Body Image, Acculturation, Menopause, and Weight-Related Behaviors in Hispanic Women

Thesis (Ph.D.)--University of Washington, 2014Daisy S. Garcia University of Washington School of Nursing ABSTRACT Of all U.S. ethnic/racial women groups, Hispanic/Latino women have the second highest rate of obesity; in addition, women aged 40 to 59 are the most affected by this condition. Physical activity and dietary behaviors are usually the target for promoting healthy weight in Hispanic women, yet personal factors, such as body image perception changes as the women acculturate, are less included, particularly when addressing middle-aged and older Hispanic women. Similar to younger populations, middle-aged and older women experience body image (dis)satisfaction. As these women acculturate, their body image discrepancy--the difference between the current and ideal body image--varies, and is associated with an increase of body weight. In addition, the current research neglects the symptoms these women face at menopause, which are known to affect women's physical functioning and quality of life. This dissertation examines the relationship between postmenopausal Hispanic women's acculturative factors, body image discrepancy, physical activity, dietary intake, body mass index (BMI), and waist-hip ratio (WHR) values. It also explores existing literature on the association between menopause and middle aged Hispanic women's physical activity and dietary behaviors. Manuscript one (Chapter II), assesses the cross-sectional association between acculturation, body image discrepancy, intake of fruit, vegetables, fats, physical activity, BMI and WHR. Results show that high acculturation is positively associated with inactivity and that body image discrepancy increase the odds of being inactive, of having normal weight and low WHR, and of being less likely to consume less than 30% calories from fat/day. Manuscript two (Chapter III) examines longitudinally the relationship between body image discrepancy and patterns of BMI and physical activity over 6 years. Results show that physical activity and BMI trajectories are not significantly different, either by Hispanic or body image discrepancy groups. However, women with greater body image discrepancy and those who perceived their figure as heavier or thinner that the ideal figure had lower physical activity scores. In manuscript three (Chapter IV), the review of literature shows that there is a void of studies focusing on dietary behaviors and symptoms at menopause, and a scarcity of studies addressing physical activity or physical functioning and symptoms at menopause. The six studies included in this review show that menopause symptoms play a role in physical mobility and that Hispanic women are more likely to report physical functional impairments and being less physically active. In general, they were mostly overweight or obese as a result. Each of the manuscripts have a different methodology and focus, but are related in that they explore factors associated with body weight in Hispanic women living in the United States. Jointly, these three manuscripts highlight the importance of considering body image perceptions, acculturative factors, and menopause discomforts as well as to embark on studies including both physical activity and dietary behaviors when addressing Hispanic women body weight needs