Acculturation, Dietary Practices and Risk for Childhood Obesity in an Ethnically Heterogeneous Population of Latino School Children in the San Francisco Bay Area

Previous studies have found increased acculturation to the US lifestyle increases risk for obesity in Latinos. However, methodologies
differ, and results in children are inconsistent. Moreover, previous studies have not evaluated risk factors within the heterogeneous
US population. We recruited 144 self-identified Latino school children and their mother or father in grades 4–6 in San Francisco
parochial schools and South San Francisco public schools using an information letter distributed to all students. Children
and parents had weights, heights, demographic information, dietary patterns and lifestyle variables collected in English or
Spanish through an interview format. A high percentage of our children were overweight [≥85th percentile body mass index (BMI)]
(62.5%) and obese (≥95th percentile BMI) (45.2%). Correspondingly parents also had a high percentage of overweight (BMI ≥ 25
& <30) (40.8%) and obesity (BMI ≥ 30) (45.3%). Mexico was the country of origin for 62.2% of parents, and 26.6% were from
Central or South America. In multivariate logistic analysis, speaking Spanish at home was an independent risk factor for obesity
[odds ratio (OR) 2.97, 95% confidence interval (CI) 1.28–6.86]. Eating breakfast daily (OR 0.34, 95% CI 0.15–0.78) and consumption
of tortas (a Mexican fast food sandwich) (OR 0.45, 95% CI 0.21–1.00) were associated with decreased risk. In stratified analysis,
significant differences in risk factors existed between Mexican origin versus Central/South American Latino children. The
processes of acculturation likely impact eating and lifestyle practices differentially among Latino groups. Interventions
should focus on ensuring that all children eat a nutritious breakfast and take into consideration ethnicity when working with
Latino populations.