Approximately 83% of Hispanic men of Mexican origin are overweight or obese, which are both associated with increased risk of chronic disease and all-cause mortality. Consequently, men of Mexican origin have some of the highest prevalence rates of obesity-related comorbidities. Physical activity (PA) may be an important strategy for Hispanic men of Mexican origin in reducing incidence and risk factors of lifestyle diseases. The current study engaged Spanish-speaking, Hispanic men of Mexican origin aged 24–64 years with overweight/obesity to examine perspectives of health behaviors related to PA. A total of 14 in-depth semistructured individual interviews were completed between September and November of 2015 and data analyzed using an iterative deductive–inductive thematic assessment strategy. The men suggested that their PA was hindered by (a) work-related energy and time constraints, (b) socioeconomic status (SES) and the need to prioritize work, (c) adaptations to majority population lifestyle norms, and (d) perceived lack of suitable access to PA-promoting spaces. The men provided valuable insight for strategies to improve PA interventions such as (a) accurately accounting for current PA levels of participants, including occupational and transportation PA, (b) considerations of family dynamics that influence PA-based behavior change, and (c) considerations of economic and geographical constraints that can be remediated. To improve effectiveness, future PA-related intervention research with Hispanic men of Mexican origin should consider methods that (a) account for transportation and occupational PA to better tailor PA to individual needs, (b) consider sociocultural and socioeconomic influences, (c) account for social support and accountability, and (d) consider economic and geographical constraints.
Introduction: Mexican-origin women suffer disproportionate rates of nonalcoholic fatty liver disease (NAFLD) and research on how to tailor NAFLD treatment interventions for this population is lacking.Objectives: The purpose of this study was to assess awareness, knowledge, perceptions, and information sources related to NAFLD in a community-based sample of Mexican-origin women.Methods: This study employed a convergent parallel mixed-methods approach and consisted of a brief questionnaire (n = 194) and interviews (n = 26) among Mexican-origin women recruited from community-based settings including health fairs, churches, and community events. Participants were eligible if they identified as Mexican-origin, had a BMI ≥ 25 kg/m2, were 18–64 years of age, had the ability to speak, read, and write in English and/or Spanish, and provided informed consent. A purposeful sampling approach was used to recruit a subset of women (n = 26) with confirmed liver steatosis indicative of NAFLD (controlled attenuation parameter ≥280 dB/m) who completed the questionnaire. The twenty-six participants then completed one on one, in-depth semi-structured interviews to ascertain their knowledge and understanding of NAFLD.Results: Qualitative findings revealed low awareness of risk factors for liver disease, NAFLD specifically. Knowledge of liver disease tended to center around cirrhosis, a condition many participants reported was prevalent in their families. Quantitative and qualitative findings both found information sources for NAFLD and liver disease to be predominantly friends, family, and media. Interviews revealed a misperception related to NAFLD risk that liver disease was only caused by high alcohol intake.Conclusion: Low levels of NAFLD awareness and knowledge warrant the need for greater efforts to educate the general population, perhaps by integrating NAFLD education into existing type 2 diabetes educational campaigns and prevention interventions. Additionally, further elicitation research conducted in Mexican-origin adults is needed to elucidate key factors within behavioral-theory constructs that can be targeted in future interventions tailored to this unique population.
ObjectiveTo assess the feasibility and acceptability of a beverage intervention in Hispanic adults.DesignEligible individuals identified as Hispanic, were 18–64 years old and had BMI 30·0–50·0 kg/m2. Participants were randomized 2:2:1 to one of three beverages: Mediterranean lemonade (ML), green tea (GT) or flavoured water control (FW). After a 2-week washout period, participants were asked to consume 32 oz (946 ml) of study beverage daily for 6 weeks and avoid other sources of tea, citrus, juice and sweetened beverages; water was permissible. Fasting blood samples were collected at baseline and 8 weeks to assess primary and secondary efficacy outcomes.SettingTucson, AZ, USA.ParticipantsFifty-two participants were recruited over 6 months; fifty were randomized (twenty-one ML, nineteen GT, ten FW). Study population mean (sd) age 44·6 (sd 10·2) years, BMI 35·9 (4·6) kg/m2; 78 % female.ResultsForty-four (88 %) completed the 8-week assessment. Self-reported adherence was high. No significant change (95 % CI) in total cholesterol (mg/dl) from baseline was shown −1·7 (−14·2, 10·9), −3·9 (−17·2, 9·4) and −13·2 (−30·2, 3·8) for ML, GT and FW, respectively. Mean change in HDL-cholesterol (mg/dl) −2·3 (−5·3, 0·7; ML), −1·0 (−4·2, 2·2; GT), −3·9 (−8·0, 0·2; FW) and LDL-cholesterol (mg/dl) 0·2 (−11·3, 11·8; ML), 0·5 (−11·4, 12·4; GT), −9·8 (−25·0, 5·4; FW) were also non-significant. Fasting glucose (mg/dl) increased significantly by 5·2 (2·6, 7·9; ML) and 3·3 (0·58, 6·4; GT). No significant change in HbA1c was demonstrated. Due to the small sample size, potential confounders and effect modifiers were not investigated.ConclusionsRecruitment and retention figures indicate that a larger-scale trial is feasible; however, favourable changes in cardiometabolic biomarkers were not demonstrated.
Background: In the U.S., Hispanic women experience a disproportionate rate of obesity and obesity-related chronic diseases. At the same time, Hispanic women remain considerably underrepresented in behavioral weight loss interventions. The purpose of this review is to systematically evaluate the evidence related to the effectiveness of weight loss interventions among Hispanic women in the U.S. This review will identify elements of successful weight loss interventions as well as areas for future research. Methods/Design: The following databases will be searched to identify all relevant articles (from inception onwards): PubMed, Embase, Scopus, Web of Science (Science Citation Index and Social Sciences Citation Index), PsycINFO, CINAHL, Chicano Database, SPORTDiscus, CAB Abstracts, and Google Scholar. We will include randomized controlled trials and quasi-experimental studies of adult women (> 18 years) from Hispanic/Latino background living in the United States. Eligible interventions will target weight-related behaviors (including diet, physical activity, behavior modification and/or their combinations). The review's primary outcome will be weight change (expressed as change in lbs/kg or body mass index (BMI) (kg/m 2 )). Three reviewers will independently screen and select data and two will extract data. The methodological quality (or risk of bias) of individual studies will be appraised using the Effective Public Health Practice Project Quality Assessment Tool. A narrative synthesis will describe quality and content of the evidence. Discussion: The aim of this systematic review is to critically examine existing weight loss interventions for Hispanic women in the U.S. and provide quality evidence for the effectiveness of these interventions on weight loss. Further, this review seeks to identify characteristics of effective interventions and suggest future directions for research efforts targeting weight loss in this population. This review will inform the development of future weight loss interventions for this population. Systematic review registration: PROSPERO CRD42019119094
The incidence of nonalcoholic fatty liver disease (NAFLD) is highest among Mexican-origin (MO) adults. Few studies have estimated the prevalence of NAFLD in this subpopulation, particularly by sex and age. We assessed the prevalence of NAFLD in a community sample of MO adults residing in a border region of southern Arizona and determined risk factors associated with NAFLD. A total of 307 MO adults (n = 194 women; n = 113 men) with overweight or obesity completed an in-person study visit, including vibration-controlled transient elastography (FibroScan) for the assessment of NAFLD status. A continuous attenuation parameter score of ≥288 dB/m (≥5% hepatic steatosis) indicated NAFLD status. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for NAFLD. We identified 155 participants (50%) with NAFLD, including 52% of women and 48% of men; there were no sex differences in steatosis (men, 287.8 dB/m; women, 288.4 dB/m). Sex, age, patatin-like phospholipase domain containing 3 (PNPLA3) risk allele carrier status, comorbidities, and cultural and behavioral variables were not associated with NAFLD status. There was some evidence for effect modification of body mass index (BMI) by sex (P interaction = 0.08). The estimated OR for an increase in BMI of 5 kg/m 2 was 3.36 (95% CI, 1.90, 5.91) for men and 1.92 (95% CI, 1.40, 2.64) for women. In post hoc analyses treating steatosis as a continuous variable in a linear regression, significant effect modification was found for BMI by sex (P interaction = 0.03), age (P = 0.05), and PNPLA3 risk allele carrier status (P = 0.02). Conclusion: Lifestyle interventions to reduce body weight, with consideration of age and genetic risk status, are needed to stem the higher rates of NAFLD observed for MO populations. (Hepatology Communications 2022;6:1322-1335).N onalcoholic fatty liver disease (NAFLD) is the hepatic manifestation of metabolic syndrome that is defined as steatosis affecting ≥5% of hepatocytes not caused by excess alcohol intake, hepatitis B or C, autoimmune hepatitis, iron overload, drugs, or toxins. (1)(2)(3) It is estimated to affect approximately 20% (64 million) of the United States (US) population each year, leading to annual medical costs exceeding $100 billion. (4) Although not all individuals with NAFLD progress to end-stage liver disease, nearly 30% are at greater risk for developing cirrhosis, portal hypertension, and hepatocellular carcinoma (HCC), making NAFLD an emerging risk factor for HCC that is projected to become the leading cause of
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