Associations of Asian Ethnicity and Parental Education with Overweight in Asian American Children and Adolescents: An Analysis of 2011–2016 National Health and Nutrition Examination Surveys

• Published in: Maternal and child health journal Vol. 23; no. 4; pp. 504 - 511
• Main Authors: Cook, Won Kim, Tseng, Winston
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-04-2019; Springer; Springer Nature B.V
• Subjects: Adolescent obesity; Adolescents; Asian American children; Asian Americans; Childhood obesity; Children; Demographic aspects; Education; Ethnicity; Gynecology; Health aspects; Health risk assessment; Maternal and Child Health; Medicine; Medicine & Public Health; Noncitizens; Obesity; Overweight; Parental influences; Pediatrics; Population Economics; Public Health; Risk factors; Socioeconomics; Sociology; Teenagers; United States; United States > US; Social determinants of health; Pediatric overweight; Asian American health; Immigrant status; Pediatric obesity
• ISSN: 1092-7875; 1573-6628
• DOI: 10.1007/s10995-018-2662-3

Objectives
Asian Americans are highly diverse in cultural, socioeconomic, and health conditions. We aimed to identify socioeconomic and cultural profiles of subgroups of Asian American children at high risk of obesity or overweight to inform targeted interventions.
Methods
A sample of 841 Asian American children and adolescents ages 6–19 from the 2011–2016 National Health and Nutrition Examination Survey was used. Multivariable logistic regression modeling was conducted. Analyses were also stratified by age (6–11 vs. 12–19). Key variables of interest were Asian ethnicity (Chinese, Korean/Japanese, Filipino, South Asian, and Southeast Asian) and parental educational level. Models adjusted for age, gender, nativity status, parental nativity status, and health insurance coverage.
Results
Filipino (AOR 2.79; 95% CI 1.30–6.00), Japanese/Korean (AOR 2.55; 95% CI 1.21–5.38), Southeast Asian (AOR 2.54; 95% CI 1.63–3.94), and South Asian (AOR 2.10; 95% CI 1.01–4.36) children ages 6–19 had higher odds of being obese/overweight than Chinese. Filipino (AOR 3.24; 95% CI 1.11–9.49) and Southeast Asian (AOR 2.47; 95% CI 1.22–5.01) ethnicities were associated with higher risk of obesity/overweight in adolescents ages 12–19. Having a parent with a 4-year college or advanced degree was inversely associated with obesity/overweight in US-born Asian adolescents (AOR 0.34; 95% CI 0.14–0.78).
Conclusions for Practice
Asian American children and adolescents in some Asian ethnic subgroups may be at higher risk of obesity/overweight than in others. Higher parental education level appears to protect US-born Asian American adolescents from being obese/overweight. Multi-sectoral efforts are needed to better understand and address sociocultural processes that increase childhood obesity/overweight in high-risk Asian subgroups.