Monday, April 9, 2012

ACTIVE LIVING & HEALTHY EATING

Today's guest blog is by Elena Ong, Communication Chair for APHA Asian Pacific Islander Caucus for Public Health

WHAT’S THE EPIDEMIC?   OVERWEIGHT & OBESITY

Nearly two-thirds of adults[i] and nearly one in three children are overweight or obese.[ii]   Being overweight or obese increases risk for heart disease, type 2 diabetes, high blood pressure, stroke, breathing problems, arthritis, gallbladder disease, sleep apnea, osteoarthritis and some cancers.[iii]

WHAT’S THE POPULATION?  ASIAN AMERICANS AND NATIVE HAWAIIANS AND OTHER PACIFIC ISLANDERS (AANHOPIs).[iv] 

Nearly half (45 percent) of AANHOPIs are not at a healthy weight, and 68.4 percent of Pacific Islanders are overweight or obese.[v]  

Obesity rates for the second generation of Asian adolescents is twice as high than first generation obesity rates[vi].

From a clinical point of view, AANHOPIs tend to have more inner abdominal fat than other races, which increases their risk for chronic disease[vii].   Mildly obese AANHOPIs are at greater risk for heart disease and diabetes.  For example, AANHOPIs have a 60 percent  higher rate of type 2 Diabetes than whites of the same BMI[viii].  

From a behavioral point of view, less than half of adult AANHOPIs meet recommended physical activity levels - only 17.8 percent of Asian adults met the 2008 Federal Physical Activity Guidelines[ix]. 

WHAT’S THE SOLUTION?  ACTIVE LIVING & HEALTHY LIFESTYLES

Empower AANHOPIs to improve their health by improving social, cultural, environmental, structural, economic and political factors that contribute to overweight and obesity-related diseases.

1.      Educate, analyze and empower “healthy weight” management in a culturally and linguistically sensitive way.  Disaggregate the NHOPI data from AANHOPI data to get a true picture of risk.
2.      Adopt API-specific BMI definitions for overweight and obesity. The WHO consultation suggests that 22 kg/m2 – 25 kg/m2 may be a better cut-off point for Asian populations.[x]
3.      Promote community wellness and active living:  public transportation, safe parks and sidewalks for exercise, physical fitness programs at schools/community centers, access to healthy food at vending machines/trucks/grocery stores/restaurants/cafeterias.
4.      Promote workplace wellness and healthy lifestyles: standing/walking meetings; exercise breaks; access to healthy foods at vending machines/cafeterias/farmer’s markets/kiosks.
5.      Promote personal wellness and healthy lifestyles:  eat well, exercise and limit videogame/computer over-use, relax, reduce stress, etc.


[i] Flegal KM, Caroll MD, et al.  Prevalence and trends in obesity among US adults, 1999-2009. JAMA. 2010 Jan 20; 303(3):235-41.
[ii] Ogden CL, MD Caroll, et al. Prevalence of high body mass index in US children and adolescents, 2007-8. JAMA. 2010 Jan 20;303(3):242-9.
[iii] US DHHS Office of Minority Health.  Health Status of Asian American and Pacific Islander Women.  May 12, 2009, http://www.omhrc.gov/templates/content.aspx?ID=3721.
[iv] US Census, 2000-2010.
[v] US National Center for Health Statistics, Vital and Health Statistics, Series 10, Number 235, Summary Health Statistics for US Adults: NHIS, 2006.
[vi] Popkin. J Nutr 1998; Haas, AJPH, 2003
[vii] Lear, Am J. Clin Nutr 2007, Davis, Ethnicity & Disease, 2004 and Craig, Acta Diabetol, 2003.
[viii] Razak http://www.ncbi.nlm.nih.gov/pubmed/14726171
[ix] Op cit.
[x] Sue Hughes.  Asian populations may need different definitions of obesity.  Heartwire, January 9, 2004

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