CHAMPAIGN, Ill. - Hispanics living in the Midwest have the highest obesity rates among Latinos in the U.S., and in Illinois, the percentage of obese Latino children 6-11 years of age has doubled since 2001, standing now at 24 percent.
However, an intervention program developed by a researcher at the University of Illinois shows promise in helping Latino parents and their children develop healthy eating and exercise habits that prevent or combat obesity. Angela R. Wiley, a professor of applied family studies in the department of human and community development, a unit in the College of Agricultural, Consumer and Environmental Sciences, leads the program.
Abriendo Caminos, "Clearing the Path," helps Latino families in Central Illinois overcome some of the obstacles and patterns in daily life that adversely affect wellness in many low-income, dual-earner families. Using a family-centered, culturally tailored approach, the six-week program emphasizes healthy eating - more fruits and vegetables, fewer sugary beverages such as soda and juice - along with shared mealtimes and joint physical activities, especially culturally relevant activities, such as Mexican folk dancing.
"Our goals were first and foremost to create awareness in the Spanish-speaking community of the problems of obesity and the consequences that follow childhood obesity," Wiley said. "We're all tempted to define overweight kids as just 'chubby,' or carrying 'baby fat,' without understanding that once it reaches a certain level of significance it has long-term consequences."
Along with elevated cholesterol and blood pressure, childhood obesity can cause sleep apnea and adversely affect children's psychosocial development as well as their academic performance. Extra weight also elevates their risks of developing serious health conditions such as heart disease, diabetes and some cancers as an adult.
Seventy-three families participated in the pilot study. To be eligible to participate, families had to be of Latin American descent and have at least one child age 5-13. Slightly more than half of the 43 children in the program were overweight or obese, as were 82 percent of the parents.
Once a week for six weeks, families attended a two-hour session that included brief lectures, discussion, hands-on demonstrations and separate 30-minute nutrition classes for parents - taught in Spanish - and age-appropriate classes for the children taught in both Spanish and English.
The nutrition curricula, developed by scholars at Illinois, was based on the U.S. Department of Agriculture's 2010 Dietary Guidelines for Americans and its recently released My Plate icon, which indicates that fruits and vegetables should compose half of every meal.
When they began the study, more than half the children and 34 percent of the adults reported rarely or never eating a vegetable daily. And 41 percent of the parents reported rarely or never consuming the 2-3 daily servings of fruit recommended by the USDA. Participants were encouraged to consume traditional foods prepared in healthier ways, such as whole grain tortillas and dessert tortilla chips topped with fruit.
At the conclusion of the study, 14.6 percent of the children were consuming fruits and vegetables five or more times a day, and 13.9 percent were still doing so two months later.
Almost half the children and 22 percent of the adults consumed a sugar-sweetened beverage such as soda or fruit juice at least once a day when they began the program.
"Soda consumption was a huge problem," Wiley said. "One of the demonstrations that I do is show them how many cubes of sugar are in a Coca-Cola. And for many of them it was a huge eye-opener. Quite frankly, I think many of them were shocked."
A 12-ounce can of Coke contains 140 calories and 39 grams of sugar, the equivalent of 10 cubes of sugar. Consuming three cans a day is the calorie equivalent of eating five tortillas, participants learned.
By the end of the program, participants had reduced their consumption of sugary beverages from about seven times a week to four times. Changes were observed in children as young as age 6.
Shared mealtimes, bonding activities and joint physical activity were also components of the program, but were especially challenging for the parents in the study, many of whom worked multiple jobs. Parents were encouraged to adapt the program to their family's circumstances, which could mean eating breakfast together as a family once or twice a week if that's all their schedules allowed.
"Lots of times we have these scripts that play in our head that say if we have a mealtime we have to have candles on the table, a number of different types of food prepared from scratch and a sit-down dinner that's all nice and pleasurable," said Wiley, who also teaches a series of workshops on work-life management. "But it doesn't have to be dinner, traditional food or fancy food. You can sit around on the living room floor and play a card game while you eat. The really important thing is finding those little bits of time where you can have a quality connection."
Because many of the families lived in "food deserts" - areas lacking stores selling nutritious, affordable food - the researchers helped participants develop strategies, such as carpooling or taking the bus to larger discount stores where they could purchase food at lower prices in large quantities and in canned or frozen forms that have longer shelf lives.
However, many parents had "a real reluctance to utilize frozen foods" because of cultural perceptions that using convenience foods "is a sign they're not providing well for their families," Wiley said. "Food is never simply about nutrition. It is so much about psychology, emotions, relationships, bonding and many other things."
For some of the parents, buying their children the junk food they asked for was a tangible way of demonstrating love and affluence.
"We helped them think about how love can also involve not always giving their children the Cheetos they're asking for but helping them develop a taste for apple slices," Wiley said. "If we can help parents investigate their own beliefs, which are often unconscious, and challenge those that are unhealthy, I think we have a much better chance of helping them sustain healthier patterns."
The researchers are working with two local organizations, C-U Fit Families and the Common Ground food co-op, to organize community-based outreach to Spanish-speaking families. They're also developing guidelines for community leaders and policymakers in rural Illinois cities with Spanish-speaking populations.
Co-authors of the study were Barbara Fiese, the director of the Family Resiliency Center and the Pampered Chef Endowed Chair in Family Resiliency; Amber J. Hammons, a postdoctoral research associate in human and community development; and Margarita Teran-Garcia, a faculty member with appointments in the department of food science and human nutrition, and the Division of Nutritional Sciences.
The research was funded by Salud America!, an initiative of the Robert Wood Johnson Foundation; the Christopher Family Foundation; the Family Resiliency Center and University of Illinois Extension.