic and NHW remained significant after adjustment for age, education, and BMI (p<0.0001). Hispanics (69.4%) were less likely than NHW (82.9 %) to correctly estimate weight (p<0.0001). Underestimation of weight was greater among Hispanics (24.8%) than NHW (5.0%); 48.5% of overweight Hispanic participants versus 12.7% of overweight NHW participants underestimated weight (p<0.0001) and 17.2% of obese Hispanic versus 0% of NHW obese participants (p=0.001) underestimated weight. The percentage underestimating the silhouette corresponding to their weight was related to years in the United States: 29.3% for<10 years, 38.3% with 10-19 years, and 49.3% with ≥20 years (p=0.01 for trend).

CONCLUSIONS

Effective prevention strategies for at-risk populations need to target CVD knowledge and awareness among overweight and obese Hispanic women.

Predicting adherence of adults to a 12-month exercise intervention

BACKGROUND

The purpose of this study was to (a) examine demographic, psychosocial, and physiological predictors of exercise adherence in a yearlong exercise intervention and (b) describe the trajectory of adherence over time.

METHODS

Participants were 51 men and 49 women aged 40 to 75 years. The supervised and home-based intervention consisted of 60 minutes/day, 6 days/ week of moderate-to-vigorous intensity exercise. Three adherence measures were used: (1) minutes/week, (2) MET-hours/week, and (3) change in cardiopulmonary fitness (VO2max). Predictors of adherence were determined separately by sex using mixed models and multivariable regression.

RESULTS

Participants performed 287 ± 98 minutes/week of moderate-to-vigorous activity with 71% adhering to at least 80% (288 minutes/week) of the prescription. Men adhered better than women (P < .001). Among women, adiposity-related variables were significantly related to poorer adherence on all 3 measures (P < .05). A less consistent pattern was observed among men but in follow-up analyses, adiposity was associated with fewer MET-hours/week of exercise. Social support, pain, and perceived benefits were predictive in some models. Men and nonobese women experienced peak adherence at 4 to 6 months, while obese women peaked during months 0 to 3.

CONCLUSIONS

When provided with supervision and support, previously sedentary men and women can achieve and maintain high levels of aerobic activity.

Socio-cultural, environmental and behavioural determinants of obesity in black South African women

South Africa (SA) is undergoing a rapid epidemiological transition and has the highest prevalence of obesity in sub-Saharan Africa (SSA), with black women being the most affected (obesity prevalence 31.8%). Although genetic factors are important, socio-cultural, environmental and behavioural factors, as well as the influence of socio-economic status, more likely explain the high prevalence of obesity in black SA women. This review examines these determinants in black SA women, and compares them to their white counterparts, black SA men, and where appropriate, to women from SSA. Specifically this review focuses on environmental factors influencing obesity, the influence of urbanisation, as well as the interaction with socio-cultural and socio-economic factors. In addition, the role of maternal and early life factors and cultural aspects relating to body image are discussed. This information can be used to guide public health interventions aimed at reducing obesity in black SA women.

An Investigation of Body Appreciation, Ethnic Identity, and Eating Disorder Symptoms in Black Women

Positive body image, such as body appreciation or acceptance, has gone largely unexamined in women of color in comparison with more pathological body attitudes. In an effort to promote and extend positive body image research, this study examined the reliability and validity of the Body Appreciation Scale (BAS) in Black college women, as well as the relation between ethnic identity and body appreciation. Participants were 228 Black college women ( M age = 19.89, SD = 4.57). The relation between BAS scores and measures of appearance evaluation, self-esteem, Western beauty ideal internalization, eating disordered behavior, and teasing was examined to investigate convergent and divergent validity. Results supported the construct validity of this measure. Similar to previous research, a confirmatory factor analysis supported a unidimensional factor structure. Ethnic identity was moderately, positively associated with body appreciation. Western beauty ideal internalization mediated the relation between ethnic identity and eating, weight, and shape concerns. Overall, findings support the use of the BAS with Black college women.

Latin American consensus on hypertension in patients with diabetes type 2 and metabolic syndrome

The present document has been prepared by a group of experts, members of cardiology, endocrinology and diabetes societies of Latin American countries, to serve as a guide to physicians taking care of patients with diabetes, hypertension and comorbidities or complications of both conditions. Although the concept of 'metabolic syndrome' is currently disputed, the higher prevalence in Latin America of that cluster of metabolic alterations has suggested that 'metabolic syndrome' is a useful nosographic entity in the context of Latin American medicine. Therefore, in the present document, particular attention is paid to this syndrome in order to alert physicians on a particularly high-risk population, usually underestimated and undertreated. These recommendations result from presentations and debates by discussion panels during a 2-day conference held in Bucaramanga, in October 2012, and all the participants have approved the final conclusions. The authors acknowledge that the publication and diffusion of guidelines do not suffice to achieve the recommended changes in diagnostic or therapeutic strategies, and plan suitable interventions overcoming knowledge, attitude and behavioural barriers, preventing both physicians and patients from effectively adhering to guideline recommendations.

Racial/ethnic differences in dietary intake among WIC families prior to food package revisions

OBJECTIVE

To compare the diets of African American and Hispanic families in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) prior to the 2009 food package revisions.

METHODS

Mother-child dyads were recruited from 12 WIC sites in Chicago, IL. Individuals with 1 valid 24-hour recall were included in the analyses (n = 331 children, n = 352 mothers).

RESULTS

Compared to their African American counterparts, diets of Hispanic mothers and children were lower (P < .001) in percentage of calories from fat, added sugars, sodium, and sweetened beverages, but higher (P < .001) in vitamin A, calcium, whole grains, fruit, and total dairy. However, no groups met national recommendations for percentage of calories from saturated fat, fiber, sodium, whole grains, vegetables, and total dairy.

CONCLUSIONS AND IMPLICATIONS

There are racial/ethnic differences in dietary intake, and future research is needed to determine whether diets improve as a result of package revisions and whether uptake of these changes varies by race/ethnicity.

Eating Disorder Examination Questionnaire (EDE-Q): norms for Black women

The current study provides Eating Disorder Examination Questionnaire (EDE-Q) norms for Black undergraduate women (N=395). EDE-Q subscale scores, clinical cutoffs, and disordered eating behavior were compared with previously published norms for primarily White undergraduate and community samples. The current sample endorsed mean EDE-Q scores similar to those of White females recruited from the community. Regarding clinical cutoffs, Black women in the current sample were most similar to White college women. Despite similar EDE-Q scores, the current sample endorsed significantly less binge eating and compensatory behaviors than White undergraduate or community women. Outcomes suggest that increased eating- and weight-related concerns among Black undergraduate women might not be associated with disordered eating behavior. Similarly, results suggest that the validity of EDE-Q cutoffs is lower in samples of Black women compared with samples of White women. Additional research is needed to enhance understanding of eating disorder risk factors for Black college women.

Ethnic differences in perceptions of body satisfaction and body appearance among U.S. schoolchildren: a cross-sectional study

BACKGROUND

Perceived body appearance and body satisfaction are potentially related to weight problems and poor health. The purpose of this study was to examine how gender, and ethnic differences in body satisfaction, perceived body appearance and weight status change by age in a representative sample of U.S. adolescents 11-17 years old.

METHODS

We used the US Health Behavior in School-Aged Children (HBSC) 2001 survey which assessed perceived body appearance, body satisfaction, self-reported body mass index (BMI) and socio-demographic indicators. The associations between age and perceived appearance, age and body satisfaction, and between z-transformed BMI and body satisfaction were analyzed using separate non-parametric regression models for both genders and the three ethnic groups.

RESULTS

Body satisfaction did not vary significantly by age except for an increase with age in the proportion of Non-Hispanic White girls who perceived themselves as too fat. Although boys did not report being too fat unless their BMI was above the age- and gender-specific median, one third of Non-Hispanic White girls felt too fat at or below the age- and gender-specific median. Compared to other ethnicities, African-American students' perceived appearance was significantly more positive and they were less likely to perceive themselves overweight at higher BMI scores. However, during adolescence, the positive self-reported perceived appearance of African-American boys dropped substantially while it remained relatively stable in African-American girls.

CONCLUSIONS

There were substantial differences in body satisfaction and perceived appearance across the three largest ethnic groups of school-age children in the U.S. Stability across age indicates that these perceptions are most likely established before the age of 10 and underline the importance of primary schools and parents in prevention. Special attention should be directed to the dramatic loss of positive perceived appearance among African-American boys.

Perceived weight gain, risk, and nutrition in pregnancy in five racial groups

OBJECTIVE

Examine perceived pregnancy weight gain needed, perceived risks to mother, and infant of excessive weight and underweight, perceptions of actual, ideal, realistic body size, nutritional intake in five racial/ethnic groups.

DESIGN

Cross-sectional Setting: Physicians' offices Participants: A total of 54 women <20 weeks gestation.

METHODS

Questionnaires-perceived weight gain needed, risks of weight gain for mother, infant, perceptions of body size, food frequency.

RESULTS

A total of 39% of women are overweight or obese (57% Caribbean Black, 50% African American). Perceived pregnancy weight gain needed highest in Central American Hispanic women, lowest Caribbean Black women. African-American women had low perceived risk for mother and infant of gaining too much pregnancy weight, highest perceived risk for both of gaining too little. Caribbean Black women perceived highest risk to mother of gaining too much pregnancy weight, highest risk to infant of gaining too little. White Non-Hispanic women reported smaller prepregnant, ideal, realistic body sizes than other four groups. Daily caloric intake ranged from 599 to 5856 calories. African-American women had significantly more calories; protein, total fats, monounsaturated, polyunsaturated, and saturated fats; carbohydrates, sugar; and iron than White Non-Hispanic women. Women in each racial/ethnic group had less than recommended intake of protein, carbohydrates, calcium, iron, folate, and fiber.

CONCLUSIONS

Education is needed to raise awareness of risks of prepregnancy weight and excessive weight gain for mother and infant. The need for prenatal nutritional counseling to reduce the intake of calories, fats, sweets, and snacks; increase intake of vegetables, fruits, foods with iron, folate, and fiber.

Physical activity and body mass perception

PURPOSE

To evaluate ethnic perceptual variations in body mass index (BMI) and accrued physical activity. Women (n = 204) from the eastern United States were stratified into the following ethnic groups: White women (WW; n = 97), Black women (BW n = 62) and Others (Hispanic and Asian women, n = 45). Participants completed questionnaires and physiologic variables were determined. BW had increased weight, BMI, waist circumference, and body fat percentage vs. WW (p < .05). Body mass was higher in BW vs. Others (p < .05). There were no differences for perception of BMI or body dissatisfaction. BW were the only group in which perception of BMI was lower than measured BMI. BW engaged in 50% less domestic and total physical activity than WW and Others. Physical activity was not correlated to perception of BMI.

CONCLUSION

Perception of BMI was similar across ethnic groups and not correlated to physical activity levels in young women.

Maternal obesity: do patients understand the risks?

OBJECTIVE

To evaluate patient knowledge of the risks of maternal obesity and compare knowledge between non-obese and obese women.

STUDY DESIGN

A face-to-face survey was administered to 105 women at their first prenatal visit. The survey assessed their knowledge of obesity-related risks during pregnancy, weight history and goals and health behaviors. Descriptive statistics described the entire sample. Student's t-test and chi(2) tests compared knowledge between non-obese (body mass index (BMI) of <30 kg m(-2)) and obese (BMI of > or =30 kg m(-2)) gravidas.

RESULT

There were 56 (54%) non-obese and 47 (46%) obese participants. There were no significant differences between the weight groups with respect to age, race, insurance, education, tobacco use and primigravity. Overall, 49% participants knew that obesity increases risks in pregnancy. The knowledge of specific risks was similar in the non-obese (60% correct) and obese (64% correct) groups (P=0.76). Obese patients were more aware of the risk for diabetes (68 vs 96%, P<0.001). Obese gravidas expressed more interest in weight loss before another pregnancy (61 vs 81%, P=0.03), although the desired BMIs (22.1+/-2.3 vs 26.2+/-3.0 kg m(-2), P<0.001) were different for non-obese and obese women, respectively. Of all participants, 9% discussed the risks of maternal obesity with a provider before study participation and 75% wanted to participate in a study on weight loss before pregnancy to determine whether it leads to healthier pregnancies.

CONCLUSION

Regardless of BMI category, patients required more knowledge about the risks of obesity in pregnancy, requested additional information and were motivated to lose weight before future pregnancies. Because obese women underestimated their optimal weight loss goals, it is necessary to target this group for further education.

A quantitative and qualitative approach to understanding fruit and vegetable availability in low-income african-american families with children enrolled in an urban head start program

BACKGROUND

Prior studies have shown low-income African Americans have low intakes of fruits and vegetables, which correlate, in part, to area of residence. To address the dietary problem, behavior-change interventions are most effective when they are theoretically based and compatible with cultural/behavioral characteristics of a given population.

OBJECTIVE

To use the Transtheoretical Model of Behavior Change to determine whether low-income African Americans were in proportionately different stages of change for increasing fruits and vegetables to their young children and identify differences in decision making, self-efficacy, and use of cognitive and behavioral strategies related to fruit and vegetable availability.

DESIGN

The two-phase, descriptive study utilized a mixed methodology consisting of a fruit and vegetable survey and focus groups.

SUBJECTS/SETTING

Convenience sample of low-income African-American parents with children enrolled in an urban area Head Start program.

STATISTICAL ANALYSES PERFORMED

chi(2) test was calculated to examine the distribution of parents into stages of change for increasing fruit and vegetable availability. Analysis of variance was used to test differences in fruit and vegetable availability to children and parents' decision making, self-efficacy, and use of cognitive and behavioral strategies. Content analysis of focus group transcripts was used to triangulate quantitative findings and further explore meanings of survey responses.

RESULTS

Of 94 participants completing the fruit and vegetable survey, 21% staged as precontemplation/contemplation, 25% staged as preparation, and 54% staged as action/maintenance (P<0.001). Parents in action/maintenance stages served significantly more fruits and vegetables (P=0.006) and used behavioral processes significantly more often (P<0.001) compared to parents in precontemplation/contemplation stages. Content analysis of focus group transcripts provided greater insight into the quantitative findings.

CONCLUSIONS

Nutrition education targeting low-income African-American parents in earlier stages of change should address planning and preparing convenient and economical meals and snacks that include fruits and vegetables. Interventions targeting parents in later stages of change should address increasing variety and healthful preparation methods. Interventions for both groups can benefit from social support strategies.

Food Systems and Public Health Disparities

The United States has set a national goal to eliminate health disparities. This article emphasizes the importance of food systems in generating and exacerbating health disparities in the United States and suggests avenues for reducing them. It presents a conceptual model showing how broad food system conditions interplay with community food environments-and how these relationships are filtered and refracted through prisms of social disparities to generate and exacerbate health disparities. Interactions with demand factors in the social environment are described. The article also highlights the separate food systems pathway to health disparities via environmental and occupational health effects of agriculture.

Self-perceptions of body size in women at an inner-city family-planning clinic

OBJECTIVE

The objective of the study was to determine the relationship between body mass index (BMI) and body size perception among female patients in an inner-city family-planning clinic.

STUDY DESIGN

All participants (n = 81) were measured for height and weight and completed an anonymous survey. Self-perceived, current, and ideal body sizes were determined by using a standardized scale. Body image discrepancy was calculated by the difference between body image perception and measured BMI.

RESULTS

Approximately two-thirds of the participants were obese or overweight. As measured BMI increased, the body image discrepancy increased, with significant differences in body perception in both obese (P < .001) and overweight (P < .001) women. Ideal body size increased with measured BMI.

CONCLUSION

Overweight and obese women in an inner-city clinic are likely to underestimate their body size. Our data support the need for culturally sensitive education for this population, because many do not view themselves at risk for complications related to excessive weight.

The relation between body size perception and change in body mass index over 13 years: the Coronary Artery Risk Development in Young Adults (CARDIA) study

The authors assessed associations of body size perception and weight change over 13 years in black men and women and white men and women from the Coronary Artery Risk Development in Young Adults (CARDIA) Study (1992-2005). The perceptions of self and ideal body size were measured by using the Stunkard 9-figure scale at the year 7 examination (1992-1993). Figures were classified into underweight, normal weight, overweight, and obese. Self-ideal discrepancy yielded 4 body size satisfaction categories. Body mass index (BMI) (measured at years 7, 10, 15, and 20) was the dependent variable in gender-specific adjusted multiple regression models stratified by year 7 BMI. Obese women who perceived themselves as obese lost 0.09 BMI units annually, while those who perceived themselves as normal weight gained 0.31 units annually (P = 0.0005); obese women who considered their body size much too large had less annual weight gain than did those who considered their body size a bit too large (0.21 vs. 0.38 BMI units; P = 0.009). Obese women with overweight ideal body size gained less weight annually than did those with normal weight ideal body size (0.12 vs. 0.27 BMI units; P = 0.04). Results for men showed fewer and weaker associations. When obese women perceive themselves as obese and feel that their body size is too large, they gain less weight over time.

Dietary behaviors and portion sizes of black women who enrolled in SisterTalk and variation by demographic characteristics

OBJECTIVE

To describe the dietary behaviors of black women who enrolled in the SisterTalk weight control study.

DESIGN

Baseline data collected via telephone survey and in-person screening.

SETTING

Boston, Massachusetts and surrounding areas.

PARTICIPANTS

461 black women completed the baseline assessments.

MAIN OUTCOME MEASURES

Measured height and weight; self-reported demographics, risk factors, and dietary variables including fat-related eating behaviors, food portion size, and fruit, vegetable, and beverage intake.

ANALYSIS

Analysis of variance (ANOVA) models with food habits questionnaire (FHQ) scores as the dependent variable and demographic categories as the independent variables; ANOVA models with individual FHQ item scores as the dependent variable and ethnic identification as the independent variable.

RESULTS

More than 60% reported eating < 5 servings of fruits and vegetables/day. Self-reported portion sizes were large for most food items. Older age, being born outside the United States, living without children, and being retired were significantly associated with a higher prevalence of fat-lowering behaviors. The frequency of specific fat-lowering behaviors and portion size also differed by ethnic identification.

CONCLUSIONS AND IMPLICATIONS

The findings support the need for culturally appropriate interventions to improve the dietary intake of black Americans. Further studies should examine the dietary habits, food preparation methods, and portion sizes of diverse groups of black women.

Population-based prevention of obesity: the need for comprehensive promotion of healthful eating, physical activity, and energy balance: a scientific statement from American Heart Association Council on Epidemiology and Prevention, Interdisciplinary Committee for Prevention (formerly the expert panel on population and prevention science)

Obesity is a major influence on the development and course of cardiovascular diseases and affects physical and social functioning and quality of life. The importance of effective interventions to reduce obesity and related health risks has increased in recent decades because the number of adults and children who are obese has reached epidemic proportions. To prevent the development of overweight and obesity throughout the life course, population-based strategies that improve social and physical environmental contexts for healthful eating and physical activity are essential. Population-based approaches to obesity prevention are complementary to clinical preventive strategies and also to treatment programs for those who are already obese. This American Heart Association scientific statement aims: 1) to raise awareness of the importance of undertaking population-based initiatives specifically geared to the prevention of excess weight gain in adults and children; 2) to describe considerations for undertaking obesity prevention overall and in key risk subgroups; 3) to differentiate environmental and policy approaches to obesity prevention from those used in clinical prevention and obesity treatment; 4) to identify potential targets of environmental and policy change using an ecological model that includes multiple layers of influences on eating and physical activity across multiple societal sectors; and 5) to highlight the spectrum of potentially relevant interventions and the nature of evidence needed to inform population-based approaches. The evidence-based experience for population-wide approaches to obesity prevention is highlighted.

Factors that influence body image representations of black Muslim women

Research on the body image perceptions of black women is limited. Although previous body image studies have explored the intersection between race and gender, the influence of religion has been neglected. Guided by a grounded theory framework, the focus of this investigation, conducted in Upstate New York, USA, was to examine the role of race and religion in the body image perceptions of 22 African-American Sunni Muslim women. Analysis of individual interviews revealed that, in contrast to using standard medical guidelines, participants' views about their bodies were largely based on positive images of an earlier body size/shape, social and family expectations and contexts, cultural norms and values, and spirituality and religious beliefs. Although the body image perceptions of black Muslim women were similar to those expressed in previous body image studies with black women, participants expressed the importance of highlighting the spiritual versus physical self by adhering to religious guidelines regarding proper dress and appearance. These findings suggest that religion, race, and gender are all important factors to be considered when conducting body image studies with black women.

Consumo alimentar na gestação e no pós-parto segundo cor da pele no município do Rio de Janeiro

OBJETIVO: Avaliar o consumo alimentar durante a gestação e pós-parto, segundo cor da pele. MÉTODOS: Estudo longitudinal prospectivo que incluiu 467 mulheres entre 15 e 45 anos no período pós-parto, no município do Rio de Janeiro, entre 1999 e 2001. Foi aplicado um questionário de freqüência de consumo de alimentos aos 15 dias pós-parto (consumo referente ao período da gestação) e aos seis meses (consumo referente ao período pós-parto). Foi utilizada análise de covariância para analisar diferenças no consumo alimentar, segundo cor da pele, controlada pela escolaridade. RESULTADOS: Durante a gestação, pretas e pardas apresentaram consumo de energia 13,4% e 9,1% (p=0,009 e p=0,028) e consumo de carboidrato 15,1% e 10,5% maior que brancas (p=0,005 e p=0,014), respectivamente. Mulheres pretas e brancas apresentaram consumo energético 34% e 20% acima das recomendações nutricionais, respectivamente (p=0,035). Durante o período pós-parto, as pretas apresentaram consumo de energia 7,7% maior e consumo de lipídios 14,8% maior que as brancas; consumo de ácidos graxos saturados 23,8% maior que brancas (p=0,003) e 13% maior que pardas (p=0,046). A adequação de consumo de lipídios e ácidos graxos saturados foi maior em pretas que em brancas (p=0,024 e p=0,011, respectivamente). CONCLUSÕES: Os resultados mostram ser necessário revisar estratégias de intervenção nutricional no pré-natal e implementar assistência nutricional no pós-parto, para ajustar o consumo alimentar a níveis adequados, considerando as diferenças por cor/raça identificadas.

Crenças e influências sobre dietas de emagrecimento entre obesos de baixa renda

A obesidade tornou-se uma epidemia carente de controle imediato, principalmente entre pobres, mulheres e pessoas de baixa escolaridade. A OMS solicita e vários estudos corroboram que estudos esclarecedores sobre os comportamentos psicológicos e sociais interferentes na aderência terapêutica aos regimes devem ser encorajados. Este estudo usou a Teoria da Ação Racional - TAR, de M. Fishbein, em Psicologia Social, e comparou duas séries de entrevistas abertas (em 2001 e 2005) que eliciaram as crenças positivas (vantagens) e negativas (desvantagens) sobre fazer dieta entre obesos de baixa renda de João Pessoa, Paraíba, além dos referentes (pessoas de opinião influente) destes pacientes quanto a segui-la. Os resultados de 2001 foram corroborados em 2005, revelando o medo das doenças relacionadas à obesidade e a vontade de sentir mais saúde e leveza de corpo. Mães, filhos e principalmente o cônjuge aparecem como apoiadores do regime. Ressaltou-se que não bastaria força de vontade, mas também reflexão e construção de habilidades de controle, apropriação e modificação das condições de vida. Preocupações estéticas não foram prioritárias. Estas informações podem fomentar melhores resultados na aderência terapêutica.

Accuracy of self-reported weight among bariatric surgery candidates: the influence of race and weight cycling

OBJECTIVE

Research on the accuracy of self-reported weight has indicated that the degree of misreporting (underestimating) weight is associated with increasing weight but is variable across patient groups. We examined the degree of discrepancy between actual and self-reported BMI in severely obese bariatric surgery candidates, and whether the degree of accuracy varied by race and by eating-related and psychological factors.

RESEARCH METHODS AND PROCEDURES

Participants were 179 obese female gastric bypass surgery candidates (31 black, 22 Hispanic, 126 white) who were asked to self-report height and weight as part of a larger assessment battery. Actual height and weight were then measured and a discrepancy score was generated (actual BMI - reported BMI).

RESULTS

In this group of severely obese patients, degree of misreporting was unrelated to BMI. The race groups did not differ in actual or self-reported BMI but differed significantly in the degree of misestimation between self-reported and actual BMI. Post hoc tests indicated that black women underestimated their BMI significantly more than white women; Hispanic women did not differ from the other race groups. No eating-related or psychological variables assessed predicted percentage discrepancy; however, the accuracy in self-reported weight was related to history of weight cycling.

DISCUSSION

Overall, obese bariatric surgery candidates were accurate in self-report of weight, although the degree of accuracy differed by race and weight cycling history.

Relations between physical activity and behavioral and perceptual correlates among midwestern college students

OBJECTIVE

Given the inconsistent findings in the literature, the authors' purpose in this study was to examine the associations between physical activity and behavioral and perceptional correlates, such as binge drinking, cigarette smoking, fruit or vegetable consumption, and weight perceptions, among midwestern college students.

PARTICIPANTS AND METHODS

The authors invited a convenience sample of 1,200 undergraduate college students enrolled in the 2004-2005 academic year in 4 different midwestern universities to participate in a survey. Of the 1,163 students who participated in the survey, a total of 1,134 usable surveys were received (response rate of 94.5%).

RESULTS

Hierarchical multiple logistic regression analyses indicated that smoking, perceived weight, and consumption of fruit were independent predictors of physical activity when controlling for other variables.

CONCLUSIONS

Physical activity promotion requires tailored approaches that are dependent on the target segment of the college student populations.

Development and validation of instruments measuring body image and body weight dissatisfaction in South African mothers and their daughters

Objective

We sought to validate questionnaires concerning body image perception, body size dissatisfaction and weight-related beliefs in multi-ethnic South African mothers and their daughters.

Settings and subjects: Girls attending primary school (ages 9–12 years, n = 333) and their mothers (n = 204) were interviewed regarding their demographics and body image. Weight, height and skinfold thicknesses were measured. Body image questions and body mass index (BMI) were compared with silhouettes adapted from the Pathways Study for girls and Stunkard's body image figures for mothers. A Feel–Ideal Difference (FID) index score was created by subtracting the score of the silhouette selected by the participants as ‘Ideal’ from the one selected as most closely representing their current appearance or ‘Feel’. We hypothesised that a higher FID index score would be associated with greater body size dissatisfaction.

Results

BMI percentiles in girls (r = 0.46, P < 0.05) and BMI in mothers (r = 0.68, P < 0.05) were positively correlated with the selected silhouettes based on size. Participants who reported feelings of being ‘fat’ and those who perceived that their family and friends were more dissatisfied with their body size had significantly higher FID index scores. Scores were lower in black than white girls (all P < 0.05). No differences were found in FID index scores between ethnic groups of mothers. Internal reliability of the ‘thin’ and ‘fat’ belief constructs for girls was demonstrated by standardised Cronbach's α values ≥0.7.

Conclusion

Silhouettes, FID index, ‘fat’ and ‘thin’ belief constructs (in girls) are age-appropriate, culturally sensitive and can be used in further intervention studies to understand body image.

Body image and eating disordered behavior in a community sample of Black and Hispanic women

OBJECTIVE

The current study examined body image concerns and eating disordered behaviors in a community sample of Black and Hispanic women. In addition, this study explored whether there are ethnic differences in the correlates or in the prediction of body image concerns.

METHOD

Participants were 120 (67 Black and 53 Hispanic) women who responded to advertisements to participate in a study of women and health. Participants completed a battery of established self-report measures to assess body image, eating disordered behaviors, and associated psychological domains.

RESULTS

Black and Hispanic women did not differ significantly in their self-reports of body image, eating disordered behaviors, or associated psychological measures. Comparisons performed separately within both ethnic groups revealed significant differences by weight status, with a general graded patterning of greater concerns in obese than overweight than average weight groups. In terms of predicting body image, multiple regression analyses testing a number of variables, including BMI, performed separately for Black and Hispanic women revealed that eating concern and depressive affect were significant predictors of body image concern for both groups.

DISCUSSION

Overall, Black and Hispanic women differed little in their self-reports of body image, eating-disordered features, and depressive affect. Higher weight was associated with a general pattern of increased body image concerns and features of eating disorders in both groups and with binge eating in Black women. Eating concerns and depressive affect emerged as significant independent predictors of body image for both ethnic groups.

Body size preferences and sociocultural influences on attitudes towards obesity among Moroccan Sahraoui women

The purpose of this investigation was to study body size preferences and to examine the influence of sociocultural factors on obesity among 249 Moroccan Sahraoui women. Participants rated their ideal body size and the size they thought to be "healthy," using a figural scale consisting of nine images ranging from thin to obese. They also noted which particular sociocultural influences affected their body size ratings. The results indicated that women's rating of ideal body size (4.88) was significantly larger than their rating of healthy body size (4.33). The desire to lose weight was very low even among the majority of obese women, and educational level did not affect desire to lose weight. Women not satisfied with their body size were more likely to report trying to gain weight rather than to lose it. The major factors reported to influence body size ideal were mothers, men, and traditional clothing. It is an enormous challenge for the health institutions of Morocco to prevent obesity and its complications. Prevention programs should include teenagers and key family members.

Influence of body fat content and distribution on variation in metabolic risk

OBJECTIVES

Several reports indicate that the body fat compartments, especially ip fat, predict metabolic risk better than total body fat. The objective of the study was to determine whether this can be confirmed and generalized throughout the population.

PARTICIPANTS

A representative sample of 1934 Black and White women and men of the Dallas Heart Study participated in the study.

DESIGN

We measured the fat in total body, trunk, and lower body with dual-energy x-ray absorptiometry and in abdominal compartments (sc, ip, and retroperitoneal) with magnetic resonance imaging. Other measurements included body mass index (BMI), waist circumference, blood pressure, plasma lipids, glucose, insulin (including homeostasis model), and C-reactive protein.

RESULTS

In all groups, total body fat correlated positively with key metabolic risk factors, i.e. homeostasis model, triglyceride/high-density lipoprotein-cholesterol ratios, C-reactive protein, and blood pressure; however, it explained less than one third of the variability of all the risk factors. After adjustment for total body fat, truncal fat conferred additional positive correlation with risk factors. Furthermore, with multivariable regression analysis, ip fat conferred independent correlation with plasma lipids beyond a combination of other compartments including truncal fat. Still, except for insulin levels, all combinations including ip fat still explained less than one third of the variability in risk-factor levels. Conversely, lower body fat correlated negatively with risk factors; i.e. lower body fat appeared to offer some protection against risk factors.

CONCLUSIONS

Body fat distribution has some influence on risk factors beyond total body fat content. Both waist circumference and BMI significantly predicted risk factors after adjustment for total body fat, and for clinical purposes, most of the predictive power for men was contained in waist circumference, whereas for women, BMI and waist circumference were similarly predictive. Finally, even though the correlations between combined body fat parameters and risk factors explained only a portion of the variation in the latter, the average number of categorical metabolic risk factors increased progressively with increasing obesity. Hence, obesity seemingly has more clinical impact than revealed in these correlative studies.

Body image and size perceptions of Mexican American women

Purpose was to examine in Mexican American women the influences of age, weight, socioeconomic status and acculturation level on body image, perceptions of attractive and acceptable female shapes, and tolerance for overweight and obesity. Participants were 276 Mexican American women. Age, body mass index, socioeconomic status, and acculturation level were measured. The Figure Rating Scale was used to assess body image, preferences for body size, and perceptions of underweight to obese and acceptable body sizes. Significant effects for acculturation level and current weight were found. Women who were more Anglo oriented showed greater preference for thinner figures. As compared to normal weight women, obese women chose larger figures as ideal, realistic, attractive, and thinnest acceptable. Findings point to the impact of acculturation and obesity on body image and size perceptions. Health professionals working with Mexican Americans should consider each individual's current weight and level of acculturation.

'Take the stairs instead of the escalator': effect of environmental prompts on community stair use and implications for a national 'Small Steps' campaign

The US government initiated a national health campaign targeting 100 'small step' lifestyle changes to combat obesity. Small Step #67 advocates stair instead of escalator usage in public settings. The aim of this study is to evaluate the effects of motivational signs prompting stair use over escalator use on pedestrians' stair usage in commuter settings. Eight studies, testing the effects of motivational prompts on stair vs. escalator usage in public settings, were reviewed. Participant and study attributes were descriptively coded. Effect size was calculated as the change in percent units of stair users during the intervention phases vs. the baseline phase. The average study included approximately 45,000 observations that were recorded across an average of 15 weeks of intervention. The mean +/- SD change in percent units of stair users was 2.8% +/- 2.4% (P < 0.001), and effects were twice as large in females (4.8%) as in males (2.4%). The number of stairs/building, baseline stair use, and total intervention weeks predicted change in stair use, although the effects were clinically miniscule. In a hypothetical city intervention, we projected that a 2.8% increase in stair usage would result in a weight loss and/or weight gain prevention of 300 g/person/year among new stair users. In sum, point-of-decision motivational signs may help communities attain Small Step #67. However, the singular impact of this community intervention on correcting energy imbalance may be minimal, having slight impact itself on reducing the national obesity prevalence.

Ethnicity and body dissatisfaction among women in the United States: A meta-analysis

The prevailing view in popular culture and the psychological literature is that White women have greater body dissatisfaction than women of color. In this meta-analysis, 6 main effect sizes were obtained for differences among Asian American, Black, Hispanic, and White women with a sample of 98 studies, yielding 222 effect sizes. The average d for the White-Black comparison was 0.29, indicating that White women are more dissatisfied, but the difference is small. All other comparisons were smaller, and many were close to zero. The findings directly challenge the belief that there are large differences in dissatisfaction between White and all non-White women and suggest that body dissatisfaction may not be the golden girl problem promoted in the literature. Implications for theory and treatment are discussed.

Are time preference and body mass index associated? Evidence from the National Longitudinal Survey of Youth

The prevalence of obesity among both adults and children in the U.S. has risen to all time highs in the past two decades. We propose that an increase in the marginal rate of time preference has contributed to increasing obesity. More people are consuming more calories than they expend because they have become less willing to trade current pleasure for potential future health benefits. Accordingly, this paper explores the association between body mass index (BMI) and time preference. We use the National Longitudinal Survey of Youth (NLSY79) to test our hypothesis that time preference and BMI are positively related. We find some evidence that there is such a positive association among black and Hispanic men and black women.

Correlates of body mass index and waist-to-hip ratio among Mexican women in the United States: implications for intervention development

INTRODUCTION

This study contributes to our understanding of acculturation and obesity by examining the association between several measures of acculturation, including a bidimensional scale of acculturation, body mass index (BMI), and waist-to-hip ratio (WHR).

METHODS

Exploratory analyses were performed using baseline data from 357 Mexican women recruited into a Spanish-language randomized community trial. The women were randomly sampled by telephone and interviewed in their homes. Women's height, weight, waist, and hip were measured to obtain estimates of their BMI and WHR. A face-to-face interview collected data on dietary intake, physical activity, acculturation, and other demographic and psychosocial variables.

RESULTS

Less than a quarter of the women were normal weight (39% overweight and 41% obese). Univariate analyses revealed that more years living in the United States and less integration into the Anglo culture were associated with a larger BMI and WHR. However, in the multivariate analyses, significant correlates of a larger BMI were less moderate physical activity and unemployment. There were trends linking a larger BMI with older age, no vigorous physical activity, more energy intake, and less integration into the Anglo culture. These same variables plus less household income were associated with a higher WHR. Exploratory analyses on acculturation revealed that bicultural Mexican-American women were more educated, more likely to be employed, reported a higher household income, and perceived fewer barriers to a healthy diet compared with traditional Mexican women.

CONCLUSIONS

Intervention designed to prevent overweight/obesity should consider promoting maintenance of Mexican cultural practices, as well as teach women how to effectively integrate into the Anglo culture.