Childhood Obesity among Impoverished Mexican Americans: Longitudinal Growth Patterns and Cultural-Bioecological Predictors from Birth to Pre-Puberty.

项目摘要 尽管儿童肥胖是一个全国性的健康问题，达到了流行病的程度，但西班牙裔儿童 非西班牙裔白人儿童肥胖的可能性几乎是非西班牙裔白人儿童的两倍，墨西哥裔美国人患肥胖症的风险更高 与其他西班牙裔亚群相比，肥胖的比例更高。与体重相关的健康问题也在以惊人的速度增加 费率。如果当代的肥胖率持续下去，“当前这一代儿童将是第一个 美国历史上一代人比他们的父母病得更重，死得更早“(罗伯特·伍德·约翰逊基金会， 2012年)。因为在孩子已经达到肥胖状态后，干预的挑战会成倍增加，它 必须了解在生命的早期阶段形成风险的过程。身份的鉴定 儿童时期关键的形成期肥胖发展的风险和弹性预测因子 提供符合预防性公共卫生干预措施的具体目标。我们打算充分利用 NIMH和NICHD资助的极低收入墨西哥裔美国人研究收集的纵向数据 母亲和婴儿(Las Madres Nuevas)，评估多种文化和环境风险和 从产前到六岁的保护性因素。我们建议利用这一现有的 纵向数据集，并收集7.5岁和9岁时的身体健康和心脏代谢风险标记物。 结合起来，我们将：1)使用先进的统计程序来绘制体重增加的轨迹图 测量从出生到9岁的13个时间点的体重和生长；2)确定关键时期 从出生到9岁，儿童偏离健康的体重增加轨迹；3)评估早期生活 作为环境影响对儿童体重增加影响的调节因素的生物敏感性 轨迹和肥胖症；4)评估文化、经济、孕产妇和儿童因素的后果；以及 新出现的身体健康和心脏代谢风险的体重增加轨迹。拟议的纵向研究， 数据来自生物测量、人体测量、父母报告、医疗记录和 是回答与低体重人群体重差异有关的关键问题的理想选择。 为MA儿童带来收入，并勾勒出MA儿童肥胖出现的机制路径。我们的科学研究 方法强调肥胖发展的文化根深蒂固，认为减少 通过了解社会文化和经济力量，可以最好地实现儿童肥胖差距 塑造饮食行为和体重增加。该项目具有解决以下核心问题的巨大潜力 在高危种族群体中，早年生活对体重增加和肥胖风险的贡献，并增加机会 用于预防肥胖和相关的健康问题。

Project Summary Although childhood obesity is a national health problem reaching epidemic proportions, Hispanic children are nearly twice as likely as non-Hispanic white children to be obese, and Mexican Americans have higher risk of obesity than other Hispanic subgroups. Weight-associated health problems are also increasing at alarming rates. If contemporary obesity prevalence rates persist, “the current generation of children will be the first generation in US history to be sicker and die earlier than their parents” (Robert Wood Johnson Foundation, 2012). Because the challenges of intervention are multiplied after a child has already reached obesity status, it is imperative to understand the processes of developing risk in the earliest years of life. The identification of risk and resiliency predictors of the development of obesity during critical formative years of childhood will provide specific targets amenable to preventive public health interventions. We propose to capitalize on longitudinal data collected by an NIMH and NICHD-funded study of very low income Mexican American mothers and infants (Las Madres Nuevas) that assesses a multitude of cultural and environmental risk and protective factors from the prenatal period through six years of age. We propose to leverage this existing longitudinal dataset, and collect physical health and markers of cardiometabolic risk at ages 7.5 and 9. In combination, we will: 1) Use advanced statistical procedures to chart trajectories of weight gain using objective measures of weight and growth measured at 13 time points from birth through age 9; 2) Identify critical periods from birth to age 9 at which children diverge from healthy weight gain trajectories; 3) Evaluate early life biological susceptibility as a moderator of the impact of environmental influences on child weight gain trajectories and obesity; 4) Evaluate the consequences of cultural, economic, maternal and child factors, and weight gain trajectories for emerging physical health and cardiometabolic risk. The proposed longitudinal study, with data drawn from biological measures, anthropometric measures, parent report, medical records, and observational sessions, is ideally situated to answer key questions related to weight disparities among low- income MA children, and delineate mechanistic pathways in the emergence of MA child obesity. Our scientific approach emphasizes the cultural embeddedness of obesity development, with the view that the reduction of child obesity disparities can best be accomplished by understanding sociocultural and economic forces that shape eating behavior and weight gain. This project holds great potential to address central questions about early life contributors to weight gain and obesity risk in a high risk ethnic group, and enhance opportunities for prevention of obesity and associated health problems.