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Obesity in Hispanic Children: Reversing the Tide. Donna Spruijt-Metz, MFA PhD Associate Professor, USC Keck School of Medicine Director, Responsible Conduct of Research [email protected] www.metzlab.net. BMI ≥ 85th Percentile (age 4-12, 6-19). Overweight has doubled in 30 years, and - PowerPoint PPT Presentation
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Obesity in Hispanic Children: Reversing the Tide
Donna Spruijt-Metz, MFA PhDAssociate Professor, USC Keck School of Medicine
Director, Responsible Conduct of [email protected]
www.metzlab.net
Persists into adulthood (Whitaker et al. NEJM: 1997;337:869-873)
Data from the National Longitudinal Survey of Youth 1986-1998, NHANES 1998-2008
Overweight has doubled in 30 years, and
Obesity has TRIPLED
Overweight has doubled in 30 years, and
Obesity has TRIPLED
Childhood Obesity: Childhood Obesity: Metabolic ConsequencesMetabolic Consequences
Childhood Obesity: Childhood Obesity: Psychosocial ConsequencesPsychosocial Consequences
• Proximal consequences: – Negative stereotyping– Teasing– Fewer friends– Poor body image
• Distal consequences:– Lower educational
attainment– Discrimination
(apartment rentals, college admissions)
– Higher poverty
Overweight Hispanic youth in Los Angeles from our studies:
• 32% have pre-diabetes
• 30% have metabolic syndrome- 90% have > 1 metabolic syndrome feature
• 38% have Non Alcoholic Fatty Liver Disease (NAFLD)
Complex Etiology of Childhood ObesityComplex Etiology of Childhood Obesity
IOM 2011 Report: Early Childhood Obesity Prevention Policies
• Role of mother’s diet, obesity & smoking during pregnancy
• Early development: – Not yet necessary to change poor dietary and
activity patterns, – Great time to promote the development of
healthy patterns.– Exclusive breast feeding for 6 months, continued
with complimentary foods for AT LEAST one year
http://www.nap.edu/catalog.php?record_id=13124
Breast feeding & Sugar Sweetened Beverage consumption
in 1483 Hispanic Children in Los Angeles WIC Clinics
Davis et al in press AJCN
Physical Activity in Hispanic Youth
Physical activityPhysical activity• Improves
– Body Composition
– Insulin sensitivity
– Cholesterol
– Sleep
– Self Esteem
– Academic Performance
• Protects against – Breast, colon and other cancers
– Obesity
Pubertal Decline in Physical Activity by Age Pubertal Decline in Physical Activity by Age (Males + Females)(Males + Females)
Troiano, Berrigan, et al. MSSE 2008;40(1):181-8.
Mea
n M
inut
es o
f MVP
A pe
r day
One Year Decline in Physical ActivityOne Year Decline in Physical Activity
Covariates: age, baseline Tanner stage, baseline SAT, baseline VAT, SISpruijt-Metz et al under review
Sugar Intake in Hispanic Youth
Sugar Intake is Related to Decreased Insulin Sensitivity
r=-0.29, p= 0.01
Davis et al, AJCN 2007
120 Hispanic children ages 10-17 years
Sugar Intake is Related to Increased Body Fat
Davis, Ventura, et al. AJCN 2007.
Ejemplo de la dieta de una niña del proyecto SOLAR(Sample diet of a 11-year-old girl from the SOLAR project)
Desayuno(Breakfast)
Lucky Charms --2 tazas/cupsLeche 2%/ 2% milk --1 taza/cupJugo Tampico/Tampico juice -- 2 tazas/cups
Resumen de esta Dieta(Summary of Diet):3100 calorias/calories7 g fibra/fiber 220 g azucar/sugarAlmuerzo
(Lunch)Pizza – 1 rebanada/slice Papas fritas (Fries) – 1 taza/cupGatorade – 1 botella de 20 onzas/FO
Merienda(Snack)
Hot Cheetos – bolsa/bag de $0.99Coca-Cola – 1 lata/can
Goal:~1800 calorias/calories25-30 g fibra/fiber<50 g azucar/sugar
Cena(Dinner)
Tortilla de Harina (Flour Tortilla) - 2Carne Asada (Grilled beef) – 1 taza/cupArroz Mexicano (Mexican Rice) – 1 taza/cup Agua de Jamaica (Sweetened hibiscus drink) – 2 tazas/cups
Summary: TARGETS to Prevent and Treat Obesity
• INCREASE & PROLONG Breastfeeding • INCREASE Physical Activity • INCREASE Fiber Intake • DECREASE Total and added sugar intake
At home, child care, schools, parks, hospitals – and GARDENS!!!
TWO NEW USC PROJECTS
to Prevent and Treat Obesity in Hispanic
Youth & Families
• 12-week after-school gardening / nutrition / cooking intervention for 4th & 5th graders:– 80 controls– 45 LA Sprouts students
• Gardening/nutrition classes (1x/wk) at Milagro Allegro Community Garden & Farmer’s market trips (4 times)
• Pre/Post Testing: BMI, Body Fat, BP, waist, dietary intake, motivation/preference/self-efficacy to eat F&V, engagement
Funded by: Kaiser and Childhood Obesity Research Center (PI: Davis)
Changes in Diet
• Increased preference for fruit and veggies
• Improved cooking and gardening self-efficacyDavis et al; in press JADAGatto and Davis; in review at JADA
A virtual gardening game for the prevention of obesity in minority youth
Virtual Sprouts Web-based Gardening Games
What is Virtual Sprouts?• A web-based gardening game designed to use gardening as a teaching tool• In the virtual garden children learn to select what crops to plant, plant their
own garden, watch it grow, tend the crops, and harvest them
Goal• To positively influence dietary intake and prevent/treat obesity in Hispanic
youth and families through meaningful play
Proposal • Bring a novel combination of technology and teaching to bear on pediatric
obesity in urban Los Angeles• Use interactive, web-based game techniques, rich narrative, a pedagogical
agent, and experiential learning to achieve the aims of the program
Using Mobile and Internet Technologies: The mHealth advantage
• Any time, anywhere, children and their families can play• Enormous reach: 84% of US Hispanics own a cell phone;
78% of US Hispanic adults and 95% of youth use the internet
• Immersive games are FUN! And engaging.• Immediate access to data for health professionals,
children, families, teachers• Real-time, personalized & tailored interventions • Strong Participatory Approach
AcknowledgementsAcknowledgements• Michael Goran• Britni Belcher• David Berrigan• Marc Weigensberg• Ana Romero• Ya Wen Janice Hsu• Arianna McClain • Javier Diaz• LeRoy Downs• Luz Castillo• Gisele Ragusa• Ting Li
• Selena Rodriguez• Adar Emken• Jaimie Davis• Nicole Gatto• Emily Ventura• Tom Wright• Adriana Padilla• Chih-Ping Chou• Courtney B.William• Christianne J. Lane• Chad Lane• Marientina Gotsis• Gillian O’Reilly
AcknowledgementsAcknowledgements
• NCI USC Center for Transdisciplinary Research on Energetics and Cancer (U54 CA 116848)
• NCCR (R25RR032159)
• NCMHD P60 002564
• Kaiser Permanente
• USC Childhood Obesity Research Center
• Study Participants
AcknowledgementsAcknowledgements