Regional and Racial/Ethnic Differences in the Association between Perceptions of Dietary Practices, Eating Habits, and Obesity among Texas Adolescents.

Purpose: Adolescent obesity is now of critical concern for Texas, as the statewide prevalence is higher than the National prevalence. The purpose of this study is to evaluate the association of perceptions of dietary practices, eating habits, weight-loss behaviors and over- weight/obesity among adolescents in three Health Service Regions (HSR5) in Texas. Methods: Our study utilized data from eighth and eleventh grade adolescents (n=3,837) who participated in the 2004-2005 School Physical Activity and Nutrition (SPAN) study. Weighted multinomial logistic regression evaluated the association of eating habits, perceptions of dietary practices, and weight-loss behaviors on adolescents' weight status (overweight or obese compared with normal/under-weight), by demographic-specific subpopulations and adjusting for race/ethnicity, gender, grade and/or HSR. Results: Approximately one third of adolescents were overweight (17.2%) or obese (17.1%). Associated factors for obesity among Texas adolescents included: (a) not meeting recommendations for dairy consumption (in African American adolescents as compared with Hispanics and White/other); and (b) perceiving eating habits as "less healthy than peers" (among Hispanic and White/other adolescents as compared with African American adolescents). Conclusions: Interesting differences arise across race/ethnicity categories and regions when evaluating the influence of perceived eating habits relative to peers on weight status. These findings highlight the importance of considering the socio-cultural context of health outcomes and health-related behaviors among adolescents. We propose that health educators should: (a) approach eating habits and nutrition education with cultural competency; and (b) continue to encourage adolescents to meet the recommendations for dairy consumption daily. Moreover, policymakers should consider the influence of perceived social norms on eating habits and weight status among adolescents. [ABSTRACT FROM AUTHOR]