Obesity in Minority Populations: An Epidemiologic Assessment

Abstract

This article reviews issues relating to the prevalence, health implications, and prevention and treatment perspectives of obesity in U.S racial and ethnic minority groups. The growing interest in obesity in minority populations reflects an awareness of the high prevalence of obesity among black, Hispanic, Asian and Pacific Islander and Native Americans as well as a generally increased interest in minority health. In addition, the fact that some aspects of obesity among minorities differ from those in whites suggests that new insights may be gained from studying obesity in diverse populations. However, there are many methodological problems to be overcome, including some that arise from the way minority groups are defined. Under the assumption that all obesity results from a period of sustained positive energy balance at the individual level, an epidemiologic explanation for the excess of obesity in minorities at the population level seems readily apparent. A surplus of obesity-promoting forces and a deficit of obesity-inhibiting forces, caused by secular changes in food availability and physical activity, accompany the early phases of modernization and economic advancement. The high prevalence of obesity in minority populations can be viewed as a function of the slope and timing of these secular changes. Genetic predisposition, cultural attitudes, and exposure to maternal obesity and diabetes in utero may be potentiating factors. In this context, interventions targeting individuals would seem inevitably to put racial and ethnic minority groups on the path toward the same weight control crisis now observed in the majority white population. This suggests that the underlying causes of the societal energy balance problem must be addressed at the population level in order for effective clinical approaches to be developed for minority populations with a high obesity prevalence.

Acculturation, socioeconomic status, and obesity in Mexican Americans, Cuban Americans, and Puerto Ricans

“…Previous studies of overweight and obesity in Hispanics have attempted to measure acculturation using measures of language 13 and multidimensional scales 6±9 with con¯icting results. However, the San Antonio Heart Study, 24 the present analysis, and others 28 suggest that when adequate measures are available, BMI is associated with acculturation in Mexican Americans even after controlling for demographic and socioeconomic variables which is not the case for Cuban Americans or Puerto Ricans. More importantly, the basic relationships of BMI with SES did not change with the addition of acculturation indicators, and no signi®cant interactions between SES and acculturation indicators were found.…”

Self‐Esteem and Obesity in Children and Adolescents: A Literature Review

“…No control group was included in the study. Self-esteem increases were observed during a 16-week weight loss program in 36 black, lower-middle income females aged 14 years old (71). However, change in self-esteem was unrelated to weight change in treatment, and no control group was included in the study.…”

“…If the effects are specific to physical appearance, females may be more negatively impacted than males due to the greater sociocultural emphasis on physical appearance for females (53,65). In addition to gender, racdethnicity may moderate the relationship between self-esteem and obesity since certain ethnic groups stigmatize obese individuals to a greater extent than other ethnic groups (e.g., whites vs. blacks) (36).…”

Aerobic fitness, physiologic difficulty and physical activity in Black and White women

“…[1][2][3] In addition, several studies have found that Black subjects have lower physical activity and higher prevalence of obesity than White subjects. [4][5][6][7][8][9][10][11] Although it is known that social and cultural factors may affect participation in physical activity, little is known concerning potential physiological factors that might influence the lower physical activity found in Black subjects.…”