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Obesity in Hispanic Children: Reversing the Tide

Obesity in Hispanic Children: Reversing the Tide. Donna Spruijt-Metz, MFA PhD Associate Professor, USC Keck School of Medicine Director, Responsible Conduct of Research dmetz@usc.edu www.metzlab.net. BMI ≥ 85th Percentile (age 4-12, 6-19). Overweight has doubled in 30 years, and

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Obesity in Hispanic Children: Reversing the Tide

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  1. Obesity in Hispanic Children: Reversing the Tide Donna Spruijt-Metz, MFA PhD Associate Professor, USC Keck School of Medicine Director, Responsible Conduct of Research dmetz@usc.edu www.metzlab.net

  2. BMI ≥ 85th Percentile (age 4-12, 6-19) Overweight has doubled in 30 years, and Obesity has TRIPLED • Persists into adulthood (Whitaker et al. NEJM: 1997;337:869-873) Data from the National Longitudinal Survey of Youth 1986-1998, NHANES 1998-2008

  3. Childhood Obesity: Metabolic Consequences

  4. Childhood Obesity: Psychosocial Consequences • Proximal consequences: • Negative stereotyping • Teasing • Fewer friends • Poor body image • Distal consequences: • Lower educational attainment • Discrimination (apartment rentals, college admissions) • Higher poverty

  5. 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)

  6. Complex Etiology of Childhood Obesity

  7. 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

  8. Breast feeding & Sugar Sweetened Beverage consumptionin 1483 Hispanic Children in Los Angeles WIC Clinics Davis et al in press AJCN

  9. Physical Activity in Hispanic Youth

  10. Physical activity • Improves • Body Composition • Insulin sensitivity • Cholesterol • Sleep • Self Esteem • Academic Performance • Protects against • Breast, colon and other cancers • Obesity

  11. Pubertal Decline in Physical Activity by Age (Males + Females) Mean Minutes of MVPA per day Troiano, Berrigan, et al. MSSE 2008;40(1):181-8.

  12. One Year Decline in Physical Activity Covariates: age, baseline Tanner stage, baseline SAT, baseline VAT, SI Spruijt-Metz et al under review

  13. Sugar Intake in Hispanic Youth

  14. Sugar Intake is Related to Decreased Insulin Sensitivity 120 Hispanic children ages 10-17 years r=-0.29, p= 0.01 Davis et al, AJCN 2007

  15. Sugar Intake is Related to Increased Body Fat Davis, Ventura, et al. AJCN 2007.

  16. Ejemplo de la dieta de una niña del proyecto SOLAR(Sample diet of a 11-year-old girl from the SOLAR project)

  17. 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!!!

  18. TWO NEW USC PROJECTS to Prevent and Treat Obesity in Hispanic Youth & Families

  19. 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)

  20. Changes in Diet • Increased preference for fruit and veggies • Improved cooking and gardening self-efficacy Davis et al; in press JADA Gatto and Davis; in review at JADA

  21. A virtual gardening game for the prevention of obesity in minority youth

  22. 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

  23. 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

  24. Acknowledgements • 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 • JaimieDavis • Nicole Gatto • Emily Ventura • Tom Wright • Adriana Padilla • Chih-Ping Chou • Courtney B.William • Christianne J. Lane • Chad Lane • MarientinaGotsis • Gillian O’Reilly

  25. Acknowledgements • 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

  26. Acknowledgements • Study Participants

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