Question 2
2.) White adolescent males had the highest incidence of metabolic syndrome (5.9%), while White adolescent females had the lowest incidence (1.5%). Overall, males had a significantly higher incidence than females. How do you explain the varied prevalence of metabolic syndrome among the three racial groups studied in this article and the increased incidence in males versus females? How would this affect your intervention strategies? (Keep in mind the 5 categories defining metabolic syndrome in adolescents and their prevalence among the various groups explained in the results section of the article).
posted by annie_weyhrauch @ 8:22 PM
21 comments
21 Comments:
The results are very interesting in that there seems to be no consistency between races and gender and the 5 categories defining metabolic syndrome. It is interesting that white males had the highest prevalence and white females the lowest. Black males and females seemed to have similar prevalences. While Mexican American females had the highest prevalence and males in the middle. This would affect intervention strategies because depending on who was in the group would determine what should be addressed. For example white adolescents had higher TG's and lower HDL's, thus the intervention would need to be tailored toward those characteristics. Blood pressure would be something to address with black adolescents, and central obesity and impaired glucose would be something to address with Mexican Americans. However it would be likely that there would be a mix of adolescents meaning every category and risk factor would need to be addressed.
Based on the study, males have higher rates of metabolic syndrome overall, with whites > mexican > black. For females, prevalence in mexican americans was the highest, but not significantly higher than whites or blacks. Males were more likely to have higher triglycerides, lower HDL, higher prevalence of impaired glucose tolerance and elevated BP, while females showed a higher incidence of central obesity. Interestingly, the prevalence of all indicators was similar among groups below and above the poverty line, the exception being central obesity, which was seen more in those below the poverty line. This is a very interesting study, but difficult to explain WHY the results are the way they are. Females had overall better Healthy Eating Index scores, which may explain why females have a lower incidence of metabolic syndrome than males. The same measure does not explain why white males have a higher incidence since black males have the lowest healthy eating index scores, however whites had the highest consumption of total fat, CHO, sugars, PRO and Saturated fat, which may explain the differences in metabolic syndrome. As far as intervention is concerned, the earlier the better. The study showed that eating patterns are healthier in the older age group, but the incidence of metabolic syndrome is also higher. The key is to prevent met. synd. before it occurs, because it is more difficult to change the indicators later in adolesence. Males tend to think about what they eat less than females, so interventions tailored to males and their commonly held beliefes about food/lifestyle choices are warrented. Complicated issue.
Steph,
You are right, in school settings, etc, it is likely we would be addressing a racially mixed group. There may be some opportunities to discuss the racially specific findings in the study, perhaps with WIC or other community programs. It would be interesting to create educational materials for each of the groups in the study based on the research findings. I also find it interesting that many of the results support previous research (blacks had higher incidence of HT, etc.).
It is interesting to see the groups targeted in this study, but it gets a little complicating when breaking down and thinking about it. It goes to show that everyone is a little bit different and when counseling someone, all aspects of that person (age, gender, race, etc.) need to be taken into consideration and analyzed carefully. I think that males’ having a higher incidence of metabolic syndrome compared to females was very interesting. For the Healthy Eating Index, females had better scores on fruits, vegetables, saturated fat, cholesterol, and sodium than males. This shows that females might be more concerned or knowledgeable on their eating habits. I wonder if hormone changes are playing a part in some of these results. This is a time when adolescent girls are going through many changes and tend to be very self conscious and concerned about their weight. When intervening with adolescents these factors are important to consider. Many factors could play a part in the results of this study, but a larger population and more research should be done to make further conclusions on this topic.
I definitely think that by looking at the healthy eating indexes, a lot of the differences in the prevalence of metabolic syndrome can be explained. For instance, between genders, females at more fruits, vegetables and lower total calories and they had a 1.7% chance of having metabolic syndrome. The males ate more grains, dairy, meats and higher total calories and had a much higher chance of having metabolic syndrome, at 5.1%. I think that when you are looking a the differences between races, you have to take into consideration the differences in eating patterns between cultures. For example, Mexicans are known for eating more fiber (beans) but also more saturated and total fat. Americans, according to their healthy eating index, consumed diets that were high in fat, total carbs, sugar, and protein. African Americans ate diets that were low in protein and fiber. As you can see, each multicultural group or gender shows differences in eating habits, which could definitely lead to the differences in the prevalence of overweight and subsequent metabolic syndrome. As far as interventions go, I think you just need to be very general about diets and multi-culturally sensitive when working with groups. If a specific individual needs more one-on-one help, that would be when you could target their specific diet and discuss changes that need to be made from there.
In order to explain the increased incidence of metabolic syndrome in males versus females we need to compare the different components defining metabolic syndrome. The males had a higher prevalence of impaired fasting glucose, higher triglycerides, higher blood pressure, and a lower HDL compared to the females. This is hard to explain why but it probably has to do with their eating habits. According to the healthy eating index the females scored higher than the males. This makes sense because male adolescents are not typically reading labels and watching what they are eating. You see alot more females who are health conscious. Within each race the results were interesting. White males had the highest prevalence of metabolic syndrome and Mexican American females had the highest prevalence. Adolescent Whites had the highest triglyceride levels and lowest HDL levels. Adolescent Blacks had the highest blood pressures. Mexican American Adolescents had the highest central obesity, and impaired fasting glucose levels. These findings would affect my intervention strategies by making sure I covered all the target groups. I didn't mention blood pressure or maintaing proper blood sugars in my strategies so I could incorporate these subjects to enhance my presentation.
The participants' results varied because each individual has his/her own genetic make-up, culture, and gender. Social and biological norms are different based on these three ideas. I think the study mentioned that the most common indicator of metabolic syndrome was high TG levels and hig BP. A person's genes, culture, and gender can play a role in the blood pressure and TG levels. There really was no consistency, as someone already mentioned. This would definitely present a challenge as far as intervention strategies. Each specific case would have to be addressed according to each problem. If high blood pressure is a key problem, there are different intervention strategies that would take place than if the issue was high blood glucose. It is important to teach prevention for each individual risk factor.
Such varied results are most likely be due to a combination of variables including diet composition of those specific groups, genetics, and activity level differences. Looking at Tables 4 & 5 for example, higher TG's in white adolescents could be related to their higher intake of CHO/sugars. Black adolescents seemed to have a similar sodium intake to white adolescents, but that combined with a significantly lower fiber intake and the fact that African Americans are more likely to be salt sensitive could greatly contribute to these findings. As for Mexican American females, the higher rate of central obesity (and thus a higher incidence of IFG) could be related to a more sedentary lifestyle. This would all greatly affect intervention strategies depending on the demographics of the school. Since some schools tend to be more ethnically diverse than others, emphasis on certain aspects could be tailored accordingly. Of course it would still be important to touch on all areas as the results from this study only speak for the majority within each group.
The prevalence of metabolic syndrome seemed to vary based on the intake levels of grains, diary, total fat, and total cholesterol intake. Cultural differences in eating patterns could account for the differences based on race.
As far as males vs. females, females had overall better scores related to fruit/vegetable intake, saturated fat, sodium and cholesterol.
Despite the differences between groups, metabolic syndrome was most often seems in adolescents who are overweight (according to BMI). So my intervention strategy would be the same for all. It would involve reaching or maintaining a healthy BMI through sound nutrition practices (high fruit/vegetable intake, lower fat intake, higher fiber, etc.)and increasing physical activity.
When comparing results across race, I think cultural background plays a big role in what trends are seen. Culture plays a big role in food choices and preference, as well as, in body size acceptance among the genders. When comparing gender, the healthy eating index showed that males chose higher calorically dense foods, such as, meats, grains, and dairy products. The females were seen choosing these food groups less often and choosing more fruits and vegetables than the males. When teaching groups on intervention strategies, it is good to be aware of these trends, but it is still necessary to cover all aspects of the issue. When teaching to groups it is impossible to put each demographic into its own group in order to tailor the class to their specific issue. Instead, it is necessary to provide a general teaching over all of the material and remind the participants they can request an individual session to get tailored suggestions just for them.
Karlie--
I agree that the intervention should focus on providing sound nutrition information while being culturally sensitve about how different groups might lean towards certain foods or food groups.
Perhaps prevalence of metabolic syndrome in males and females stems from total quality of their diets. The females scored higher on fruits and vegetables, than the males with the Healthy Eating Index. The increase in fiber reduces chances of metabolic syndrome as well as diets high in fruit with the powerful antioxidants having a positive effect on insulin secretions. When educating the three different groups, use the Healthy Eating Index results as a guide to what topics would benefit each group. By doing this it would be a another step towards understanding the lifestyle changes regarding adolescent metabolic syndrome.
When we try to explain and figure out why the white males had a higher prevalence than the white females, there are so many external factors that could play a role. Sam touched on the fact that hormones could be an issue. Females in general normally are more pear shaped so the fact that this study showed that they had more abdominal fat is very interesting. The other factor with the females is the age range of 12-19. This age range targets females that have had their first menstrual cycle and some who maybe have not. The different levels of estrogen could have been an issue. When doing an intervention, again I think that general knowledge at first to see what the students in that group know would be good, and then you could increase the complexity of the topics as you found out what they knew.
Tori
I believe that body image may play a role in the difference between males and females prevalence of metabolic syndrome. With females being more self-conscious about weight gain they would be less likely to consume the same amount and types of foods that males would. Males in pursuit of a muscular physique would consume more meats in belief that this would build muscle which contains higher amounts of calories and saturated fats. Even though the three racial groups and the genders varied in the 5 different categories defining metabolic syndrome they would all benefit from the same advice. Making healthy food choices and including physical activity in their lifestyles would be beneficial to all the different groups studied.
Lauren,
I like what you said about different cultures. The study looked at whites, Mexicans, and blacks. Even though they all live in the United States they have very different cultural backgrounds that play a role in what they eat and how it is prepared. No two groups are the same, so no two interventions are going to be the same.
Tori McRoberts
When taking a look at white males having an increased incidence compared to white females, I would think that it is because at the adolescent age, females are more conscious about what they eat and how they look. Many young girls are concerned about their appearance and therefore, are more careful about what they are eating. This is also indicated by the Healthy Eating Index. When comparing the other races, it could be explained by their cultural dietary differences. When suggesting intervention strategies, I would suggest discussing healthy eating options while keeping in mind their multicultural dietary differences. Focus on foods in general in order to not discriminate a certain diet.
I agree that body image and the fact that females are more concious about what they eat. Colin also touched on the fact that boys often want to build muscle so they consume many meats and in turn increase their saturated fat intake, which is evident by table 4. As for racial differences, this could be due to cultural differences and famililal habits. All would benefit from the same general education, however, we must be able to tailor food recommendations based on cultural and familial normalities.
Katherine McCullah
The differences between races and gender is interesting research. I think it could be attributed to the type of food that is typical for their culture. Which is important because those foods are a staple in their diet and would need to be incorporated, just maybe in smaller portions or prepared differently. The difference between male and females could be because of their genetic make up. As for intervention because of funding availability it's hard to cater to everyone in a school setting but it is a must. I think focussing on getting the RDA of all the food groups while the adolescents are at school is important. Susan
There could have been many, many different factors that affected the outcomes of this study; some of which may have not been taken into account from the NHANES data used. For example, white males have the highest incidence of metabolic syndrome out of all classifications. Could this be due to socioeconomic status and/or accessibility to food? It is difficult because cause and effect can not be defined from this study. There may also have been a sampling error that affected the results. Although a sample size as large as this one (4,450) is considered a good size, does it accurately represent a population of 31 Million adolescents in the US?
This study is making us aware of populations that may be at higher risk for metabolic syndrome. This in turn, can help dietitians better identify metabolic syndrome in adolescents, and therefore intervene earlier. Earlier intervention can then obviously lead to lower rates of metabolic syndrome.
There are many different factors that could all have come together to play a part as to why males had higher incidences of metabolic syndrome than females. First, we must consider that the males of this study were noted to be consuming more sugar and fat in their foods and females were noted to be consuming more fruits and vegetables. Also, the amount of sodium played a factor for African American males, more than likely because of cultural differences in our bodies. Overall, the researchers found metabolic syndrome to be associated with groups of children that were overweight. I would still keep my main foundation of my program focused on healthy eating, but also my strategy would incorporate exercise. I would recommend to get active by limiting the amount of time spent in front of the television, videogames, and computers. I would recommend getting involved in extracurricular activities since they not only promote activity, but also are great social experiences for the children.
Karlie-
I think your right in that you do need to look at the healthy eating indexes. Eating habits greatly influenced prevalence of metabolic syndrome. It is also interesting to look at the eating habits and see how females and males differ, and those differences should be addressed in any nutrition education they receive. At least that way you know ahead of time what females and males are more likely to eat and how they need to change.
Post a Comment
<< Home