Kaiser Permanente Study Pilots “De Por Vida” Program
April 30, 2012 (Portland, Oregon)—Mexican-American women who participated in a culturally tailored weight management program lost weight, reduced their fat and sugar consumption and improved their eating habits according to a new study funded by the National Institutes of Health and published in the Journal of Immigrant and Minority Health. At the end of the year-long De Por Vida (“For Life”) program, the women had lost an average of nearly 16 pounds.
“More than three-quarters of Mexican-American women in this country are overweight or obese, and they became that way after trading in their traditional Mexican diet for an American diet with larger portions and a higher fat and sugar content,” said Nangel Lindberg, PhD, lead author of the study and researcher at the Kaiser Permanente Center for Health Research in Portland, Ore.
“We suggested that the women return to a more traditional Mexican diet, which includes lots of fruits and vegetables, and instead of eating pancakes, muffins or breakfast bars for breakfast, we advised eating protein and vegetables. And to help the women control portion size and calorie intake, we educated them about using basic measuring cups and spoons, which are not commonly used in Mexico.”
Lindberg, herself a native of Mexico, explains that the Spanish language lacks a specific word for teaspoon or tablespoon. She says a typical Mexican recipe calls for “enough” or “not too much” of an ingredient, rather than a specific measurement.
Because of these cultural differences, it’s not enough to simply translate materials from English to Spanish. “Most of these women are completely unfamiliar with keeping a food diary, counting calories, and eating the right number of foods from the various food groups,” Lindberg said. “We spent a lot of time during the weekly group meetings demonstrating and explaining these concepts.”
To enroll in the study women had to speak Spanish and identify themselves as Mexican or Mexican-American. They also had to be at least 18-years old and have a body mass index of 30 or higher.
The original goal was to enroll 30 women, but recruitment efforts through Spanish media and local Hispanic businesses were so successful that 47 enrolled. Twenty-six completed the full year of the program, while others dropped out due to work or school conflicts or because they returned to Mexico. Notably, seven women had to leave the study because they became pregnant, but those women had lost an average of 7.4 percent of their body weight before becoming pregnant.
The women met weekly for the first six months and monthly during the second half of the program. The 90-minute meetings, led by female interventionists who were also Mexican-American, included a weigh-in and instruction and discussion about nutrition, exercise, goal setting, and behavior change.
Women started the program weighing an average of 207 pounds. After six months, they had lost an average of 11.7 pounds. After 12 months, the average weight loss was 15.8 pounds.
Authors say they are encouraged by the results and are applying for funding to test the De Por Vida program with more women in a controlled clinical trial.
De Por Vida represents an innovative partnership in research between Kaiser Permanente and academia, as well as a binational model/community of practice to combat a global problem.
The study was funded by a grant from the National Heart, Lung, and Blood Institute at the National Institutes of Health. Authors include Nangel Lindberg, PhD, Victor Stevens, PhD,Tia Kauffman, MPH, and Mariana Rosales Calderon, MD from the Kaiser Permanente Center for Health Research in Portland, Oregon; Sonia Vega-Lopez, PhD from Arizona State University in Tempe; and Maria Antonieta Cervantes, MA from the National School of Anthropology and History in Mexico City, Mexico.
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About the Kaiser Permanente Center for Health Research (http://www.kpchr.org) Kaiser Permanente's Center for Health Research, founded in 1964, is a nonprofit research institution dedicated to advancing knowledge to improve health. It has research sites in Portland, Ore., Honolulu, and Atlanta.