Obesity and hunger among Mexican-Indian migrant children on the US-Mexico border

Double burden of malnutrition among migrants and refugees in developed countries: A mixed-methods systematic review

Migrants and refugees living in high income countries (HICs) have an increased risk of developing non-communicable diseases (NCDs) due to malnutrition at different stages over their life course. This systematic review aims to examine the double burden of malnutrition (DBM) among migrants and refugees in developed countries. This review was informed by the standard Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. Eligible studies were peer-reviewed observational studies that focused on the DBM in refugee or migrant populations; and were written in English with full texts available and accessible. A combination of keywords was used to search 8 electronic bibliographic databases including Ovid MEDLINE, EMBASE, PsycINFO, CINAHL, ProQuest, Scopus, PubMed, and web of science. There is a paucity of research into the DBM among migrants and refugees residing in HICs. Of a total of 2344 articles retrieved from eight databases, 5 studies met the inclusion criteria. All included studies showed the co-existence of some form of undernutrition and overnutrition within the same population. Overnutrition (overweight and obesity) in the studied populations ranged from 11.1% to 42% while undernutrition (stunting, wasting and underweight) ranged from 0.3% to 17%. Standard measures for anthropometry as determined by World Health Organization (WHO) were used for data collection in all included studies. A piloted form informed by the Cochrane Public Health Group Data Extraction and Assessment Template was used in the extraction of data from retrieved studies. Quality assessment of included studies was performed using the study assessment tools of the National Heart, Lung, and Blood Institute of the National Institutes of Health (NIH) and showed that all studies were of fair quality. Interventions that simultaneously target more than one form of malnutrition especially amongst migrant and refugee populations must be implemented for policy solutions to be effective. This review has been registered by the PROSPERO international prospective registry for systematic reviews, reference CRD42020192416.

Dyslipidemia, Obesity, and Ethnicity in Mexican Children

The aim of this study was to assess lipid disorders in children from five ethnic groups, both urban and indigenous, from northern and central Mexico. We measured the lipid profile to determine the ability of the body mass index (BMI) to discriminate an abnormally high lipid level using receiving operating characteristics (ROC). We analyzed the association and interaction of obesity and ethnicity with lipid disorders using generalized linear models in 977 children. The highest prevalence of lipid disorders (high TG, high TC, high LDL, high APOB, and dyslipidemia) was found in central Mexico-Mexico City and urban northern Mexico. The BMI performed better at predicting low HDL in Seris, a northern indigenous group (0.95, CI: 0.69-0.85), and Mexico City (0.75, CI: 0.69-0.82), and high LDL in Puebla (central Mexico, 0.80, CI: 0.69-0.85). Obesity significantly (p < 0.05) increases lipid disorders by around two times (OR~2) for almost all lipid markers. Obesity and ethnic interaction increase the lipid disorders by more than five times for different lipid markers and ethnic groups (high total cholesterol OR = 5.31; low HDL OR = 5.11, and dyslipidemia OR = 5.68). Lipid disorders are not restricted to children with high BMIs, but obesity exacerbates these. The emerging lipid disorder risk depends on the ethnic group.

Prevalence of food insecurity and related factors among slum households in Kerman, south of Iran

INTRODUCTION

Household food insecurity (FI) is defined as limited or uncertain access to nutritionally adequate and safe food or limited ability to obtain foods in socially acceptable ways has become a global issue in recent decades.

METHODS

This cross-sectional study was conducted in Kerman, southeast of Iran in 2019, covering 559 marginalised households. United States Department of Agriculture food security measure was used for data collection. Finally, data were analysed using t-test, χ ² , Mann-Whitney tests and logistic regression.

RESULTS

The prevalence of FI was 82% among slums households. The most important experience of FI in households was reliance on low-cost foods. There was a significant relationship between slums FI and gender of head of household, household size, household income, household education level and marital status (p ˂ 0.05). According to the results of the multivariate regression the variables of education, household income level and household size significantly determined FI (p ˂ 0.05).

CONCLUSION

The most important determinant of FI was low socioeconomic status (income, education, household size). Hence, public policies targeting socioeconomic factors should be made to improve the socioeconomic status of slum dwellers.

Effect of multi-component school-based program on body mass index, cardiovascular and diabetes risks in a multi-ethnic study

Background

Mexico occupies one of the first places worldwide in childhood obesity. Its Mestizo and Indigenous communities present different levels of westernization which have triggered different epidemiological diseases. We assessed the effects of a multi-component school-based intervention program on obesity, cardiovascular and diabetes risk factors.

Methods

A physical activity, health education and parent involvement (PAHEPI) program was developed and applied in six urban (Mestizo ethnic group) and indigenous (Seri and Yaqui ethnic groups) primary schools for 12 weeks. A total of 320 children aged 4–12 years participated in intervention program; 203 under Treatment 1 (PAHEPI program) and 117, only from Mestizo groups, under Treatment 2 (PAHEPI+ school meals). For Body Mass Index (BMI), cardiovascular and diabetes factors, pairwise comparisons of values at baseline and after treatments were done using Wilcoxon signed rank test. Generalized linear models were applied to assess the intervention effect by age, sex and nutritional status in relation to ethnicity and treatment.

Results

We observed improvements on BMI in children with overweight-obesity and in triglycerides in the three ethnic groups. The Mestizo ethnic group showed the largest improvements under Treatment 2. While Seris showed improvements only in cardiovascular risk factors, Yaquis also showed improvements in diabetes risk factors, though not in BMI.

Conclusions

This study showed that the same intervention may have positive but different effects in different ethnic groups depending on their lifestyle and their emerging epidemiological disease. Including this type of intervention as part of the school curriculum would allow to adapt to ethnic group in order to contribute more efficiently to child welfare.

Trial registration

This study was retrospectively registered under the identifier NCT03768245.

Associations Among Food Insecurity, Academic Performance, and Weight Status in Primary Schoolchildren in Tehran, Iran: A Cross-sectional Study

OBJECTIVE

To examine the associations among household food insecurity (FI), academic performance, and weight status in urban primary schoolchildren.

DESIGN

Cross-sectional study.

SETTING

Primary schools in Tehran, Iran.

PARTICIPANTS

A total of 803 students (419 boys and 384 girls), aged 10-12 years, were recruited from 43 primary schools.

MAIN OUTCOME MEASURES

Levels of FI were measured using a locally validated, 18-item household food security survey module. Academic performance was assessed by 152 teachers through a specifically designed, 20-scale questionnaire. Standard anthropometric measurements were also taken.

ANALYSIS

Linear and multinomial regressions were conducted.

RESULTS

At the household level, FI was associated with poorer grades in all subjects studied (except for social science in FI without hunger) (P < .05). At the child level, a significant association was observed between low food security and poorer grades in all subjects studied, whereas for very low food security, this relationship was significant only for mathematics, reading, and science (P < .05). Food insecurity without hunger (odds ratio = 2.56; 95% confidence interval, 1.05-6.23) and low food security (odds ratio = 4.41; 95% confidence interval, 1.58-12.23) were associated with overweight only in girls.

CONCLUSIONS AND IMPLICATIONS

The findings confirm the need for policies and programs to improve students' dietary quality and food security to improve their health as well as educational attainment. Future research is needed to explore further the association between food security and academic performance.

Measurement of the dimensions of food insecurity in developed countries: a systematic literature review

OBJECTIVE

Food insecurity is a salient health issue comprised of four dimensions - food access, availability, utilization and stability over time. The aim of the present study was to conduct a systematic literature review to identify all multi-item tools that measure food insecurity and explore which of the dimensions they assess.

DESIGN

Five databases were searched (CENTRAL, CINAHL plus, EMBASE, MEDLINE, TRIP) for studies published in English since 1999. Inclusion criteria included human studies using multi-item tools to measure food security and studies conducted in developed countries. Manuscripts describing the US Department of Agriculture Food Security Survey Module, that measures 'food access', were excluded due to wide acceptance of the validity and reliability of this instrument. Two authors extracted data and assessed the quality of the included studies. Data were summarized against the dimensions of food insecurity.

SETTING

A systematic review of the literature.

SUBJECTS

The majority of tools were developed in the USA and had been used in different age groups and cultures.

RESULTS

Eight multi-item tools were identified. All of the tools assessed the 'food access' dimension and two partially assessed the dimensions 'food utilization' and 'stability over time', respectively. 'Food availability' was not assessed by existing tools.

CONCLUSIONS

Current tools available for measuring food insecurity are subjective, limited in scope, with a majority assessing only one dimension of food insecurity (access). To more accurately assess the true burden of food insecurity, tools should be adapted or developed to assess all four dimensions of food insecurity.

The Association between Food Insecurity and Obesity in Children-The National Health and Nutrition Examination Survey

BACKGROUND

Food insecurity can put children at greater risk of obesity because of altered food choices and nonuniform consumption patterns.

OBJECTIVE

We examined the association between obesity and both child-level food insecurity and personal food insecurity in US children.

DESIGN

Data from 9,701 participants in the National Health and Nutrition Examination Survey, 2001-2010, aged 2 to 11 years were analyzed. Child-level food insecurity was assessed with the US Department of Agriculture's Food Security Survey Module based on eight child-specific questions. Personal food insecurity was assessed with five additional questions. Obesity was defined, using physical measurements, as body mass index (calculated as kg/m²) greater than or equal to the age- and sex-specific 95th percentile of the Centers for Disease Control and Prevention growth charts. Logistic regressions adjusted for sex, race/ethnic group, poverty level, and survey year were conducted to describe associations between obesity and food insecurity.

RESULTS

Obesity was significantly associated with personal food insecurity for children aged 6 to 11 years (odds ratio=1.81; 95% CI 1.33 to 2.48), but not in children aged 2 to 5 years (odds ratio=0.88; 95% CI 0.51 to 1.51). Child-level food insecurity was not associated with obesity among 2- to 5-year-olds or 6- to 11-year-olds.

CONCLUSIONS

Personal food insecurity is associated with an increased risk of obesity only in children aged 6 to 11 years. Personal food-insecurity measures may give different results than aggregate food-insecurity measures in children.

Bimodal distribution of risk for childhood obesity in urban Baja California, Mexico

In Mexico, higher socioeconomic status (SES) has been found to be associated with increased risk for obesity in children. Within developed urban areas, however, there may be increased risk among lower SES children. Students in grades 4-6 from five public schools in Tijuana and Tecate, Mexico, were interviewed and weight, height and waist circumference (WC) measurements were taken. Interviews consisted of questions on food frequency, food insecurity, acculturation, physical activity and lifestyle practices. Multivariate logistic models were used to assess risk factors for obesity (having a body mass index [BMI] ≥95th percentile) and abdominal obesity (a WC >90th percentile) using Stata 11.0. Five hundred and ninety students were enrolled; 43.7% were overweight or obese, and 24.3% were obese and 20.2% had abdominal obesity. Independent risk factors for obesity included watching TV in English (odds ratio [OR] 1.60, 95% confidence interval [CI] 1.06-2.41) and perceived child food insecurity (OR 1.57, 95% CI 1.05-2.36). Decreased risk for obesity was associated with female sex (OR 0.64, 95% CI 0.43-0.96), as was regular multivitamin use (OR 0.63, 95% CI 0.42-0.94). Risk obesity was also decreased with increased taco consumption (≥1×/week; OR 0.64, 95% CI 0.43-0.96). Independent risk factors for abdominal obesity included playing video games ≥1×/week (OR 1.18, 95% CI 1.11-2.96) and older age group (10-11 years, OR 2.47, 95% CI 1.29-4.73 and ≥12 years, OR 2.21, 95% CI 1.09-4.49). Increased consumption of tacos was also associated with decreased risk for abdominal obesity (≥1×/week; OR 0.56, 95% CI 0.40-1.00). We found a bimodal distribution for risk of obesity and abdominal obesity in school aged children on the Mexican border with the United States. Increased risk for obesity and abdominal obesity were associated with factors indicative of lower and higher SES including watching TV in English, increased video game playing and perceived food insecurity. Increased consumption of tacos (≥1×/week) was associated with decreased risk, possibly suggesting an association with children from middle income families. Regular multivitamin use was protective and future studies may focus on micronutrient supplementation as a means to prevent obesity in children or further investigate factors associated with vitamin use. Additionally, future studies need to examine the processes of acculturation on both sides of the US-Mexican border that contribute to increased risk for obesity in children in relation to SES.

High food insecurity and its correlates among families living on a rural American Indian Reservation

OBJECTIVES

We sought to better understand the prevalence and consequences of food insecurity among American Indian families with young children.

METHODS

Parents or caregivers of kindergarten-age children enrolled in the Bright Start study (dyad n=432) living on the Pine Ridge Reservation in South Dakota completed a questionnaire on their child's dietary intake, the home food environment, and food security. We assessed food security with a standard 6-item scale and examined associations of food insecurity with family sociodemographic characteristics, parents' and children's weight, children's dietary patterns, and the home food environment.

RESULTS

Almost 40% of families reported experiencing food insecurity. Children from food-insecure households were more likely to eat some less healthful types of foods, including items purchased at convenience stores (P= .002), and food-insecure parents reported experiencing many barriers to accessing healthful food. Food security status was not associated with differences in home food availability or children's or parents' weight status.

CONCLUSIONS

Food insecurity is prevalent among families living on the Pine Ridge Reservation. Increasing reservation access to food that is high quality, reasonably priced, and healthful should be a public health goal.

Traditional food and monetary access to market-food: correlates of food insecurity among Inuit preschoolers

OBJECTIVES

To evaluate correlates of food insecurity among Inuit preschoolers. Study design. Cross-sectional health survey.

METHODS

Correlates of food insecurity were assessed in 3-5 year old children (n=388) residing in 16 Nunavut communities (2007-2008) in whom a high prevalence of child food insecurity (56%) has been documented. A bilingual team conducted interviews, including 24-hour dietary recalls and past-year food security assessment involving monetary access to market foods.

RESULTS

Children residing in child food insecure homes were more likely to have consumed traditional food (TF) (51.7% vs. 39.9%, p ≤ 0.01), and less likely to have consumed any milk (52.2% vs. 73.2%, p ≤ 0.001) compared to children in child food secure homes. Median healthy eating index scores were significantly lower (77.1 vs. 79.9, p ≤ 0.01) and sugar drink intake higher (429 vs. 377 g/day, p ≤ 0.05) in children from child food insecure than food secure households. Children that consumed TF had higher protein and lower carbohydrate intake (p ≤ 0.05) and tendencies for a lower prevalence of iron deficiency (plasma ferritin <12 μg/l; p ≤ 0.10) regardless of food security status. A borderline significant interaction of TF by food security status (p ≤ 0.10) was observed where the percent of anemia (hemoglobin <110 and <115 g/l for 3-4 and 5 yr. olds, respectively) was highest among children from child food insecure homes who consumed no TF.

CONCLUSIONS

TF and market food contribute to food security and both need to be considered in food security assessments. Support systems and dietary interventions for families with young children are needed.

Factors associated with overweight and obesity among children of Mexican descent: results of a binational study

The prevalence of childhood obesity is high among young children of Mexican origin in the United States, however, the determinants are poorly understood. We conducted a binational study with a sample from California (CA) and Mexico (MX), to identify and compare the most important factors associated with overweight and obesity among children of Mexican descent. Significantly more children were classified as overweight or obese in CA compared to MX (53.3 vs. 14.9%, P < 0.01). In CA and MX, having an obese mother was significantly associated with being overweight or obese. In MX, male gender, high socioeconomic status and very low food insecurity were associated with being overweight or obese. These data offer hypotheses for how migration may influence the high prevalence of overweight among the Mexican children in California.

Household food insecurity and childhood overweight in Jamaica and Québec: a gender-based analysis

Background

Childhood overweight is not restricted to developed countries: a number of lower- and middle-income countries are struggling with the double burden of underweight and overweight. Another public health problem that concerns both developing and, to a lesser extent, developed countries is food insecurity. This study presents a comparative gender-based analysis of the association between household food insecurity and overweight among 10-to-11-year-old children living in the Canadian province of Québec and in the country of Jamaica.

Methods

Analyses were performed using data from the 2008 round of the Québec Longitudinal Study of Child Development and the Jamaica Youth Risk and Resiliency Behaviour Survey of 2007. Cross-sectional data were obtained from 1190 10-year old children in Québec and 1674 10-11-year-old children in Jamaica. Body mass index was derived using anthropometric measurements and overweight was defined using Cole's age- and sex-specific criteria. Questionnaires were used to collect data on food insecurity. The associations were examined using chi-square tests and multivariate regression models were used to estimate odds ratios (OR) and 95% confidence intervals.

Results

The prevalence of overweight was 26% and 11% (p < 0.001) in the Québec and Jamaican samples, respectively. In Québec, the adjusted odds ratio for being overweight was 3.03 (95% CI: 1.8-5.0) among children living in food-insecure households, in comparison to children living in food-secure households. Furthermore, girls who lived in food-insecure households had odds of 4.99 (95% CI: 2.4-10.5) for being overweight in comparison to girls who lived in food-secure households; no such differences were observed among boys. In Jamaica, children who lived in food-insecure households had significantly lower odds (OR 0.65, 95% CI: 0.4-0.9) for being overweight in comparison to children living in food-secure households. No gender differences were observed in the relationship between food-insecurity and overweight/obesity among Jamaican children.

Conclusions

Public health interventions which aim to stem the epidemic of overweight/obesity should consider gender differences and other family factors associated with overweight/obesity in both developed and developing countries.

Childhood obesity in transition zones: an analysis using structuration theory

Childhood obesity is particularly prevalent in areas that have seen rapid economic growth, urbanisation, cultural transition, and commodification of food systems. Structuration theory may illuminate the interaction between population and individual-level causes of obesity. We conducted in-depth ethnographies of six overweight/obese and four non-overweight preschool children in Hong Kong, each followed for 12-18 months. Analysis was informed by Stones' strong structuration theory. Risk factors played out differently for different children as social structures were enacted at the level of family and preschool. The network of caregiving roles and relationships around the overweight/obese child was typically weak and disjointed, and the primary caregiver appeared confused by mixed messages about what is normal, expected and legitimate behaviour. In particular, external social structures created pressure to shift childcare routines from the logic of nurturing to the logic of consumption. Our findings suggest that threats to what Giddens called ontological security in the primary caregiver may underpin the poor parenting, family stress and weak mealtime routines that mediate the relationship between an obesogenic environment and the development of obesity in a particular child. This preliminary study offers a potentially transferable approach for studying emerging epidemics of diseases of modernity in transition societies.

Bounding the effects of food insecurity on children's health outcomes

Previous research has estimated that food insecure children are more likely to suffer from a wide array of negative health outcomes than food secure children, leading many to claim that alleviating food insecurity would lead to better health outcomes. Identifying the causal impacts is problematic, however, given endogenous selection into food security status and potential mismeasurement of true food security status. Using recently developed nonparametric bounding methods and data from the 2001-2006 National Health and Nutritional Examination Survey (NHANES), we assess what can be identified about the effects of food insecurity on child health outcomes in the presence of nonrandom selection and nonclassical measurement error. Under relatively weak monotonicity assumptions, we can identify that food security has a statistically significant positive impact on favorable general health and being a healthy weight. Our work suggests that previous research has more likely underestimated than overestimated the causal impacts of food insecurity on health.

Food insecurity is not associated with childhood obesity as assessed using multiple measures of obesity

There has been extensive previous research examining the connection between obesity and food insecurity, 2 serious nutrition challenges facing low-income children in the US. All of this work used BMI to categorize a child as obese. Although BMI is one way to categorize the obesity status of a child, other measures have not been used to understand the connection between food insecurity and obesity. In response, this study used multiple measures of obesity taken from the 2001 to 2004 NHANES. The sample included 2516 children between the ages of 8 and 17 y in households with annual incomes <200% of the poverty line. Within this sample, 36.6% of children were in food-insecure households. The prevalence of obesity depended on the measure employed (BMI, waist circumference, triceps skinfold thickness, trunk fat mass, body fat), with prevalence rates ranging from 15.4 to 44.8%. Logistic regression models estimated the probability of a child being obese using multiple measures of obesity conditional on food-insecurity status and other covariates. The results indicated that food-insecure children were no more likely to be obese than their food-secure counterparts across all measures of obesity. This relationship held after controlling for other factors and examining subpopulations based on race/ethnicity, gender, and race/ethnicity and gender. These results suggest that efforts to alleviate food insecurity and childhood obesity will work independently.

Recent findings concerning childhood food insecurity

PURPOSE OF REVIEW

Food insecurity is a relatively new measure of household and child malnutrition. This paper reviews recent studies that have examined aspects of its etiology and adverse child health and development.

RECENT FINDINGS

Smoking by adults in children's homes has recently been found to be highly associated with childhood food insecurity. Much recent research has also examined the relationship between food insecurity and childhood obesity, and thus far, whereas suggestive, results are conflicting. Some studies have found that parenting practices and parental depression are factors that link household food insecurity with childhood obesity. Other health outcomes recently shown to be associated with food insecurity include undernutrition, decreased mental proficiency, increased developmental risk, adverse pregnancy outcomes, and poor health status. Most of the studies of food insecurity to date have come from the USA. There is, however, absolutely no reason to believe that this measure, and the negative child health outcomes associated with it, does not apply to other developed nations. Similarly, it is likely that children and families living in developing countries suffer a greater prevalence and severity of food insecurity and its negative consequences.

SUMMARY

Childhood food insecurity has numerous significant negative effects on childhood health and development, may be associated with obesity, and occurs much more often in impoverished homes with adult smokers.

Food security, maternal stressors, and overweight among low-income US children: results from the National Health and Nutrition Examination Survey (1999-2002)

OBJECTIVE

A high proportion of children in the United States are overweight, suffer from food insecurity, and live in households facing maternal stressors. The objective of this article was to identify the associations of food insecurity and maternal stressors with childhood overweight among low-income children. We hypothesized that maternal stressors may exacerbate the relationship between food insecurity and child obesity.

METHODS

The sample included 841 children (3-17 years old) and their mothers with incomes below 200% of the poverty line from the 1999-2002 National Health and Nutrition Examination Survey. Food insecurity was based on US Department of Agriculture protocol, maternal stressors were assessed from survey questions, and BMI was used to classify weight status. Probit regression models predicted the probability of a child being overweight or obese.

RESULTS

In most specifications, there was no direct association between food insecurity or maternal stressors and overweight for children of any age. Among 3- to 10-year-olds, the interaction of food insecurity and maternal stressors was significantly linked to the probability of being overweight; more specifically, an increase in maternal stressors amplified a food secure child's probability of being overweight or obese. This result is robust to alternative specifications. However, these results were not found among 11- and 17-year-old youth.

CONCLUSIONS

Younger children in food secure, low-income households in the United States who are experiencing higher levels of maternal stressors have a greater probability of being overweight than food insecure children. This finding was contrary to the hypothesis; 3 reasons for this are covered in the article. Those who create policies that address childhood obesity could consider the benefits to low-income children's well-being resulting from reducing their mothers' stressors. Because most children in the United States are food secure, these policies could have a profound impact on childhood overweight.

Child-specific food insecurity and overweight are not associated in a sample of 10- to 15-year-old low-income youth

In the United States, 17% of children and adolescents are overweight and 20% live in a food insecure household. Previous studies examining the association between household food insecurity and overweight among children have been inconclusive but are limited insofar as they did not assess child-specific measures of food insecurity and overweight. In response, this study examined the association between food insecurity and child overweight status when these variables were measured for the same child using information on children (n = 1031) aged 10-15 y from the Three-City Study. Approximately 8% of the children were food insecure, whereas 50% were either at risk of overweight or overweight. Bivariate analyses indicated that there were no significant differences in the prevalence of at risk of overweight and overweight between food secure and food insecure children. Gender, race, and income showed similar patterns. Results from logistic regression analyses also indicated that the likelihood of being overweight or at risk of overweight was not significantly different for food secure and food insecure children. Although child-specific food insecurity was not associated with overweight in this sample of low-income children, food insecurity and overweight coexist among these low-income children, because approximately 25% of the food insecure children were overweight. Additional research is needed to explore the potential relationships between food insecurity and overweight and to better inform policy that attempts to address these issues among low-income households with children.

Stigmatization of overweight Mexican children

The present study was designed to determine the weight-based stigmatization of Mexican overweight (OW) and non-OW children by their mothers and peers, who rated both boys and girls with varying physical characteristics. Four hundred and thirty-two fifth and sixth graders and 342 mothers participated in the study. Children were administered a questionnaire displaying six drawings. Participants' responses were numbered in order of preference from 1 to 6 (most to least well liked). Participants were divided into categories based on socioeconomic status, ethnicity, and current body mass index. The majority of children chose the child in a wheelchair as the preferred friend. Boys and girls, Indian and non-Indian, with and without risk of OW chose the obese peer as the least-preferred friend. Non-OW girls and their mothers liked the obese child less than non-OW boys and their mothers. Agreement correlations between mothers and children were rho = 0.19 (P = 0.0001), rho = 0.17 (P = 0.001), and rho = 0.13 (P = 0.02) for the healthy child, child with missing arm, and obese child, respectively. There was a strong correlation between Indian mothers and non-OW daughters (rho = 0.54, P = 0.009) on choosing the drawing of the obese child as the least preferred friend. These data suggest an influential effect of the negative attitude of mothers toward the obese child, which are projected to their children.

Nutrition provided to Mexican-American preschool children on the Texas-Mexico border

The purpose of this study was to assess whether nutrients offered to border Mexican-American preschool children met the Recommended Dietary Allowances. Nutrient contents of two dietary patterns were examined in this study, one composed exclusively of home foods and one containing a combination of both home and school foods. The sample consisted of 198 Mexican-American preschoolers living on the Texas-Mexico border, who were recruited using a convenience sampling technique. A self-administered, precoded 24-hour recall questionnaire was used. Nutrient values of home foods were collected during a weekend day, and nutrient values containing a combination of both home and school foods were collected during a weekday. Fisher's exact test or chi2 test and t test were used for analyses. Mean nutrient contents of foods provided to the border Mexican-American children exceeded recommendations for total energy (P<0.001), total fat (P<0.001), saturated fat (P<0.001), carbohydrates (P<0.001), protein (P<0.001), sodium (P<0.001), and niacin (P<0.001). Foods offered were also significantly insufficient in fiber (P<0.001), vitamin A (P<0.001), and potassium (P<0.001). Nutrition interventions targeting low-income border Mexican-American families should emphasize the need and importance of providing children with diets that meet the Recommended Dietary Allowances.

Family food insufficiency is related to overweight among preschoolers’

This paper studies the relationship between family food insufficiency and being overweight in a population-based cohort of preschool children (n=2103) using data from the Longitudinal Study of Child Development in Québec (1998-2002) (LSCDQ). Family food insufficiency status was derived when children were 1.5 years of age (from birth to 1.5 years) and at 4.5 years of age (from 3.5 to 4.5 years). Children's height and weight were measured at home at 4.5 years. Overweight was defined according to the US CDC sex- and age-specific growth charts and Cole's criteria. Statistical analyses were done with SAS (version 8.2). In multivariate analyses, mean body mass index (BMI) was higher for children from food insufficient families compared to children from food sufficient families, even when important factors associated with BMI, such as child's birth weight, parental BMI, maternal education, and family income sufficiency were considered. We did not report any gender effects in the multivariate analyses. The presence of family food insufficiency at some point during preschool years more than tripled (OR 3.4, 95% CI 1.5-7.6) the odds for obesity using the Cole criteria, and doubled (OR 2.0, 95% CI 1.1-3.6) the odds for overweight at 4.5 years using the CDC growth curves indicator. We observed an interaction between birth weight and family food insufficiency in relation to being overweight at 4.5 years. Low-birth-weight children living in a household that experienced food insufficiency during preschool years are at higher risk of overweight at 4.5 years. Given this important finding, supportive interventions targeting low-income and food insufficient families, including pregnant women, are recommended for preventing overweight and obesity among their children.

Overweight and stunting in migrant Hispanic children in the USA

In order to evaluate the need for preventive interventions to improve nutrition, the BMI/sex/age percentile, height/sex/age percentile, prevalence of stunting, at-risk-for-overweight and overweight in a group of migrant Hispanic children, aged 2-18, in southern New Jersey, USA, was assessed using anthropometric measurements of height, weight and skinfold thickness with reference to the NHANES 1999-2000. Results showed that the frequency of overweight in this sample--20%--exceeds that of the general U.S. pediatric population and equals or exceeds (in 2-5-year olds) that of settled Mexican-Americans. Being born in the U.S. significantly diminished the prevalence of stunting, especially in boys. The children of migrant Hispanic agricultural workers belong to a marginalized, poor and insecure population who are not included in the National Health and Nutrition Examination studies, because of their transience. This is the first anthropometric study to evaluate growth in this population in over 20 years.

A flexible, low-glycemic index mexican-style diet in overweight and obese subjects with type 2 diabetes improves metabolic parameters during a 6-week treatment period

OBJECTIVE

The aim of this study was to compare the effects of a flexible lower- and higher-glycemic index (GI) Mexican-style diet on biochemical data and BMI during a 6-week treatment period.

RESEARCH DESIGN AND METHODS

This study was a randomized, crossover design of two 6-week periods with a 6-week washout period between treatments. Subjects with type 2 diabetes (n = 36) with a BMI >25 kg/m(2) were selected. Fourteen subjects completed the study with eligible dietary records. Dietary instruction was provided on flexible diets with both a high and low GI. Fasting venous blood samples were taken at the start and finish of each dietary period, and biochemical data were analyzed. Multi- and univariate one-factor repeated-measures ANOVA were used to compare biochemical data.

RESULTS

Glycemic load and GI were lower during the low-GI diet, and dietary fiber was lower during the high-GI diet. The participants in the low-GI period consumed significantly fewer carbohydrates, such as white-wheat bread, white long-grain rice, potatoes, high-GI fruits, and carrots, and more carbohydrates, such as pinto beans, whole-meal wheat bread, and low-GI fruits than did participants in the high-GI period. There were no differences in the amount of carbohydrates consumed, such as corn tortillas and dairy products. At the end of the study periods, A1c was improved on the low- compared with the high-GI diet (P < 0.008).

CONCLUSIONS

We conclude that a low-GI diet, containing Mexican-style foods, may help to improve the metabolic control in type 2 obese diabetic subjects during a 6-week period.