Hence, efforts should be made to prevent GDM and excess maternal weight gain during pregnancy; otherwise, this vicious cycle may continue and affect subsequent generations in a family. Goals should be realistic, of specific duration, and revised as needed. Powell AD, Kahn AS: Racial differences in women's desires to be thin. Prevention efforts should fall within the framework of the socio-ecological model, which views children in the context of their families, communities, and cultures. The primary care provider should routinely discuss obesity risk during encounters with children and families. The duration of this brief, focused discussion may need to vary not only based on the child's risk of obesity but also on the child's culture and the education level and SES of the child/family. One secondary analysis of a single-center trial of sibutramine suggested that obese white adolescents may have better weight loss with the combination of behavioral therapy and sibutramine than obese black adolescents (73). These children are disproportionately minority and residents of low-SES areas. Bacha F, Saad R, Gungor N, Janosky J, Arslanian SA: Obesity, regional fat distribution, and syndrome X in obese black versus white adolescents: race differential in diabetogenic and atherogenic risk factors. Disparities were found in children of other race/ethnicities. Consider cultural and gender preferences with regard to advice about physical activity. It is important to plot BMI, to show the child/family the plot of BMI over time, and to explain the meaning of BMI, BMI percentile, and upward crossing of percentiles. Obesity-related risk factors and diseases formerly seen only in adults are increasingly being recognized in obese adolescents and even younger children. International data indicate that the prevalence of obesity is greater among boys than girls 519 years of age in the majority of high and upper middle-income countries worldwide. African American and Hispanic children have lower insulin sensitivity than white children. Pham KL, Harrison GG, Kagawa-Singer M: Perceptions of diet and physical activity among California Hmong adults and youths. There is an association between parents perceptions of neighborhood safety and childhood obesity (65). Bilingual school-age children from immigrant Mexican households serve as agents of dietary acculturation by rejecting the lower-calorie traditional foods prepared at home and favoring the higher-calorie foods, beverages, and snacks they consume at school or see advertised on television (50) and may resist efforts by their parents to restrict the availability of foods from the mainstream culture. For instance, exposure to food-related television advertising was found to be 60% greater among African American children, with fast food as the most frequent category (54). Even in some developing countries, where undernutrition has traditionally been one of the major health concerns in children, overweight and obesity are now more prevalent. The purpose of this chapter was to determine if obesity is culturally influenced. Liese AD, DAgostino RB Jr, Hamman RF, Kilgo PD, Lawrence JM, Liu LL, Loots B, Linder B, Marcovina S, Rodriguez B, Standiford D, Williams DE: The burden of diabetes mellitus among US youth: prevalence estimates from the SEARCH for Diabetes in Youth Study. WebObesity is defined as having a BMI at or above the 95th percentile. Despite this observed sex Similarly, there have been changes in patterns of physical activity linked to risk of obesity in both adults and children worldwide, including increased use of motorized transport, fewer opportunities for recreational physical activity, and increased sedentary recreation (44). Lupien SJ, King S, Meany MJ, McEwen BS: Child's stress hormone levels correlate with mother's socioeconomic status and depressive state. They are not all the same. Food habits can be established early in life, which makes it important to counsel parents of toddlers about appropriate food intake. The best available data from studies of weight loss in adults suggest that total calorie intake, not diet composition, determines long-term weight loss. The panel agrees with the report's call to restrict television advertising of food items of low nutrient density to children. There are few full-service supermarkets in poorer neighborhoods but many convenience stores selling calorie-dense less nutritious foods. The child and family are influenced by a wide variety of factors such as economic resources, geography, the built environment, available grocery/food stores, community resources, transportation, media/messaging, the work site, and schools. While consumption of traditional food with family may lower the risk of obesity in some children (e.g., Asians) (52), it may increase the risk of obesity in other children (e.g., African Americans) (53). Culture plays a significant role in how women perceive obesity in terms of both appearance and health, according to a study by Yale School of Nursing researchers in the Journal of Advanced Nursing. Ethnicity is used to categorize on the basis of cultural characteristics such as shared language, ancestry, religious traditions, dietary preferences, and history. The prevalence of type 2 diabetes in youth is low but increasing, especially in some racial and ethnic groups. Individuals with low SES in low-income countries are at risk of undernutrition. We need to better understand how to translate the socio-ecological model into practice. The relationships between stress and illness differ markedly by race/ethnicity, in part due to differences in exposure to social and environmental stressors; the degree to which the environment, SES, and discrimination are appraised as stressful; culturally appropriate strategies for coping with stress; biological vulnerability to stress; and the expression of stress as illness (30). It has increased in both sexes and in all racial, ethnic, and socioeconomic groups. Ogden CL, Flegal KM, Carroll MD, Johnson CL: Prevalence and trends in overweight among US children and adolescents, 19992000. The authors thank the researchers who presented their work at the conference: Silva Arslanian, MD; Robert Branson, PhD; Paula Braveman, MD, MPH; John Elder, PhD, MPH; Jose Fernandez, PhD; Michael Freemark, MD; Elizabeth Goodman, MD; Michael Goran, PhD; Bernard Gutin, PhD; Gail Harrison, PhD; David Ludwig, MD, PhD; Teresia OConnor, MD, MPH; Roland Sturm, PhD; and Denise Wilfley, PhD. Krieger N: Does racism harm health? In adults, whites experience more weight loss following gastric bypass surgery or gastric banding surgery than blacks or Hispanics (75,76). Finally, culture may influence the manner in which the risk for obesity varies by social status. Liraglutide was the first such drug to be approved as a treatment for obesity, and has been available for that use since 2014. Cultural contexts shape values and norms about body weight and change weight through modernization, migration and acculturation, and historical contexts change weights and attitudes about weight over time. Comprehensive lifestyle interventions including behavior modification produce significant treatment effects in children (70). Guidelines exist to identify, evaluate, and treat obese children (66), but there is insufficient evidence to recommend a specific treatment approach according to the race/ethnicity of the child. Prevention of future obesity is yet another reason to assure that pregnant women have access to prenatal care, optimal nutrition, efforts to reduce prenatal stress, and counseling to avoid alcohol, drugs, and cigarettes. Its hard to feel like you might have to give up your history to manage your health. The association of obesity in childhood with the emergence of type 2 diabetes is also disproportionately seen in Hispanic, Native American, and African American adolescents. Setting Five primary Palinkas LA, Colcord CL: Health risks among enlisted males in the U.S. Navy: race and ethnicity as correlates of disease incidence. Barlow SE, Expert Committee: Expert Committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Johnson LD, Delva J, OMalley PM: Sports participation and physical education in American secondary schools: current levels and racial/ethnic and socioeconomic disparities. Although childhood obesity is increasing in all ethnic and racial groups, its prev-alence is higher in nonwhite populations. Data on household SES are often limited to self-reported parental education and income levels. Is Obesity Cultural? Obesity is a biopsychosocial phenomenon. Race and ethnicity are terms used to categorize populations on the basis of shared characteristics. Although federal regulation requires that these meals must meet certain nutritional standards, the NSLP relies upon foods purchased and donated by the USDA. 8600 Rockville Pike Birch LL, Fisher JO: Mothers child-feeding practices influence daughters eating and weight. Neighborhood of residence may influence access to healthy foods, opportunities for physical activity, the quality of local schools, time allocation, and commuting time. A study by Katz et al. Cultural patterns of shared understandings influence food consumption in several ways. The socio-ecological model also focuses on interactions between a person's physical, social, and cultural surroundings, and therefore we believe it to be the best approach in efforts to prevent obesity in all ethnic groups. For example, a dance program for African American girls (68) and resistance training for Latino boys (69) have shown good acceptance. WebBy arguing this way, obesity prevention comes into view as a public endeavor that involves public discourse as well as shared action. For instance, perceived ideal body size for African American women is significantly larger than it is for white women, and African American men are more likely than non-Hispanic white men to express a preference for larger body size in women (45). F.R.K. Public health strategies for prevention of childhood obesity must address these factors along with other disparities. Did child abuse exist before 1962? The effect of the federal government's farm subsidy program may also be contrary to sound dietary practices. Rural migrants abandon traditional diets rich in vegetables and cereal in favor of processed foods and animal products. Schwimmer JB, Burwinkle TM, Varni JW: Health-related quality of life of severely obese children and adolescents. One hypothesis linking SES variables and childhood obesity is the low cost of widely available energy-dense but nutrient-poor foods. Also, parental concern about neighborhood crime and, therefore, their children's safety may lead to children remaining at home after school (particularly if no adult caretakers are available) and engaging in sedentary rather than physical activity. The answers to your question are obvious, and obesity is not the most important result. Although research has examined ethnicity as a factor of childhood obesity, few studies have examined cultural influences. Adair LS, Gordon-Larsen P: Maturational timing and overweight prevalence in US adolescent girls. For those who are insured, there may still be disparities in the availability and quality of health care. As a library, NLM provides access to scientific literature. official website and that any information you provide is encrypted These discussions need to vary in frequency based on the child's risk of obesity (which is particularly high in African American girls and Hispanic boys), should be culturally sensitive, and should take into account the education level and SES of the child/family. The assumption that race reflects only biological distinctions is inaccurate. U.S. Department of Agriculture: The Thrifty Food Plan, 1999: revisions of the Markey Baskets. Such findings could have important implications for personalized and predictive strategies in both the prevention and treatment of childhood obesity. Acculturation to the U.S. is also significantly associated with lower frequency of physical activity participation in 7th-grade Latino and Asian American adolescents (42). According to the World Health Organization (WHO), obesity is defined as the fatness level sufficient to increase risk of morbidity or mortality ().The prevalence of this health issue in young populations has risen substantially worldwide in less than one generation, especially in developing countries ().Excess body fat in children and What are the implications of race/ethnicity on the prevention of childhood obesity? Impaired fasting glucose, a risk factor for type 2 diabetes, was found in 13% of Mexican American adolescents, 7% of non-Hispanic white adolescents, and 4% of non-Hispanic black adolescents in the 19992002 NHANES (14). While this price is attractive, it has been estimated that TFP menus would require the commitment of 16 h of food preparation per week. Obesity has deleterious associations in childhood and adolescence that increase morbidity and contribute to risk for cardiovascular disease and diabetes. Childhood obesity prevalence also varies by geographic location. WebGenetic changes in human populations occur too slowly to be responsible for the obesity epidemic. These twin indexes of parental education and household income levels, however, fail to fully convey the complexities of SES and social class. 3,4 The first has been termed the surface structure and describes the matching of materials and messages to cultural Obesity has reached epidemic proportions in the U.S. A subsequent analysis (7) suggested that the prevalence may have reached a plateau, although further tracking of data will be needed to confirm or refute this. Culture can influence the utilization of health services, affecting the likelihood that childhood obesity can be prevented or effectively treated in specific ethnic groups. With both acculturation and globalization there are changes in preferences for certain foods and forms of leisure/physical activity, as well as educational and economic opportunities. There are differences in lipids and lipoproteins related to race/ethnicity (36). Although the government advises more consumption of fruits and vegetables, these are relatively expensive items. Most interventions have used only health education, awareness, and behavior change approaches to improve individual and small-group behaviors, with minimal long-term success. DeLany JP, Bray GA, Harsha DW, Volaufova J: Energy expenditure in African American and white boys and girls in a 2-year follow-up of the Baton Rouge Children's Study. Given that women typically assume primary responsibility for the care, feeding, and education of children, including the transmission of shared cultural understandings, the beliefs that women possess with respect to their own body image have implications for their perception of and response to the body image of their children. A barrier to children achieving the recommended 60 min of physical activity per day is that most primary, middle, and secondary schools across the country do not provide even 30 min of daily physical activity to students. Unger JB, Reynolds K, Shakib S, Spruijt-Metz D, Sun P, Johnson CA: Acculturation, physical activity, and fast-food consumption among Asian-American and Hispanic adolescents. We also need to determine how to effectively deliver the appropriate care, including ways to tailor behavioral interventions to suit an individual's culture and environment. Robinson TN, Killen JD, Kraemer HC, Wilson DM, Matheson DM, Haskell WL, Pruitt LA, Powell TM, Owens AS, Thompson NS, Flint-Moore NM, Davis GJ, Emig KA, Brown RT, Rochon J, Green S, Varady A: Dance and reducing television viewing to prevent weight gain in African-American girls: the Stanford GEMS pilot study. A 2006 Institute of Medicine report (62) cited television advertising as influencing children and adolescents to adopt unhealthy lifestyle choices. Nevertheless, the social importance given to these constructs to describe groups that have been treated in similar ways based on presumed biological characteristics, as well as the acknowledgment that such classifications themselves have contributed to inequalities in health and health care access, necessitates that we continue to use the terms race and ethnicity. They must also play a role in advocacy, policy setting locally and nationally, and schools to help develop a healthy environment to prevent obesity. Culture influences the risk of obesity in children, and cultural differences may account, in part, for the disparities in childhood obesity. Monsivais P, Drewnowski A: The rising cost of low-energy-density foods.
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