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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.

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Presentation on theme: "Obesity in Hispanic Children: Reversing the Tide Donna Spruijt-Metz, MFA PhD Associate Professor, USC Keck School of Medicine Director, Responsible Conduct."— Presentation transcript:

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  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

3 Childhood Obesity: Metabolic Consequences Visceral Fat Insulin Sensitivity Leptin Resistance Inflammation CVD NAFLD Some Cancers Diabetes

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 consumption in 1483 Hispanic Children in Los Angeles WIC Clinics Davis et al in press AJCN

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11 Physical Activity in Hispanic Youth

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

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

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

15 Sugar Intake in Hispanic Youth

16 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

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

18 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/cups Leche 2%/ 2% milk --1 taza/cup Jugo Tampico/Tampico juice -- 2 tazas/cups Resumen de esta Dieta (Summary of Diet): 3100 calorias/calories 7 g fibra/fiber 220 g azucar/sugar Almuerzo (Lunch) Pizza – 1 rebanada/slice Papas fritas (Fries) – 1 taza/cup Gatorade – 1 botella de 20 onzas/FO Merienda (Snack) Hot Cheetos – bolsa/bag de $0.99 Coca-Cola – 1 lata/can Goal: ~1800 calorias/calories 25-30 g fibra/fiber <50 g azucar/sugar Cena (Dinner) Tortilla de Harina (Flour Tortilla) - 2 Carne Asada (Grilled beef) – 1 taza/cup Arroz Mexicano (Mexican Rice) – 1 taza/cup Agua de Jamaica (Sweetened hibiscus drink) – 2 tazas/cups

19 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!!!

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

21 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)

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23 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

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

25 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

26 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

27 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 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

28 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

29 Study Participants Acknowledgements


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