Asian American mothers' perception of their children's weight: a comparison with other racial/ethnic groups in Los Angeles.

OBJECTIVE: While mother's perception of child's weight is important for the success of early childhood obesity prevention programs, few studies have examined that of Asian Americans. Our study examined their perception and compared it to that of mothers of other racial/ethnic groups. DESIGN: Cross-sectional study of 2,051 randomly selected mothers of children aged 2-5 years living in Los Angeles County who were enrolled in the Special Supplemental Nutrition Program for Women Infants and Children (WIC). MAIN OUTCOME MEASURE: The primary outcome was mother's perception of child's weight. RESULTS: We found that Asian American mothers were 2.12 (95% CI: 1.27-3.54) times as likely as Hispanic mothers to accurately perceive their children's weight, adjusting for child's age, sex and birthweight, and mother's age and education. However, this relationship disappeared after adjusting for mother's BMI. We did not find differences in perception of child's weight among non-Hispanic White, non-Hispanic Black and Hispanic mothers. CONCLUSION: It appears that Asian American mothers' increased accurate perception of child's weight status can be partially explained by their lower prevalence of obesity. Our findings suggest that early childhood obesity prevention programs should consider the weight status of mothers.

Using population reach as a proxy metric for intervention impact to prioritize selection of obesity prevention strategies in Los Angeles County, 2010-2012.

Recent federal initiatives have used estimates of population reach as a proxy metric for intervention impact, in part to inform resource allocation and programmatic decisions about competing priorities in the community. However, in spite of its utility, population reach as a singular metric of intervention impact may be insufficient for guiding multifaceted program decisions. A more comprehensive, validated approach to measure or forecast dose may complement reach estimates to inform decision makers about optimal ways to use limited resources.

"Sometimes they'll tell me what they want": family and inter-generational food preferences in the food decisions of Singaporean women.

This study examines responses to questions regarding food choices and decisions from 18 focus groups of women (n=130) age 30-55 years living in Singapore. Focusing on the responses to the questions in the interview protocol closely associated with decision making identified several themes. Food choices and eating decisions are composite phenomenon. These composite food decisions reflect flexible, open systems we refer to here as idiosyncratic regimes in which environmental, social, and intra-personal streams of influence are prioritized as individuals generate possible food decisions. Food decisions represent the imagined and actual presence of the "family" and differing inter-generational food preferences. As women attempt to create harmony from the diversity of food preferences they generate idiosyncratic regimes of food and eating reflecting "triadic streams of influence" manifest in the context of everyday contingencies of family and individual life. Recent concern in Singapore on the part of the Health Promotion Board and the Saw Swee Hock School of Public Health at the National University of Singapore regarding the increasing prevalence of diet-related diseases and obesity among Singaporeans provided the impetus for conducting this qualitative study of food and eating among Singaporean women.

Diet in midpuberty and sedentary activity in prepuberty predict peak bone mass.

BACKGROUND: An average daily calcium intake of 1300 mg is recommended for North American adolescents aged 9-18 y. However, questions remain about these recommendations. OBJECTIVE: We assessed whether there is a stage of puberty when dietary calcium is more strongly related to peak bone mass, as indicated by young adult bone mass (YABM); whether dietary calcium intake > 1000 mg/d in adolescence is associated with higher YABM; and whether race affects any of these associations between dietary calcium and YABM. Secondarily, we evaluated relations between sedentariness and YABM. DESIGN: In a retrospective cohort study, we recruited 693 black and white women aged 21-24 y who had participated in the 10-y National Heart, Lung, and Blood Institute Growth and Health Study and measured YABM with the use of dual-energy X-ray absorptiometry. Dietary calcium and sedentary activity data, gathered through 3-d food records and self-reports of television-video viewing at 8 annual examinations, were averaged over 3 pubertal stages. Complete data were available from 161 black and 180 white females. Multiple regression, controlling for race, weight, and height, was applied to assess diet and activity relations with YABM. RESULTS: Dietary calcium was most strongly associated with YABM in midpuberty. Calcium intake > 1000 mg/d was associated with higher YABM, but this association was not significant at all skeletal sites. Race did not affect the observed relations between calcium and YABM. Sedentary activity in prepuberty was inversely associated with YABM. CONCLUSIONS: Interventions should focus on ensuring adequate calcium intake in midpuberty and on minimizing sedentariness in prepuberty.

Ethnic differences in bone mass of young women vary with method of assessment.

To examine ethnic differences in bone mass measured by calcaneus ultrasound (CUS) and dual energy X-ray absorptiometry (DXA), and to compare the two methodologies, CUS was performed in 904 healthy Asian, African American, Latina, and Caucasian women 20-26 yr old using the Lunar Achilles Plus ultrasonometer. CUS measurements (broadband ultrasound attenuation [BUA] and speed of sound [SOS]) were made following standard methodology (standard CUS) and repeated adjusting for foot size using shims (with-shim CUS). Areal bone mineral density (BMD) and estimated volumetric bone density (BMAD) at the spine, femoral neck, and whole body were determined using the Lunar DPX-IQ. African Americans had greater height- and weight-adjusted BUA than Caucasians, while Asians and African Americans had greater SOS than Caucasians and Latinas. Additionally, African Americans had greater height- and weight-adjusted BMD and BMAD than all other groups. CUS and DXA measurements correlated moderately (r = 0.2-0.5). With-shim CUS values were 0.9-7.8% lower than standard CUS values. In conclusion, African American women had greater DXA measurements than all others and greater CUS measurements than Caucasians. In contrast to DXA, CUS measurements in Asians and Latinas were not significantly lower than those in African Americans. Most notably, Asians had greater values for SOS than Caucasians and Latinas. Discrepancies in ethnic comparisons and modest correlations suggest that CUS and DXA methods may capture different bone qualities.

Immigrant enclaves and obesity in preschool-aged children in Los Angeles County.

While neighborhood environments are increasingly recognized as important contributors to obesity risk, less has been reported on the socio-cultural aspects of neighborhoods that influence obesity development. This is especially true among immigrants, who may lack the necessary language skills to navigate their new living environments. In this study, we tested the hypothesis that young children of immigrants would be at lower obesity risk if they lived in neighborhoods where neighbors share the same language and culture. Using 2000 Census data and 2003-2009 data from the Special Supplemental Nutrition Program for Women, Infants and Children in Los Angeles County, we examined the relation between BMI z-scores in low-income children aged 2-5 years (N = 250,029) and the concentration of neighborhood residents who spoke the same language as the children's mothers. Using multi-level modeling and adjusting for child's gender and race/ethnicity, household education, neighborhood socioeconomic status, and year the child was examined, we found that percent of neighborhood residents who spoke the same language as the child's mother was negatively associated with BMI z-scores. This relation varied by child's race/ethnicity and mother's preferred language. The relation was linear and negative among children of English-speaking Hispanic mothers and Chinese-speaking mothers. However, for Hispanic children of Spanish-speaking mothers the relation was curvilinear, initially exhibiting a positive relation which reversed at higher neighborhood concentrations of Spanish-speaking residents. Our findings suggest that living in neighborhoods where residents share the same language may influence obesity-related behaviors (namely diet and physical activity) possibly through mechanisms involving social networks, support, and norms.

Dietary patterns in adolescence are related to adiposity in young adulthood in black and white females.

Few studies have systematically used a total diet approach to classify adolescent dietary patterns. We examined dietary patterns in relation to nutrient intakes and adiposity in the National Heart, Lung, and Blood Institute Growth and Health Study cohort of 2371 black and white girls recruited at 9-10 y of age and followed for 10 y. Serial measurements were obtained for indices of anthropometry, dietary intake, physical activity, and sociodemographic variables. Dietary patterns for the 2 racial subgroups were separately identified by cluster analysis of 40 food groupings derived from 3-d food records. Nutrient intakes and measures of adiposity (BMI, percent body fat, and waist circumference) were compared by dietary pattern. We identified 4 discrete dietary patterns for black and for white adolescents. A Healthy pattern, followed by 12% of white girls and characterized by a high intake of fruits, vegetables, dairy, grains without added fats, mixed dishes and soups, and a low intake of sweetened drinks, other sweets, fried foods, burgers, and pizza, was related to more favorable nutrient intakes and a smaller increase in waist circumference. Among black girls, none of the dietary patterns appeared distinctly advantageous in terms of mitigating increases in adiposity. In conclusion, a cumulative pattern of food intake consistent with recommendations for general health appears to help prevent overweight, but this pattern was followed by only a minority of adolescent girls.

Socioeconomic influences on bone health in postmenopausal women: findings from NHANES III, 1988-1994.

Our objectives were (1) to examine the associations of education and income with bone health in non-Hispanic White, non-Hispanic Black and Mexican-American postmenopausal women, (2) to determine if any observed associations can be explained by behavioral factors such as calcium intake and physical activity and (3) to determine if government food assistance and education are associated with increased calcium intake among low-income women. Cross-sectional data were gathered by the Third National Health and Nutrition Examination Survey, 1988-1994 (NHANES III) using a stratified multistage probability design. Bone health was indicated by total hip bone mineral density (BMD, g/cm2). Multiple linear regression was used to evaluate the associations of education, income and behavioral factors with BMD. There were 2,905 postmenopausal women with acceptable DXA scans and complete relevant data selected from a nationally representative sample of the civilian non-institutionalized population aged 2 months and older. Education and income were positively associated with BMD in Black and White women, respectively, but not in Mexican-American women. When behavioral factors were included in the analyses, associations with education and income were eliminated. Instead, positive associations with estrogen use, calcium intake and physical activity, and a negative association with smoking, were noted in White women. Among low-income women, education was associated with increased calcium intake, while participation in the Food Stamp Program was associated with increased calcium intake in Black women. We conclude that education and/or income are positively associated with BMD among Black and White postmenopausal women, and that efforts to promote bone health among low-income women are warranted.