The Obesity Epidemic Remains A Public Health Concern Worldwide

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CHAPTER 1: LITERATURE REVIEW Overview The obesity epidemic remains a public health concern worldwide. Obesity rates remain high in the United States, where one third of adults are obese.1 According to the National Health and Nutrition Examination Survey (NHANES), the percent of children (ages 2-19 years) who are obese rose from 14.5% in 1999 to 17.3% in 2012.1 A recent study based on the 2012-2013 NHANES suggests a stabilization in obesity rates since 2003-2004, with a significant decrease among 2-5 year olds but no significant changes observed in other age groups.2 This literature review will examine the following topics: I) racial/ethnic disparities in the obesity trends and health implications; II) dietary and other factors driving the obesity epidemic; III) methods to assess dietary outcomes of interventions; IV) examples of interventions to reverse childhood obesity; V) the design of the Niños Sano, Familia Sana (Healthy Children, Healthy Family) study; and VI) the rationale and need for this research. Throughout, these topics will particularly highlight evidence in Latino populations. . The Latino population in the United States is diverse. In this dissertation, the term Mexican-Origin is used to identify our study subjects who self-report as Mexican-American, Chicano or Mexican. The original terms (e.g. Latino, Hispanic, Mexican-American) used in other studies cited below will be retained to preserve integrity of the literature. I Racial/Ethnic Disparities in

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