Super-sizing Asian Americans

Poor diet and a sedentary lifestyle, with resulting overweight and obesity, contribute to one in three cancers in this country, as well as to such chronic illnesses as diabetes and heart disease.

"California has the most Asian Americans in the United States, and we've got the opportunity to mount aggressive programs to prevent the unhealthy acculturation-related changes in diet and physical activity that have occurred with other immigrant groups," said Susan Foerster, chief of the Cancer Prevention and Nutrition Section of the California Department of Health Services. "Efforts to stop the erosion of the healthy traditional Asian and Pacific Islander dietary and activity patterns are urgently needed to stop the sharp increases we're seeing in overweight people, especially children."

As a first step, Foerster and her colleagues at DHS, working with investigators at the UCLA School of Public Health, recently conducted 24 focus groups involving more than 200 individuals from three low-income Asian-American ethnic groups: Chinese, Vietnamese and Hmong. Interviews were conducted in Mandarin, Cantonese, Vietnamese and Hmong. The study was supported in part by the National Cancer Institute's Asian American Network for Cancer Awareness, Research and Training (AANCART), headquartered at UC Davis, and the DHS California Nutrition Network, with funding from the U.S. Department of Agriculture Food Stamp Program.

The study revealed that Asian immigrants have a lot to teach mainstream America about health. All three Asian subgroups agreed a healthy lifestyle depends on eating nutritious foods, especially fresh produce, being physically active, and fostering mental and emotional health.

According to the research, Chinese, Hmong and Vietnamese immigrants alike regard "freshness" as a requisite for healthfulness, and they define "fresh" foods as those that aren't frozen, dried, canned or preserved and are pesticide- and hormone-free. Dried or frozen foods, sodas, fried foods, fast food (include take-out Chinese) and excessive sweets are seen as unhealthy. Home-cooked meals are considered healthier than restaurant food. All three Asian groups emphasized eating vegetables over fruit.

Interviewees also emphasized the importance of physical activity, and they shared a belief that exercise benefits the overall health of individuals by increasing energy and strength, improving physical and mental wellbeing, promoting weight management and preventing sickness.

At the same time, many of the focus group members expressed a sense of powerlessness over the influence of television and food advertising and the school environment on their children, according Margorie Kagawa-Singer, associate professor of public health in the UCLA School of Public Health and Asian American Studies Department.

"The marketplace and schools are the main purveyors of poor dietary practices," said Kagawa-Singer, who led the focus group research. "Nobody is telling immigrant families that their traditional diets are good and should be maintained."

Said Moon S. Chen, Jr., professor of public health sciences at UC Davis School of Medicine and Medical Center and principal investigator for AANCART: "We cannot afford to wait to prevent the development of diseases that are often irreversible once they start. The Asian American populations in California offer a rare opportunity to avert a health disparity before it occurs."

Beginning in the late 1980s, California launched what is now the largest national public education campaign to increase fruit and vegetable consumption for cancer prevention. The California 5 a Day Campaign has since been tailored for Latinos, African Americans, children and low-income families.

"To counter the seemingly inevitable Americanized diet and protect the beneficial traditional Asian diet and physical activity patterns, a tailored campaign is strongly recommended for California's low-income, immigrant Chinese, Vietnamese and Hmong communities," Foerster said.

Asian Americans and Pacific Islanders constitute almost 5 percent of the population of the United States and 12 percent of the California population. About 70 percent of Asian Americans in this country are first-generation immigrants.

Statewide, low-income children are increasingly overweight. Among low-income white children, 18 percent are overweight or obese, a 50-percent increase between 1994 and 2003. The rate is 19 percent for blacks, up 46 percent, and 23 percent for Latinos, a 44-percent increase.

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AANCART is the largest project ever undertaken to reduce cancer in Asian Americans. Headquartered at UC Davis, it includes researchers from seven other institutions: Harvard, Columbia, the M.D. Anderson Cancer Center at the University of Texas, the University of Washington, UCLA, UC San Francisco and the University of Hawaii.

The 5th Asian Cancer Control Academy is sponsored by the National Cancer Institute; the U.S. Office of Minority Health, Region IX; AANCART; the California Department of Health Services; the American Cancer Society; and UC Davis.

Copies of all news releases from UC Davis Health System are available on the Web at http://www.ucdmc.ucdavis.edu/newsroom.