The effects of acculturation on healthy lifestyle characteristics among Hispanic fourth-grade children in Texas public schools, 2004-2005.

Obesity and overweight have tripled in the last 3 decades among children ages 6-11.1 Despite the Healthy People 2010 overweight prevalence target for children in this age group of 5%,2 almost 35% are considered overweight or obese and 19.6% are considered obese.3 It is important to prevent and treat obesity among children as it is a significant predictor of certain chronic conditions, some of which can begin before adulthood, including hypertension, metabolic syndrome, diabetes, orthopedic problems,4 cardiovascular disease, certain cancers,5 joint degeneration, heart disease, stroke, and decreased self-esteem.6 It is also necessary to decrease childhood overweight and obesity prevalence as they are also associated with adult overweight and obesity5 and research has demonstrated that it is more difficult for adults to lose and maintain a healthy weight than children.6 Hispanic children are disproportionately affected by overweight and obesity. Data from the National Health and Nutrition Examination Survey (NHANES) 2007-2008 demonstrate that 25.1% of Hispanic children ages 6 to 11 years are obese, compared with 19% of non-Hispanic White children and 19.4% of non-Hispanic Black children.3 Because Hispanics currently represent 15% of the US population, and are projected to represent 25% of the US population by 2050,7,8 it is particularly important to understand predictors of overweight and obesity in Hispanic children. There is evidence that increased acculturation contributes to childhood overweight and obesity among Hispanics.9 Research has demonstrated that acculturation, defined as “the degree to which individuals adopt the values, behaviors, lifestyle, and language of the mainstream culture,”10 has led to both positive and negative health outcomes among Hispanic adults and children in the US.11 Evidence has indicated that more acculturated Hispanic adults have worse dietary practices11,12 and are more likely to be obese6 than less acculturated Hispanic adults. In addition, research has shown that children of more acculturated Hispanic adults tend to have higher rates of overweight and obesity.4,5 This rise in overweight and obesity among children of more acculturated Hispanics may be due to changes in healthy lifestyle characteristics, including worsening dietary habits.13 Because more Hispanic children are disproportionately affected by overweight and obesity than their counterparts, it is important to investigate how mediating factors, such as acculturation and its effect on healthy lifestyle characteristics, affect this population. Most research on health acculturation has focused on adolescents or adults, but because childhood obesity has been directly associated with an increased risk of adult obesity,5 it is important to study healthy lifestyle characteristics among children. In addition, most research conducted on health outcomes and acculturation has focused on diet and physical activity, but few studies have addressed nutrition knowledge or weight loss behaviors. Using a sample of 4th grade children in Texas public schools, the objective of this study was to investigate differences in calcium intake, fruit consumption, meal patterns, nutrition knowledge, and weight loss behaviors among Spanish-speaking and English-speaking Hispanic children.