Abstract
Background
Immigration to the United States has been associated with obesity, yet the relationship
of acculturation to obesity and energy balance (ie, physical activity/dietary intake)
in adults is a complex issue. Limited longitudinal data are available on immigrant
Asians and Pacific Islanders.
Design
Analyses were conducted on baseline data and change data from baseline to 24 months
in the hotel-based cluster-randomized Work, Weight and Wellness trial involving 15
control and 15 intervention hotels on the island of Oahu, Hawaii.
Sample
Participants were adult employees of predominantly Asian and Pacific Islander ancestry
who were assessed one or more times over the course of 24 months. The full sample
consisted of 4,236 hotel workers (about 40% of hotel workforce) at baseline, 3,502
hotel workers at Year 1 and 2,963 hotel workers at the 24-month follow up. One thousand
one hundred fifteen hotel workers had at least two measurements, and were included
in the analysis.
Intervention
The Work, Weight, and Wellness trial was designed to promote weight loss via motivation
and support for increases in physical activity and increased access to and consumption
of healthy low-fat/low-energy foods. The measure of acculturation consisted of a score
that was a compilation of a participant's age when he or she immigrated to the United
States, country of birth, language spoken at home, and years of education.
Statistical analyses
We used mixed effect regression models for cross-sectional baseline models and longitudinal
multilevel regression analysis of change in diet and physical activity behaviors and
obesity over time using a random intercept. Estimates of the intervention effect are
expressed as an annual rate of change for all study outcomes.
Results
At baseline acculturation was positively associated with body mass index; physical
activity level; and fruit, meat, and sweetened drink intake level. In analyses of
change across 24 months, acculturation did not significantly influence change in dietary
intake or indexes of obesity (ie, body mass index or waist-to-height ratio). However
physical activity increased significantly more in the intervention group during the
course of the intervention compared with the control group, which decreased activity,
when sociodemographic factors (including acculturation) and food intake behavior were
controlled for.
Keywords
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Biography
R. Novotny is a professor, Department of Human Nutrition Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii, Honolulu, Kaiser Permanente Center for Health Research, Honolulu, HI, and University of Hawaii Cancer Center, Honolulu.
Biography
C. Chen is a senior analystis, Kaiser Permanente Center for Health Research, Portland, OR.
Biography
V. J. Stevens is a senior investigator, Kaiser Permanente Center for Health Research, Portland, OR.
Biography
A. E. Williams is an investigator, Kaiser Permanente Center for Health Research, Honolulu, HI.
Biography
C. E. S. Oshiro is a research associate, Kaiser Permanente Center for Health Research, Honolulu, HI.
Biography
C. L. Albright is an associate professor, University of Hawaii Cancer Center, Honolulu.
Biography
C. R. Nigg is an associate professor, Department of Public Health Sciences, University of Hawaii, Honolulu.
Article info
Publication history
Published online: April 25, 2012
Accepted:
February 3,
2012
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT This project was supported by funds from National Institutes of Health/National Heart, Lung, and Blood Institute grant no. NIH/NHLBI 5-R01 HL079505.
Identification
Copyright
© 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
