Academic journal article Childhood Obesity

Obesity Risk in Children: The Role of Acculturation in the Feeding Practices and Styles of Low-Income Hispanic Families

Academic journal article Childhood Obesity

Obesity Risk in Children: The Role of Acculturation in the Feeding Practices and Styles of Low-Income Hispanic Families

Article excerpt

[Author Affiliation]

Thomas G. Power. 1 Department of Human Development, Washington State University, Pullman, WA.

Teresia M. O'Connor. 2 Department of Pediatrics, Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, Houston, TX.

Jennifer Orlet Fisher. 3 Department of Public Health, Temple University, Center for Obesity Research and Education, Philadelphia, PA.

Sheryl O. Hughes. 2 Department of Pediatrics, Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, Houston, TX.

Address correspondence to: Sheryl O. Hughes, PhD, Assistant Professor of Pediatrics, Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030-2600, E-mail: shughes@bcm.edu

Introduction

The immigrant paradox, the tendency of second- and third-generation immigrants to have poorer health outcomes than first-generation immigrants, despite having more economic and social resources,1,2 has been the focus of much discussion and debate in the academic community. This phenomenon is labeled a paradox, because traditional models of cultural assimilation predict better outcomes across generations.3,4 Besides applying to the health of adults, the immigrant paradox also applies to childhood obesity, with second- and third-generation children from Asia and Latin America having higher levels of obesity than first-generation immigrants.5-8 This has led scholars, such as Garcia-Coll and Marks,9 to ask the question, "Is becoming American a developmental risk?"

If exposure to and adoption of US lifestyles increases the risk of childhood obesity, one would expect positive relationships between acculturation and obesity in immigrant populations. The data on this, however, are mixed. In studies of Hispanic children (the focus of the current article), some studies uncovered a positive association between maternal or child acculturation and child weight status10,11 and some showed a negative relationship.12,13 The data for Hispanic adults are also inconsistent. In a recent systematic review of nine studies of Hispanic adults, Delavari and colleagues14 found that six studies showed a positive relationship between adult acculturation and BMI, whereas the other three found a negative relationship (especially for women). Insufficient research has been conducted in this area to determine whether these differences in results are owing to the measures of acculturation employed; the countries of origin; regional or neighborhood differences; or other factors.

Studies conducted to explain the lower rates of child and adult obesity in first-generation Hispanic immigrants have identified a number of factors that could contribute to these differences in obesity rates. Compared to later generations, first-generation Hispanic immigrant children and/or adults eat more fruits and vegetables15-19 ; eat more rice11,16 ; drink less soda15,16 ; eat less fast food, cheese, and/or high-calorie snacks11,16 ; and show lower levels of sedentary behavior 6,11 (although first-generation adults engage in less exercise than later generations20,21 ).

Although these lifestyle and consumption patterns might explain some of the differences in childhood obesity between first and later generations, it is possible that other aspects of children's eating environments (such as maternal feeding practices or styles) might change with acculturation as well, increasing obesity risk. A growing body of research now supports the idea that parental feeding styles and practices can increase young children's obesity risk by influencing children's eating behavior. Although studies of white, middle class families suggest that highly controlling or restrictive feeding practices may contribute to obesity by over-riding children's responsiveness to internal satiety cues,22 a series of studies by Hughes and colleagues23-29 suggest that highly permissive, indulgent feeding patterns are the feeding styles related to child obesity in low-income, Hispanic samples. …

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