Acculturation and weight change in Asian-American children: Evidence from the ECLS-K:2011.

Despite relatively low rates of overweight and obesity among Asian-American children, disparities exist based on acculturation, socioeconomic status, and Asian ethnicity. The purpose of this study was to examine the association between acculturation and weight change in Asian-American children. Secondary aims were to compare changes by Asian ethnic group and acculturation x socioeconomic status. Participants included 1200 Asian-American children from the Early Childhood Longitudinal Study, Kindergarten Class of 2010-11, a longitudinal study of U.S. children attending kindergarten in 2010-2011. Multinomial logistic regressions were conducted to predict weight change based on body mass indices in kindergarten (spring 2011) and second grade (spring 2013): consistently healthy weight, consistently overweight/obese, healthy weight change, and unhealthy weight change. Models included demographic, household, socioeconomic status, and acculturation measures, specifically mother's English proficiency and percentage of life spent in the U.S. Overall, 72.3% of children were at healthy weights in kindergarten and second grade. Of all Asian ethnic groups, Filipino children had the highest rate of being consistently overweight/obese (24.8%) and the lowest rate of being consistently healthy weight (62.9%). In addition, mother's English proficiency predicted unhealthy weight change (OR: 0.83; 95% CI: 0.75-0.92) and healthy weight change (OR: 0.75; 95% CI: 0.65-0.86), relative to "consistently healthy weight." English proficiency also predicted being consistently overweight/obese for children with less educated mothers. Findings enhance our understanding of obesity disparities within Asian Americans and highlight the need to disaggregate the population. Obesity interventions are needed for Filipino children and families with low socioeconomic status but high English proficiency.

Predicting habits of vegetable parenting practices to facilitate the design of change programmes.

OBJECTIVE: Habit has been defined as the automatic performance of a usual behaviour. The present paper reports the relationships of variables from a Model of Goal Directed Behavior to four scales in regard to parents' habits when feeding their children: habit of (i) actively involving child in selection of vegetables; (ii) maintaining a positive vegetable environment; (iii) positive communications about vegetables; and (iv) controlling vegetable practices. We tested the hypothesis that the primary predictor of each habit variable would be the measure of the corresponding parenting practice. DESIGN: Internet survey data from a mostly female sample. Primary analyses employed regression modelling with backward deletion, controlling for demographics and parenting practices behaviour. SETTING: Houston, Texas, USA. SUBJECTS: Parents of 307 pre-school (3-5-year-old) children. RESULTS: Three of the four models accounted for about 50 % of the variance in the parenting practices habit scales. Each habit scale was primarily predicted by the corresponding parenting practices scale (suggesting validity). The habit of active child involvement in vegetable selection was also most strongly predicted by two barriers and rudimentary self-efficacy; the habit of maintaining a positive vegetable environment by one barrier; the habit of maintaining positive communications about vegetables by an emotional scale; and the habit of controlling vegetable practices by a perceived behavioural control scale. CONCLUSIONS: The predictiveness of the psychosocial variables beyond parenting practices behaviour was modest. Discontinuing the habit of ineffective controlling parenting practices may require increasing the parent's perceived control of parenting practices, perhaps through simulated parent-child interactions.

Predicting use of ineffective vegetable parenting practices with the Model of Goal Directed Behavior.

OBJECTIVE: Increasing a parent's ability to influence a child's vegetable intake may require reducing the parent's use of ineffective vegetable parenting practices. The present study was designed to understand the psychosocial influences on ineffective vegetable parenting practices. DESIGN: A cross-sectional web-based survey was conducted to model use of ineffective vegetable parenting practices using validated scales from a Model of Goal Directed Vegetable Parenting Practices. SETTING: The dependent variable was a composite ineffective vegetable parenting practices index. The independent variables included validated subscales of intention, habit, perceived barriers, desire, competence, autonomy, relatedness, attitudes, norms, perceived behavioural control and anticipated emotions. Models were analysed using block regression with backward deletion. SUBJECTS: Parents of 307 pre-school children (3-5 years old). RESULTS: Variables significantly positively related to ineffective vegetable parenting practices in order of relationship strength included habit of controlling vegetable practices (standardized ß=0·349, P<0·0001) and desire (standardized ß=0·117, P=0·025). Variables significantly negatively related to ineffective vegetable parenting practices in order of relationship strength included perceived behavioural control of negative parenting practices (standardized ß=-0·215, P<0000), the habit of active child involvement in vegetable selection (standardized ß=-0·142, P=0·008), anticipated negative parent emotional response to child vegetable refusal (standardized ß=-0·133, P=0·009), autonomy (standardized ß=-0·118, P=0.014), attitude about negative effects of vegetables (standardized ß=-0·118, P=0·015) and descriptive norms (standardized ß=-0·103, P=0·032). The model accounted for 40·5 % of the variance in use of ineffective vegetable parenting practices. CONCLUSIONS: The present study is the first report of psychometrically tested scales to predict use of ineffective vegetable parenting practices. Innovative intervention procedures will need to be designed and tested to reduce ineffective vegetable parenting practices.

Predicting use of effective vegetable parenting practices with the Model of Goal Directed Behavior.

OBJECTIVE: To model effective vegetable parenting practices using the Model of Goal Directed Vegetable Parenting Practices construct scales. DESIGN: An Internet survey was conducted with parents of pre-school children to assess their agreement with effective vegetable parenting practices and Model of Goal Directed Vegetable Parenting Practices items. Block regression modelling was conducted using the composite score of effective vegetable parenting practices scales as the outcome variable and the Model of Goal Directed Vegetable Parenting Practices constructs as predictors in separate and sequential blocks: demographics, intention, desire (intrinsic motivation), perceived barriers, autonomy, relatedness, self-efficacy, habit, anticipated emotions, perceived behavioural control, attitudes and lastly norms. Backward deletion was employed at the end for any variable not significant at P<0·05. SETTING: Houston, TX, USA. SUBJECTS: Three hundred and seven parents (mostly mothers) of pre-school children. RESULTS: Significant predictors in the final model in order of relationship strength included habit of active child involvement in vegetable selection, habit of positive vegetable communications, respondent not liking vegetables, habit of keeping a positive vegetable environment and perceived behavioural control of having a positive influence on child's vegetable consumption. The final model's adjusted R 2 was 0·486. CONCLUSIONS: This was the first study to test scales from a behavioural model to predict effective vegetable parenting practices. Further research needs to assess these Model of Goal Directed Vegetable Parenting Practices scales for their (i) predictiveness of child consumption of vegetables in longitudinal samples and (ii) utility in guiding design of vegetable parenting practices interventions.

Vegetable parenting practices scale. Item response modeling analyses.

OBJECTIVE: To evaluate the psychometric properties of a vegetable parenting practices scale using multidimensional polytomous item response modeling which enables assessing item fit to latent variables and the distributional characteristics of the items in comparison to the respondents. We also tested for differences in the ways item function (called differential item functioning) across child's gender, ethnicity, age, and household income groups. METHOD: Parents of 3-5 year old children completed a self-reported vegetable parenting practices scale online. Vegetable parenting practices consisted of 14 effective vegetable parenting practices and 12 ineffective vegetable parenting practices items, each with three subscales (responsiveness, structure, and control). Multidimensional polytomous item response modeling was conducted separately on effective vegetable parenting practices and ineffective vegetable parenting practices. RESULTS: One effective vegetable parenting practice item did not fit the model well in the full sample or across demographic groups, and another was a misfit in differential item functioning analyses across child's gender. Significant differential item functioning was detected across children's age and ethnicity groups, and more among effective vegetable parenting practices than ineffective vegetable parenting practices items. Wright maps showed items only covered parts of the latent trait distribution. The harder- and easier-to-respond ends of the construct were not covered by items for effective vegetable parenting practices and ineffective vegetable parenting practices, respectively. CONCLUSIONS: Several effective vegetable parenting practices and ineffective vegetable parenting practices scale items functioned differently on the basis of child's demographic characteristics; therefore, researchers should use these vegetable parenting practices scales with caution. Item response modeling should be incorporated in analyses of parenting practice questionnaires to better assess differences across demographic characteristics.

Understanding Diabetes Self-Management Among Vietnamese Americans: A Focused Ethnography.

INTRODUCTION: The Vietnamese American (VA) population is projected to grow to 3.9 million by 2030. This demographic shift could affect health care cost as VAs have greater susceptibility for type 2 diabetes mellitus (T2DM). Few studies have explored diabetes self-management (DSM) among VAs. The aim of this study was to explore and describe how VAs with T2DM perceive diabetes and DSM practices. METHOD: A focused ethnographic design, using semi-structured interviews and participant observation, was used to understand DSM among VAs. RESULTS: The following four themes emerged: (a) defining diabetes and its etiology, (b) body awareness as a way of managing diabetes, (c) maintaining strength after being diagnosed with diabetes, and (d) navigating sources of information regarding diabetes. DISCUSSION: The study findings suggest that DSM is a complex and recursive process, with integrations of cultural practices and influences from the environment. These findings can help the development of culturally tailored interventions to assist with DSM.

Lower perceived stress among physically active elite private university students with higher levels of gratitude.

Elite private universities have high stress levels, particularly for underrepresented populations. While physical activity and gratitude can both reduce stress, independent effects from gratitude and interaction effects between physical activity and gratitude on stress are insufficiently explored. Our study investigated these effects among undergraduates at elite private universities. Undergraduates (n = 145) completed an online survey in Fall 2022. Moderate-high physical activity levels were reported by 96.19% of the sample. No significant interaction effect between physical activity and gratitude was seen nor a significant main effect of physical activity on perceived stress. A significant main effect of gratitude on perceived stress [F (2, 99) = 16.732, p < .001, ω2 = .253] was found with higher perceived stress among participants with low compared to moderate (p = .001) or high gratitude (p < .001). Gratitude exerted an independent, significant effect on perceived stress among elite university undergraduates and could be used as an additional healthy coping mechanism along with physical activity to combat stress.

Psychometric assessment of scales for a Model of Goal Directed Vegetable Parenting Practices (MGDVPP).

BACKGROUND: Vegetable intake has been related to lower risk of chronic illnesses in the adult years. The habit of vegetable intake should be established early in life, but many parents of preschoolers report not being able to get their child to eat vegetables. The Model of Goal Directed Behavior (MGDB) has been employed to understand vegetable parenting practices (VPP) to encourage a preschool child's vegetable intake. The Model of Goal Directed Vegetable Parenting Practices (MGDVPP) provides possible determinants and may help explain why parents use effective or ineffective VPP. Scales to measure effective and ineffective vegetable parenting practices have previously been validated. This manuscript presents the psychometric characteristics and factor structures of new scales to measure the constructs in MGDVPP. METHODS: Participants were 307 parents of preschool (i.e. 3 to 5 year old) children, used for both exploratory (EFA) and confirmatory factor analyses (CFA). Data were collected via an internet survey. First, EFA were conducted using the scree plot criterion for factor extraction. Next, CFA assessed the fit of the exploratory derived factors. Then, classical test theory procedures were employed with all scales. Finally, Pearson correlations were calculated between each scale and composite effective and ineffective VPP as a test of scale predictive validity. RESULTS: Twenty-nine subscales (164 items) within 11 scales were extracted. The number of items per subscale ranged from 2 to 13, with three subscales having 10 or more items and 12 subscales having 4 items or less. Cronbach's alphas varied from 0.13 to 0.92, with 17 being 0.70 or higher. Most alphas <0.70 had only three or four items. Twenty-five of the 29 subscales significantly bivariately correlated with the composite effective or ineffective VPP scales. DISCUSSION: This was the initial examination of the factor structure and psychometric assessment of MGDVPP scales. Most of the scales displayed acceptable to desirable psychometric characteristics. Research is warranted to add items to those subscales with small numbers of items, test their validity and reliability, and characterize the model's influence on child vegetable consumption.

Influences on children's dietary behavior, and innovative attempts to change it.

Fruit and vegetable (FV) intake may protect against several chronic diseases, and the preferences and habits in relation to FV intake appear to form in early childhood. Child FV intake reflects many influences from multiple levels (e.g. internal to the child, family, school, and neighborhood). We have documented influences at each of these levels, but more definitive research in longitudinal samples remains to be conducted. Even though validated comprehensive models of influences on child FV intake in longitudinal studies are not available to guide intervention design for children of different ages, there has been an urgency to initiate chronic disease prevention interventions to mitigate the substantial health consequences. Effective interventions use known behavior change procedures to change the influences on FV intake enough to change the behavior, but few such interventions have demonstrated effectiveness at meaningful levels. Innovative methods need to be explored. Videogames for Health offer a medium that is attractive to children and shows promising results, especially for dietary behavior change. Exciting additional research is needed to clarify possible bidirectional influences between the environmental and individual influences on child intake with possible age-related differences in influence and in the optimal design of video games for dietary change.

Dimensions of vegetable parenting practices among preschoolers.

The objective of this study was to determine the factor structure of 31 effective and ineffective vegetable parenting practices used by parents of preschool children based on three theoretically proposed factors: responsiveness, control and structure. The methods employed included both corrected item-total correlations and confirmatory factor analysis. Acceptable fit was obtained only when effective and ineffective parenting practices were analyzed separately. Among effective items the model included one second order factor (effectiveness) and the three proposed first order factors. The same structure was revealed among ineffective items, but required correlated paths be specified among items. A theoretically specified three factor structure was obtained among 31 vegetable parenting practice items, but likely to be effective and ineffective items had to be analyzed separately. Research is needed on how these parenting practices factors predict child vegetable intake.

Engaging the Asian American Community to Address Cancer Burden: Experiences and Lessons Learned.

BACKGROUND: Reducing cancer health disparities in Asian Americans requires orchestrated efforts and partnerships. OBJECTIVES: To describe the approach used by the University of Texas MD Anderson Cancer Center, HOPE Clinic, and Asian American organizations to understand and engage Houston's Asian American communities in cancer research, as well as to share lessons learned. METHODS: The community-academic-medical partnership used community-based research principles to build the partnership, form the community advisory board, conduct a community needs assessment, and offer cancer prevention engagement and education. RESULTS: Some lessons learned included balancing language needs with limited resources, incorporating more time and resources to conduct health research in an ethnically diverse community, and promoting awareness of research and its role in cancer prevention in Asian American communities. CONCLUSIONS: Community-academic-medical partnerships are promising ways to engage the community, draw on combined expertise, and create research and programs that are scientifically strong and meaningful to the community.

Living Situation and Physical Activity in the COVID-19 Pandemic Among American Private University Students.

Many university students experienced changes during the COVID-19 pandemic, including potential changes in physical activity (PA) levels and living situation. As PA behaviors in young adulthood help establish life-long habits and future health outcomes, the purpose of this study was to investigate overall change in PA, as well as change in PA due to living situation, among private university students during the COVID-19 pandemic. Private university students (n = 109) between 18 and 25 years of age completed an online survey that included the International Physical Activity Questionnaire - Short Form. T-tests examined changes in overall time spent in PA from before to during the COVID-19 pandemic, and the differences in MET-minute distributions between groups. Students performed significantly less activity during the COVID-19 pandemic than before (t(108) = 3.51, p = .001, d = 0.493), with 70.6% of all students meeting exercise recommendations before the pandemic and 51.4% after. Students living with vs. without a parent/guardian attained similar PA levels (t(107) = -.114, p = .910) before the pandemic (73.1% vs. 69.9%, respectively), but students living with a parent/guardian engaged in significantly less PA (t(107) = 2.04, p = .044, d = 0.475) than those living without a parent/guardian during the pandemic (37.5% vs. 57.1%, respectively). The declines in PA suggest the need for targeted interventions and education among private university students. In order to maximize the health benefits of PA, it is crucial that activity engagement return to at least pre-COVID-19 levels.

Dietary behaviors and food insecurity among Houston college students during the COVID-19 pandemic.

Objective: This study assessed the impact of the COVID-19 pandemic on college students' nutrition, including dietary behaviors and food security status. Participants: Participants included 140 students between 18 and 25 years of age, who were enrolled in a college or university in the greater Houston area. Methods: Analyses included descriptive statistics, t tests, and ANOVAs to analyze differences in dietary behaviors by demographic variables, and chi-square tests to assess characteristics associated with food security status. Results: The majority of participants reported changing their diets due to the COVID-19 pandemic. There were no significant differences by demographics. However, there were significant differences in food security status by race/ethnicity and social class. Conclusion: This study identified changes and disparities in college students' dietary behaviors and food security status during the COVID-19 pandemic. Findings help inform future policy, programs, and research to address college students' nutrition during the ongoing COVID-19 pandemic.

Study protocol: a lifestyle intervention for African American and Hispanic prostate cancer survivors on active surveillance and their partners.

BACKGROUND: Prostate cancer is the most commonly diagnosed cancer in both African American and Hispanic men. Active surveillance is a treatment option for low- or very low-risk prostate cancer survivors, and lifestyle interventions have been found to reduce the disease progression and improve the quality of life for both survivors and their partners. To date, no lifestyle interventions that specifically target African American or Hispanic men and their partners exist. This protocol describes a study that tests the feasibility of a randomized controlled trial, a lifestyle intervention developed to enhance healthy lifestyle and quality of life among African American and Hispanic men on active surveillance and their partners. METHODS: A mixed-method study, including a two-arm randomized controlled trial (n = 30 dyads in the intervention arm and n = 10 dyads in the control arm) and in-depth interviews, will be conducted. Intervention arm participants will receive bi-weekly health coaching calls (a total of 12 calls based on Motivational Interviewing), as well as physical activity-specific (e.g., power point slides, print materials about physical activity, and activity trackers for self-monitoring) and nutrition-specific education (e.g., two nutrition counseling sessions from a registered dietitian, print materials about nutrition, and food intake recording for self-monitoring) over 6 months. All participants will be assessed at baseline, month 3, and month 6. Blood will be collected at baseline and month 6 from the prostate cancer survivors. Finally, in-depth interviews will be conducted with subsamples (up to n = 15 dyads in the intervention arm and up to n = 5 dyads in the control arm) at baseline and months 3 and 6 to conduct a process evaluation and further refine the intervention. DISCUSSION: If effective, the intervention may have a higher health impact compared with a typical lifestyle intervention targeting only survivors (or partners), as it improves both survivors' (tertiary prevention) and partners' health (primary prevention). Results from this study will provide important information regarding recruiting racial/ethnic minority cancer survivors and their partners. Lessons learned from this study will be used to apply for a large-scale grant to test the impact of the dyadic intervention in a fully powered sample. TRIAL REGISTRATION: ClinicalTrials.gov (NCT No. 03575832) registered on 3 July 2018.

Organized Sports and Physical Activities as Sole Influencers of Fitness: The Homeschool Population.

Homeschool children may rely solely on organized sports and physical activities to achieve recommended levels of physical activity and fitness. The purpose of this study was to investigate differences in fitness levels between homeschool children who did, and did not, participate in organized sports or physical activities, and then examine relationships between hours per week in sports or physical activities and cardiorespiratory fitness as measured by portions of the FitnessGram® test battery. Organized sports/physical activity participation information was gathered on 100 children ages 10-17 years who completed tests of upper, abdominal, and cardiorespiratory fitness. The current investigation revealed that participation alone was not associated with higher levels of physical fitness as assessed by the 90° push-up test or curl-up test nor was time in participation related to cardiorespiratory fitness as assessed by the Progressive Aerobic Capacity Endurance Run (PACER). These activities alone may be insufficient for meeting physical activity recommendations and improving physical fitness. Therefore, children and adolescents educated at home may need additional opportunities to participate in unstructured daily physical activity.

Physical Activity Behaviors and Influences Among Chinese-American Children Aged 9-13 Years: A Qualitative Study.

Low physical activity is a major health issue among Chinese Americans. This study explored Chinese-American children's physical activity behaviors and influencing factors. Twenty-five children of Chinese or Taiwanese descent were interviewed to understand their favorite sports or physical activities, physical activity environments, and influences on their physical activity. All were between the ages of 9 and 13. Interviews were transcribed and coded using thematic data analysis procedures. Major themes included: (1) team sports, particularly basketball, were commonly listed as favorite sports or activities; (2) physical activity occurred mostly at school or an after-school setting; and (3) family played a major role in physical activity. Some trends/differences were detected based on age, sex, and socioeconomic status. Interventions to promote physical activity among Chinese-American children should emphasize team sports and encourage physical activity in schools, but also explore ways to involves families outside of school.

Culture and Diet Among Chinese American Children Aged 9-13 Years: A Qualitative Study.

OBJECTIVE: To examine Chinese American children's behaviors, food preferences, and cultural influences on their diet. DESIGN: Qualitative individual interviews using constructs from the proposed model of dietary acculturation. SETTING: Community centers and Chinese schools in Houston, TX. PARTICIPANTS: Twenty-five Chinese American children aged 9-13 years. PHENOMENON OF INTEREST: Diet, favorite restaurants, and parents' cooking and grocery shopping habits. ANALYSIS: Content analysis and thematic data analysis to identify code categories and themes. Coders also identified patterns based on demographic and acculturation factors. RESULTS: Overall, participants described their diets and associated behaviors as Asian and non-Asian. Key themes included preference for Asian and non-Asian foods; consumption of non-Asian foods for breakfast and lunch, but Asian foods for dinner; infrequent dining at restaurants; grocery shopping at Asian and non-Asian stores; and familial influences on diet. Acculturated children and children of higher socioeconomic status appeared to prefer and consume a more Westernized/non-Asian diet. CONCLUSIONS AND IMPLICATIONS: Results illustrate that Chinese American children in this study practiced both Asian and non-Asian dietary behaviors. Findings corroborated existing acculturation research with parents and caregivers; supported constructs in the model of dietary acculturation; and provide guidance for research and programs related to dietary behaviors, determinants, and culture among this population.

Assessing Feedback in a Mobile Videogame.

BACKGROUND: Player feedback is an important part of serious games, although there is no consensus regarding its delivery or optimal content. "Mommio" is a serious game designed to help mothers motivate their preschoolers to eat vegetables. The purpose of this study was to assess optimal format and content of player feedback for use in "Mommio." MATERIALS AND METHODS: The current study posed 36 potential "Mommio" gameplay feedback statements to 20 mothers using a Web survey and interview. Mothers were asked about the meaning and helpfulness of each feedback statement. RESULTS: Several themes emerged upon thematic analysis, including identifying an effective alternative in the case of corrective feedback, avoiding vague wording, using succinct and correct grammar, avoiding provocation of guilt, and clearly identifying why players' game choice was correct or incorrect. CONCLUSIONS: Guidelines are proposed for future feedback statements.

Acculturation and Plasma Fatty Acid Concentrations in Hispanic and Chinese-American Adults: The Multi-Ethnic Study of Atherosclerosis.

BACKGROUND: Acculturation to the U.S. is associated with increased risk of cardiovascular disease, but the etiologic pathways are not fully understood. Plasma fatty acid levels exhibit ethnic differences and are emerging as biomarkers and predictors of cardiovascular disease risk. Thus, plasma fatty acids may represent one pathway underlying the association between acculturation and cardiovascular disease. We investigated the cross-sectional relationship between acculturation and plasma phospholipid fatty acids in a diverse sample of Hispanic- and Chinese-American adults. METHODS AND FINDINGS: Participants included 377 Mexican, 320 non-Mexican Hispanic, and 712 Chinese adults from the Multi-Ethnic Study of Atherosclerosis, who had full plasma phospholipid assays and acculturation information. Acculturation was determined from three proxy measures: nativity, language spoken at home, and years in the U.S., with possible scores ranging from 0 (least acculturated) to 5 (most acculturated) points. α-Linolenic acid, linoleic acid, eicosapentaenoic acid, docosahexaenoic acid, and arachidonic acid were measured in fasting plasma. Linear regression models were conducted in race/ethnicity-stratified analyses, with acculturation as the predictor and plasma phospholipid fatty acids as the outcome variables. We ran secondary analyses to examine associations between acculturation and dietary fatty acids for comparison. Covariates included age, gender, education, and income. Contrary to our hypothesis, no statistically significant associations were detected between acculturation and plasma phospholipid fatty acids for Chinese, non-Mexican Hispanic, or Mexican participants. However, acculturation was related to dietary total n-6 fatty acids and dietary n-3/n-6 ratios in expected directions for Mexican, non-Mexican Hispanic, and combined Hispanic participants. In Chinese individuals, acculturation was unexpectedly associated with lower arachidonic acid intake. CONCLUSION: Absence of associations between acculturation and plasma phospholipid fatty acids suggests that changes in the plasma phospholipid fatty acids studied do not account for the observed associations of acculturation to the U.S. and cardiovascular disease risk. Similar findings were observed for eicosapentaenoic acid and docosahexaenoic acid, when using dietary intake. However, the observed associations between dietary n-6 fatty acids and acculturation in Hispanic individuals suggest that dietary intake may be more informative than phospholipids when investigating acculturation effects. In Chinese individuals, acculturation may have a possible protective effect through decreased arachidonic acid intake. Further research on dietary fatty acids and other cardiovascular disease biomarkers is needed to identify possible etiologic mechanisms between acculturation and cardiovascular disease.

Risk Factors for Childhood Obesity among Asian Americans: A Systematic Review of Literature and Recommendations for Health Care Research.

Childhood obesity has become an epidemic across all racial/ethnic groups in the U.S., including Asian Americans. With different cultures, beliefs, and lifestyles, Asian Americans may face unique sets of risk factors for childhood obesity. This review critically assesses and summarizes the literature on risk factors for childhood obesity among Asian Americans. Among the 14 studies identified, five (35.7%) used national or state-level data, seven (50%) targeted Chinese Americans, and two (14.3%) focused on Hmong Americans. Multiple risk factors for childhood obesity among Asian Americans were reported, including acculturation, generational status, and family functioning. Limitations of the literature included use of small samples, scarcity of ethnically specific data for Asian American subgroups, shortage of qualitative studies, and lack of theoretical foundation. More disaggregated studies are needed to examine the important variability that may exist in risk factors for childhood obesity among Asian American subgroups.