- Author: Rob Waters, Kaiser Health News
Saira Diaz uses her fingers to count the establishments selling fast food and sweets near the South Los Angeles home she shares with her parents and 13-year-old son. “There's one, two, three, four, five fast-food restaurants,” she says. “And a little mom and pop store that sells snacks and sodas and candy.”
In that low-income, predominantly Latino neighborhood, it's pretty hard for a kid to avoid sugar. Last year, doctors at St. John's Well Child and Family Center, a nonprofit community clinic seven blocks away, became alarmed by the rising weight of Diaz's son, Adrian Mejia. They persuaded him to join an intervention study run by the University of Southern California and Children's Hospital Los Angeles (CHLA) that weans participants off sugar in an effort to reduce the rate of obesity and diabetes among children.
It also targets a third condition fewer people have heard of: fatty liver disease.
Linked both to genetics and diets high in sugar and fat, “fatty liver disease is ripping through the Latino community like a silent tsunami and especially affecting children,” said Dr. Rohit Kohli, chief of gastroenterology, hepatology and nutrition at CHLA.
Recent research shows about 1 in 4 people in the U.S. have fatty liver disease. But among Latinos, especially of Mexican and Central American descent, the rate is significantly higher. One large study in Dallas foThe USC-CHLA study is led by Michael Goran, director of the Diabetes and Obesity Program at CHLA, who last year made an alarming discovery: Sugar from sweetened beverages can be passed in breast milk from mothers to their babies, potentially predisposing infants to obesity and fatty livers.
Called HEROES, for Healthy Eating Through Reduction of Excess Sugar, his program is designed to help children like Adrian, who used to drink four or more sugary drinks a day, shed unhealthy habits that can lead to fatty liver and other diseases.
Fatty liver disease is gaining more attention in the medical community as lawmakers ratchet up pressure to discourage the consumption of sugar-laden drinks. Legislators in Sacramento are mulling proposals to impose a statewide soda tax, put warning labels on sugary drinks and bar beverage companies from offering discount coupons on sweetened drinks.
“I support sugar taxes and warning labels as a way to discourage consumption, but I don't think that alone will do the trick,” Goran said. “We also need public health strategies that limit marketing of sugary beverages, snacks and cereals to infants and children.”
William Dermody, a spokesman for the American Beverage Association said: “We understand that we have a role to play in helping Americans manage consumption of added sugars, which is why we are creating more drinks with less or no sugar.”
In 2016, 45 deaths in Los Angeles County were attributed to fatty liver disease. But that's a “gross underestimate,” because by the time people with the illness die, they often have cirrhosis, and that's what appears on the death certificate, said Dr. Paul Simon, chief science officer at the L.A. County Department of Public Health.
Still, Simon said, it was striking that 53% of the 2016 deaths attributed to fatty liver disease were among Latinos — nearly double their proportion of total deaths in the county.
Medical researchers consider fatty liver disease a manifestation of something called metabolic syndrome — a cluster of conditions that include excess belly fat and elevated blood pressure, blood sugar and cholesterol that can increase the risk of heart disease, stroke and diabetes.
Until 2006, few doctors knew that children could get fatty liver disease. That year Dr. Jeffrey Schwimmer, a professor of pediatrics at the University of California-San Diego, reviewed the autopsies of 742 children and teenagers, ages 2 to 19, who had died in car crashes or from other causes, and he found that 13% of them had fatty liver disease. Among obese kids, 38% had fatty livers.
After Schwimmer's study was released, Goran began using MRIs to diagnose fatty liver in living children.
A 2008 study by another group of researchers nudged Goran further. It showed that a variant of a gene called PNPLA3 significantly increased the risk of the disease. About half of Latinos have one copy of that high-risk gene, and a quarter have two copies, according to Goran.
He began a new study, which showed that among children as young as 8, those who had two copies of the risky gene and consumed high amounts of sugar had three times as much fat in their livers as kids with no copy of the gene. Now, in the USC-CHLA study, he is testing whether reduced consumption of sugar decreases the fatty liver risk in children who have the PNPLA3 gene variant.
At the start of the study, he tests kids to see if they have the PNPLA3 gene, uses an MRI to measure their liver fat and catalogs their sugar intake. A dietitian on his team educates the family about the impact of sugar. Then, after four months, they measure liver fat again to assess the impact of the intervention. Goran expects to have results from the study in about a year.
More recently, Goran has been investigating the transmission of sugar from mothers to their babies. He showed last year that in nursing mothers who drank beverages sweetened with high-fructose corn syrup — the primary sweetener in standard formulations of Coca-Cola, Pepsi and other sodas — the fructose level in their breast milk rose and stayed elevated for several hours, ensuring that the baby ingested it.
This early exposure to sugar could be contributing to obesity, diabetes and fatty livers, based on previous research that showed fructose can enhance the fat storage capacity of cells, Goran said.
In neighborhoods like South Los Angeles, where Saira Diaz and Adrian Mejia live, a lack of full-service markets and fresh produce makes it harder to eat healthily. “Access to unhealthy food options — which are usually cheaper — is very high in this city,” Derek Steele, director of health equity programs at the Social Justice Learning Institute in Inglewood, Calif., told Kaiser Health News.
The institute has started farmers markets, helped convert two corner stores into markets with healthier food options and created 109 community gardens on public and private lands in South L.A. and neighboring Inglewood, which has 125 liquor and convenience stores and 150 fast-food outlets.
At Torrance Memorial Medical Center, 10 miles down the road, Dr. Karl Fukunaga, a gastroenterologist with Digestive Care Consultants, said he and his colleagues are seeing so many patients with fatty liver disease that they plan to start a clinic to address it. He urges his patients to avoid sugar and cut down on carbohydrates.
Adrian Mejia and his mother received similar advice from a dietitian in the HEROES program. Adrian gave up sugary beverages, and his liver fat dropped 43%. Two months ago, he joined a soccer league.
“Before, I weighed a lot and it was hard to run,” he said. “If I kept going at the pace I was going, probably later in my life I would be like my [diabetic] grandma. I don't want that to happen.”
This KHN story first published on California Healthline, a service of the California Health Care Foundation.
Source: Published originally on USAToday.com, Fatty liver disease strikes Latino children like a ‘silent tsunami', by Rob Waters, Kaiser Health News, April 19th , 2019.
With Hispanics driving population growth, the Carsey School researchers highlight that Hispanic infants are nearly 2.8 times more likely than non-Hispanics to be born into poverty.
“Today, over 5.4 million U.S. Latino children live in poverty, a number that exceeds the number of poor white children and the number for every other racial or ethnic minority group,” the report reads. “Latino children comprise 23.1 percent of America's children but 37.3 percent of its poor children.”
Hispanic fertility rates are 20 percent higher than non-Hispanics. However, according to the researchers, the poorest, least educated women — “for example non-citizens or non-English speakers” — disproportionately contribute to the number of Hispanic births.
The areas with the highest Hispanic fertility, the report notes, are those regions considered destinations for immigrants.
“High rates of Hispanic fertility in nonmetro areas are driven largely (but not entirely) by the high fertility of Mexican-origin Hispanics, who tend to be the least educated and skilled, and who typically have poverty rates well in excess of the native-born white population,” the report reads. “Hispanic fertility rates are particularly high in the new destinations that are receiving significant net inflows of Hispanic migrants.”
The fertility phenomena is contributing to significant demographic shifts where researchers expect younger, poorer Hispanics to overtake the older, non-poor white population.
“This racial and ethnic transformation will occur first and most rapidly in today's established and new Hispanic boomtowns, which are rapidly diversifying from the ‘bottom up,'” the report reads.
According to the Carsey School researchers, Hispanic mothers disproportionately have high indicators for poverty. For example, one in four begin childbearing in their teens, 70 percent have a high school education or less, and 40 percent are unmarried.
“Poverty risks are also higher among infants with foreign-born mothers and those with limited English. Hispanic infants are much more likely to have foreign-born mothers (52 percent), and those who do have a poverty rate of 38 percent. A disproportionately large share (12 percent) of Hispanic infants also have mothers who speak no English or poor English compared to all mothers (3 percent),” the report reads. “Poverty rates are exceptionally high for Hispanic infants whose mothers have limited English (52.4 percent).”
The report takes issue with the fact that just half of the families of poor Hispanic children are on food stamps and just 12 percent are accepting other forms of welfare, arguing that it reflects an unmet need.
“Poverty among recent Hispanic infants clearly raises the specter of new rural Hispanic ghettos and growing physical, social, and cultural isolation from the mainstream,” the researchers conclude.
“The results suggest that the prospect of full incorporation into American society is jeopardized for many Hispanic infants. Indeed, our analysis reveals especially large disadvantages among rural Hispanic infants and those in new destinations. The substantive implication is that the lack of income from work and government (for example, cash assistance) in new destinations is experienced disproportionately by Hispanics,” the researchers add.
Source: Published originally on http://www.breitbart.com/ as Nearly 25 percent of U.S. infants Hispanic ,have higher risk of poverty, by Caroline May, August 24, 2015.
U.S. Hispanic low-income households are multifaceted; a diverse hodgepodge of families who differ when it comes to national background, racial identifiers, family structure, legal status, nativity, disability, household size, household structure, geographical location, accessibility to government services, and adult employment. To understand this is to better understand how to service low-income Hispanic children and their families. Relative data highlights the likely and unlikely needs of a child in particular low-income immigrant families, compared those from low-income families with U.S.-native parents.
Today, one in four children are Hispanic; two-thirds of those children live in low-income households; and one-third lives in poverty. And programs and policies established to help low-income families are invalidated by the fact that policy developers don't know who they're targeting.
Latinos have lower rates of participation when it comes to government programs and services, despite high levels of poverty and unemployment. And that's because programs misidentify the community, and many policies don't understand that a sizable amount of Hispanic population growth can be attributed to U.S. births, not foreign births. Nor have they acknowledged nationally relative data, which shows variations in housing patterns and unique obstacles.
"The Center was established to address the question of what, if anything, should programs and policies be doing differently to better serve the Hispanic children and families," Kimberly Turner, co-author and research scientist, said to Latin Post. "This particular research compares the household of low-income Hispanic children in immigrant families to that of low-income Hispanic children with only U.S.-born parents. Not only do we find that parental nativity status matters, but we find that low-income Hispanic children in immigrant families experience some advantages.
"As we think about our programs and policies and how best to support healthy child development among low-income Latino children and families, it is important to consider family experiences and possible differences among families. This is particularly important because data suggest that Latinos have lower rates of participation in government program and services despite their relatively high levels of poverty."
Low-income Latino children, especially those born to foreign-born parents, tend to be born into two-parent households or co-residential unions. Roughly two-thirds of low-income Hispanic children live in households with at least one foreign-born parent, and one-third live in a household with only U.S-born parents.
The research also says that Latinas are likely to be married or living with partner in a co-residential union (67 percent) when impregnated, and this number is slightly higher for foreign-born women (36 percent compared to 26 percent). For more than half of Latinas, this will happen by the time she's 20-years-old, revealing that low-income foreign-born Hispanics are more likely to be married than any other group. For men, the numbers are 35 compared to 24 percent. And when it comes to exclusivity and procreation, only 10 percent of foreign-born Hispanic males reported having children with more than one woman, compared to 30 percent of U.S.-born men, who are less likely to be married.
With regards to parenting, it's important to note that children who grow up in low-conflict, two-parent households fare better than children from other types of households. As it stands, low-income children tend to come from single-parent homes with absent biological fathers; this is particularly the case with U.S.-born Hispanic parents. Low-income Hispanic children with at least one foreign-born parent are more likely to live with their biological father than other low-income children. Also, nearly half of low-income Hispanic children with only U.S.-born parents live in single-parent households.
The research also revealed that 40 percent of low-income children with at least one foreign-born parent live in crowded conditions (compare to 21 percent for U.S.-born parents). This means that children in these households are living with close to five people, on average. Despite large household size, low-income Hispanic children live in houses and apartments that have fewer rooms and fewer bedrooms than their low-income racial-ethnic counterparts, particularly for foreign-born parents. And crowded housing for children can have adverse outcomes, such as sleep deprivation, behavioral problems, and less-responsive parenting. Then, again, living in seemingly overflowing households may be beneficial.
It's important to note that many children find healthy developmental support from other related and unrelated adults (cohabiting partners of the resident parent, grandparents, cousins, aunt's, etc.) living in the home, who offer employment wages, child care, housework assistance and other stabilizing benefits, such as providing regularity in schedules and routines, as a contribution.
Although many low-income children come from unstable homes with strained resources, stress and conflict, many parents have jobs, albeit more precarious in low-income, which offers additional resources to parents and children. The majority of low-income children live with at least one employed adult, and that number is highest among households with at least one foreign-born parent, which also tends to include at fulltime employment.
Children of immigrants are more likely to grow up in married households and live with their biological fathers than are their low-income Hispanic peers with only U.S.-born parents, signifying greater economic and emotional wellbeing. Those with at least one foreign-born parent have the greatest advantage. And just 10 percent of low-income Hispanic children with a U.S.-born parent (OR parents) lives in a household with two married parents; almost half live in single-parent households.
"Understanding differences among low-income families between households with at least one foreign parents compared to U.S, parents, as we have found in this report, helps inform our programs, particularly now as the bulk of the growth of the Hispanic population is no longer due to immigration but to births in the U.S," stated Turner.
When it comes to assisting low-income Hispanics children, it's important to recognize many rural and urban regions aren't equipped with resources to assist particular needs. But to determine that, research must to done to understand low-income Hispanic children.
Source: Published originally on LatinPost.com as The diverse and multifaceted households of low-income Hispanic children living in the US by Nicole Akoukou Thompson, February 10, 2015.
- Posted By: Lisa M. Rawleigh
- Written by: National Council of La Raza
One in every four children in the United States under the age of five is Hispanic, a growth rate that is predicted to continue multiplying in the coming decade. In states such as California, Hispanics make up more than half of all school children enrolled in public schools. While the population of Latino children in the school system has significantly increased, many of the schools educating our nation’s youngest students may still lag behind in developing quality measures that ensure they are addressing the needs of this culturally and linguistically diverse population.
This approach would have a significant impact on Latinos, who are among the children least likely to have a preschool experience before kindergarten. In 2009, only 48 percent of Hispanic four-year-olds attended preschool, compared to 70 percent of White and 69 percent of Black children of the same age.
This lack of preschool participation contributes to the school-readiness gap and to future educational disparities. For example, a California study documented that Latino children start kindergarten already two months behind White students in reading and math skills. Clearly, any attempt to equalize educational outcomes for Latinos must begin well before kindergarten.
Almost three-fifths (59 percent) of Latino children live in low-income families, which puts them at risk for poor educational outcomes. Low levels of maternal education are also associated with low levels of school readiness and poor language acquisition, and Hispanic children are more likely than their peers to live in a household with a mother who did not graduate from high school.
In 2008, for example, 42 percent of Latino children lived with a mother who did not complete high school, compared to 25 percent of Black children and 10 percent of White children. This may partially explain why, by age two, Latino children are already behind White children in vocabulary and problem-solving skills. Hispanic children also represent a large proportion (80 percent) of the nation’s English language learners. Among Latino students, nearly two-fifths are ELLs, and the majority of ELLs (65 percent) are native-born citizens.
These students often require additional support to succeed academically, but the quality and effectiveness of education programs varies widely.
Furthermore, Hispanic children are concentrated in schools that primarily serve low-income students and have fewer available resources. In 2003–2004, one-third of Hispanic children were enrolled in high-poverty schools. Latinos account for 46 percent of all students attending school in high-poverty urban areas.
In 2009, 39 percent of Latino eighth graders scored “below basic” in reading, and 43 percent scored “below basic” in mathematics, compared to 16 percent and 17percent of White students, respectively. Additionally, only 55 percent of Hispanic students who enter ninth grade graduate on time with a traditional diploma.
Source: National Council of La Raza, “Preschool education: Delivering on the promise for Latino children”, September 2011.