NTRS 511

Fall 2015

A Community-Based
Intervention in East
Los Angeles Involving
Children and with a
Focus on Improving
Vitamin D Nutriture

Silvia Martinez
Stephanie Ng

Childhood Obesity in America

- Unhealthy diets, physical inactivity,
sedentary lifestyle, and race
- Obese children ages 6-18 years old =
17%
- Obesity rate in Latino children =
22.4%

Hypothesis

Provide nutrition education to parents and children

Outdoor physical activity for children

Emphasis on vitamin D
Childhood obesity rates will decline

Specific Aim 1
To increase nutrition education for children
ages 6 to 18 with an emphasis on vitamin D
intake in a one year period.

Specific Aim 2
To increase cutaneous vitamin D
synthesis from sun exposure by
encouraging children to participate
more in outdoor physical activities in
a one year period.

Specific Aim 3
To teach parents on purchasing and
making healthier food choices with an
emphasis on increasing vitamin D
intake in a one year period.

Background & Significance

-

Belvedere Community Regional Park

Overweight Latino youth ages 2-19 = 38%
Obese Latino youth ages 2-19 = 21%
Parents impact on childrens lifestyle
Vitamin D deficiency linked to childhood obesity
Negative impact on future

Vitamin D
- 25 hydroxyvitamin D
- Dietary food sources
- fortified milk, cheese, eggs, oily fish, mushrooms, cereals
- Sun exposure to UV rays
- Skin pigmentation
- more melanin in dark-pigmented individuals reduce absorption
for Latino children
- Vitamin D deficiency in obese Latino children = 52%

Innovation
-

Combined treatment of nutrition education and outdoor physical exercise

Parental involvement
No intervention in these East Los Angeles Latino communities

Research Design
-

Approved by Institutional Review Board (IRB)

Quasi-experimental research
Total of 200 male and female children, aged 6-18
East Los Angeles region
Measurement of percentile & vitamin D levels
- @ 0, 3, 6, 9, and 12 month

Research Design: Recruitment Strategy

-

Flyers, brochures, & postings on bulletin

boards
Attend health fairs at schools and
community events
Collaboration with health providers
from local clinics
School nurses in ELA

Research Design
Specific Aim 1. To increase nutrition education with an emphasis on vitamin D
intake for children between the ages of 6 to 18 in the one-year study

Daily group-based sessions, 1 hour duration

-

English & Spanish

Age group: 6-10, 11-13, 14-18 years old
USDA guidelines
Reading nutrition labels
Understand serving size
Importance of breakfast
Sugar content in foods and beverages
Recipes for healthy snacks
Daily recording in food journals

Measurements
-

Height, weight, waist circumference

Percentile
-

Vitamin D levels
-

underweight (BMI <5th percentile), healthy weight (BMI >5th and <85th percentile), overweight
and obese (BMI >85th percentile)
inadequate (below 20 ng/ml), adequate (20-30 ng/ml), optimal (30 ng/ml and above)

0, 3, 6, 9, and 12 months

Research Design
Specific Aim 2. To increase cutaneous vitamin D synthesis from sun
exposure by encouraging children to participate more in outdoor physical
activities on a daily basis for one year.

Lets Get Moving - 30 minutes

- variety of dance classes
- hip-hop, contemporary, salsa, traditional
Aztec dancing, and zumba
Game Play - 30 minutes
- sports
- dodgeball, kickball, flag football, soccer,
baseball, swimming, street hockey, track &
field, and volleyball.

Research Design
Specific Aim 3: To teach parents on purchasing and making healthier food
choices with an emphasis on increasing vitamin D intake in a one year
period.

Parent workshops (12 sessions/year)

-

5 classes = focus on healthy eating and

nutrition-related topics
- Understand nutrition labels,
- Fat and sugar content
- Portion size
7 classes = healthy food preparation
- Meals with same ingredient
- Integrating vitamin D into their diet

Statistical Analysis
Paired t-testing
Regression analysis
Statistical significance at p-value = 0.05

Timeline

Limitations
1.
2.

3.

Inaccurate reporting in childrens daily food journals

- additional dietary control may be challenging
Non-compliance in children
- parents must sign daily forms of childs intake and exercise
Lack of parental involvement
-

long working hours

they have purchasing power
involved in cooking meals for families

Expected Outcomes
-

Maintain healthy BMI/ percentile for children and adults

Adequate vitamin D levels by end of one year program
10 years anthropometric measurements of participants
-

adequate vitamin D levels

healthy BMI range (adults) or percentile (child)

References
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