Elsevier

Preventive Medicine

Volume 47, Issue 6, December 2008, Pages 583-586
Preventive Medicine

Commentary
Ethnic minorities and weight control research priorities: Where are we now and where do we need to be?

https://doi.org/10.1016/j.ypmed.2008.09.012Get rights and content

Abstract

Within the overall obesity epidemic, the burden of obesity and related health problems is particularly high among African Americans, Hispanic/Latino Americans, American Indians, and Pacific Islanders—both children and adults. The often asked question of what types of obesity interventions work in these populations reflects uncertainty about how applicable standard interventions are to diverse socio-cultural groups and socio-environmental contexts. A meta-analysis in this issue of Preventive Medicine (Seo and Sa, 2008. A meta-analysis of psycho-behavioral obesity interventions among US multiethnic and minority adults) includes selected multi-ethnic and minority-focused studies that in total had 40% minority participants. Although the authors' conclusions were congruent with current general guidance for weight loss programs, insights about how to intervene with minority populations were limited by the small amount and nature of the available evidence. Ethnic minorities in the aggregate are now a third of the U.S. population. We should be purposeful in identifying research needs and quality standards for conducting and reporting studies with these populations and in motivating related research. Improving the relevance to and quality of evidence on obesity prevention and treatment for a more diverse set of populations will also improve the weight control literature as a whole.

Section snippets

Why this matters

The reason these queries arise is that the prevalence of obesity is higher in most U.S. ethnic minority populations—in both children and adults—compared to non-Hispanic whites (Kumanyika, 1993a, Kumanyika, 1994, Ogden et al., 2006, Ogden et al., 2008, Adams and Schoenborn, 2006). This higher prevalence is a mandate to identify effective interventions to address the associated health disparities (Must et al., 1999, Smith et al., 2005, Ostir et al., 2000, McTigue et al., 2006, Kumanyika and

Are things improving?

I was cautiously optimistic to see the meta-analysis in this issue of Preventive Medicine (Seo and Sa, 2008), thinking—from the title at least—that we might have arrived at a point of being able to obtain some clear guidance. Seo and Sa (2008) attempt to identify features of lifestyle weight loss interventions that are successful with adults in U.S. minority populations, using studies published in peer-reviewed journals between 1980 and 2006. However, in the third paragraph of the Introduction,

What do we really need to know?

Knowing that studies that include minority populations are more effective when multiple components are included is not sufficient. As already mentioned, the reason for paying special attention to weight interventions in ethnic minority populations is the concern that typical programs may not be as effective in minority compared to other participants, while the more prevalent obesity in minority populations suggests a need for programs that have above-average effectiveness. We need to determine

Setting goals

Evidence reviews such as the one by Seo and Sa can help to assess progress, identify gaps, and sharpen the questions being asked. However, there has to be evidence to review. This evidence will not materialize unless more and better quality studies are conducted. Both minority-specific studies and multi-ethnic studies with reporting of ethnicity-specific subgroup data are needed. Systematic reviews have become foundational for recommending evidence-based programs and policies in relation to a

Conflict of interest statement

I have no competing interests to declare.

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