Childhood Obesity and Cardiometabolic Health among Impoverished Mexican Americans

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Project Summary Substantial health inequities exist for Hispanic children. Recent national statistics indicate Hispanic youth are nearly twice as likely to be obese as non-Hispanic white youth. Cardiometabolic risk indicators are also elevated among Hispanic children relative to children of other ethnicities. The identification of risk and resiliency predictors of poor health during childhood and adolescence from a longitudinal and developmental perspective will provide specific targets amenable to preventive public health interventions. We propose to capitalize on longitudinal data collected by an NIH-funded study of very low-income Mexican American mothers and youth (Las Madres Nuevas) that assessed a multitude of cultural, biological, family, and environmental risk and protective factors from the prenatal period through ten years of age, including 13 objective measures of child weight and health beginning at birth. We propose to leverage this existing longitudinal dataset and evaluate weight gain and cardiometabolic health trajectories, and additional risk and resiliency factors at child ages 12-13 and 15-16. The COVID-19 pandemic and racial tensions in the U.S. provide natural ecological stressors that can disrupt normally-developing trajectories or worsen at-risk trajectories. With data collected recently on the impact of these stressors on youth, the project is ideally situated to examine health-related consequences of these significant social and environmental challenges. In combination, we will: 1) Examine trajectories of child weight gain from birth to age 15-16 years and associated cardiometabolic health consequences (e.g., blood pressure, HbA1c, cholesterol, CRP, IL-6); 2) Examine macro-level social, cultural, and environmental risk and protective factors (e.g., negative racial climate, concentrated disadvantage, neighborhood opportunity) that influence developmental trajectories in weight gain and cardiometabolic health. 3) Examine proximal influences (e.g., acculturation and cultural values; maternal and child mental health; family feeding and behavioral practices) on trajectories of weight gain and cardiometabolic health; 4) Conduct a nuanced examination of ecological and salient major life events (e.g., COVID, puberty) that potentially divert weight gain and cardiometabolic trajectories, focusing on the unique characteristics of youth who are relatively unaffected, recover, or are chronically affected. The proposed study utilizes data from biological measures, anthropometric measures, parent report, youth report, medical records, and observational protocols. Our scientific approach emphasizes the cultural embeddedness of healthy development, with the view that health equity can best be achieved by understanding sociocultural and economic forces that shape eating behavior and weight gain. This project holds great potential to address central questions about contributors to weight gain and obesity risk in a high-risk group, and enhance opportunities for prevention of obesity and associated health problems.