Health Behaviors and Weight Gain Among Immigrant Youth: a Novel Approach to Understanding Immigrant Adolescent Health

Pediatric obesity is considered a debilitating chronic illness, and a major public health concern in the United States. Researchers have recently observed that certain social groups in the U.S. are at a higher risk of overweight and obesity, such as immigrant children and adolescents. Two competing models in the literature, risk and protective frameworks, have been used to characterize the trajectory of weight gain as immigrants spend more in the U.S. Risk models assert that first generation immigrant groups are at higher risk of overweight and obesity while protective models refer to the phenomenon wherein obesity is less prevalent in first generation immigrant youth when compared to second and third generation co-ethnic peers. Thus far, literature examining immigrant health in relation to weight gain has been mixed with each model garnering support. In addition to conflicting findings throughout the literature, current research is also limited in that it merely describes health outcomes without explaining why differences across generations may exist. Therefore, the present research seeks to identify specific health behaviors and changes in cultural context that may contribute to weight gain among immigrant adolescents. In Study 1, we examined the mediating role of several health behaviors on the relation between obesity and generation status among a nationally representative sample of Latino immigrant youth. The results showing that sedentary behaviors partially mediated the relation between obesity and generation status provide a first step in explaining weight gain among Latino immigrants. In Study 2, we further examined how these health behaviors might change from one cultural context to another. A new behavioral model, the Operant Model of Acculturation, was directly tested among a community-based sample of immigrant adolescents to examine if changes in culturally-reinforced behaviors from one culture to another account for differences in healthy and unhealthy behaviors across various levels of assimilation. The results indicate that changes in culturally-reinforced behaviors do, indeed, account for changes in health behaviors as immigrants spend more time in the U.S. Findings from both studies can be used to inform the development of targeted preventive efforts to reduce weight gain among immigrant adolescent groups

Family Meal Frequency, Diet, and Family Functioning:A Systematic Review With Meta-analyses

ObjectiveTo examine the direction and magnitude of the relation between family meal frequency and dietary and family functioning outcomes in children (aged 2–18 years).DesignSystematic literature review with meta-analysis.MethodsIndependent electronic searches, 1 for each outcome of interest, were conducted across 5 databases: PubMed, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Scopus, and PsycINFO. Studies were included if they were peer-reviewed and published in English in the US through December 2018.Main Outcome MeasuresDiet and family functioning.ResultsDietary outcomes showed some evidence of a positive association between family meal frequency and fruits, vegetables, fruits and vegetables, sugar-sweetened beverages, and the Healthy Eating Index. There was less clear evidence of this relation in snacks, fast food, and desserts. A positive association was found between family meal frequency or dinner family meal frequency and family functioning outcomes. All studies included had cross-sectional and longitudinal study designs.Conclusions and ImplicationsThere is some evidence to show a positive relation between family meal frequency and dietary outcomes. There is stronger evidence for the relation with family functioning outcomes. Most articles included in the systematic reviews were excluded from meta-analysis owing to inadequate data and high methodological diversity across exposure and outcome variables

Development of a theory-based intervention to increase children's understanding of health

The present study examined the effectiveness of a theory-based intervention in increasing 3-to 4-year-olds’ understanding (e.g., classification) and preference for healthy foods and exercise. This study used a pre-test/intervention/post-test design and children were randomly assigned to one of three conditions: theory (i.e., 20 children received the theory-based intervention); non theory (i.e., 20 children received the non theory-based intervention); and control (i.e., 20 children received no intervention). The results showed that children in the theory group performed significantly better on measures for understanding than children in the non theory and control groups. The theory group also performed significantly more accurately on the preference task, specifically on high-fat food and non exercise questions, than children in the non theory and control groups. These results suggest that theory-based interventions are effective in increasing children’s understanding and preferences for healthy behaviors, and could be used to educate children about health at a young age

Family Meal Frequency, Diet, and Family Functioning:A Systematic Review With Meta-analyses

ObjectiveTo examine the direction and magnitude of the relation between family meal frequency and dietary and family functioning outcomes in children (aged 2–18 years).DesignSystematic literature review with meta-analysis.MethodsIndependent electronic searches, 1 for each outcome of interest, were conducted across 5 databases: PubMed, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Scopus, and PsycINFO. Studies were included if they were peer-reviewed and published in English in the US through December 2018.Main Outcome MeasuresDiet and family functioning.ResultsDietary outcomes showed some evidence of a positive association between family meal frequency and fruits, vegetables, fruits and vegetables, sugar-sweetened beverages, and the Healthy Eating Index. There was less clear evidence of this relation in snacks, fast food, and desserts. A positive association was found between family meal frequency or dinner family meal frequency and family functioning outcomes. All studies included had cross-sectional and longitudinal study designs.Conclusions and ImplicationsThere is some evidence to show a positive relation between family meal frequency and dietary outcomes. There is stronger evidence for the relation with family functioning outcomes. Most articles included in the systematic reviews were excluded from meta-analysis owing to inadequate data and high methodological diversity across exposure and outcome variables

Modification of the association between recreational physical activity and survival after breast cancer by promoter methylation in breast cancer-related genes

Background: Mechanisms underlying the inverse association between physical activity and survival after breast cancer are unresolved, but DNA methylation may play a role. We hypothesized that promoter methylation of breast cancer-related genes, as well as global methylation, may modify the association between prediagnostic recreational physical activity (RPA) and breast cancer mortality. Methods: Using a population-based sample of 1254 women diagnosed with first primary breast cancer, we examined modification of the RPA-mortality association by gene-specific promoter methylation and global methylation. Average lifetime RPA was assessed from menarche to diagnosis through structured in-home interviews. Promoter methylation of 13 breast cancer-related genes was evaluated in archived tumor by methylation-specific polymerase chain reaction and MethyLight assay. Global methylation in white blood cell DNA was determined at long interspersed nucleotide element 1 and by the luminometric methylation assay. After approximately 15 years of follow-up, 486 patients had died, and 186 of the deaths were breast cancer-related. We used Cox proportional hazards regression to estimate HRs and 95% CIs as well as likelihood ratio tests to assess multiplicative interactions. Results: All-cause mortality was lower only among physically active women with methylated promoter of APC (HR 0.60, 95% CI 0.40–0.80), CCND2 (HR 0.56, 95% CI 0.32–0.99), HIN (HR 0.55, 95% CI 0.38–0.80), and TWIST1 (HR 0.28, 95% CI 0.14–0.56) in tumors, but not among those with unmethylated tumors (significant interaction p < 0.05). We found no interaction between RPA and global methylation. Conclusions: The improved survival after breast cancer that is associated with RPA may be more pronounced in women with promoter tumor methylation in biologically plausible genes

DNA methylation modifies the association between obesity and survival after breast cancer diagnosis

Mechanisms underlying the poor breast cancer prognosis among obese women are unresolved. DNA methylation levels are linked to obesity and to breast cancer survival. We hypothesized that obesity may work in conjunction with the epigenome to alter prognosis. Using a population-based sample of women diagnosed with first primary breast cancer, we examined modification of the obesity-mortality association by DNA methylation. In-person interviews were conducted approximately 3 months after diagnosis. Weight and height were assessed [to estimate body mass index (BMI)], and blood samples collected. Promoter methylation of 13 breast cancer-related genes was assessed in archived tumor by methylation-specific PCR and Methyl Light. Global methylation in white blood cell DNA was assessed by analysis of long interspersed elements-1 (LINE-1) and with the lumino-metric methylation assay (LUMA). Vital status among 1308 patients (with any methylation biomarker and complete BMI assessment) was determined after approximately 15 years of follow-up (N = 194/441 deaths due to breast cancer-specific/all-cause mortality). We used Cox proportional hazards regression to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) using two-sided p values of 0.05. Breast cancer-specific mortality was higher among obese (BMI ≥ 30) patients with promoter methylation in APC (HR = 2.47; 95 % CI = 1.43–4.27) and TWIST1 (HR = 4.25; 95 % CI = 1.43–12.70) in breast cancer tissue. Estimates were similar, but less pronounced, for all-cause mortality. Increased all-cause (HR =1.81; 95 % CI = 1.19–2.74) and breast cancer-specific (HR = 2.61; 95 % CI = 1.45–4.69) mortality was observed among obese patients with the lowest LUMA levels. The poor breast cancer prognosis associated with obesity may depend on methylation profiles, which warrants further investigation

Polycyclic aromatic hydrocarbon (PAH)–DNA adducts and breast cancer: modification by gene promoter methylation in a population-based study

Polycyclic aromatic hydrocarbons (PAH)-DNA adducts have been associated with breast cancer incidence. Aberrant changes in DNA methylation may be an early event in carcinogenesis. However, possible relations between PAH-DNA adducts, methylation and breast cancer are unknown. The objectives of this study were to (1) assess associations between PAH-DNA adducts and breast cancer, stratified by DNA methylation markers; and, (2) to examine interactions between adducts and DNA methylation in association with breast cancer and tumor subtype

Global DNA Methylation, Measured by the Luminometric Methylation Assay (LUMA), Associates with Postmenopausal Breast Cancer in Non-Obese and Physically Active Women

Introduction: Little is known about how modifiable lifestyle factors interact with the epigenome to influence disease. Body mass index (BMI, weight kg/height m2) and physical activity are associated with postmenopausal breast cancer, but the mechanisms are not well-understood. We hypothesized that BMI or physical activity may modify the association between markers of global DNA methylation and postmenopausal breast cancer risk

Genetic variation in multiple biologic pathways, flavonoid intake, and breast cancer

We previously reported an inverse association between flavonoid intake and breast cancer incidence, which has been confirmed by others; but no studies have considered simultaneously potential interactions of flavonoids with multiple genetic polymorphisms involved in biologically-relevant pathways (oxidative stress, carcinogen metabolism, DNA repair, and one-carbon metabolism)

Genetic polymorphisms in DNA repair and oxidative stress pathways may modify the association between body size and postmenopausal breast cancer

Obesity is associated with increased bioavailability of estrogen, hyperinsulemia and chronic inflammation, all of which may promote tumor growth. Given DNA repair and oxidative stress pathways may work together with these mechanisms to influence carcinogenesis, we hypothesized that genetic variation in these pathways may modify the obesity-postmenopausal breast cancer association