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Prevalence by age and body mass index category of cardiovascular disease risk factors: hypertension (upper left); diabetes (upper middle); high low‐density lipoprotein cholesterol (LDL‐C) level (upper right); low high‐density lipoprotein cholesterol (HDL‐C) level (lower left); hypertriglyceridemia (lower middle); high C‐reactive protein (CRP) level (lower right). Smoothed curves display the age‐ and sex‐specific prevalence of each CVD risk factor within groups defined by normal weight, BMI ≥18.5 and <25 kg/m2; overweight, BMI ≥25 and <30 kg/m2; class I obesity, BMI ≥30 and <35 kg/m2; and class II to III obesity, BMI ≥35 kg/m2. Black curves represent males and red curves represent females. Hypertension was defined as systolic blood pressure of ≥140 mm Hg, diastolic blood pressure of ≥90 mm Hg, or use of antihypertensive medication. Diabetes was defined as fasting plasma glucose of ≥126 mg/dL, 2‐hour postload glucose levels of ≥200 mg/dL, hemoglobin A1c level of ≥6.5%, or use of antidiabetic medication. High LDL‐C level was defined as (calculated) LDL‐C of ≥160 mg/dL or statin use. Low HDL‐C level was defined as <40 mg/dL in men and <50 mg/dL in women. Hypertriglyceridemia was defined as ≥200 mg/dL. High CRP was defined as 3 to 10 mg/L (individuals with CRP levels >10 mg/L were excluded from analyses). Smoothed curves were drawn by using local polynomials estimation using the svysmooth procedure with a bandwidth of 20 in the R statistical program. BMI indicates body mass index; CVD, cardiovascular disease.

Prevalence by age and body mass index category of cardiovascular disease risk factors: hypertension (upper left); diabetes (upper middle); high low‐density lipoprotein cholesterol (LDL‐C) level (upper right); low high‐density lipoprotein cholesterol (HDL‐C) level (lower left); hypertriglyceridemia (lower middle); high C‐reactive protein (CRP) level (lower right). Smoothed curves display the age‐ and sex‐specific prevalence of each CVD risk factor within groups defined by normal weight, BMI ≥18.5 and <25 kg/m2; overweight, BMI ≥25 and <30 kg/m2; class I obesity, BMI ≥30 and <35 kg/m2; and class II to III obesity, BMI ≥35 kg/m2. Black curves represent males and red curves represent females. Hypertension was defined as systolic blood pressure of ≥140 mm Hg, diastolic blood pressure of ≥90 mm Hg, or use of antihypertensive medication. Diabetes was defined as fasting plasma glucose of ≥126 mg/dL, 2‐hour postload glucose levels of ≥200 mg/dL, hemoglobin A1c level of ≥6.5%, or use of antidiabetic medication. High LDL‐C level was defined as (calculated) LDL‐C of ≥160 mg/dL or statin use. Low HDL‐C level was defined as <40 mg/dL in men and <50 mg/dL in women. Hypertriglyceridemia was defined as ≥200 mg/dL. High CRP was defined as 3 to 10 mg/L (individuals with CRP levels >10 mg/L were excluded from analyses). Smoothed curves were drawn by using local polynomials estimation using the svysmooth procedure with a bandwidth of 20 in the R statistical program. BMI indicates body mass index; CVD, cardiovascular disease.

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Background: All major Hispanic/Latino groups in the United States have a high prevalence of obesity, which is often severe. Little is known about cardiovascular disease (CVD) risk factors among those at very high levels of body mass index (BMI). Methods and results: Among US Hispanic men (N=6547) and women (N=9797), we described gradients across...

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... relating BMI with CVD risk factors at different ages (Figure 3) recapitulated the overall (age-adjusted) associa- tions between BMI and cardiovascular risk factors that appear in Figure 2. The increase in prevalences of hypertension and diabetes at higher levels of BMI was relatively consistent across the observed age range of 18 to 74 years. For other risk factors including low HDL-C level and high CRP level, the differences in prevalence comparing overweight or obese individuals versus normal-weight individuals were larger among younger age groups than among older age groups. ...

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... Although limited prospective data exist on the etiology of weight gain in this understudied population, it is thought that such within group differences may reflect differential exposures to either demographic or sociocultural risk factors (e.g. nativity, age at immigration, acculturative stress, etc.) for weight gain, or differential experiences with obesity-related health conditions later in adulthood [6][7][8]. ...
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Background United States (US) Hispanic/Latinos experience a disproportionate burden of obesity, which may in part be related to demographic or sociocultural factors, including acculturation to an US diet or inactive lifestyle. Therefore, we sought to describe the association between adulthood weight histories and demographic and sociocultural factors in a large diverse community-based cohort of US Hispanic/Latinos. Methods We estimated the effect of several factors on weight gain across adulthood, using multivariable linear mixed models to leverage 38,759 self-reported current body weights and weight histories recalled for 21, 45 and 65 years of age, from 15,203 adults at least 21 years of age at the baseline visit of the Hispanic Community Health Study/Study of Latinos (2008–2011). Results The average rate of weight gain was nearly 10 kg per decade in early adulthood, but slowed to < 5 kg a decade among individuals 60+ years of age. Birth cohort, gender, nativity or age at immigration, Hispanic/Latino background, and study site each significantly modified the form of the predicted adulthood weight trajectory. Among immigrants, weight gain during the 5 years post-migration was on average 0.88 kg (95% CI: 0.04, 1.72) greater than the weight gain during the 5 years prior. The rate of weight gain appeared to slow after 15 years post-migration. Conclusions Using self-reported and weight history data in a diverse sample of US Hispanic/Latinos, we revealed that both demographic and sociocultural factors were associated with the patterning of adulthood weight gain in this sample. Given the steep rate of weight gain in this population and the fact that many Hispanic/Latinos living in the US immigrated as adults, efforts to promote weight maintenance across the life course, including after immigration, should be a top priority for promoting Hispanic/Latino health and addressing US health disparities more broadly.
... Nationally, almost 36% of Latinos have been diagnosed with diabetes (Centers for Disease Control and Prevention 2018). While cardiovascular disease is low among Latinos compared to other ethnic groups, growing rates of obesity may put many at risk for future disease (Kaplan et al. 2014). Currently, Latinos in the USA have a high prevalence of both overweight and obesity with Latinas more likely than Latinos to have a higher body mass index (Kaplan et al. 2014;Ogden et al. 2015). ...
... While cardiovascular disease is low among Latinos compared to other ethnic groups, growing rates of obesity may put many at risk for future disease (Kaplan et al. 2014). Currently, Latinos in the USA have a high prevalence of both overweight and obesity with Latinas more likely than Latinos to have a higher body mass index (Kaplan et al. 2014;Ogden et al. 2015). With increasing weight, chronic health issues and doctor visits become more common (Hubert et al. 2005). ...
... Health needs identified in this study included healthcare services and prevention programs aimed at chronic conditions such as diabetes and obesity, which match conditions facing Latino communities nationally (Centers for Disease Control and Prevention 2018; Hubert et al. 2005;Kaplan et al. 2014;Ogden et al. 2015). While most faith-based health promotion programs have been conducted with African American churches, diabetes and obesity programs with Latino congregations have shown success (Bopp et al. 2011;Gutierrez et al. 2014;Krukowski et al. 2010). ...
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... Metabolic disease conditions are a major health concern for Latina immigrants. Findings from the Hispanic Community Health Study/Study of Latinos (N=16,415) indicate that 45% of first-generation Latina immigrants (ie, Latinas born outside of the United States) are obese [1] and 17% have type 2 diabetes [2]. In comparison, national surveys estimate the prevalence of these conditions as 38% and 7%, respectively, among non-Latina White women and 40% and 9% among the US population as a whole [3,4]. ...
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Background Metabolic diseases, including obesity and type 2 diabetes, are a major health concern for Latina immigrants. Performing regular aerobic physical activity (PA) is a lifestyle behavior associated with the prevention and control of these conditions. However, PA levels of most Latina immigrants are below national guidelines. Neighborhood environmental factors may influence the PA levels of adults, but limited research has explored associations between the neighborhood environment and PA levels among Latina immigrants. Objective The objective of this study was to explore the PA patterns of first-generation US Latina immigrants and how neighborhood environmental factors are related to those PA patterns. Methods Using a cross-sectional study design, 50 first-generation Latina immigrants completed the International Physical Activity Questionnaire (IPAQ) and the Neighborhood Scales Questionnaire, which assessed 6 perceived neighborhood factors: (1) walking environment, (2) aesthetic quality, (3) safety, (4) violence, (5) social cohesion, and (6) activities with neighbors. Median self-reported metabolic equivalent (MET)-minutes/week of PA were used to summarize domain-specific (ie, work, domestic/household, leisure, and transportation) and intensity-specific (ie, walking, moderate, vigorous, moderate to vigorous) PA patterns. Logistic regression examined associations between neighborhood factors and engaging in leisure-time PA (ie, dichotomous outcome of some versus no leisure-time PA), transportation PA (ie, dichotomous outcome of some versus no transportation PA), and meeting national PA guidelines (ie, dichotomous outcome of meeting versus not meeting guidelines). ResultsPreliminary analyses showed that 10 participants reported excessively high PA levels and 1 participant had incomplete PA data; these women were excluded from analyses based on IPAQ scoring guidelines. The remaining 39 participants (mean age 40.5 years; mean length of US residency 4.6 years) reported a median of 4512 MET-minutes/week of total PA. The majority of PA was acquired through domestic activities (median 2160 MET-minutes/week), followed by leisure-time PA (median 396 MET-minutes/week), transportation PA (median 198 MET-minutes/week), and work PA (0 MET-minutes/week). Intensity-specific PA patterns showed a median of 594 MET-minutes/week of walking activity and 3500 MET-minutes/week of moderate-to-vigorous PA. Logistic regression models indicated that the neighborhood factors of walking environment, aesthetic quality, and safety were positively associated with engaging in leisure-time PA (odds ratios of 5.95, 95% CI 1.49-23.74; 2.45, 95% CI 1.01-5.93; and 3.30, 95% CI 1.26-8.67, respectively) and meeting national PA guidelines (odds ratios of 4.15, 95% CI 1.13-15.18; 6.43, 95% CI 1.45-28.39; and 2.53, 95% CI 1.00-6.36, respectively). The neighborhood factors of violence, social cohesion, and activities with neighbors were not significantly associated with PA outcomes. Conclusions Although most participants met national PA guidelines (ie, ≥500 MET-minutes/week of moderate-to-vigorous PA), the majority of their PA was achieved through domestic activities, with limited leisure, transportation, and work PA. Given that leisure-time PA in particular plays a significant role in improving health outcomes, findings suggest that many Latina immigrants could benefit from a leisure-time PA intervention. Such interventions should consider neighborhood environmental influences, as these factors may serve as determinants of PA.
... In this study adults with lesser volume of MVPA had increases in all the cardiometabolic biomarkers over time except for LDL cholesterol; these increases were not statistically significantly different from adults meeting MVPA guidelines except for fasting glucose in the overall group and in fasting glucose and HOMA-IR in the healthiest group (normoglycemic without cardiovascular disease.) These data suggest that an active lifestyle may blunt the association of advancing age with worsening cardiometabolic risk factors [34]. ...
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Background Whether physical activity can reduce cardiometabolic risk particularly in understudied populations such as US Hispanics/Latinos is of public health interest. We prospectively examined the association of physical activity and cardiometabolic biomarkers in n = 8049 participants of the Hispanic Community Health Study/Study of Latinos, a community-based cohort study of 16,415 adults aged 18–74 yr who self-identified as Hispanic/Latino from four US urban centers. Methods We assessed physical activity using accelerometry in 2008–2011 at visit 1. We assessed cardiometabolic biomarkers twice: once at visit 1 and collected a second measure in 2014–2017 at visit 2. We used survey linear regression models with changes in cardiometabolic markers as the dependent variables and quartiles of sedentary behavior or whether adults met guidelines for moderate-to-vigorous physical activity as the independent variables. Results In normoglycemic adults without cardiovascular disease, but not in adults with evidence of cardiometabolic disease, those who were in the lowest quartile for sedentary behavior (< 10.08 h/day) had a significant decline in mean LDL-cholesterol of − 3.94 mg/dL (95% CI: − 6.37, − 1.52) compared to adults in the highest quartile (≥13.0 h/day) who exhibited a significant increase in LDL-cholesterol of 0.14 mg/dL (95% CI, − 2.15,2.42) over the six year period ( P < 0.02 in fully adjusted models.) There was also a trend toward lower mean increase in HbA1c comparing the lowest with the highest quartile of sedentary behavior. Overall regardless of glycemic level or evidence of cardiometabolic disease, adults who met guidelines for moderate-to-vigorous physical activity at visit 1, had significantly lower mean increases in level of fasting glucose compared to adults not meeting guidelines in fully adjusted models. Conclusions In this cohort of Hispanics/Latinos, being free of cardiometabolic disease and having low levels of sedentary behavior were associated with health benefits. Among all adults regardless of cardiometabolic disease, meeting guidelines for moderate-to-vigorous physical activity was associated with health benefits. Overall these data suggest that an active lifestyle may blunt the association of advancing age with worsening cardiometabolic risk factors.
... Although poor health outcomes associated with obesity arise in the later stages of life, their causes can be developed during childhood [1,3]. This is especially true for minority children in the United States of America [2][3][4]. For instance, the trends for obesity have shown a high prevalence in Hispanic groups in the United States, which is even more profound in children who reside in low-income households. ...
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... In the current manuscript, the term "Hispanic" is representative of individuals who classify themselves as a person of Mexican, Cuban, South or Central American, Puerto Rican, or other Spanish culture or origin, regardless of race. Importantly, the ongoing Hispanic Community Health Study/Study of Latinos (HCHS/SOL) continues to provide new insights into factors involved in the prevention and treatment of chronic disease among Hispanic/Latino persons from different countries of origin [43,44]. We acknowledge the considerable heterogeneity of the term "Hispanic" and will recognize other terms (e.g., Latino/a/x) and/or subgroups (e.g., Mexican American) within our search strategy in efforts to be as inclusive as possible. ...
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Background: In the U.S., Hispanic women experience a disproportionate rate of obesity and obesity-related chronic diseases. At the same time, Hispanic women remain considerably underrepresented in behavioral weight loss interventions. The purpose of this review is to systematically evaluate the evidence related to the effectiveness of weight loss interventions among Hispanic women in the U.S. This review will identify elements of successful weight loss interventions as well as areas for future research. Methods/design: The following databases will be searched to identify all relevant articles (from inception onwards): PubMed, Embase, Scopus, Web of Science (Science Citation Index and Social Sciences Citation Index), PsycINFO, CINAHL, Chicano Database, SPORTDiscus, CAB Abstracts, and Google Scholar. We will include randomized controlled trials and quasi-experimental studies of adult women (> 18 years) from Hispanic/Latino background living in the United States. Eligible interventions will target weight-related behaviors (including diet, physical activity, behavior modification and/or their combinations). The review's primary outcome will be weight change (expressed as change in lbs/kg or body mass index (BMI) (kg/m2)). Three reviewers will independently screen and select data and two will extract data. The methodological quality (or risk of bias) of individual studies will be appraised using the Effective Public Health Practice Project Quality Assessment Tool. A narrative synthesis will describe quality and content of the evidence. Discussion: The aim of this systematic review is to critically examine existing weight loss interventions for Hispanic women in the U.S. and provide quality evidence for the effectiveness of these interventions on weight loss. Further, this review seeks to identify characteristics of effective interventions and suggest future directions for research efforts targeting weight loss in this population. This review will inform the development of future weight loss interventions for this population. Systematic review registration: PROSPERO CRD42019119094.
... In addition, obesity was associated with low bacterial alpha diversity consistent with other studies, but the findings of higher Prevotella to Bacteroides ratio in obese individuals was enigmatic suggesting a unique aspect of the GMB-host relationship in Latinos. This in turn suggests the hypothesis that particular aspects of the microbiome may explain unusual epidemiological patterns observed among the Latino community, such as high prevalence of diabetes, obesity, and asthma [47,54,55], concurrent with a paradoxical propensity for longevity [56]. ...
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Background: Hispanics living in the USA may have unrecognized potential birthplace and lifestyle influences on the gut microbiome. We report a cross-sectional analysis of 1674 participants from four centers of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), aged 18 to 74 years old at recruitment. Results: Amplicon sequencing of 16S rRNA gene V4 and fungal ITS1 fragments from self-collected stool samples indicate that the host microbiome is determined by sociodemographic and migration-related variables. Those who relocate from Latin America to the USA at an early age have reductions in Prevotella to Bacteroides ratios that persist across the life course. Shannon index of alpha diversity in fungi and bacteria is low in those who relocate to the USA in early life. In contrast, those who relocate to the USA during adulthood, over 45 years old, have high bacterial and fungal diversity and high Prevotella to Bacteroides ratios, compared to USA-born and childhood arrivals. Low bacterial diversity is associated in turn with obesity. Contrasting with prior studies, our study of the Latino population shows increasing Prevotella to Bacteroides ratio with greater obesity. Taxa within Acidaminococcus, Megasphaera, Ruminococcaceae, Coriobacteriaceae, Clostridiales, Christensenellaceae, YS2 (Cyanobacteria), and Victivallaceae are significantly associated with both obesity and earlier exposure to the USA, while Oscillospira and Anaerotruncus show paradoxical associations with both obesity and late-life introduction to the USA. Conclusions: Our analysis of the gut microbiome of Latinos demonstrates unique features that might be responsible for health disparities affecting Hispanics living in the USA.
... The trends for obesity have shown a high prevalence in Hispanic children in the United States. Consequently, the alarmingly high incidence rate of obesity places this population at high risk for developing future health problems such as type 2 diabetes mellitus, dyslipidemia, atherosclerosis, and hypertension [3,4,6]. ...
... Sample size was estimated using the operating characteristic curve [25]. Power calculations were conducted to assess the overall changes in %body fat within the group using results from Kelishadi et al. [6] which indicated that 15 subjects in each group were needed to detect notable changes in %body fat through an intervention program with 80% power at α = 0.05. All statistical analyses were conducted using Sigmaplot 13 (Systat Software, inc., San Jose, CA, USA). ...
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This study investigated whether 10 month telephone follow-up intervention effectively stabilizes reductions in %body fat, and markers of inflammation and oxidative stress obtained from summer camp in obese Hispanic children. Fifty-six obese children (19 SUTI: summer camp and 10 months of follow-up telephone intervention, 18 SU: summer camp intervention only, and 19 CON: no intervention) completed this study. Anthropometric data and blood samples were obtained before (PRE), after 8 weeks of summer camp, and a 10month follow-up telephone intervention to measure markers of inflammation and oxidative stress. Eight weeks of summer camp significantly reduced %body fat, and levels of tumor necrosis factor-alpha, C-reactive protein and 8-hydroxydeoxyguanosine. It also elevated levels of adiponectin and total antioxidant status in SUTI and SU (p < 0.05). However, results of the 10month follow-up measurement were reverted back to PRE in SU, whereas the results for SUTI remained different to PRE (p < 0.05). Results confirm that levels of inflammation and oxidative stress are correlated to changes in %body fat, indicating that fat loss is effective in preventing and managing obesity-associated disorders. It is suggested that a telephone intervention is an effective follow-up tool for stabilizing reductions in %body fat as well as levels of inflammation and oxidative stress that were obtained from an intensive summer camp program in obese Hispanic children.
... 18 Hispanic/Latino individuals are the largest minority in the United States that is at high risk for obesity and related diseases. [19][20][21][22] Compared with white subjects, Hispanic/Latino individuals have been understudied. [23][24][25] The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is a partial attempt to remedy this disparity. ...
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Background The relationship of poor sleep patterns to the increased risk of obesity has been reported, but the results are variable. This study evaluated the association between objectively measured sleep patterns and obesity in a representative adult population of Hispanic/Latino subjects living in the United States. Methods This cross-sectional study was an analysis of a multicenter, community-based cohort of 2,156 participants aged 18 to 64 years from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Recruitment was conducted in San Diego, California; Chicago, Illinois; Bronx, New York; and Miami, Florida. Models were controlled for age, sex, ethnic background, site, income, education, and apnea-hypopnea index. Seven days of wrist actigraphy data were collected. Obesity was defined as BMI ≥ 30 kg/m², and abdominal obesity was defined as waist circumference ≥ 88 cm in women and ≥ 102 cm in men. Napping was defined as more than one 15-min nap per week. Results An inverse linear relationship was found between sleep duration and prevalence of obesity (P linear trend ≤ 0.01). A reduction of 1 h sleep increased obesity prevalence by 4.1% (95% CI, 1.6-6.6; P = .002) and abdominal obesity prevalence by 3.6% (95% CI, 1.1-6.1; P = .007). Daytime napping increased obesity prevalence by 10.4% (95% CI, 3.5-17.3; P = .004) and abdominal obesity prevalence by 7.1% (95% CI, 1.0-13.2; P = .02). Conclusions In a population of young to older adult Hispanic/Latino subjects, we found an inverse linear association between sleep duration and the prevalence of obesity. Daytime napping was strongly associated with greater adiposity. Interventional and longitudinal studies are needed to better understand how abnormal sleep patterns contribute to the obesity epidemic.
... Since the introduction of the Quetelet index (QI) {body mass index (BMI)} in 1832 (Eknoyan, 2008), it was widely used as a measure of excess adiposity or obesity (Price et al., 2018;Volkovicher et al., 2018). Not only that, BMI was also found to be associated with different metabolic and physiological abnormalities (Ghosh and Bandyopadhyay, 2007;Xu et al., 2008;Kaplan et al., 2014;Leonska-Duniec et al., 2018). However, epidemiological studies in Asian populations, especially in Indians revealed higher prevalence of cardiovascular disease and type 2 diabetes with a lower mean BMI, but interestingly had higher percent body fat (PBF) at a corresponding BMI value than Europeans (Razak et al., 2007;Xu et al., 2008). ...