McEligot Archana Jaiswal, McMullin Juliet, Pang Ka'ala, Bone Momi, Winston Shauna, Ngewa Rebekah, Tanjasiri Sora Park
Department of Health Science, California State University Fullerton, 800 N. State College Blvd., Fullerton, CA 92834, USA.
Hawaii Med J. 2010 May;69(5 Suppl 2):16-20.
Native Hawaiians are at higher risk for cardiometabolic disease, including diabetes and cardiovascular disease compared with other ethnic groups. Diet, body mass index (BMI) and psychosocial, as well as cultural issues may influence risk for cardiometabolic disease. Our team conducted a community-based participatory research study and examined diet, height/weight, psychosocial factors, and community health concerns in Native Hawaiians living in Southern California.
Cross-section of 55 participants, <18-years-old. Dietary data were collected via three 24-hr dietary recalls, anthropometrics were measured, and psychosocial factors and cardiometabolic conditions were self-reported. Talk story related to diet and health was completed in a sub-sample. Means and frequencies were calculated on dietary intakes, cardiometabolic disease and BMI. Independent t-test and chi square analyses, as appropriate, were performed to assess differences in dietary intakes, obesity and psychosocial factors between those with and without a pre-existing cardiometabolic condition.
Of those with pre-existing health conditions (n=28), 72% reported being diagnosed with a cardiometabolic condition. For those with pre-existing cardiometabolic conditions, the daily vegetable consumption was 2.57 servings (+/-1.66) and the mean fruit consumption was 1.43 servings (+/-0.1.99). The mean fiber intake was 16.24 grams (+/-6.92), the mean percentage energy from fat was 34.82% (+/-6.40) and the mean % energy from carbohydrate was 47.15 (+/-6.77). The psychosocial data showed significantly (p<0.05) lower social support, social interaction, self-monitoring and cognitive-behavioral strategies related to exercise for those with cardiometabolic disease compared with those without disease. All the talk story discussion groups expressed concern over diabetes and weight management, both as an individual and community issue.
The dietary data indicate that Native Hawaiians residing in Southern California should aim to increase their vegetable, fiber, and reduce % energy from fat and saturated fat. Additionally, the psychosocial data suggests that implementing physical activity programs based on socio-cultural values such as ohana, community gatherings, as well as individual self-monitoring and cognitive-behavioral strategies may improve cardiometabolic outcomes. In efforts to reduce cardiometabolic disease disparity, these data suggest that Native Hawaiians in Southern California are aware and concerned about cardiometabolic disease in the community, and that implementation of an effective energetic (diet plus physical activity) intervention that is socially, and culturally specific for Native Hawaiians in Southern California is critical.
与其他种族群体相比，夏威夷原住民患心脏代谢疾病（包括糖尿病和心血管疾病）的风险更高。饮食、体重指数（BMI）、心理社会因素以及文化问题可能会影响心脏代谢疾病的风险。我们的团队开展了一项基于社区的参与性研究，调查了居住在南加州的夏威夷原住民的饮食、身高/体重、心理社会因素以及社区健康问题。
对55名18岁以下参与者进行横断面研究。通过三次24小时饮食回顾收集饮食数据，测量人体测量指标，并让参与者自行报告心理社会因素和心脏代谢状况。在一个子样本中完成了与饮食和健康相关的“聊天故事”。计算了饮食摄入量、心脏代谢疾病和BMI的均值及频率。酌情进行独立t检验和卡方分析，以评估患有和未患有心脏代谢疾病者在饮食摄入量、肥胖和心理社会因素方面的差异。
在已有健康问题的人群（n = 28）中，72%报告被诊断患有心脏代谢疾病。对于已有心脏代谢疾病的人群，每日蔬菜摄入量为2.57份（±1.66），水果平均摄入量为1.43份（±0.199）。平均纤维摄入量为16.24克（±6.92），脂肪提供的平均能量百分比为34.82%（±6.40），碳水化合物提供的平均能量百分比为47.15（±6.77）。心理社会数据显示，与未患疾病者相比，患有心脏代谢疾病者在社会支持、社交互动、自我监测以及与运动相关的认知行为策略方面显著较低（p<0.05）。所有“聊天故事”讨论组都表达了对糖尿病和体重管理的担忧，认为这既是个人问题也是社区问题。
饮食数据表明，居住在南加州的夏威夷原住民应增加蔬菜和纤维的摄入量，并降低脂肪和饱和脂肪提供的能量百分比。此外，心理社会数据表明，实施基于诸如“奥哈纳”（家庭）、社区聚会等社会文化价值观的体育活动计划，以及个人自我监测和认知行为策略，可能会改善心脏代谢状况。为了减少心脏代谢疾病差距，这些数据表明，南加州的夏威夷原住民意识到并关注社区中的心脏代谢疾病，对于南加州的夏威夷原住民而言，实施一项针对其社会和文化特点的有效能量干预措施（饮食加体育活动）至关重要。
