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Among the general US population, cardiovascular disease (CVD) is the main cause of mortality for Mexican-Americans. CVD is less prevalent among Mexican-Americans than non-Hispanic Whites or African Americans. However, there is limited research regarding the factors associated with increased CVD risk among Mexican-Americans. Thus, this cross-sectional study was conducted to evaluate the effects of non-biological factors (income, education, employment, acculturation) and diet on CVD risk factors in 75 Mexican-American adults (26 males, 49 females; age=37.6±9.3 y, BMI=28.9±5.3 kg/m2, systolic BP=117±11 mmHg, diastolic BP=73±9 mmHg, LDL cholesterol=114±32 mg/dL, HDL cholesterol=44±11 mg/dL, triglycerides=115±61 mg/dL, serum glucose=92±7 mg/dL). Aside from collecting anthropometric measurements, blood pressure, and measuring fasting blood lipids, glucose, and insulin, information about participants' socioeconomic status, income, employment, education, and acculturation were gathered using a survey. Diet data was collected using the Southwestern Food Frequency Questionnaire. Weight, BMI, and waist circumference were significantly greater for those with a monthly income of $3000 than for those earning$3000 (81±15 kg vs. 71±15 kg; 29.8±4.6 kg/m2 vs. 26.5±5.1 kg/m2; 98±12 cm vs. 89±14 cm; respectively) and with an education level of high school graduate or less than for those with some college (84±16 kg vs. 72±14 kg; 30.6±4.2 kg/m2 vs. 26.9±4.9 kg/m2; 100±11 cm vs. 91±13 cm; respectively). HDL-C was higher for those with a monthly income of>$3000 than those earning $3000 (49±12 mg/dL vs. 41±10 mg/dL), those with some college education than those with high school or less (47±10 mg/dL vs. 37±9 mg/dL), and for those employed than those not employed (46±10 mg/dL vs. 40±12 mg/dL). There was no association between acculturation and CVD risk factors. Percent of energy consumed from fat was greater and percent of energy from carbohydrates was lower in those earning
Mexican-Americans are disproportionately burdened by metabolic syndrome, a medical condition characterized by the concurrence of clinical abnormalities that contributes to diabetes, obesity, and cardiovascular disease (CVD). This is alarming since Mexican-Americans constitute two-thirds of the US Latino population, the largest minority and fastest growing group in the US. Investigating acculturative stressors associated with immigration is crucial for eliminating health disparities, but few studies have examined the acculturative impact of Mexican migration to the United States or the relationship between acculturation and metabolic syndrome among Mexican-Americans. The purpose of this dissertation research was to investigate the associations between acculturation and metabolic syndrome among a bi-national sample of Mexicans and Mexican-Americans. Metabolic syndrome was assessed among a bi-national sample of individuals with diabetes using the definition outlined by the International Diabetes Federation, and acculturation was assessed by proxy measures (years lived in the US and generational status) and responses on the Acculturation Rating Scale for Mexican-Americans, version-II. Chi-square, analysis of variance, and logistic regression were used to determine relationships between country, gender, and acculturation status and metabolic syndrome and its biomarkers. The overall prevalence of metabolic syndrome was 79.7%, with 85.0% prevalence among Mexican-Americans and 75.7% among Mexicans (p=0.069). Mexican-Americans had higher blood pressure and central obesity, while Mexicans had higher triglycerides levels. The majority (81.2%) of Mexican-Americans was first generation and lived in the US for an average of 27.65 +/- 16.05 years. The mean acculturation score was -1.83 +/- 1.56, which indicated participants in this study were Mexican-oriented, or more closely associated to Mexican cultural influences than Anglo cultural influences. Higher acculturation scores were positively associated with fasting blood glucose and systolic blood pressure and lower acculturation was negatively associated with fasting blood glucose. Logistic regression analysis showed first generation Mexicans-Americans were more likely to develop metabolic syndrome than second generation Mexican-Americans (OR 7.399, 95% CI 1.464-37.401, p=0.015). Mexican and Mexican-American individuals with type 2 diabetes have a high prevalence of metabolic syndrome, which increases their risk for heart disease and other cardiovascular complications. Mexican-Americans are especially affected by central obesity and hypertension and Mexican immigrants appear to be impacted by negative lifestyle factors upon entering the United States. Acculturation is a complex process and the unclear relationship between acculturation and metabolic syndrome warrants further investigations. The electronic version of this dissertation is accessible from http://hdl.handle.net/1969.1/148115
The purpose of the study was to examine the relationship between acculturation indicators and metabolic syndrome (MetS) among Hispanic adults living in the Dallas-Fort Worth metropolitan area in Texas. MetS is a pressing public health problem, and Hispanics have the highest prevalence among all ethnic groups in the United States (35.4%). MetS is a cluster of five risk factors (blood pressure, waist circumference, high-density lipoprotein cholesterol, fasting blood glucose, and triglycerides) that increase a person’s risk of developing cardiovascular disease and diabetes. Currently, Hispanics are the second-largest ethnic group in the United States, and more than one-third of the U.S. Hispanic population is foreign-born. As immigrants and subsequent generations are exposed to the mainstream U.S. culture, the process of acculturation impacts their lifestyle behaviors and health. Acculturation indicators (nativity, duration in the United States, and scores from the Short Acculturation Scale for Hispanics) and the five MetS markers were assessed among 128 adult participants. Logistic regression modeling was conducted to predict MetS status (present/not present) by acculturation indicators and covariates (sex, age, and education). Additional analyses were conducted to assess the relationship between each individual MetS marker, acculturation indicators, and the identified covariates. For every one-unit increase in a participant’s duration in the United States (measured in years), the likelihood of having abnormal blood pressure increased by 6% and the likelihood of having abnormal blood glucose increased by 5%. Results indicate increasing exposure to the mainstream American culture negatively impacts health risks and status among Hispanics. The primary treatment for MetS is lifestyle modification that includes regular physical activity, healthy eating, and weight loss. Health care providers can aid in reducing MetS prevalence by raising awareness of the condition and associated risk factors among their patients as well as recommending lifestyle modification to reduce their risk. Study results can aid health educators in planning, implementing, and evaluating health communication campaigns and health education/promotion programs to prevent MetS among Hispanics. Further examination of what changes occur in health behaviors that increase risk of MetS would provide further insight into why duration in the United States is associated with elevated blood pressure and elevated fasting blood glucose levels.
Mexican Americans have an increased risk for type 2 diabetes and premature cardiovascular disease (CVD). The association of hyperglycemia with traditional CVD risk factors in this population has been established, but there is limited data regarding other non-traditional CVD risk factors. Thus, this cross-sectional study was conducted to evaluate CVD risk among Mexican Americans by measuring concentrations of lipids, high-sensitivity C-reactive protein (hsCRP), and cholesterol in low-density-lipoprotein (LDL) and high-density-lipoprotein (HDL) subfractions. Eighty overweight/obese Mexican-American adults participating in the Maricopa Insulin Resistance Initiative were randomly selected from each of the following four groups (n = 20 per group): nomolipidemic/normoglycemic controls (NC), dyslipidemic/normoglycemic (DN), dyslipidemic/prediabetic (DPD) and dyslipidemic/diabetic (DD). Total cholesterol (TC) was 30% higher among DD than in NC participants (p
Acculturation has been associated with health behaviors, and to a lesser extent, health outcomes among Latinos; however, inconsistencies exist regarding the nature of these relationships. Moreover, little is known about the underlying mechanisms linking acculturation to Latino health outcomes. The current study examined the relationship between acculturation, behavioral risk factors, and cardio-metabolic dysfunction in Mexican American women, and evaluated the contribution of social and economic pathways to observed associations. Participants were a random sample of 302 Mexican American women (mean age 49.77 years), recruited from communities with wide-ranging socioeconomic status (SES) located on the United States (US) side of the Tijuana (Mexico) - San Diego (US) border. Women underwent a clinical exam and completed a battery of questionnaires including demographic (age, US exposure, education, and income), cultural (language acculturation, familism, fatalism, religiosity), social (social support, sociability), and behavioral (leisure-time physical activity, sedentary behavior, walking, fruit and vegetable servings, and dietary fat) variables. Confirmatory factor analyses (CFA) and structural equation models (SEMs) were performed in the total sample. CFAs revealed single latent constructs for English language acculturation (childhood language, English proficiency, and adult language patterns), SES (education and income), resilient cultural values (familism and religiosity), and social resources (social support and sociability). SEMs showed statistically significant direct effects of English language acculturation to more sedentary behavior and resilient cultural values to more self-reported walking. In addition, the indirect effects of US exposure to more sedentary behavior through language acculturation, English language acculturation to more sedentary behavior through SES, and resilient cultural values to more fruit and vegetable servings through social resources were also significant (CFI = 0.90, RMSEA = .10, SRMR = 0.04). Finally, significant mediated effects were found for English language acculturation to lower cardio-metabolic dysfunction via higher SES, and higher SES to lower cardio-metabolic dysfunction via lower fatalism (CFI= .89, RMSEA = .11, SRMR = .04). Behavioral variables did not appear to mediate the acculturation and cardio-metabolic dysfunction relationship. Acculturation and related cultural variables were associated with behavioral risk factors and cardio-metabolic dysfunction in middle-aged Mexican American women. SES and social resources may represent relevant pathways in explaining these associations.
Studies have identified metabolic health factors to be a major concern in Mexican-Americans, including Mexican immigrants to the United States (U.S.). Acculturation stress has been hypothesized to be a factor in the development of many health-related concerns in this population. Specifically, previous studies have shown that acculturation stress contributes to health concerns, including metabolic health concerns (e.g., diabetes, metabolic syndrome). The primary purpose of this study was to examine the relationship between cultural orientation, a measure of acculturation designed to provide more information than traditional acculturation measures, and metabolic health outcomes. Specific acculturation-related stressors (social support, job-related stress, and depression) were hypothesized mediators in this relationship among a convenience sample of 98 foreign-born Mexicans living in Utah County, Utah controlling for age, gender, socio-economic status (SES), and years in the U.S. Data were collected twice with a three year interval to examine change over time. Changes in these constructs were examined through the use of Growth Modeling with Bayesian estimation. The Acculturation Rating Scale for Mexican-Americans (ARSMA-II) was used to measure Anglo Cultural Orientation and Mexican Cultural Orientation. Standard blood analyses were used to measure metabolic health outcomes, which included glycosylated hemoglobin (HbA1c), insulin, and glucose. The Interpersonal Support Evaluation List (ISEL-12) was used to measure social support, the Job Content Questionnaire (JCQ) was used to measure job-related stress, and the Center for Epidemiological Studies-Depression Scale (CES-D) was used to measure depression. No change was identified in Anglo Cultural Orientation or Mexican Cultural Orientation over time in the majority of subjects. A positive relationship between Anglo Cultural Orientation and HbA1c was found, as was a negative relationship between Mexican Cultural Orientation and HbA1c. Mediation analyses showed a mediation effect of depression on the relationship between Anglo Cultural Orientation and glucose. Implications of findings, limitations, and directions for future research are discussed.