The rates of obesity have soared in the past couple decades in the United States. Yet obesity has not affected all groups equally. A disparity in the prevalence of obesity among different ethnic and racial groups continues to exist. More Latino children and adults are affected by obesity than their white counterparts. This is a pressing issue in California, where the Latino population is predicted to become a majority during the next few decades. There is a need for research that investigates how to address obesity in Latino populations, especially those of Mexican descent. This dissertation presents findings from the Niños Sanos, Familia Sana (NSFS, Healthy Children, Healthy Family) study conducted between June 2010 and May 2015. The study sample included Mexican-origin children ages 3 to 8 years (n=594) and their parents living in the rural Central Valley of California. This dissertation was completed in three phases. The first phase consisted of qualitative research among parents to explore their perspectives on childhood obesity, barriers to a healthy lifestyle, and ideas for obesity interventions. Five focus groups were conducted among Mexican-origin parents (n=33) in 2010-2011 in Firebaugh CA. A major theme that emerged from these focus groups is that the transition to school negatively influences children's eating preferences. A nutrition message that resonated with participants was eating meals as a family and the role it can play in living a healthy lifestyle. The second phase compared different methods for the assessment of fruit and vegetable consumption within the NSFS study. To understand how dietary patterns and food behaviors change over time, instruments such as food frequency questionnaires (FFQ) and dietary recalls are commonly used. However, there are newer methods and technology that allow for more objective measurements of diet. Fruit and vegetable intake among Mexican-origin children (n= 51) was assessed using a noninvasive technology that measures the levels of carotenoids in the skin. The results from this chapter demonstrate a significant correlation between skin carotenoid levels and reported dietary recall vegetable intake (r=0.41, p=0.003), but not with dietary recall fruit, FFQ fruit, and FFQ vegetable consumption. Lastly, the third phase examined differences between intervention (n=105) and control (n=70) children in consumption of vegetables and fast/convenience food from baseline until the end of the second year of the intervention. The predictors of fruit and vegetable consumption were also examined in this study. At the end of year 2, no significant effect of the intervention was observed between groups in vegetable consumption (p=0.579). However a significant reduction on fast and convenience food consumption (p=0.001) was observed in the intervention children only. After adjusting for covariates, child BMI z-score was found to have a negative relationship with vegetable intake (n=108, [beta]=-2747.5, SE=849.4, p=0.002). The findings from this dissertation contribute to the obesity literature and provide the foundation for future nutrition and obesity interventions, which are culturally adapted to Mexican-origin populations.

The prevalence of obesity in Mexican-American children is higher than in non-Hispanic white children. Binational studies conducted in US immigrant and Mexican communities can provide a unique perspective on factors that may be related to childhood obesity. This dissertation presents the findings from a cross-sectional, binational study, conducted from April to December 2006. The sample included families with children ages one to six years, living in immigrant households in Ventura County, California (US) with a similar cohort of children, living in the municipality of Cueramaro, Guanajuato (MX), where out-migration is common. The interview included items to collect data on demographic characteristics; household food security; infant and child feeding practices; maternal perception of the child's diet and weight; a 30-item food frequency questionnaire (FFQ); and a 24-hour dietary recall (DR). Also weight and height (or length for younger children) was measured on all children one to six years living in the household to calculate the body mass index-for-age z-scores (BMIZ) and the height-for-age z-scores (HAZ), indicators of body fatness and linear growth, respectively. The final sample includes 95 families in US and 200 families in MX. The present work includes four chapters. The first is a literature review that examines biological, family and community-level factors contributing to the development of childhood overweight and obesity among Mexican-American populations. The second chapter compares maternal perceptions and concerns; infant and child feeding practices; and growth status among US and MX populations. The third chapter identifies differences in child feeding strategies and dietary intakes across populations and also examines associations between feeding strategies and dietary intakes. The final chapter examines potential mechanisms through which country of residence is associated with childhood overweight among families in MX and US. Specifically, the study examines evidence for the hypothesis that food security mediates the relationship between country of residence and childhood obesity. Results of the analyses provide evidence that the prevalence of low and very low food security is significantly higher in the MX than in the US sample. Overweight and obesity is significantly higher among the US children compared to their counterparts in MX. There are also differences in child eating patterns and maternal concerns about their child's weight among countries. Based on the FFQ, children in the US, compared to children in MX, consume more pizza, hot dogs, hamburgers, instant noodles, ready-to-eat cereal, and American cheese and less fried beans, corn tortillas, and rice. However children in MX, compared with children in US, consume soda more often. Based on the 24-DR, there are few differences in most of the macro or micronutrient intakes. In examining the relationship between feeding strategies and nutrients intakes; children who ask for food/beverages or take food from the refrigerator or pantry between meals, have significantly higher intakes of total and animal protein. Children, whose mothers use food or beverages to calm his or her child, have significantly higher intakes of saturated fatty acids. Food security status is significantly related to BMIZ using different scales for food security. In the regression models to evaluate the mediation effect of food security on the country and BMIZ, food security does not remain significant in the models. However, after adjusting for household size and maternal education, about 15% of the relationship between country and BMIZ is explained by food insecurity, a Mexican dietary pattern, and maternal feeding strategies.

The Joint U.S.-Mexico Workshop on Preventing Obesity in Children and Youth of Mexican Origin was initiated by a desire to share experiences regarding the problem of obesity in children and youth of Mexican origin on both sides of the border, with a particular focus on potential solutions. U.S and Mexican researchers, public health officials, industry leaders, and policy-makers engaged in valuable dialogue to share perspectives, challenges, and opportunities. Commonalities and differences in the United States and Mexico regarding risk factors, potential interventions and programs, and need for all sectors to collaborate and make progress toward solving this serious public health problem were also discussed. This dialogue served as a basis to explore a bi-national agenda for addressing this epidemic, which was the ultimate goal of the workshop.

This book examines the scale and characteristics of the obesity epidemic, the respective roles and influence of market forces and governments, and the impact of interventions.

Hispanics and the Future of America presents details of the complex story of a population that varies in many dimensions, including national origin, immigration status, and generation. The papers in this volume draw on a wide variety of data sources to describe the contours of this population, from the perspectives of history, demography, geography, education, family, employment, economic well-being, health, and political engagement. They provide a rich source of information for researchers, policy makers, and others who want to better understand the fast-growing and diverse population that we call "Hispanic." The current period is a critical one for getting a better understanding of how Hispanics are being shaped by the U.S. experience. This will, in turn, affect the United States and the contours of the Hispanic future remain uncertain. The uncertainties include such issues as whether Hispanics, especially immigrants, improve their educational attainment and fluency in English and thereby improve their economic position; whether growing numbers of foreign-born Hispanics become citizens and achieve empowerment at the ballot box and through elected office; whether impending health problems are successfully averted; and whether Hispanics' geographic dispersal accelerates their spatial and social integration. The papers in this volume provide invaluable information to explore these issues.