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Unhealthy side of assimilation

Susana Sierra was a healthy child.

Her muscles ached from picking tomatoes. Mom cooked Mexican dishes of rice, beans and chicken from scratch. Dad came home with bags of fresh fruit. She chased friends through yards, running as fast as she could.

Today, Sierra works in an office. Her children watch television after school, finish homework and eat snacks. Sierra cooks, but often fast food and pizza make do.

Seem like a typical American family?

They are in at least one very important way: They're gaining weight.

Hispanic immigrants and their children are adopting America's unhealthy lifestyle at alarming rates, experts say.

Studies have long shown that Hispanic immigrants arrive in this country in better health than the U.S. population, even when leaving behind Third World conditions.

In the United States, their health steadily declines as they absorb mainstream, high-fat diets and lifestyles devoid of fruits, vegetables and exercise.

Now their rates of obesity are higher than that of the general population.

Given the expanding and dangerous national epidemic of obesity plus the surging Hispanic population - half the country's growth - doctors and health care workers are scrambling to reach them.

In mid October, the National Institutes of Health announced the funding of the largest study of health and disease in Latin American populations in the United States.

The six-year, $61-million study will address a range of illnesses such as heart disease, stroke and diabetes by looking at risk factors, including diet and obesity.

The first to track differences between Hispanic groups, the study's planners hope to learn how immigrants adapt to an unhealthy U.S. lifestyle so they can prevent it.

"I work, my husband works, the children are always eating out,'' said Sierra, who tries to rally her family to the track between school and church events. "We're not eating the Mexican style my mother used to cook.''

When it comes to eating and exercise, Sierra and her family are finding that assimilation is bad for their health.

Poor affected most

Obesity isn't just an American problem. It exists alongside famine and malnutrition in places such as India and Mexico, a product of industrialization and Western eating habits.

But unlike India, where obesity and diabetes afflict the middle class, obesity in the United States greatly affects the poor.

Here, fattening food is cheaper, low-income families get inferior health care, and there's more crime in their neighborhoods, forcing children indoors, health experts say.

When many Hispanic immigrants arrive, they start on the bottom rung of the economic ladder.

"Is it cheaper for me to get a salad at McDonald's or a burger with fries?'' said Dr. Leslene Gordon, community health director with the Hillsborough County Health Department. "If I am challenged with my finances, I will take the burger and fries.

"We are surrounded by messages that say, 'Eat, eat, and eat cheap.' ''

In immigrant families, both parents often work long hours. Home-cooked meals are replaced by processed, store-bought items full of sodium and simple carbohydrates, which break down into sugar, doctors say.

Nutrition 'imperative'

Roberto Salazar, administrator of food and nutrition services for the U.S. Department of Agriculture, unveiled the new food pyramid in Spanish last year.

He called it "imperative'' to reach Hispanics about nutrition. Salazar, who grew up in New Mexico in a Hispanic family, understands the problem firsthand.

Away at college and starting his career, he ate fried and fast food. He watched his weight balloon from 98 to 210 pounds. His own father died at 67 from heart disease, brought on by obesity.

"I really had to make changes in my own life and take control of my diet and lifestyle,'' he said.

Old habits, new home

Sometimes Hispanic immigrants maintain old diets that include fatty foods. But in the United States, they eat more of it, and exercise less. Even manual labor doesn't always help unless workers move fast enough for long periods to burn calories, experts say.

Madali Rodriguez is a pediatric nurse practitioner and diabetes educator for Premier Community HealthCare Group in eastern Pasco County, where more than a third of patients are Hispanic.

Rodriguez, of Cuban descent, said Cuban immigrants love pork, yucca and beans. But food is rationed in Cuba. Here, portion sizes swell. And Americans walk less than people in Cuba, where few own cars and buses often break down.

Rodriguez encourages teenage patients to play sports, but many care for younger siblings after school and don't have time.

Other teens don't have transportation to games or from late practices, said Tanya Liberato, a pediatrician who worked for years in Plant City and Ruskin, where most of her patients were of Mexican descent. She argues that schools need to help with buses or vans.

Liberato said mothers of her patients tried to follow advice on healthy eating, Liberato said. But some husbands didn't, taking the children to pizza joints and all-you-can-eat buffets, she said.

Cultural issues

Doctors report that Hispanic parents think a fat baby is a healthy baby and expect children to grow out of their plumpness. But in this country, there's a good chance they won't. Obesity in childhood accounts for a quarter of adult obesity cases, according to the Centers for Disease Control and Prevention.

What's more, type 2 diabetes, a major consequence of obesity, now makes up a substantial portion of all new diabetes cases in children and teenagers, the CDC reports. This type of diabetes in children was nearly unheard of 10 years ago.

This year, the Legislature approved more than $2-million for Hispanic obesity prevention.

Ninfa Rodriguez isn't waiting for studies or state funds. Last year, the Dover Elementary School teacher started after-school exercise and nutrition classes.

Wylie Alvarez, 18, sat back in his chair one recent morning. The Plant City High School senior had circled the huevos rancheros recipe in his food preparation class.

Of the recipes in front of him, surely the huevos rancheros was the healthiest, with its 19 grams of protein, he thought. But he missed a crucial detail: the 1,182 milligrams of sodium. That's almost half the daily recommended maximum, teacher Ann Lyons said. The chili recipe had about a third less salt and was the right answer.

On the wall above their heads hung a sign suggesting why, when it comes to nutrition, the nation can't afford to get this wrong. "Government studies,'' it stated, "show young people today may be the first not to live longer than their parents.''

Times Researcher Cathy Wos contributed to this report. Saundra Amrhein can be reached at (813) 661-2441 or amrhein@sptimes.com.

BY THE NUMBERS

66.3% All U.S. adults both overweight and obese.

75.8% Mexican-American adults overweight and obese.

37% Mexican-American children and teens at risk of being overweight and obese.

Source: Journal of the American Medical Association, 2006

FAST FACTS

Cost in lives, cash

Lives: Obesity and overweight conditions account for about 300,000 deaths in the country every year, second only to tobacco-related deaths.

Total: The total direct and indirect costs of obesity and overweight conditions reached $117-billion in 2000.

Online:www.surgeongeneral.gov/topics/obesity/

What is obesity?

The National Institutes of Health defines obesity and being overweight using a Body Mass Index or BMI. It is a weight in kilograms divided by the square of height in meters. A BMI of 25 and above is considered overweight; a BMI of 30 and more is an obese adult.

For children and teenagers, overweight is defined as a sex-and-age specific BMI at or above the 85th percentile, and the 95th percentile for obesity.

On the Web

- State health officials published the Healthy Hispanic Foods Resource Kit this fall, with recipes in Spanish and English. Visit www.doh.state.fl.us/Family/DCP/hispanic/index.html

- For more information about the National Institutes of Health's Hispanic Community Health Study, visit: www.nih.gov/news/pr/oct2006/nhlbi-12.htm.

Source: Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity

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