February 4, 2009

New to America and Tipping the Scales

Tufts receives NIH grant to study obesity prevention in recent immigrants

“To our knowledge, this would be the first clinical trial on obesity prevention in new immigrants,” says principal investigator Christina Economos.

When new immigrants arrive in Somerville, Mass., they are often overwhelmed with the day-to-day business of getting by, and end up not paying much attention to their diets. That often leads to meals filled with fat and calories, and ill health is often just around the corner.

Now Tufts researchers, in collaboration with local immigrant community groups, will design and test an obesity prevention program for new immigrants, thanks to a new $2.3 million National Institutes of Health grant.

Led by Christina Economos, an assistant professor and New Balance Chair in Childhood Nutrition at the Friedman School of Nutrition Science and Policy, the clinical trial will follow more than 400 mothers and their elementary school-age children who have lived in Somerville for two years.

“A previous Tufts research initiative, Shape Up Somerville, engaged local government, schools, community-based organizations and families, and showed us that a community approach to a healthy lifestyle is effective,” Economos says. “In partnership with Somerville-based agencies serving Haitian, Brazilian and other Latin American immigrants, we will design and test an intervention that will teach people unfamiliar with the American diet and lifestyle about choosing healthy foods and exercising regularly, while maintaining their cultural preferences. To our knowledge, this would be the first clinical trial on obesity prevention in new immigrants.”

The four-year grant is from NIH’s Eunice Kennedy Shriver National Institute of Child Health and Development. The research team includes Tufts’ David Gute, an associate professor of civil and environmental engineering; Aviva Must, professor and chair of the department of public health and family medicine at the School of Medicine; Raymond Hyatt Jr., an assistant professor of public health and family medicine; and Elizabeth Goodman, director of the Childhood and Adolescent Obesity Center at Tufts Medical Center.

The team will work with partners at the Immigrant Service Providers Group/Health (ISPG/H) in Somerville, the Welcome Project, the Haitian Coalition, the Brazilian Women’s Group and the Community Action Agency of Somerville.

“The new grant to study obesity addresses a key concern identified by Somerville’s immigrant population,” says David Gute, an associate professor of civil and environmental engineering. Photo: Melody Ko

Reversing an Unhealthy Trend

Another research team member, Alex Pirie, coordinator of the ISPG/H, regularly sees new immigrants struggle with food choices and fall into sedentary lifestyles. “When people arrive in the United States, they are overwhelmed with finding housing, jobs and adequate health care,” says Pirie. “Diet and home country nutritional practices tend to fade into the background in favor of more pressing needs.”

“Due to the stress, people resort to convenience foods with considerably higher calorie and fat content compared to foods they consumed in their native countries,” Economos adds. “There are a number of studies that show immigrants have a greatly increased tendency to become obese after they arrive in the United States, particularly during the first seven years.”

Based on those findings, the clinical trial will enroll more than 400 pairs of mothers and elementary school-age children who have lived in the U.S. for less than five years. The goal is to reduce or moderate weight gain in both the adults and children. In the mothers’ group, researchers will focus on weight loss and maintenance, while the children mainly will work on preventing undesirable weight gain.

Factors such as proximity to playgrounds, parks and other open spaces and access to healthy foods will also be assessed.

“A program focused on obesity prevention has the potential to help curb the burgeoning cost to the health-care system,” Economos says. “People who weigh less are at lower risk of developing chronic conditions such as heart disease and diabetes.”

The clinical trial is a product of ongoing community-based participatory research in Somerville’s immigrant community. Co-investigator and epidemiologist Gute is already working with the ISPG/H, the Haitian Coalition, the Brazilian Women’s Group and other Somerville organizations on a research initiative to advance understanding of occupational health risks faced by immigrant workers.

“Like our occupational health work, the new grant to study obesity addresses a key concern identified by Somerville’s immigrant population and includes the participants in the design, recruitment and execution of the clinical trial,” Gute says. “By actively involving the community, they will have the knowledge to build on this groundwork in the years to come.”

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