Department of Human Nutrition Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii, Honolulu, HI 96822, USA.
J Acad Nutr Diet. 2012 May;112(5):649-56. doi: 10.1016/j.jand.2012.02.002. Epub 2012 Apr 25.
Immigration to the United States has been associated with obesity, yet the relationship of acculturation to obesity and energy balance (ie, physical activity/dietary intake) in adults is a complex issue. Limited longitudinal data are available on immigrant Asians and Pacific Islanders.
Analyses were conducted on baseline data and change data from baseline to 24 months in the hotel-based cluster-randomized Work, Weight and Wellness trial involving 15 control and 15 intervention hotels on the island of Oahu, Hawaii.
Participants were adult employees of predominantly Asian and Pacific Islander ancestry who were assessed one or more times over the course of 24 months. The full sample consisted of 4,236 hotel workers (about 40% of hotel workforce) at baseline, 3,502 hotel workers at Year 1 and 2,963 hotel workers at the 24-month follow up. One thousand one hundred fifteen hotel workers had at least two measurements, and were included in the analysis.
The Work, Weight, and Wellness trial was designed to promote weight loss via motivation and support for increases in physical activity and increased access to and consumption of healthy low-fat/low-energy foods. The measure of acculturation consisted of a score that was a compilation of a participant's age when he or she immigrated to the United States, country of birth, language spoken at home, and years of education.
We used mixed effect regression models for cross-sectional baseline models and longitudinal multilevel regression analysis of change in diet and physical activity behaviors and obesity over time using a random intercept. Estimates of the intervention effect are expressed as an annual rate of change for all study outcomes.
At baseline acculturation was positively associated with body mass index; physical activity level; and fruit, meat, and sweetened drink intake level. In analyses of change across 24 months, acculturation did not significantly influence change in dietary intake or indexes of obesity (ie, body mass index or waist-to-height ratio). However physical activity increased significantly more in the intervention group during the course of the intervention compared with the control group, which decreased activity, when sociodemographic factors (including acculturation) and food intake behavior were controlled for.
移民到美国与肥胖有关，但成年人的文化适应与肥胖和能量平衡（即体力活动/饮食摄入）之间的关系是一个复杂的问题。关于亚洲和太平洋岛民移民的纵向数据有限。
在夏威夷瓦胡岛上的基于酒店的集群随机化工作、体重和健康试验中，对基线数据和从基线到 24 个月的变化数据进行了分析，该试验涉及 15 个对照组和 15 个干预组酒店。
参与者为主要具有亚洲和太平洋岛民血统的成年员工，他们在 24 个月的过程中接受了一次或多次评估。在基线时，全样本由 4236 名酒店工作人员（约占酒店劳动力的 40%）组成，在第 1 年和第 2 年有 3502 名酒店工作人员，在 24 个月的随访中有 2963 名酒店工作人员。1115 名酒店工作人员至少有两次测量值，并纳入了分析。
工作、体重和健康试验旨在通过增加体力活动的动机和支持以及增加获得和消费健康的低脂/低能量食物来促进减肥。文化适应程度的衡量标准是参与者移民到美国的年龄、出生地、家庭语言以及受教育年限的综合评分。
我们使用混合效应回归模型进行横断面基线模型分析，使用随机截距进行跨时间的饮食和体力活动行为变化以及肥胖的纵向多层回归分析。所有研究结果的干预效果估计均表示为每年的变化率。
在基线时，文化适应程度与体重指数、体力活动水平以及水果、肉类和含糖饮料的摄入量呈正相关。在 24 个月的变化分析中，文化适应程度并没有显著影响饮食摄入或肥胖指标（即体重指数或腰高比）的变化。然而，在控制社会人口因素（包括文化适应程度）和饮食行为的情况下，与对照组相比，干预组的体力活动在干预过程中显著增加，而对照组的体力活动减少。
