Birthplace, years of residence in the United States, and obesity among Mexican-American adults

Objective: To evaluate the association between birthplace (Mexico or U.S.) and obesity in men and women and to analyze the relationship between duration of U.S. residency and prevalence of obesity in Mexican immigrants. Research Methods and Procedures: We used cross‐sectional data from 7503 adults of Mexican descent residing in Harris County, TX, to evaluate the relationships among BMI, birthplace, and years of residency in the U.S., controlling for demographic characteristics, physical activity level, and acculturation level. Results: U.S.‐born adults had an increased risk (between 34% and 65%) of obesity compared with their Mexican‐born counterparts. After controlling for recognized confounders and risk factors, this association was maintained in the highly acculturated only. Among highly acculturated obese U.S.‐born men, 6% of the cases were attributable to the joint effect of birthplace and acculturation; in women, this proportion was 25%. Among Mexican‐born women, there was an increasing trend in mean BMI with increasing duration of residency in the U.S. Compared with immigrants who had lived in the U.S. for <5 years, Mexican‐born women who had resided in the U.S. for ≥15 years had an adjusted BMI mean difference of 2.12 kg/m² (95% confidence interval, 1.53–2.72). Discussion: Mexican‐born men and women have a lower risk of obesity than their U.S.‐born counterparts, but length of U.S. residency among immigrants, especially in women, is directly associated with risk of obesity. Development of culturally specific interventions to prevent obesity in recent immigrants may have an important public health effect in this population.     

Maternal BMI and country of birth as indicators of childhood obesity in children of Mexican origin

Objective: The goal of this study was to evaluate the relationship between maternal and childhood BMI at baseline in a group of 5‐ to 18‐year‐old children and their mothers, all of whom were of Mexican origin, low socioeconomic status, and enrolled in a cohort study in Houston, TX. Research Methods and Procedures: Using data from 438 mother‐child dyads residing in the same household, we completed logistic regression analyses to determine maternal factors associated with the child being overweight or at‐risk‐for‐overweight, after adjusting for the child's gender, age, and level of physical activity and other maternal confounders. Results: Almost one‐half of the boys and girls (47% and 44%, respectively) were either overweight or at‐risk‐for‐overweight. Obese mothers were twice as likely to have an overweight and/or at‐risk‐for‐overweight child compared with normal‐weight mothers. Women born in the U.S. were twice as likely to have an overweight and/or at‐risk‐for‐overweight child compared with women born in Mexico. In addition, women with less than a high school education were twice as likely to have an overweight child compared with their more educated peers. Discussion: The high prevalence of overweight or at‐risk‐for‐overweight among Mexican‐origin children of low socioeconomic status suggests a continued need to develop and implement culturally sensitive preventive interventions for this minority population. Our data also suggest a need to tailor such interventions particularly for children of obese mothers and those born in the U.S.     

Health-related quality of life and weight loss among overweight and obese U.S. adults, 2001 to 2002

Objective: To examine the prevalence and association of health‐related quality of life (HRQOL) with trying to lose weight and with weight loss practices (eating fewer calories, physical activity, and both) among overweight and obese U.S. adults ≥ 20 years of age. Research Methods and Procedures: This study used data from the 2001 to 2002 National Health and Nutrition Examination Survey, a continuous annual survey of the civilian non‐institutionalized U.S. population. This analysis included those ≥ 20 years of age with BMI ≥ 25 (n = 2578) who responded to four standard HRQOL measures that assessed general health status and recent physical health, mental health, and activity limitation. Results: Among obese men, but not women, there were significant increasing linear trends in the adjusted prevalence of trying to lose weight as physically unhealthy and activity limitation days increased. Regardless of BMI or HRQOL, reducing calories was a common weight loss practice (66% to 86%). Except for recent activity limitation, respondents with BMI ≥ 35 did not generally differ by HRQOL level in the attainment of recommended physical activity either alone or in combination with reduced calories, whereas those in the BMI 25 to 34.9 groups often differed significantly by HRQOL level. Specifically, increased unhealthy or activity limitation days were associated with reduced prevalence of attained physical activity. Discussion: Our findings indicate an association between trying to lose weight and a greater number of unhealthy days reported by obese men, suggesting that these men may be influenced by traditional clinical weight‐loss counseling that is prompted by weight and comorbidity, whereas women had a high prevalence of trying to lose weight irrespective of weight and HRQOL. Assessment of HRQOL, especially measures that evaluate physical domains, could provide subjective information to assist with weight counseling.     

Neighborhood risk factors for obesity

Objective: The goal of this study was to explore neighborhood environmental factors associated with obesity in a sample of adults living in a major U.S. metropolitan area. Research Methods and Procedures: This was a multi‐level study combining data from the U.S. Behavioral Risk Factor Surveillance System with data from the U.S. Census. A total of 15,358 subjects living in 327 zip code tabulation areas were surveyed between 1998 and 2002. The outcome was obesity (BMI >30), and independent variables assessed included individual level variables (age, education, income, smoking status, sex, black race, and Hispanic ethnicity), and zip code level variables (percentage black, percentage Hispanic, percentage with more than a high school education, retail density, establishment density, employment density, population density, the presence of a supermarket, intersection density, median household income, and density of fast food outlets). Results: After controlling for individual level factors, median household income [relative risk (RR) = 0.992; 95% confidence interval (CI) = 0.990, 0.994], population density (RR = 0.98; 95% CI = 0.972, 0.990), employment density (RR = 1.004; 95% CI = 1.001, 1.009), establishment density (RR = 0.981 95% CI = 0.964, 0.999), and the presence of a supermarket (RR = 0.893; 95% CI = 0.815, 0.978) were associated with obesity risk. Fast food establishment density was poorly associated with obesity risk. Discussion: Where one lives may affect obesity status. Given the influence of the presence of a supermarket on obesity risk, efforts to address food access might be a priority for reducing obesity.     

Association of cigarettes smoked daily with obesity in a general adult population

Objective: We analyzed the cross‐sectional association between obesity and smoking habits, taking into account diet, physical activity, and educational level. Research Methods and Procedures: We used data from the 2002 Swiss Health Survey, a population‐based cross‐sectional telephone survey assessing health and self‐reported health behaviors. Reported smoking habits, height, and weight were available for 17,562 subjects (7844 men and 9718 women) ≥25 years of age. BMI was calculated as (self‐reported) weight divided by height². Results: Mean BMI was 25.1 kg/m² for non‐smokers, 26.1 kg/m² for ex‐smokers, 24.6 kg/m² for light smokers (1 to 9 cigarettes/d), 24.8 kg/m² for moderate smokers (10 to 19 cigarettes/d), and 25.3 kg/m² for heavy smokers (≥20 cigarettes/d) in men and 24.0, 24.1, 22.9, 22.9, and 23.3 kg/m², respectively, in women. Obesity (BMI ≥ 30 kg/m²) was increasingly frequent with older age, lower physical activity, lower fruits/vegetables intake, and lower educational level. Compared with non‐smokers, the odds ratio for obesity vs. normal weight (BMI = 18.5 to 25.0 kg/m²) adjusted for age, nationality, educational level, leisure time physical activity, and fruit/vegetable intake were 1.9 (95% confidence interval: 1.5 to 2.3) for ex‐smokers, 0.5 (0.3 to 0.8) for light smokers, 0.7 (0.4 to 1.0) for moderate smokers, and 1.3 (1.0 to 1.7) for heavy smokers in men and 1.3 (1.1 to 1.6), 0.7 (0.5 to 1.0), 0.8 (0.5 to 1.0), and 1.1 (0.8 to 1.4), respectively, in women. Discussion: Among smokers, obesity was associated in a graded manner with the number of cigarettes daily smoked, particularly in men. More emphasis should be put on the risk of obesity among smokers.     

Associations of adiposity with measured and self-reported academic performance in early adolescence

Objective: To examine the associations of adiposity with measured and self‐reported academic performance independently of demographics and physical activity among U.S. adolescents. Research Methods and Procedures: We surveyed 666 students 11 to 14 years old from seven middle schools in Los Angeles, CA. Weight and height were measured. Actual grade point average was obtained from school records. Self‐reported school grades and physical activity time were measured by questionnaire. Adiposity measures included BMI, BMI percentile (≥85th percentile defined as at‐risk‐of‐overweight), and percentage body fat (bioimpedance). Results: After adjusting for gender, ethnicity, age, and physical activity time, overweight at‐risk status, BMI, and percentage body fat were negatively related to only self‐reported (p < 0.01) but not measured grades. Level of moderate‐to‐vigorous physical activity time was negatively related to measured and self‐reported grades, independently of adiposity (p < 0.01). Discussion: To our knowledge, this is the first study to examine both body mass and body fat in relation to measured and self‐reported school grades. Adiposity did not relate to actual academic performance in a sample of predominantly Latino and Asian‐American adolescents. The use of measured vs. self‐reported academic outcomes may represent different constructs and influence study conclusions. Cultural factors may also play a role in our findings, but this requires further study.     

Physical Activity,TV Viewing,and Weight in U.S. Youth: 1999 Youth Risk Behavior Survey

Objective: To examine the relationship between physical activity, TV watching, and weight in U.S. youth ages 14 to 18 years. Research Methods and Procedures: Data from a nationally representative sample of 15,143 U.S. high‐school students participating in the 1999 Centers for Disease Control and Prevention (CDC) Youth Risk Behavior Survey were examined. Prevalence rates of participation in moderate physical activity (MPA), vigorous physical activity (VPA), and television watching (TV) were determined. The association between MPA, VPA, TV and the body mass index (BMI) and overweight status (BMI ≥85th percentile of age‐ and sex‐specific CDC/National Center for Health Statistics reference values) were examined by analysis of covariance and logistic regression. Results: Overall, 45% reported participating in MPA ≥3 d/wk, 65% reported participating in VPA ≥3 d/wk, and 25% reported watching TV ≥4 h/school day. Boys reporting six to seven bouts of MPA had a significantly lower BMI compared with boys reporting three to five or less than two. The mean BMI differed significantly between the lowest and highest levels of MPA groups in girls. The mean BMI was significantly lower in the highest VPA group compared with the other two groups in both sexes. There was a significant graded response for BMI across all levels of TV. Decreased levels of MPA and 3 to 4 days of VPA were significantly associated with an increased risk of overweight in boys when compared with those engaging in 6 to 7 d/wk (odds ratio = 1.26 to 1.37). A graded response existed between TV and overweight in both sexes. Boys and girls were ～20% to 25% less likely to be classified as overweight if they reported 2 to 3 hours of TV per day and ～40% less likely to be classified as overweight if they reported ≤1 hour of TV per day compared with those who watched ≥4 hours of TV. In general, youth who engaged in less physical activity watched more TV per week. Discussion: Increased levels of physical activity are associated with a lower BMI and less TV watching. However, the relationship between TV watching and weight status is more pronounced.     

Stemming the obesity epidemic: a tantalizing prospect

Objective: Obesity is a growing problem worldwide, but there are no good methods to assess the future course of the epidemic and the potential influence of interventions. We explore the behavior change needed to stop the obesity epidemic in the U.S. Research Methods and Procedures: We modeled the population distribution of BMI as a log‐normal curve of which the mean shifts upward with time due to a positive population energy balance. Interventions that decrease food intake or increase physical activity result in more favorable trends in BMI. Results: The recently observed trend in average BMI implies that the average U.S. adult over‐consumes by ～10 kcal/d. If this trend continues unaltered, obesity prevalence will exceed 40% for men and 45% for women in 2015. To stop the epidemic, it suffices to decrease caloric consumption by ～10 kcal or walk an extra 2 to 3 minutes per day, on average. Discussion: This leads to a paradox: little behavior change seems sufficient to halt the epidemic, but in practice this proves hard to achieve. The obesogenic environment is the likely culprit. Individuals trying to maintain a healthy weight need to be supported by environments that stimulate physical activity and do not encourage over‐consumption. Research should show what measures are effective.     

Girls' perception of neighborhood factors on physical activity, sedentary behavior, and BMI

Objective: The purpose of this study was to examine the association of perceived physical neighborhood factors with physical activity, sedentary behavior, and BMI among adolescent girls. Research Methods and Procedures: Sixth grade girls (n = 1554) completed a questionnaire on neighborhood factors (e.g., safety, esthetics, access to physical activity resources). The dependent variables included non‐school metabolic equivalent weighted moderate to vigorous physical activity (MW‐MVPA) and non‐school sedentary behavior, both measured using accelerometry, and BMI. Results: The following neighborhood factors were associated with lower BMI: seeing walkers and bikers on neighborhood streets, not having a lot of crime in the neighborhood, seeing other children playing outdoors, having bicycle or walking trails in the neighborhood, and access to physical activity facilities. The absolute contribution for the average girl for each of these neighborhood factors was relatively small, with none of these factors exceeding 0.8 kg/m² BMI units. The following neighborhood factors were associated with higher MW‐MVPA: having well‐lit streets at night, having a lot of traffic in the neighborhood, having bicycle or walking trails in the neighborhood, and access to physical activity facilities. Girls with ≥9 places to go for physical activity had 14.0% higher non‐school MW‐MVPA than girls with ≤4 places. Discussion: This study identified several neighborhood factors associated with non‐school MW‐MVPA and BMI, but none of the factors explored were associated with non‐school sedentary behavior. Of all of the neighborhood factors we examined, reporting more physically active destinations contributed the largest absolute amount to the average girl's non‐school MW‐MVPA, according to this cross‐sectional study.     

Associations among Active Transportation,Physical Activity,and Weight Status in Young Adults

Objective: To describe prevalence of active, public, and car transit by overweight status and amount of leisure‐time physical activity in a nationally representative cohort of ethnically diverse young adults. Research Methods and Procedures: Questionnaire data on patterns of transportation were collected from U.S. adolescents enrolled in Wave III (2001) of the National Longitudinal Study of Adolescent Health (N = 10, 771). Measured height and weight data were used to calculate BMI and classify adults by overweight status (BMI ≥ 25). Self‐reported physical activity data were used to classify adults into those who achieved ≥ 5 bouts of weekly moderate‐vigorous physical activity and those who did not. Results were stratified by overweight and physical activity status. Results: The vast majority of young adults used car transit (work, 90.4%; school, 74.7%). A small proportion of young adults used active means of transportation to work (8.1%) and school (26.7%), and fewer used public transportation to work or school (<10%). The proportion of individuals using active transportation was higher among the nonoverweight traveling to work (9.2%) and school (29.7%) and among the more active traveling to work (15.2%) and school (37.0%) relative to the overweight and less active young adults. Discussion: The vast majority of young adults of all racial/ethnic backgrounds, particularly blacks and Hispanics, did not use active transportation to school and/or work. Active transportation was more common among nonoverweight and more active young adults, of high socioeconomic status, particularly full‐time students. Population‐level efforts (and environmental supports) to increase non‐leisure physical activity, particularly active transportation, are sorely needed as a means of supporting and promoting overall physical activity.     

Design characteristics of worksite environmental interventions for obesity prevention

Objective: This paper describes the design characteristics of the National Heart, Lung, and Blood Institute (NHLBI)‐funded studies that are testing innovative environmental interventions for weight control and obesity prevention at worksites. Research Methods and Procedures: Seven separate studies that have a total of 114 worksites (～48,000 employees) across studies are being conducted. The worksite settings include hotels, hospitals, manufacturing facilities, businesses, schools, and bus garages located across the U.S. Each study uses its own conceptual model drawn from the literature and includes the socio‐ecological model for health promotion, the epidemiological triad, and those integrating organizational and social contexts. The interventions, which are offered to all employees, include environmental‐ and individual‐level approaches to improve physical activity and promote healthful eating practices. Environmental strategies include reducing portion sizes, modifying cafeteria recipes to lower their fat contents, and increasing the accessibility of fitness equipment at the workplace. Across all seven studies about 48% (N = 23,000) of the population is randomly selected for measurements. The primary outcome measure is change in BMI or body weight after two years of intervention. Secondary measures include waist circumference, objective, and self‐report measures of physical activity, dietary intake, changes in vending machines and cafeteria food offerings, work productivity, healthcare use, and return on investment. Discussion: The results of these studies could have important implications for the design and implementation of worksite overweight and obesity control programs.     

Lifecourse socioeconomic position and weight change among blacks: The Pitt County study

Objective: The elevated prevalence of obesity among U.S. blacks has been attributed to low socioeconomic position (SEP), despite inconsistent empirical findings. It is unclear whether low SEP at various lifecourse stages differentially influences adulthood BMI and BMI change. Research Methods and Procedures: Among 1167 black adults in the Pitt County Study, we examined independent cross‐sectional and longitudinal associations between SEP, measured in childhood and adulthood, and BMI and 13‐year BMI change. Low vs. high childhood SEP was measured by parental occupation and childhood household deprivation; low vs. high adulthood SEP was assessed by employment status, education, and occupation. Using childhood and adulthood SEP, four lifecourse SEP categories were created: low‐low, low‐high, high‐low, high‐high. Results: We found no consistent associations between SEP and BMI or BMI change among men. Among women, we observed the expected inverse association between SEP and BMI at baseline. In multivariable‐adjusted analyses, socioeconomically advantaged women demonstrated larger 13‐year increases in BMI: skilled vs. unskilled parental occupation (6.1 vs. 4.8 kg/m², p = 0.04); college‐educated vs. < high school (6.2 vs. 4.5 kg/m², p = 0.04); white‐collar vs. blue‐collar job (5.8 vs. 4.8 kg/m², p = 0.05); and high‐high vs. low‐low lifecourse SEP (6.5 vs. 4.6 kg/m², p = 0.02). Discussion: For women in this black cohort, lower SEP predicted earlier onset of obesity; however, low SEP was less predictive of BMI increases over time. Our findings demonstrate complex patterns of association between SEP and BMI change among black women.     

Physical Activity in Confined Conditions as an Indicator of Free‐Living Physical Activity

Objective: The main determinants of daily energy expenditure are body size and physical activity. Activity energy expenditure is the most variable component of total energy expenditure. It was assessed whether the physical activity level in confined conditions is an indicator of free‐living physical activity. Research Methods and Procedures: Activity energy expenditure was measured over 1 day in a confined environment of a respiration chamber (floor space, 7.0 m²), where activities were restricted to low‐intensity activities of daily living, and over 2 weeks in a free‐living environment using doubly labeled water. Subjects were 16 women and 29 men (age, 31 ± 10 years; BMI, 24.2 ± 2.7 kg/m²). Results: The free‐living activity level of the subjects, as a multiple of resting energy expenditure, was 1.76 ± 0.13. Activity energy expenditure in the chamber was 47 ± 13% of the value in daily life, and the two values were correlated (r = 0.50, p < 0.001; partial correlation corrected for age, gender, and BMI: 0.40, p < 0.01). The chamber value explained 25% of the total variance in free‐living activity energy expenditure. Discussion: The activity level of a subject under sedentary conditions is an indicator of activity energy expenditure in daily life, showing the importance of nonexercise activity for daily energy expenditure.     

Prevalence of Overweight among Inner City Hispanic‐American Children and Adolescents

Objective: National surveys have pointed to a particularly high risk of pediatric overweight among U.S. Hispanics. However, the data have been primarily from the Mexican‐American community. We studied the prevalence of overweight and clinical comorbidities in children and youth of predominantly El Salvadoran ancestry. Research Methods and Procedures: A sample of 309 Hispanic youth, 6–18 years was surveyed from two inner city Washington, DC, clinics. BMI; triceps skinfold (TSF) and subscapular skinfold thickness (SSSF); bioelectrical impedance analysis (BIA); and blood pressure measures were obtained, along with information regarding physical activity, sedentary behavior, dietary history, family, and personal medical history. Results: Thirty‐eight percent were overweight (BMI ≥ 95th percentile) and 22% at risk for overweight (BMI 85–94th percentile). Thirty‐four percent had TSF ≥ 90th percentile and 29% had SSSF ≥ 90th percentile. Fifty‐one percent of males and 70% of females had body fat > 30%. Compared to their nonoverweight counterparts, overweight youth had significantly higher systolic blood pressure (111.4 ± 1.3 vs. 104.5 ± 0.9 mm Hg, p < 0.0001). Among children younger than 11 years, overweight was associated with onset of adrenarche (23% vs. 10%, p = 0.01). Participation in one or more sports teams was negatively correlated with overweight) p = 0.04). Discussion: The prevalence of overweight and at risk for overweight in this sample was twice the national average for U.S. children and 1.7 times greater than that of Mexican‐American children in national surveys. Overweight was associated with advanced pubertal development, high body fat, elevated blood pressure, and decreased sports participation.     

Impact of cardiometabolic risk factor clusters on health-related quality of life in the U.S

Objective: Research has shown that risk factors for cardiovascular disease often cluster together, most notably overweight/obesity, diabetes, hyperlipidemia, and hypertension. The impact of cardiometabolic risk factor clusters on health‐related quality of life (HRQL) is not well understood. The purpose of this study was to examine and quantify the impact of cardiometabolic risk factor clusters on HRQL as measured by the SF (Short Form)‐12 Mental Component Scale (MCS‐12), SF‐12 Physical Component Scale (PCS‐12), EQ‐5D index (a generic quality of life index), and Visual Analogue Scale. Research Methods and Procedures: The Medical Expenditure Panel Survey is a nationally representative survey of the U.S. population. From 2000 to 2002, detailed information on sociodemographic characteristics and health conditions were collected for 36,697 adults with complete responses. Controlling for comorbidity and sociodemographic characteristics, this study estimated the marginal impact of cardiometabolic risk factor clusters on MCS‐12, PCS‐12, EQ‐5D index, and Visual Analogue Scale scores. Cardiometabolic risk factor clusters were defined as the presence of BMI ≥25 kg/m² and at least two of the following: diabetes, hyperlipidemia, and hypertension. Using BMI ≥30 kg/m² as the cut‐off was also examined. Results: The marginal impact of cardiometabolic risk factor clusters was highly statistically significant across all four HRQL measures and seemed to be clinically significant for all but the MCS‐12. The PCS‐12 showed a greater decrease in HRQL associated with physical function compared with mental function‐related domains of the MCS‐12. Discussion: Common cardiometabolic risk factor clusters such as overweight/obesity, diabetes, hypertension, and hyperlipidemia have a significant and negative impact on HRQL in the United States.     

Leisure‐Time Physical Activity and Reduced Plasma Levels of Obesity‐Related Inflammatory Markers

Objective: This study investigated the relationship between physical activity and the obesity‐related inflammatory markers C‐reactive protein, interleukin‐6, and soluble tumor necrosis factor receptors (sTNF‐Rs) 1 and 2. Furthermore, we examined the relationship between physical activity and insulin sensitivity (insulin, C‐peptide, and hemoglobin A_1c levels) and whether inflammatory markers mediate this association. Research Methods and Procedures: Biomarkers were measured in 405 healthy men and 454 healthy women from two large ongoing prospective studies. Information about physical activity and other variables was assessed by questionnaires. Results: After adjustment for other predictors of inflammation, physical activity was inversely associated with plasma levels of sTNF‐R1, sTNF‐R2, interleukin‐6, and C‐reactive protein (p = 0.07, p = 0.004, p = 0.04, and p = 0.009). After further adjustment for BMI and leptin, as a surrogate for fat mass, most of these associations were no longer significant. Physical activity was also inversely related to insulin and C‐peptide levels (p = 0.008 and p < 0.001); however, in contrast to BMI and leptin, levels of inflammatory markers explained only very little of this inverse relationship. Discussion: These results suggest that frequent physical activity is associated with lower systemic inflammation and improved insulin sensitivity. These associations can partially be explained by a lower degree of obesity in physically active subjects. Although inflammatory markers may mediate obesity‐dependent effects of physical activity on inflammatory related diseases such as type 2 diabetes or coronary heart disease, our study suggests that they do not directly account for the beneficial effects of physical activity on insulin resistance.     

BMI, body composition, and physical functioning in older adults

Objective: Recent studies have emphasized the importance of muscle and fat mass in relation to age‐related decline in physical function. Our objective was to determine whether BMI, as a surrogate measurement of fat mass, may be used as a measure of risk factor for physical functioning in older adults and whether body composition measurements confer any advantage over BMI. Research Methods and Procedures: Four thousand men and women ≥65 years of age living in the community, stratified by age and sex, underwent the following measurements: body composition by DXA; grip strength; and timed 6‐m walk. Subjects were grouped into five categories of BMI using Asian criteria for health‐related risks, and between‐group differences in physical performance measures and body composition were analyzed using analysis of covariance adjusting for age, physical activity level, and presence of chronic disease. Results: Subjects in the two obese categories had a significantly greater number of instrumental activities of daily living (IADL) impairments compared with the underweight and normal‐weight groups. Those with BMI ≥30 kg/m² had the worst walking performance, and the groups with BMI in the normal and overweight range had optimal performance. Fat mass, but not appendicular muscle mass, was associated with walking speed after adjusting for BMI. Discussion: Fat mass seems to be a more important factor than appendicular muscle mass in determining walking speed in community‐living older adults, even after adjusting for BMI.     

Hip-Hop to Health Jr. for Latino preschool children

Objective: Hip‐Hop to Health Jr. was a diet/physical activity intervention designed to reduce gains in BMI (kilograms per meter squared) in preschool minority children. Research Methods and Procedures: Twelve predominantly Latino Head Start centers participated in a group‐randomized trial conducted between Fall 2001 and Winter 2003. Six centers were randomized to a culturally proficient 14‐week (three times weekly) diet/physical activity intervention. Parents participated by completing weekly homework assignments. The children in the other six centers received a general health intervention that did not address either diet or physical activity. The primary outcome was change in BMI, and secondary outcomes were changes in dietary intake and physical activity. Measures were collected at baseline, post‐intervention, and at Years 1 and 2 follow‐up. Results: There were no significant differences between intervention and control schools in either primary or secondary outcomes at post‐intervention, Year 1, or Year 2 follow‐ups. Discussion: When Hip‐Hop to Health Jr. was conducted in predominantly black Head Start centers, it was effective in reducing subsequent increases in BMI in preschool children. In contrast, when the program was conducted in Latino centers, it was not effective. Although the intervention did not prevent excessive weight gain in Latino children, it was very well received. Future interventions with this population may require further cultural tailoring and a more robust parent intervention.     

Utility of Childhood BMI in the Prediction of Adulthood Disease: Comparison of National and International References

Objective: To determine whether the U.S. Centers for Disease Control and Prevention (CDC; CDC Reference) or International Obesity Task Force (IOTF; IOTF Reference) BMI cut‐off points for classifying adiposity status in children are more effective at predicting future health risk. Research Methods and Procedures: The sample (N = 1709) included 4‐ to 15‐year‐old (at baseline) boys and girls from the Bogalusa Heart Study. Overweight and obesity status were determined using both the CDC Reference and IOTF Reference BMI cut‐off points at baseline. The ability of childhood overweight and obesity, determined from the two BMI classification systems, to predict obesity and metabolic disorders in young adulthood (after a 13‐ to 24‐year follow‐up) was then compared. Results: Independently of the classification system employed to determine adiposity based on childhood BMI, the odds of being obese and having all of the metabolic disorders in young adulthood were significantly (p < 0.05) higher in the overweight and obese groups by comparison with the nonoverweight groups. Childhood overweight and obesity, determined by both the CDC Reference and IOTF Reference, had a low sensitivity and a high specificity for predicting obesity and metabolic disorders in young adulthood. Overweight and obesity as determined by the CDC Reference were slightly more sensitive and slightly less specific than the corresponding values based on the IOTF Reference. Discussion: Overweight and obesity during childhood, as determined by both the CDC and IOTF BMI cut‐off points, are strong predictors of obesity and coronary heart disease risk factors in young adulthood. The differences in the predictive capacity of the CDC Reference and IOTF Reference are, however, minimal.