Health-related quality of life among Mexican-origin Latinos: the role of immigration legal status.

OBJECTIVE: To assess the relationship between immigration legal status and related vulnerabilities and health-related quality of life (HRQoL) among Mexican-origin Latinos living in a U.S.-Mexico border region. METHODS: Data were obtained using multistage sampling from 393 Latino adults who took part in the 2009 San Diego Prevention Research Center community survey. RESULTS: Significant differences in HRQoL were found across immigration legal status subgroups. Vulnerabilities associated with HRQoL varied across immigration legal status subgroups, and only depression was associated with HRQoL regardless of immigration legal status. CONCLUSION: Results from this study emphasize the need for policies and programs to facilitate access to preventive services, including mental health services, in order to maintain the health of at-risk Latino immigrants.

Intervention Effects on Latinas' Physical Activity and Other Health Indicators.

INTRODUCTION: U.S. Latinas do not engage in sufficient leisure-time physical activity. This study examined whether adding promotor-facilitated healthy lifestyle classes to an exercise intervention would promote exercise session attendance and improve health indicators. METHODS: The Familias Sanas y Activas II (Healthy and Active Families II) study used a within-subjects, longitudinal design, with measures at baseline and at 6 and 12 months post-baseline. The intervention was developed by the San Diego Prevention Research Center and implemented between May 2011 and June 2014 in South San Diego County. Three organizations each hired a part-time coordinator and trained volunteer promotores (six to ten per organization) to deliver the intervention in various community locations. A convenience sample of 442 Latinas were in the evaluation cohort. Measured variables included a step test, blood pressure, waist circumference, height, and weight; physical activity was self-reported. RESULTS: Attendance at healthy lifestyle classes was positively associated with exercise session attendance (p≤0.001). Mixed effects models showed improvements in systolic and diastolic blood pressure (p≤0.001); waist circumference (p≤0.001); weight (p≤0.05); and BMI (p≤0.05) between baseline and 12 months. At 12 months, fewer participants met clinical guidelines for being hypertensive and having an at-risk waist circumference. Exercise session attendance was associated with improved fitness (p≤0.05) and increased self-reported MET minutes of leisure-time physical activity (p≤0.01). CONCLUSIONS: The intervention represents an effective strategy for improving the health status of Latinas, a population with significant health disparities, including high obesity rates. Research efforts are needed to assess methods for scaling up such interventions.

Neighborhoods, Social and Cultural Correlates of Obesity Risk among Latinos living on the U.S.-Mexico border in Southern California.

OBJECTIVES: We explored the relationship between obesity and neighborhood-related, social, and cultural variables and possible moderation by acculturation and cross-national practices. METHODS: We obtained data from the 2009 San Diego Prevention Research Center's community survey, which used multistage sampling methods to recruit 397 adult respondents and conducted multilevel logistic analytic methods. RESULTS: Nearly half of the respondents were obese. Respondents had low acculturation scores and reported crossing the U.S.-Mexico border about three times per month, mostly to visit family and friends. Neighborhoods where respondents lived were predominantly Latino and had 27% home ownership. A significant cross-level interaction emerged: those who reported crossing the border and reported higher levels of collective efficacy were more likely to be obese than those who had not crossed. CONCLUSIONS: Study findings provide evidence of the complex relationship among obesity risk factors in a U.S.-Mexico border community that warrant further examination to prevent and control obesity.

Neighborhoods, Social and Cultural Correlates of Obesity Risk among Latinos living on the U.S.-Mexico border in Southern California.

OBJECTIVES: We explored the relationship between obesity and neighborhood-related, social, and cultural variables and possible moderation by acculturation and cross-national practices. METHODS: We obtained data from the 2009 San Diego Prevention Research Center's community survey, which used multistage sampling methods to recruit 397 adult respondents and conducted multilevel logistic analytic methods. RESULTS: Nearly half of the respondents were obese. Respondents had low acculturation scores and reported crossing the U.S.-Mexico border about three times per month, mostly to visit family and friends. Neighborhoods where respondents lived were predominantly Latino and had 27% home ownership. A significant cross-level interaction emerged: those who reported crossing the border and reported higher levels of collective efficacy were more likely to be obese than those who had not crossed. CONCLUSIONS: Study findings provide evidence of the complex relationship among obesity risk factors in a U.S.-Mexico border community that warrant further examination to prevent and control obesity.

Emerging Role of Nitric Oxide and Heat Shock Proteins in Insulin Resistance.

Insulin resistance (IR) is present in pathologies such as diabetes, obesity, metabolic syndrome, impaired glucose tolerance, hypertension, inflammation, cardiac disease, and dyslipidemias. Population studies show that IR is multifactorial and has genetic components, such as defects in the insulin-signaling pathway (as serine phosphorylation on insulin substrate or decreased activation of signaling molecules) and RAS/MAPK-dependent pathways. IR is connected to mitochondrial dysfunction, overproduction of oxidants, accumulation of fat, and an over-activation of the renin-angiotensin system linked to the NADPH oxidase activity. In addition, nitric oxide (NO), synthesized by nitric oxide synthases (endothelial and inducible), is also associated with IR when both impaired release and reduced bioavailability of all which lead to inflammation and hypertension. However, increased NO may promote vasculoprotection. Moreover, reduced NO release induces heat shock protein 70 kDa (HSP70) expression in IR and diabetes, mediating beneficial effects against oxidative stress injury, inflammation and apoptosis. HSP70 may be used as biomarker of the chronicity of diabetes. Hsp72 (inducible protein) is linked to vascular complications with a high-fat diet by blocking inflammation signaling (cytoprotective and anti-cytotoxicity intracellular role). Elucidating the IR signaling pathways and the roles of NO and HSPs is relevant to the application of new treatments, such as heat shock and thermal therapy, nitrosylated drugs, chemical chaperones or exercise training.

The link between border crossing and obesity.

Research examining border crossing and health has focused on substance abuse, healthcare utilization and air pollution. Living in border communities allows for frequent crossing and exposure to different sociocultural and structural environments. Given high rates of obesity among Latinos and the large percentage living in border communities, it is important to consider the relationship between border crossing and obesity. This study explored the relationship between frequency of border crossing, obesigenic behaviors, measured obesity, and chronic disease. Multistage sampling methods were used to recruit 397 Latino adults living in border communities in South San Diego County. Selected participants completed a face-to-face interview and height and weight measurements. More frequent border crossing was associated with more fast food consumption and a greater reported diagnosis of high cholesterol. Understanding the extent to which border crossing is associated with obesigenic behaviors and chronic disease is important for developing relevant interventions along the border.

Correlates of measured prehypertension and hypertension in Latina women living along the US-Mexico border, 2007-2009.

INTRODUCTION: Although Latinos have lower hypertension rates than non-Latino whites and African Americans, they have a higher prevalence of undiagnosed and uncontrolled hypertension. Research on predictors of hypertension has mostly focused on intrapersonal factors with no studies assessing the combined influence of intrapersonal, interpersonal, and environmental factors. The purpose of this study was to assess a broad range of correlates including intrapersonal, interpersonal, and environmental factors on measured blood pressure category (nonhypertensive, prehypertensive, and hypertensive) in a sample of Latina women residing in San Diego, California. METHODS: This cross-sectional study used baseline data from the San Diego Prevention Research Center's Familias Sanas y Activas program, a promotora-led physical activity intervention. The sample was 331 Latinas who self-selected into this program. Backward conditional logistic regression analysis was conducted to determine the strongest correlates of measured blood pressure category. RESULTS: Logistic regression analysis suggested that the strongest correlates of prehypertension were soda consumption (odds ratio [OR] = 1.34, [1.00-1.80], P ≤ .05) and age (OR = 1.03, [1.00-1.05], P ≤ .05). The strongest correlates of hypertension were soda consumption (OR = 1.92, [1.20-3.07], P ≤ .01), age (OR = 1.09, [1.05-1.13], P ≤ .001), and measured body mass index (OR = 1.13, [1.05-1.22], P ≤ .001). All analyses controlled for age and education. No interpersonal or environmental correlates were significantly associated with blood pressure category. CONCLUSION: Future research should aim to further understand the role of soda consumption on risk for hypertension in this population. Furthermore, interventions aimed at preventing hypertension may want to focus on intrapersonal level factors.

Community health partnerships for chronic disease prevention among Latinos: the San Diego Prevention Research Center.

Over 20 years ago, university-community partnerships (i.e., Prevention Research Centers [PRCs]) across the United States were funded by the Centers for Disease Control and Prevention to conduct research and training in order to promote health and prevent disease in underserved populations. In 2004, the San Diego PRC (SDPRC) became the first PRC to focus on obesity prevention and control in a community of mostly Mexican Americans/Mexican immigrants. The SDPRC was also the first PRC to comprise a university-community partnership with a school of public health, a school of medicine, and a federally qualified health center. In conjunction with two additional funded community partners and involvement of a community advisory board, the SDPRC seeks to develop effective intervention strategies that ultimately lead to behavior change. Now in its second cycle of funding, the SDPRC has identified three primary principles that are important for these and similar efforts: (1) developing culturally appropriate interventions requires community engagement; (2) building the evidence in a systematic and rigorous way yields meaningful strategies for translation to practice; and (3) translating evidence-based interventions to practice involves capacity building for both researchers and community partners. This article describes these principles to help others involved in similar intervention efforts identify the best approach for promoting health in their own communities.

Role of mitochondria in paricalcitol-mediated cytoprotection during obstructive nephropathy.

Vitamin D slows the progression of chronic kidney disease. Furthermore, activators of vitamin D receptors (VDR) have suppressant effects on the renin-angiotensin system, as well as anti-inflammatory and antifibrotic actions. This study aimed to evaluate the cytoprotective effects of paricalcitol, a VDR activator, at the mitochondrial level using an obstructive nephropathy model [unilateral ureteral obstruction (UUO)]. Rats subjected to UUO and controls were treated daily with vehicle or paricalcitol. The control group underwent a sham surgery. The treatment was done for 15 days (30 ng/kg). The following were determined: biochemical parameters; fibrosis; apoptosis; mitochondrial morphology; VDR, AT(1) receptor, and NADPH oxidase 4 expression; and NADPH oxidase activity (in total and in mitochondrial fractions from the renal cortex). VDR activation prevented fibrosis (20 ± 5 vs. 60 ± 10%) and the number of TUNEL-positive apoptotic cells (10 ± 3 vs. 25 ± 4) in UUO. Biochemical, histological, and molecular studies suggest mitochondrial injury. Electron microscopy revealed in UUO electronically luminous material in the nucleus. Some mitochondria were increased in size and contained dilated crests and larger than normal spaces in their interiors. These changes were not present with paricalcitol treatment. Additionally, high AT(1)-receptor mRNA and NADPH activity was reverted in mitochondrial fractions from obstructed paricalcitol-treated animals (0.58 ± 0.06 vs. 0.95 ± 0.05 relative densitometry units and 9,000 ± 800 vs. 15,000 ± 1,000 relative fluorescence units·µg protein(-1)·min(-1), respectively). These changes were consistent with an improvement in VDR expression (0.75 ± 0.05 vs. 0.35 ± 0.04 relative densitometry units). These results suggest that paricalcitol confers a protective effect and reveal, as well, a possible AT(1) receptor-dependent protective effect that occurs at the mitochondrial level.