Obesity Among First and Second Generation Hispanic Adolescents in the United States: Insights from 2011-2012 National Survey of Children's Health

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Introduction: More than one-third of adults and 17% of children/adolescents in the US are overweight or obese contributing to significant morbidity and mortality, and healthcare costs. Studies have reported the persistence of adolescent obesity to adulthood, resulting in increased risk of chronic diseases such as asthma, type 2 diabetes mellitus, cardiovascular, and liver diseases. Little is known about obesity patterns in subethnic populations in the US with high prevalence of obesity or overweight reported in Hispanic youth (21.9%) compared to non-Hispanic blacks (19.5%) and non-Hispanic whites (14.7%). Several genetic, uterine, and nutritional factors, and unhealthy behaviors were identified as risk factors. Evidence is emerging about the possible role of generational status in influencing adolescent obesity. The purpose of this study is to assess the association of generation status with adolescent overweight or obesity in Hispanics in the US. Methods: Data from the 2011-2012 National Survey of Children's Health (NSCH)were used to conduct this study. Only Hispanic adolescents aged 10 to 17 years were included as study population. Using the age-sex-race specific cut-off points, we defined adolescent as being overweight or obese if they were above 85th or 95th percentile cut off point values for BMI. Generation status of an adolescent was categorized into three groups: a) generation 1 for those who were not born in US or to US citizens abroad, and migrated to US as children, b) generation 2 are those born in US but have at least one parent who is foreign born, and c) generation 3 or higher adolescents are those born in US to native-born parents. Multivariable models were conducted to test the association of generation status with adolescent obesity in Hispanics, adjusting for potential confounders. Results: A total of 5,217 Hispanic adolescents were included in the study. Approximately 1,650 and 31.7% of adolescents reported being overweight or obese. Approximately 857, 2,216 and 2,144 of adolescents are 1st, 2nd and 3rd generation Hispanic youth. Comparing to 3rd generation adolescents, those belonging to 1st and 2ndgenerations were associated with increased odds of adolescent obesity in Hispanics OR1.48, 95% CI 1.177 – 1.867 and OR 1.405, 95% CI 1.227-1.610 for 1st and 2nd generation, respectively. Conclusion: Generational status is associated with increased relative odds of overweight or obesity in Hispanic adolescents. Aggregated estimates not accounting for nativity or county of origin of an adolescent contribute to significant heterogeneity or disparities in obesity prevalence or patterns, with implications for generation-specific interventions.

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