Impact of a Culturally Targeted Lifestyle Course on Dietary and Weight Outcomes of Chinese Americans in Texas

Abstract

Purpose

This study aimed to assess the impact of a culturally targeted lifestyle course on the dietary and weight outcomes of Asian Americans.

Design

This was an observational study of participants for a culturally targeted lifestyle course taught online by a Nutrition Scientist and Board-Certified Holistic Health Practitioner.

Setting

From 2021 to 2022, 284 participants were recruited through 4 community organizations in Texas and completed the informed consent.

Subjects

140 Chinese Americans finished 3 surveys before, after, and 6 months after the course.

Measures

Participants’ fruit and vegetable consumption was assessed using the questionnaire from the Behavioral Risk Factor Surveillance System and their physical activities were evaluated by the Godin-Shephard Leisure-Time Exercise Questionnaire.

Analysis

We conducted repeated measures ANOVA to compare participants’ dietary and weight outcomes before, after, and 6 months after the course. Paired t-tests were performed to investigate how the outcomes differed from the baseline.

Results

The participants’ weights and BMI values at the 6-month follow-up were significantly lower than the baseline, though the changes were not significant immediately after the course. Rice consumption dropped significantly both after the class and at the 6-month follow-up. Participants also significantly reduced their intake of 100% juice and fried potatoes immediately after the class.

Conclusion

Community-based Participatory Approaches might be used to improve the dietary and weight outcomes of Asian Americans.

Keywords

nutrition education community-based participatory approach dietary intake weight control obesity prevention

Get full access to this article

View all access options for this article.

References

Curtin

Tejada-Vera

Bastian

. Deaths: leading causes for 2020. In: National Vital Statistics Reports. Hyattsville, MD: National Center for Health Statistics; 2023. doi:10.15620/cdc:133059

Hassan

Gujral

Quarells

, et al. Disparities in diabetes prevalence and management by race and ethnicity in the USA: defining a path forward. Lancet Diabetes Endocrinol. 2023;11(7):509-524. doi:10.1016/S2213-8587(23)00129-8

Metzgar

Nickols-Richardson

. Effects of nutrition education on weight gain prevention: a randomized controlled trial. Nutr J. 2015;15:1-13. doi:10.1186/s12937-016-0150-4

Moore

Alsabeeh

Apovian

, et al. Weight, blood pressure, and dietary benefits after 12 months of a web-based nutrition education program (DASH for health): longitudinal observational study. JMIR. 2008;10(4):e52. doi:10.2196/jmir.1114

Atoloye

Savoie-Roskos

Guenther

Durward

. Effectiveness of expanded food and nutrition education program in changing nutrition-related outcomes among adults with low income: a systematic review. J Nutr Educ Behav. 2021;53(8):691-705. doi:10.1016/j.jneb.2021.03.006

Batres-Marquez

Jensen

Upton

. Rice consumption in the United States: recent evidence from food consumption surveys. J Am Diet Assoc. 2009;109(10):1719-1727. doi:10.1016/j.jada.2009.07.010

Pan

Malik

Sun

. White rice consumption and risk of type 2 diabetes: meta-analysis and systematic review. BMJ. 2012;344:e1454. doi:10.1136/bmj.e1454

Sun

Spiegelman

van Dam

, et al. White rice, brown rice, and risk of type 2 diabetes in US men and women. Arch Intern Med. 2010;170(11):961-969. doi:10.1001/archinternmed.2010.109

Bhavadharini

Mohan

Dehghan

, et al. White rice intake and incident diabetes: a study of 132,373 participants in 21 countries. Diabetes Care. 2020;43(11):2643-2650. doi:10.2337/dc19-2335

10.

United States Census Bureau . Asian American, native Hawaiian and pacific islander heritage month: may 2023. https://www.census.gov/newsroom/facts-for-features/2023/asian-american-pacific-islander.html. Accessed 5 November 2024.

11.

Beasley

Ahn

Kwon

Wylie-Rosett

. Dietary patterns in Chinese Americans are associated with cardiovascular disease risk factors, the Chinese American cardiovascular health assessment (CHA CHA). J Immigr Minority Health. 2019;21:1061-1069. doi:10.1007/s10903-018-0800-z

12.

Israel

Schulz

Parker

Becker

. Review of community-based research: assessing partnership approaches to improve public health. Annu Rev Publ Health. 1998;19:173-202. doi:10.1146/annurev.publhealth.19.1.173

13.

Wallerstein

Duran

. Using community-based participatory research to address health disparities. Health Promot Pract. 2006;7(3):312-323. doi:10.1177/1524839906289376

14.

Smith

Witte

Rocha

Basner

. Effectiveness of incentives and follow-up on increasing survey response rates and participation in field studies. BMC Med Res Methodol. 2019;19:1-13. doi:10.1186/s12874-019-0868-8

15.

Centers for Disease Control and Prevention . Data user’s guide to the BRFSS fruit and vegetable module. https://www.cdc.gov/nutrition/data-statistics/data-users-guide.html. Accessed 24 August 2020.

16.

Godin

Shephard

. A simple method to assess exercise behavior in the community. Can J Appl Sport Sci. 1985;10(3):141-146.

17.

Amireault

Godin

Lacombe

Sabiston

. The use of the Godin-Shephard leisure-time physical activity questionnaire in oncology research: a systematic review. BMC Med Res Methodol. 2015;15(60):1-11. doi:10.1186/s12874-015-0045-7

18.

Sikes

Richardson

Cederberg

Sasaki

Sandroff

Motl

. Use of the Godin leisure-time exercise questionnaire in multiple sclerosis research: a comprehensive narrative review. Disabil Rehabil. 2019;41(11):1243-1267. doi:10.1080/09638288.2018.1424956

19.

Cullen

Lara Smalling

Thompson

Watson

Reed

Konzelmann

. Creating healthful home food environments: results of a study with participants in the expanded food and nutrition education program. J Nutr Educ Behav. 2009;41(6):380-388. doi:10.1016/j.jneb.2008.12.007

20.

Ismail

Materwala

Al Kaabi

. Association of risk factors with type 2 diabetes: a systematic review. Comput Struct Biotechnol J. 2021;19:1759-1785. doi:10.1016/j.csbj.2021.03.003

21.

Coughlin

Smith

. Community-based participatory research to promote healthy diet and nutrition and prevent and control obesity among African-Americans: a literature review. J Racial Ethn Health Disparities. 2017;4:259-268. doi:10.1007/s40615-016-0225-0

22.

Soriguer

Colomo

Olveira

, et al. White rice consumption and risk of type 2 diabetes. Clin Nutr. 2013;32(3):481-484. doi:10.1016/j.clnu.2012.11.008

23.

Brand-Miller

Hayne

Petocz

Colagiuri

. Low–glycemic index diets in the management of diabetes: a meta-analysis of randomized controlled trials. Diabetes Care. 2003;26(8):2261-2267. doi:10.2337/diacare.26.8.2261

24.

Kaur

Ranawana

Henry

. The glycemic index of rice and rice products: a review, and table of GI values. Crit Rev Food Sci Nutr. 2016;56(2):215-236. doi:10.1080/10408398.2012.717976

25.

Rivera

Maulding

Eicher-Miller

. Effect of supplemental nutrition assistance program–education (SNAP-Ed) on food security and dietary outcomes. Nutr Rev. 2019;77(12):903-921. doi:10.1093/nutrit/nuz013

26.

Lee

Moore

Park

Harris

Blanck

. Adults meeting fruit and vegetable intake recommendations — United States, 2019. MMWR Morb Mortal Wkly Rep. 2022;71:1-9. doi:10.15585/mmwr.mm7101a1

27.

Lee

Shiroma

Lobelo

, et al. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012;380(9838):219-229. doi:10.1016/S0140-6736(12)61031-9

28.

Chin

Kahathuduwa

Binks

. Physical activity and obesity: what we know and what we need to know. Obes Rev. 2016;17(12):1226-1244. doi:10.1111/obr.12460

29.

American Heart Association . American heart association recommendations for physical activity in adults and kids. https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults. Accessed 9 June 2024.

30.

Swift

Johannsen

Lavie

Earnest

Church

. The role of exercise and physical activity in weight loss and maintenance. Prog Cardiovasc Dis. 2014;56(4):441-447. doi:10.1016/j.pcad.2013.09.012

31.

Leschewski

Aragon

Weatherspoon

, et al. Expanded food and nutrition education program generates economic value through body mass index improvement: a cost-benefit analysis. J Ext. 2024;61(4):17. doi:10.34068/joe.61.04.17

32.

Connor Gorber

Tremblay

Moher

Gorber

. A comparison of direct vs self-report measures for assessing height, weight and body mass index: a systematic review. Obes Rev. 2007;8(4):307-326. doi:10.1111/j.1467-789X.2007.00347.x