International Joumal of Applied Sports Sciences2011, Vol. 23, No. 2, 371-382.frj Korea Institute of Sport Science

High Fat Caloric Consumption and Low Levels ofPhysical Activity May Induce Prevalence of Obesity

in Hispanic American QiildrenSuk-Ho Lee", Cordelia R. Rodriguez'', & Kwangseok Hong"

Texas A&M International University", & Laredo Independent School District'', USA

AbstractThe number of obese youth has increased dramatically in recent decades, yet

very little data has assessed how children's lifestyles have led to this increase inobesity. This study inxxstigated possible factors (media viewing, dietary patterns,and levels of physical activity) contributing to the prevalence in obese HispanicAmerican children. Twenty-four Hispanic boysaged 6-13 years uvre recruited. Basedon initial body ntass index screenings, the stibjects uvre assigned to either a controlor obese group (obese > 25% by % fat). Both groups were administered assessmentson ntedia viewing, dietary patterns, and levels of physical activiti/ by tising a dailylog and pedometer. Tliere was no significant difference in media viewing betweenthe obese group and the control group. The total amount of caloric intake in theobese group was not different from that of the control group. However, thepercentage of fat calories in the obese group was significantly higher tlian that ofthe cotttrol group. The average steps per day in the control group were sigttificantlyhiglier than that in the obese group. It was assunted that the dominantdetemtinants in obese Hispanic boysmight be heavily infitienced by a highpercentage of fat calories consumption and ou> levels of physical activity, not mediavievnng and total amount of caloric intake.

Key VJords: Dietary patterns. Levels of physical activity. Media viewirtg. Obese;Percentage of fat calories. Total amount of caloric intake

Introduction

Preliminary data revealed startling restilts that the obesity rate was more than50% among approximately 2,200 third-graders in Texas-Mexico border region (Lee

Submitted : 2 May 2011, Revised : 15 June 2011, Aeeepted : 28 June 2011Correspondence : Suk-Ho Lee (slee@tamiu.edu)

372 Suk-Ho Lee et al

et a l , 2005; Richards, 2007). The pervasiveness of overweight/obesity becomes agreater aspect between African American and Hispanic groups in comparison tothose of Caucasians (Bray, 2003; Rich et al , 2005). In children 6 ?o7/-year-old,22% of Hispanic children were overweight, compared to 14% of non-Hispanic/White children and 18.8% average for all other ethnic groups (Centers for DiseaseControl and Prevention, 2007). The number of overweight and obese youth hasincreased dramatically in recent decades. However, the underlying mechanisms andfactors inducing fatness in Hispanic youth are poorly understood.

There is the likelihood that obesity begins in early childhood, and will persistthroughout a general life span (Epstein et al , 1987). Long-term prospective studieshave determined that obesity is closely related to the onset of several varyingdiseases; including stroke, hypertension, type II diabetes, and coronary/artery disease(Katzmarzyk & Janssen, 2004). Furthermore, obese children and adolescence maysuflfer disturbances in psychosocial functioning, for iastance, low self-image or poorrelationship with peers (Makara-Studzinska & Zaborska, 2009).

Children who watched more television were more likely to be overweight thanchildren who watched less television (Gortmaker et al , 1996; Jago et a l , 2005).This not only displaces time spent in physical activity, but by also attracting highcalorie food intake (Lowry et al , 2002). Page (2007) reported a total of 147commercials promoting consumption of unhealthy foods with high fat and sugarcontent that were broadcast during prime time children's TV programs in U.S. Itwas also reported that there was a high conelation between TV viewing andunhealthy food consumption (Taveras et al , 2006). Modification of sedentarylifestyle, reduction of TV viewing time, has been shown to contribute to loweringrate of overweight and obesity in children (Gordon-Larsen et a l , 2002).

The consumption of energy density food and dietary fiber has been identified asan essential factor for determining overweight and obesity risks (World HealthOrganization, 2003). The significant rate of obesity has been found to link with theamount of carbohydrate intake, especially from chips/crackers and soft drinks during TVviewing (Stunn, 2005). Therefore, finding different patterns of food consumption wouldprovide valuable information for determining the factors affecting obese HispanicAmerican children, and altogether altering the crisis of an overweight society.

Only 30% of students fulfill the recommended physical activity of at least 60minutes per day/ 5 days a week (Vadiveloo et al , 2009). Mier et al. (2007)reported that the majority of border Mexican/American children (52%) did not

High Fat Caloric Consumption and Low Levels ofFysical Avity Nfey Indu Ftevalen of Obesity in Hispanic American Qiildren 373

exercise at all. These low levels of physical activity are clasely related to this trendin obesity. The obese status can be modified by high levels of moderate to vigorousphysical activity (Hamilton et al., 2007).

The purpose of this study was to compare media viewing, dietary pattems, andlevels of physical activity between a control group and obese group. The identifyingmajor factors contributing to the plight of obese Hispanic boyswould be the essentialstep for developing treatment and/or prevention programs for obese children.

Methods

Subjects and experimental design

After initial screening and using body mass index, fifty-eight healthy Hispanicboysaged from 6 to 13 years who participated in summer swimming class at arecreational center in Laredo, Texas were recruited for this study. Among those, atotal of twenty-four subjects completed the experiment and successfully retumed alldata. The subjects were assigned to either a control group (n=12) or an obese group(n=12) based on the data from the percentage of body fat (%body fat) (obese group> 25% by Skin fold method). The characteristics of subjects in both groups areshown in Table I. Subjects in both groups were required to have written consent.This study was approved by an Institutional Review Board.

T>k 1. Owracteristics of subjects (=24).Group & Variables Age (year) Height (inch) Weight (lbs) BMl (kg/m") %body fat (%)

Control Group(n=12) 9.33 2.60 55.47 5.23 97.33 34.20 22.57 5.68 18.37 1.50

Obese Group(n=12) 9.83 2.04 53.83 5.48 134.75 38.75 29.01 + 5.61 28.48 3.20

* Significantly different from control group (p

374 Suk-Ho Lee et al

Measurements

Body Composition

The Body Mass Index (BMI) was calculated by an equation [BMI=Weight (kg)/Height" (m)]. The %lxxly fat was estimated using the data obtained by skin foldcaliper (Beta Technology Incorporated, Cambridge, MD). The %body fat wascalculated based on previous research (Jackson & Pollock, 1985). The triceps andsupraspinale were the following areas assessed for %body fat. For the measurementof the triceps, distance between lateral projection of acromial process and inferiormargin of olecranon process was measured on lateral aspect of the arm with elbowflexed at 90 degrees using a tape measure. Midpoint was marked on the lateral sideof arm. Fold was lifted 1 cm above the marked line on posterior aspect of the arm.Caliper was applied at marked level. For the supraspinale, fold was along naturalcleavage line of skin just inferior to inferior angle of scapula, with caliper applied1 cm below fingers. The skin fold measurements and equations used for this studywere as follows; 1) if SK < 35mm, %body fat =1.21 (SK) - 0.008 (SK)^ - 3.2and 2) if SK > 35mm, %body fat = 0.783 (SK) + 1.6 ('SK' indicates the sum oftriceps and supraspinale, obesity > 25%) (Slaughter et al., 1988). The data were alsocollected using a body fat analyzer (Omron Healthcare, Vemon Hill, IL) as asubstitute for the subjects who were not comfortable with skin fold methods.

Media Viewing

In this study, TV viewing, video game playing, and computer using arecollectively considered as the media viewing. A total hour of media viewing forseven consecutive days was recorded by parents or legal guardiatis using a dailytime log. Total hours for each category (TV viewing, video game playing andcomputer using) and average hours of overall media viewing per day werecalculated.

Dietary Patterns

Personal diet logs were developed based on previous researches and given to thesubjects. The parents or legal guardians of the subjects were asked to record all foodconsumptions including drinks and snacks of their children for seven consecutive

FSgJi Fat Caloric Consumpticn and Low Levels ofActivity Vfay Induce FVevalence of Obesity in Hspanic American Children 375

days. Also, the parents or legal guardians were instructed to record all food consumedby subjects throughout the whole day. Diet patterns (total caloric intake, percentage offat calorie) were assessed by the researcher based on the daily log using softwarecalled Diet Power (Diet Power, Inc., 7 Kilian Drive, Danbury, CT 06811).

Levels of Physical ActivityA pedometer was used to assess the levels of physical activity (Omeron Health,

Inc., Illinois, HJ-150). A pedometer is a beeper sized device that clips onto thesubjects belt or waistband and counts the number of stejjs the subject takes whilewalking or jogging. It has been used in numerous research studies and has shownaccuracy to estimate the levels of physical activity (Beets et al., 2005). A personalphysical activity log (recording form for steps using Pedometer) was given to thesubjects. The subjects were instructed to wear the pedometer all day (from momingto immediately before bed time). At the end of the day, the subjects were able toremove the pedometer from their body and then should record the niunber of stepstaken for that day on their physical activity log. This procedure was conducted forseven days. An average steps per day was calculated based on the total number ofsteps for seven days.

Statistical Analysis

Numerical data were expressed as means ^ SD. In order to verify differencesbetween two groups in each variable, the independent t-test was performed. A pvalue of less than .05 was considered statistically significant. The SPSS software(SPSS 15.0) was used for all statistical analyses.

Results

Body Composition

The average %body fat in the obese group was significantly higher than theaverage in the control group (28.48% 3.2 vs 18.37% 1.5) (p

376 Suk-Ho Lee et al

25.3% to 37.7% in the obese group. Therefore, all subjects in the obese group inthis study were categorized as overweight or obese.

Media Viewing

The mean daily reported for media viewing in the control group was as follows:TV viewing (2.76 hours 0.9); video game playing (1.0 hours 0.1); andcomputer usage (0.84 hours 0.2). Additionally, there was TV viewing (2.11 hours 0.5); video game playing (1.8 hours 0.5); and computer usage (0.32 hours 0.1) in the obese group. However, there was not a significant difference in theoverall media viewing between the control group (4.66 hours 1.3) and obesegroup (4.22 hours 1.1).

Dietary Patterns

The total amount of caloric intake in the obese group (2,398.3 Kcal + 302) wasnot different from that of the control group (1,986.1 Kcal + 254). However, thepercentage of fat calories in the obese group (39.83% + 2.2) was significantlyhigher than that of the control group (33.62% 1.5) (p

Fat Caloric Gonsunpticn and Low Levels ofPhysical Activity fvfey Indu Pfevalenoe of Cbesity in Hspanic American Children 377

Levels of Physical Activity

Tlic average steps per day in the control group was significantly higher than thatin the obese group (5,565 steps 332 vs 3,612 steps 432) (ps. 3,612 steps 432),* Significantly different from control group (P < .05).

Discussion

TTiis study sought to identify contributing factors (tnedia viewing, dietarypatterns, and levels of physical activity) that were associated with obese HispanicAmerican children. The recommended daily TV viewing for children is 2 hours perday. The study found that 58.9% of the children spent more than 2 hours per dayfor viewing TV (Swinbum & Shelly, 2008). In addition, the percentage of Hispanicstudents who watched TV for more than 2 hours/day (52%) was greater than that ofwhite students (34%) (Lowry et a l , 2002).

It is likely for children watching more television during kindergarten and firstgrade to be overweight by third-grade (Gable et al., 2007). The excessive TVviewing seems to decrease time spent in physical activity, and also decrease restingmetabolic rate, yet increase food intake (Robinson, 2001). In contrast, children whowere assigned to a television reduction group in an intervention study showed

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significant decrease in body mass index and fatness (Gable et al., 2007). Swinbumand Shelly (2008) and also demonstrated that there was a reductioti of body massindex (0.45 kg/m^) per hour of TV viewing also decreased. However, based onother studies, TV viewing did not corresfXDnd to children's weight status(Vandewater et al., 2004; Choi et al., 2006). This study also did not coincide withprevious studies identifying a positive relationship between being obese and TVviewing, and found the obese group in this study did not to be influenced by mediaviewing. Consequently, the relationship between being obese and media viewing isextremely complicated and not clear. Possible mechanisms explaining the associationbetween being obese and TV viewing increase food intake while watching TV andlowers physical activity.

It is possible for an energy imbalance to cause pdiatrie diseases threateningchildren's healthy lifestyles. Children tend to enjoy consuming high caloric foodswith excessive fat and sugar. In this study, there was no significant difference intotal amount of caloric intake between groups, but percentage of fat calorie in theobese group was significantly higher than that in the control group. This impliesthat high fat caloric consumption may contribute to being obese. The DietaryGuidelines for Americatis encourages children to consume 25% to 35% of the fatcalorie from the total amount of caloric intake (U.S. Department of Health andHtiman Services, 2005). However, only 2% of school-aged children have shown tofollow these guidelines (Vadiveloo et al., 2009). In this study, the obese groupshowed a higher consumption of the total amount of caloric intake (2,398. 3 Kcal 302) than the recommended intake (2,000 Kcal) by the Dietary Guidelines forAmericans (U.S. Department of Health and Human Services, 2005). Furthermore,percentage of fat calorie (39.83% 2.2) in the obese group was in excess of theDietary Guideline for Americans (25-35 %), whereas the control group (33.62% 1.5) was in the recommended range.

Even though genetic factors play a significant role in inducing overweight orobesity, excessive food intake and a sedentary lifestyle also are strong contributingcomponents (Gable et al., 2007). Moreover, frequent TV viewing makes childrenincrease snacking and constimption of food high in fat because TV programsbroadcast aggressive advertising and marketing of high calorie food (Page, 2007). Inthis study, media viewing in the obese group might not affect direct aspects ofdietary patterns. Time spent media viewing in the obese group was not higher thanthat of the control group. Therefore, this study found a component causing

Fat Caloric Ccnsumption and Low Levels ofFtiysical Activity May Induce ftevalerce of Obesity in Hspianic American Children 379

overweight/obesity was more likely to be due to an effect of higher fat caloricintake. A study of dietary patterns showed unhealthy dietary patterns in 5-year-oldchildren including more fast foods consumption elevated the risk of overweight(Shin et a l , 2007), which supported the result of this study.

There have been numerous studies showing that low levels of physical activityclosely relate to obesity and have a similar relationship with chronic diseases asmentioned already, including diabetes, coronary heart disease, and high bloodpressure, etc. (Hamilton et al , 2007). Adopting a formal exercise program or simplybecoming more active is valuable to bum much fat, increase energy expenditure,and maintain weight loss. Thus, physical activity plays a significant role inpreventing children from becoming obese.

This study reported that children in the obese group had lower levels of physicalactivity than those of the control group, meaning that lower levels of physicalactivity may give rise to being obese. As this study was conducted in the summer,it was considered that the levels of physical activity in both groups were relativelylow (control group: 5,565 stepys 332 and obese group: 3,612 steps 432).However, even with above consideration, average steps per day from both groupswere significantly lower than values (12,270 + 3,350) from similar age group(McCormack et al , 2011). A value of 10,000 steps/day is gaining popularity withthe media and in practice. However, 10,(XX) steps/day as a universal step goal isprobably too low for children (Tudor-Locke & Bassett, 2004). Based on pedometer-determined physical activity (Tudor-Locke & Bassett, 2004), the obese and controlgroups in this study could be categorized in a "sedentary lifestyle" and "lowactive", respectively. It is recommended that optimal cut points of daily steps are12,000 for younger males 5-16 years old (Dollman et al , 2010).

The obese group may be affected by low levels of physical activity along withhigh f)ercentage of fat calorie intake despite no difference in media viewing. In alarge pan, the levels of physical activity in children are determined by parents orlegal guardians (Gable et al , 2007); thus, it is suggested that intervention of parentsor legal guardians should be examined further to identify causes of factors affectingobese children.

In the end, it is important to mention that this study has a few limitations. First,the conclusions in this study may not be fully accepted because a cross-sectionaldesign was applied to this study. Second, the dietary patterns were not measuredwhile the subjects watched TV or used video games and the computer. Third, the

380 Suk-Ho Lee et al

levels of physical activity of the subjects was limited because this study wasconducted in a specific period (summer season) which may restrict the subjects'out-door activities. Fotuth, we used skin fold method for measuring % body fat.Even though, one person who has more than 20 years of experience completed allmeasurements using research grade caliper, the validity and reliability may be alimitations. Also, this study used equation developed for black and white childrenby (Slaughter et al., 1988) because age specific equation for Hispanic Americanchildren is not available. Lastly, other factors (e.g., level of parents' intervention)affecting media viewing, weight status, and dietary pattems were not considered.

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