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Acculturation, socioeconomic status, obesity and lifestyle factors among low-income Puerto Rican women in Connecticut, U.S., 1998-1999 Translated title: Aculturación, clase social, obesidad y factores relacionados con el estilo de vida en mujeres puertorriqueñas de bajos ingresos residentes del estado de Connecticut, Estados Unidos, 1998-1999

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      Abstract

      OBJECTIVES: To examine the associations of socioeconomic status and acculturation with obesity and lifestyle characteristics that may be risk factors for diabetes and cardiovascular disease among low-income Puerto Rican women. METHODS: This cross-sectional study was conducted between 1998 and 1999 by interviewing a convenience sample of 200 low-income Puerto Rican female caretakers of young children in Hartford, Connecticut, United States of America. Various recruitment methods were used to ensure adequate representation of the target community. The associations of obesity (body mass index > 30.0) and lifestyle factors (physical activity, cigarette smoking, alcohol consumption, food intake) with socioeconomic status (education, employment, car ownership), acculturation, age, and marital status were examined with Spearman rho, chi-squared, and Mann-Whitney U tests and logistic regression analyses. RESULTS: Mean age was 29 years. Obesity (40%), physical inactivity (47%), and cigarette smoking (32%) were common. Less acculturated participants were 57% less likely to smoke and 54% less likely to be obese than their more acculturated counterparts. Lower socioeconomic status (not finishing high school or not owning a car) was associated with a higher likelihood of obesity, but unemployed (vs. employed) women were less likely to be obese (P < 0.05). Women who did not own a car consumed meat, eggs and fish less often than those who owned a car. Smokers were more likely to have an unhealthy food intake pattern than nonsmokers. CONCLUSIONS: The associations of acculturation and socioeconomic status with some lifestyle characteristics suggest the need for culturally appropriate programs to promote healthy lifestyle behaviors in this low-income community.

      Translated abstract

      OBJETIVOS: Examinar las asociaciones entre el estado socioeconómico y la aculturación con las características del estilo de vida que podrían constituir factores de riesgo de diabetes y de enfermedades cardiovasculares en mujeres puertorriqueñas de bajos ingresos. MÉTODOS: Este estudio transversal se llevó a cabo entre 1998 y 1999 mediante entrevistas a una muestra de conveniencia compuesta de 200 mujeres puertorriqueñas de bajos ingresos que cuidaban a niños pequeños en Hartford, Connecticut, Estados Unidos de América. Se usaron diversas formas de reclutamiento para conseguir que hubiera una buena representación de la comunidad blanco. Las asociaciones entre la obesidad (índice de masa corporal > 30,0) y factores propios del estilo de vida (actividad física, tabaquismo, consumo de alcohol, alimentación) por un lado y la clase social (escolaridad, empleo, tenencia de un automóvil), aculturación, edad y estado civil por el otro se examinaron mediante la prueba de rho de Spearman, la de ji al cuadrado y la de la U de Mann-Whitney y análisis de regresión logística. RESULTADOS: La edad promedio fue de 29 años. La obesidad (40%), inactividad física (47%) y el tabaquismo (32%) fueron comunes. Las participantes con menos grado de aculturación fueron 57% menos propensas a ser fumadoras y 54% menos propensas a ser obesas que las que estaban más aculturadas. Pertenecer a una clase social más baja (no haber terminado la secundaria o no tener automóvil) se asoció con una mayor probabilidad de ser obesa, pero las mujeres sin trabajo (por oposición a las que sí lo tenían) mostraron menor propensión a ser obesas (P < 0,05). Las mujeres que no tenían automóvil consumían carne, huevos y pescado con menos frecuencia que las que sí lo tenían. Las fumadoras tenían más probabilidad de tener una alimentación malsana que las que no fumaban. CONCLUSIONES: Las asociaciones entre el grado de aculturación y el estado socioeconómico con algunas características del estilo de vida apuntan a la necesidad de crear programas apropiados desde el punto de vista cultural para promover conductas sanas en esta comunidad de bajos ingresos.

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      Most cited references 61

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      Diet, lifestyle, and the risk of type 2 diabetes mellitus in women.

      Previous studies have examined individual dietary and lifestyle factors in relation to type 2 diabetes, but the combined effects of these factors are largely unknown. We followed 84,941 female nurses from 1980 to 1996; these women were free of diagnosed cardiovascular disease, diabetes, and cancer at base line. Information about their diet and lifestyle was updated periodically. A low-risk group was defined according to a combination of five variables: a bodymass index (the weight in kilograms divided by the square of the height in meters) of less than 25; a diet high in cereal fiber and polyunsaturated fat and low in trans fat and glycemic load (which reflects the effect of diet on the blood glucose level); engagement in moderate-to-vigorous physical activity for at least half an hour per day; no current smoking; and the consumption of an average of at least half a drink of an alcoholic beverage per day. During 16 years of follow-up, we documented 3300 new cases of type 2 diabetes. Overweight or obesity was the single most important predictor of diabetes. Lack of exercise, a poor diet, current smoking, and abstinence from alcohol use were all associated with a significantly increased risk of diabetes, even after adjustment for the body-mass index. As compared with the rest of the cohort, women in the low-risk group (3.4 percent of the women) had a relative risk of diabetes of 0.09 (95 percent confidence interval, 0.05 to 0.17). A total of 91 percent of the cases of diabetes in this cohort (95 percent confidence interval, 83 to 95) could be attributed to habits and forms of behavior that did not conform to the low-risk pattern. Our findings support the hypothesis that the vast majority of cases of type 2 diabetes could be prevented by the adoption of a healthier lifestyle.
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        Do healthy behaviors decline with greater acculturation? Implications for the Latino mortality paradox.

        Relative to non-Latino whites, Latinos in the United States have a lower socioeconomic status (SES) profile, but a lower all-cause mortality rate. Because lower SES is associated with poorer overall health, a great deal of controversy surrounds the Latino mortality paradox. We employed a secondary data analysis of the 1991 National Health Interview Survey to test the health behavior and acculturation hypotheses, which have been proposed to explain this paradox. These hypotheses posit that: (1) Latinos have more favorable health behaviors and risk factor profiles than non-Latino whites, and (2) Health behaviors and risk factors become more unfavorable with greater acculturation. Specific health behaviors and risk factors studied were: smoking, alcohol use, leisure-time exercise activity, and body mass index (BMI). Consistent with the health behaviors hypothesis, Latinos relative to non-Latino whites were less likely to smoke and drink alcohol, controlling for sociodemographic factors. Latinos, however, were less likely to engage in any exercise activity, and were more likely to have a high BMI compared with non-Latino whites, after controlling for age and SES. Results provided partial support for the acculturation hypothesis. After adjusting for age and SES, higher acculturation was associated with three unhealthy behaviors (a greater likelihood of high alcohol intake, current smoking, a high BMI), but improvement in a fourth (greater likelihood of recent exercise). Gender-specific analyses indicated that the observed differences between Latinos and non-Latino whites, as well as the effects of acculturation on health behaviors, varied across men and women. Results suggest that the health behaviors and acculturation hypotheses may help to at least partially explain the Latino mortality paradox. The mechanisms accounting for the relationship between acculturation and risky behaviors have yet to be identified.
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          New standards of weight and body composition by frame size and height for assessment of nutritional status of adults and the elderly.

           A Frisancho (1984)
          The study includes measurements of height, weight, triceps skinfold, subscapular skinfold, upper arm circumference, and elbow breadth of a cross-sectional multiracial sample of 21,752 subjects aged 25 to 74 yr derived from the data sets of the first and second National Health and Nutrition Examination Surveys (NHANES I and NHANES II). Based on these data, percentiles of weight, skinfolds, and bone-free upper arm muscle area by height, sex, and frame size were established for all races combined in two groups: adults aged 25 to 54 yr and the elderly aged 55 to 74 yr. These new standards can be used to differentiate those who are at risk of being obese and undernourished. It is recommended that assessment of anthropometric nutritional status and health status of contemporary adult and elderly populations be made with reference to the present standards in conjunction with age correction factors.
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            Author and article information

            Affiliations
            [1 ] State University of New Jersey USA
            [2 ] University of South Florida USA
            [3 ] Hispanic Health Council USA
            [4 ] Hispanic Health Council
            [5 ] Connecticut Department of Public Health USA
            [6 ] Connecticut Latino Health Disparities NIH EXPORT Center USA
            Contributors
            Role: ND
            Role: ND
            Role: ND
            Role: ND
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            Role: ND
            Journal
            rpsp
            Revista Panamericana de Salud Pública
            Rev Panam Salud Publica
            Organización Panamericana de la Salud (Washington )
            1020-4989
            May 2006
            : 19
            : 5
            : 306-313
            S1020-49892006000500003 10.1590/s1020-49892006000500003

            http://creativecommons.org/licenses/by/4.0/

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            Product Information: SciELO Public Health
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            Health Policy & Services

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