Mexican-American women who participated in a culturally tailoredweight management program lost weight, reduced their fat and sugarconsumption and improved their eating habits according to a newstudy funded by the National Institutes of Health and published inthe Journal of Immigrant and Minority Health. At the end of the year-long De Por Vida ("For Life") program, thewomen had lost an average of nearly 16 pounds. "More than three-quarters of Mexican-American women in this countryare overweight or obese, and they became that way after trading intheir traditional Mexican diet for an American diet with largerportions and a higher fat and sugar content," said Nangel Lindberg,PhD, lead author of the study and researcher at the KaiserPermanente Center for Health Research in Portland, Ore. "We suggested that the women return to a more traditional Mexicandiet, which includes lots of fruits and vegetables, and instead ofeating pancakes, muffins or breakfast bars for breakfast, weadvised eating protein and vegetables.
And to help the womencontrol portion size and calorie intake, we educated them aboutusing basic measuring cups and spoons, which are not commonly usedin Mexico." Lindberg, herself a native of Mexico, explains that the Spanishlanguage lacks a specific word for teaspoon or tablespoon. She saysa typical Mexican recipe calls for "enough" or "not too much" of aningredient, rather than a specific measurement. Because of these cultural differences, it's not enough to simplytranslate materials from English to Spanish. "Most of these womenare completely unfamiliar with keeping a food diary, countingcalories, and eating the right number of foods from the variousfood groups," Lindberg said.
"We spent a lot of time during theweekly group meetings demonstrating and explaining these concepts." To enroll in the study women had to speak Spanish and identifythemselves as Mexican or Mexican-American. They also had to be atleast 18-years old and have a body mass index of 30 or higher. The original goal was to enroll 30 women, but recruitment effortsthrough Spanish media and local Hispanic businesses were sosuccessful that 47 enrolled. Twenty-six completed the full year ofthe program, while others dropped out due to work or schoolconflicts or because they returned to Mexico.
Notably, seven womenhad to leave the study because they became pregnant, but thosewomen had lost an average of 7.4 percent of their body weight before becoming pregnant. The women met weekly for the first six months and monthly duringthe second half of the program. The 90-minute meetings, led byfemale interventionists who were also Mexican-American, included aweigh-in and instruction and discussion about nutrition , exercise, goal setting, and behavior change. Women started the program weighing an average of 207 pounds.
Aftersix months, they had lost an average of 11.7 pounds. After 12months, the average weight loss was 15.8 pounds. Authors say they are encouraged by the results and are applying forfunding to test the De Por Vida program with more women in acontrolled clinical trial. De Por Vida represents an innovative partnership in researchbetween Kaiser Permanente and academia, as well as a biculturalmodel/community of practice to combat a global problem.
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