Obesity in the Latino Community Michael A. Rodriguez, MD, MPH UCLA Department of Family Medicine
Obesity Trends* Among U.S. Adults BRFSS, 1985 (*BMI 30, or ~ 30 lbs overweight for 5 4 woman) No Data <10% 10% 14%
Obesity Trends* Among U.S. Adults BRFSS, 1990 (*BMI 30, or ~ 30 lbs overweight for 5 4 woman) No Data <10% 10% 14%
Obesity Trends* Among U.S. Adults BRFSS, 1995 (*BMI 30, or ~ 30 lbs overweight for 5 4 woman) No Data <10% 10% 14% 15% 19%
Obesity Trends* Among U.S. Adults BRFSS, 2000 (*BMI 30, or ~ 30 lbs overweight for 5 4 woman) No Data <10% 10% 14% 15% 19% 20
Obesity Trends* Among U.S. Adults BRFSS, 2005 (*BMI 30, or ~ 30 lbs. overweight for 5 4 person) No Data <10% 10% 14% 15% 19% 20% 24% 25% 29% 30%
Obesity Trends* Among U.S. Adults BRFSS, 2010 (*BMI 30, or ~ 30 lbs. overweight for 5 4 person) No Data <10% 10% 14% 15% 19% 20% 24% 25% 29% 30%
U.S. Prevalence of Overweight in Children by Ethnicity 45.0% 40.0% 35.0% 30.0% 25.0% 20.0% Non-Hispanic White Hispanic 15.0% 10.0% 5.0% 0.0% 0-2 years old 2-19 years old Source: Ogden, C., Carroll,M., Kit, B. Flegal, K., 2012, Prevalence of Obesity and Trends in Body Mass Index Among US Children and Adolescents, 1999-2010
Source: Ogden CL, Carroll MD, Flegal KM. High Body Mass Index for Age Among US Children and Adolescents, 2003 2006. JAMA 2008;299:2401 2405
Physical Health Glucose intolerance and insulin resistance Type 2 diabetes Hypertension Dyslipidemia Hepatic Steatosis Cholelithiasis Sleep apnea Menstrual abnormalities Impaired balance Orthopedic problems Asthma Source: Institute of Medicine of the National Academics
Age-Adjusted Rates of Death from Diabetes Mellitus Epidemiologic Reviews The Author 2009. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.
Emotional Health Low self-esteem Negative Body Image Depression Source: Institute of Medicine of the National Academics
Social Discrimination Stigma Negative Stereotyping Teasing Bullying Source: Institute of Medicine of the National Academics
Is it just Lifestyle?
Contributing Factors to Obesity Increased portion size Increased consumption of high calorie foods and drinks Decreased physical activity (including sedentary lifestyles) Source: LA County Task Force on Children and Youth Physical Fitness Report to the Board of Supervisors, 2002
Super-sizes Plenty of Saturated Fats and Carbohydrates Huge Portions! Cheap, available food everywhere Early Start! (357gms) 960 Cal 46g Carbs 63 g Fat 1420 mg Na (116gms) 370 Cal 43g Carbs 20gFat 240 mg Na
The Special Case of Sugar-Sweetened Beverages
It is unreasonable to expect that people will change their behavior easily when so many forces in the social, cultural, and physical environment conspire against such change.
The Main Determinants of Health Work environment Living and working conditions Unemployment Education Water and sanitation Agriculture and food production Age, sex and constitutional factors Health care services Housing Dahlgren G, Whitehead M. Policies and strategies to promote social equity in health. Stockholm: Institute for Future Studies. Figure 1: The main determinants of health. 2007.
Environment Urban and suburban designs that discourage walking and other physical activities Unsafe neighborhoods discouraging outdoor activities Source: Institute of Medicine of the National Academics; California Adolescent Nutrition and Fitness Program & California Pan-Ethnic Health Network, 2003
Other Contributing Factors to Obesity Financial barriers to accessing healthy foods and lifestyles Neighborhood design Unsafe neighborhoods Intensive marketing of unhealthy foods Highly accessible processed and fatty foods in low-income neighborhoods Low number and poor quality of recreational facilities Lack of funding for nutrition and physical activity programs Source: California Adolescent Nutrition and Fitness Program & California Pan-Ethnic Health Network, 2003
But what more can we do?
CHANGE in our Environments
School Programs Banning sweetened beverages School-based nutrition education Beyond the Bell Source: http://www.publichealthadvocacy.org/legislation/lausd.html http://www.lausd.k12.ca.us/lausd/offices/btb/youth.html http://www.lausdnutritionnetwork.org/
Community Programs Hospitals and clinics Parks Pacoima Wash Project
Good News About Physical Activity
Only with combined efforts of all sectors and disciplines of society... Educational Institutions Media Legal Sector Business Labor Faith Communi ty Non-Profits & Community-Based Organizations...can we hope to address obesity.
THANKS! Contact me with any questions! Michael Rodriguez MRodriguez@mednet.ucla.edu