Journal of Behavioral Medicine

, Volume 42, Issue 5, pp 947–959 | Cite as

Extra-familial social factors and obesity in the Hispanic Community Children’s Health Study/Study of Latino Youth

  • Julia I. BravinEmail author
  • Angela P. Gutierrez
  • Jessica L. McCurley
  • Scott C. Roesch
  • Carmen R. Isasi
  • Alan M. Delamater
  • Krista M. Perreira
  • Linda Van Horn
  • Sheila F. Castañeda
  • Elizabeth R. Pulgaron
  • Gregory A. Talavera
  • Martha L. Daviglus
  • Maria Lopez-Class
  • Donglin Zeng
  • Linda C. Gallo


Hispanic/Latino youth are disproportionately affected by obesity. However, how social factors outside of the family relate to Hispanic/Latino youth obesity is not well understood. We examined associations of extra-familial social factors with overweight/obesity prevalence, and their variation by sex and age, in 1444 Study of Latino Youth participants [48.6% female; 43.4% children (8–11 years); 56.6% adolescents (12–16 years)], who were offspring of the Hispanic Community Health Study/Study of Latinos participants. Youth self-reported general social support from friends, dietary-, and physical activity (PA)-specific support from peers, and awareness/internalization of thinness ideals. Overweight/obesity was defined as body mass index ≥ 85th percentile. Logistic regression models assessed effects of social factors and their interactions with age-group and sex, adjusting for potential confounders. Social support from friends interacted with both age and sex in relation to overweight/obesity. Female children who reported lesser (OR 0.60; 95% CI [0.39, 0.91]) and female adolescents who reported greater (OR 1.35; 95% CI [1.06, 1.74]) social support from friends had higher odds of overweight/obesity. Among males, greater awareness/internalization of thinness ideals related to higher odds of overweight/obesity (OR 2.30; 95% CI [1.59, 3.31]). Awareness/internalization of thinness ideals was not associated with overweight/obesity among females. Dietary and PA-specific peer support did not relate to overweight/obesity. Social support from friends and awareness/internalization of thinness ideals were significantly related to odds of overweight/obesity in Hispanic/Latino youth; associations varied by age and sex, and persisted after control for intra-familial factors (overall family support/function; diet and activity specific support).


Children Obesity Hispanic Latino Social factors Peer support 



The SOL Youth Study was supported by Grant Number R01HL102130 from the National Heart, Lung, and Blood Institute. The youth participants are drawn from the study of adults: The Hispanic Community Health Study/Study of Latinos, which was supported by contracts from the National Heart, Lung, and Blood Institute (NHLBI) to the University of North Carolina (N01-HC65233), University of Miami (N01-HC65234), Albert Einstein College of Medicine (N01-HC65235), Northwestern University (N01-HC65236), and San Diego State University (N01-HC65237). The following Institutes/Centers/Offices contribute to the HCHS/SOL through a transfer of funds to the NHLBI: National Center on Minority Health and Health Disparities, the National Institute of Deafness and Other Communications Disorders, the National Institute of Dental and Craniofacial Research, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute of Neurological Disorders and Stroke, and the Office of Dietary Supplements. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, And Blood Institute or the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders.

Compliance with ethical standards

Conflict of interest

Julia I. Bravin, Angela P. Gutierrez, Jessica L. McCurley, Scott C. Roesch, Carmen R. Isasi, Alan M. Delamater, Krista M. Perreira, Linda Van Horn, Sheila F. Castañeda, Elizabeth R. Pulgaron, Gregory A. Talavera, Martha L. Daviglus, Maria Lopez-Class, Donglin Zeng, and Linda C. Gallo declare that they have no conflict of interest.

Human and animal rights and informed consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent, or assent as appropriate, was obtained from all individual participants included in the study.


  1. Allen, S. J., Meyer, M. R. U., & Sharkey, J. R. (2016). Physical activity of Mexican-origin children: Examining parental support. Journal of Health Care for the Poor and Underserved, 27, 685–699. CrossRefPubMedGoogle Scholar
  2. Ayala, G., Mickens, L., Galindo, P., & Elder, J. (2007). Acculturation and body image perception among Latino Youth. Ethnicity & Health, 12, 21–41. CrossRefGoogle Scholar
  3. Ayala, G. X., Carnethon, M., Arredondo, E., Delamater, A. M., Perreira, K., Van Horn, L., et al. (2014). Theoretical foundations of the Study of Latino (SOL) Youth: Implications for obesity and cardiometabolic risk. Annals of Epidemiology, 24, 36–43. CrossRefPubMedGoogle Scholar
  4. Bandura, A. (1989). Human agency in social cognitive theory. American Psychologist, 44, 1175–1184. CrossRefPubMedGoogle Scholar
  5. Baranowski, T., Perry, C. L., & Parcel, G. S. (2002). How individuals, environments, and health behavior interact. In K. Glanz, B. K. Rimer, & F. M. Lewis (Eds.), Health behavior and health education: Theory, research, and practice (3rd ed., pp. 165–184). San Francisco, CA: Jossey-Bass.Google Scholar
  6. Barkley, J. E., Salvy, S. J., & Roemmich, J. N. (2012). The effect of simulated ostracism on physical activity behavior in children. Pediatrics, 129, e659–e666. CrossRefPubMedGoogle Scholar
  7. Bishop, W., Chavarin, C., Gonzales, H. A., Iparraguirre, J., Mann, J., Specker, S., et al. (2018). Healthy eating and physical activity among low-income Hispanic adolescents and a school-based intervention. Children and Youth Services Review, 86, 151–156. CrossRefGoogle Scholar
  8. Bruening, M., MacLehose, R., Eisenberg, M. E., Kim, S., Story, M., & Neumark-Sztainer, D. (2015). Friends like me: Associations in overweight/obese status among adolescent friends by race/ethnicity, sex, and friendship type. Childhood Obesity, 11, 722–730. CrossRefPubMedPubMedCentralGoogle Scholar
  9. Byles, J., Byrne, C., Boyle, M. H., & Offord, D. R. (1988). Ontario Child Health Study: Reliability and validity of the general functioning subscale of the McMaster Family Assessment Device. Family Process, 27, 97–104. CrossRefPubMedGoogle Scholar
  10. Caccavale, L. J., Farhat, T., & Iannotti, R. J. (2012). Social engagement in adolescence moderates the association between weight status and body image. Body Image, 9, 221–226. CrossRefPubMedPubMedCentralGoogle Scholar
  11. Center for Disease Control and Prevention. (2016). Child Development. Retrieved November 2, 2018 from
  12. Cheng, L. A., Mendonça, G., & Farias Júnior, J. C. D. (2014). Physical activity in adolescents: Analysis of the social influence of parents and friends. Jornal de Pediatria, 90, 35–41. CrossRefPubMedGoogle Scholar
  13. Chung, S. J., Ersig, A. L., & McCarthy, A. M. (2017). The influence of peers on diet and exercise among adolescents: A systematic review. Journal of Pediatric Nursing, 36, 44–56. CrossRefPubMedGoogle Scholar
  14. Couch, D., Thomas, S. L., Lewis, S., Blood, R. W., Holland, K., & Komesaroff, P. (2016). Obese people’s perceptions of the thin ideal. Social Science and Medicine, 148, 60–70. CrossRefPubMedGoogle Scholar
  15. de la Haye, K., Dijkstra, J. K., Lubbers, M. J., van Rijsewijk, L., & Stolk, R. (2017). The dual role of friendship and antipathy relations in the marginalization of overweight children in their peer networks: The TRAILS Study. PLoS ONE, 12, e0178130. CrossRefPubMedPubMedCentralGoogle Scholar
  16. Dulloo, A. G., & Montani, J. P. (2015). Pathways from dieting to weight regain, to obesity and to the metabolic syndrome: An overview. Obesity Reviews, 16, 1–16. CrossRefPubMedGoogle Scholar
  17. Edwards, L. M. (2004). Measuring perceived social support in Mexican American youth: Psychometric properties of the multidimensional scale of perceived social support. Hispanic Journal of Behavioral Sciences, 26, 187–194. CrossRefGoogle Scholar
  18. Enders, C. K. (2010). Applied missing data analysis. New York: Guilford Press.Google Scholar
  19. Franko, D. L., Jenkins, A., Roehrig, J. P., Luce, K. H., Crowther, J. H., & Rodgers, R. F. (2012). Psychometric properties of measures of eating disorder risk in Latina college women. International Journal of Eating Disorders, 45, 592–596. CrossRefPubMedGoogle Scholar
  20. Global Burden of Disease 2015 Obesity Collaborators. (2017). Health effects of overweight and obesity in 195 countries over 25 years. New England Journal of Medicine, 377, 13–27. CrossRefGoogle Scholar
  21. Grogan, S. (2016). Body image: Understanding body dissatisfaction in men, women and children. London: Routledge.CrossRefGoogle Scholar
  22. Hagler, A. S., Norman, G. J., Radick, L. R., Calfas, K. J., & Sallis, J. F. (2005). Comparability and reliability of paper-and computer-based measures of psychosocial constructs for adolescent fruit and vegetable and dietary fat intake. Journal of the American Dietetic Association, 105, 1758–1764. CrossRefPubMedGoogle Scholar
  23. Halliday, J. A., Palma, C. L., Mellor, D., Green, J., & Renzaho, A. M. N. (2014). The relationship between family functioning and child and adolescent overweight and obesity: A systematic review. International Journal of Obesity, 38, 480. CrossRefPubMedGoogle Scholar
  24. Harriger, J. A., & Thompson, J. K. (2012). Psychological consequences of obesity: Weight bias and body image in overweight and obese youth. International Review of Psychiatry, 24, 247–253. CrossRefPubMedGoogle Scholar
  25. Heinberg, L. J., Thompson, J. K., & Stormer, S. (1995). Development and validation of the sociocultural attitudes towards appearance questionnaire. International Journal of Eating Disorders, 17, 81–89.;2-y CrossRefPubMedGoogle Scholar
  26. Isasi, C. R., Carnethon, M. R., Ayala, G. X., Arredondo, E., Bangdiwala, S. I., Daviglus, M. L., et al. (2014). The Hispanic community children’s health study/study of Latino youth (SOL youth): Design, objectives, and procedures. Annals of Epidemiology, 24, 29–35. CrossRefPubMedGoogle Scholar
  27. Isasi, C. R., Parrinello, C. M., Ayala, G. X., Delamater, A. M., Perreira, K. M., Daviglus, M. L., et al. (2016). Sex differences in cardiometabolic risk factors among Hispanic/Latino youth. The Journal of pediatrics, 176, 121–127. CrossRefPubMedPubMedCentralGoogle Scholar
  28. Kilanowski, J. F. (2016). Influences on healthy-eating decision making in Latino adolescent children of migrant and seasonal agricultural workers. Journal of Pediatric Health Care, 30, 224–230. CrossRefPubMedGoogle Scholar
  29. Kuczmarski, R. J., Ogden, C. L., Guo, S. S., Grummer-Strawn, L. M., Flegal, K. M., Mei, Z., ... Johnson, C. L. (2002). 2000 CDC Growth Charts for the United States: Methods and development. Vital Health Stat, 11, 1–190. Retrieved November 5, 2018 from
  30. LaVange, L. M., Kalsbeek, W. D., Sorlie, P. D., Avilés-Santa, L. M., Kaplan, R. C., Barnhart, J., ... Criqui, M. H. (2010). Sample design and cohort selection in the Hispanic Community Health Study/Study of Latinos. Annals of Epidemiology, 20, 642–649.
  31. Lenhart, A., Purcell, K., Smith, A., & Zickuhr, K. (2015). Pew Internet & American Life Project. 2014. Young adults, mobile phones and social media: Technology and the transition to adulthood. Retrieved November 4, 2018 from
  32. Mancilla-Díaz, J., López-Aguilar, X., Franco-Paredes, K., Alvarez-Rayón, G., Vázquez-Arévalo, R., Ocampo Téllez-Girón, M. T., et al. (2012). Role of peer influence and thin-ideal internalization on body dissatisfaction and disordered eating in Mexican girls. Revista Colombiana de Psicología, 21, 343–353.Google Scholar
  33. Muthén, L. K., & Muthén, B. O. (2006). Mplus. Los Angeles: Muthén & Muthén.Google Scholar
  34. Norman, G. J., Sallis, J. F., & Gaskins, R. (2005). Comparability and reliability of paper-and computer-based measures of psychosocial constructs for adolescent physical activity and sedentary behaviors. Research Quarterly for Exercise and Sport, 76, 315–323.CrossRefPubMedGoogle Scholar
  35. Ogden, C. L., Carroll, M. D., Lawman, H. G., Fryar, C. D., Kruszon-Moran, D., Kit, B. K., et al. (2016). Trends in obesity prevalence among children and adolescents in the United States, 1988–1994 through 2013–2014. Journal of the American Medical Association, 315, 2292–2299. CrossRefPubMedGoogle Scholar
  36. Ohri-Vachaspati, P., DeLia, D., DeWeese, R. S., Crespo, N. C., Todd, M., & Yedidia, M. J. (2015). The relative contribution of layers of the Social Ecological Model to childhood obesity. Public Health Nutrition, 18, 2055–2066. CrossRefPubMedGoogle Scholar
  37. Orth, U., Robins, R. W., Widaman, K. F., & Conger, R. D. (2014). Is low self-esteem a risk factor for depression? Findings from a longitudinal study of Mexican-origin youth. Developmental Psychology, 50, 622–633. CrossRefPubMedGoogle Scholar
  38. Perloff, R. M. (2014). Social media effects on young women’s body image concerns: Theoretical perspectives and an agenda for research. Sex Roles, 71, 363–377. CrossRefGoogle Scholar
  39. Puhl, R. M., Peterson, J. L., DePierre, J. A., & Luedicke, J. (2013). Headless, hungry, and unhealthy: A video content analysis of obese persons portrayed in online news. Journal of Health Communication, 18, 686–702. CrossRefPubMedGoogle Scholar
  40. Raffaelli, M., Andrade, F. C., Wiley, A. R., Sanchez-Armass, O., Edwards, L. L., & Aradillas-Garcia, C. (2013). Stress, social support, and depression: A test of the stress-buffering hypothesis in a Mexican sample. Journal of Research on Adolescence, 23, 283–289. CrossRefGoogle Scholar
  41. Rawlins, W. (2017). Friendship matters. New York: Routledge.Google Scholar
  42. Rodgers, R. F., & Melioli, T. (2016). The relationship between body image concerns, eating disorders and internet use, part I: A review of empirical support. Adolescent Research Review, 1(2), 95–119. CrossRefGoogle Scholar
  43. Romo, L. F., Mireles-Rios, R., & Hurtado, A. (2016). Cultural, media, and peer influences on body beauty perceptions of Mexican American adolescent girls. Journal of Adolescent Research, 31, 474–501. CrossRefGoogle Scholar
  44. Rubin, K. H., Bukowski, W. M., & Parker, J. G. (1998). Peer interactions, relationships, and groups. Handbook of Child Psychology. CrossRefGoogle Scholar
  45. Sabatelli, R. M., & Mazor, A. (1985). Differentiation, individuation, and identity formation: The integration of family system and individual developmental perspectives. Adolescence, 20, 619–633. Retrieved June 11, 2018 from
  46. Sahoo, K., Sahoo, B., Choudhury, A. K., Sofi, N. Y., Kumar, R., & Bhadoria, A. S. (2015). Childhood obesity: Causes and consequences. Journal of Family Medicine and Primary care, 4, 187–192. CrossRefPubMedPubMedCentralGoogle Scholar
  47. Salvy, S. J., De La Haye, K., Bowker, J. C., & Hermans, R. C. (2012). Influence of peers and friends on children’s and adolescents’ eating and activity behaviors. Physiology & Behavior, 106, 369–378. CrossRefGoogle Scholar
  48. Schaefer, L. M., Harriger, J. A., Heinberg, L. J., Soderberg, T., & Kevin Thompson, J. (2017). Development and validation of the sociocultural attitudes towards appearance questionnaire-4-revised (SATAQ-4R). International Journal of Eating Disorders, 50, 104–117. CrossRefPubMedGoogle Scholar
  49. Siahpush, M., Tibbits, M., Shaikh, R. A., Singh, G. K., Kessler, A. S., & Huang, T. T. K. (2015). Dieting increases the likelihood of subsequent obesity and BMI gain: Results from a prospective study of an Australian national sample. International Journal of Behavioral Medicine, 22, 662–671. CrossRefPubMedGoogle Scholar
  50. Skinner, A. C., Perrin, E. M., Moss, L. A., & Skelton, J. A. (2015). Cardiometabolic risks and severity of obesity in children and young adults. New England Journal of Medicine, 373, 1307–1317. CrossRefPubMedGoogle Scholar
  51. Smolak, L., Levine, M. P., & Thompson, J. K. (2001). The use of the sociocultural attitudes towards appearance questionnaire with middle school boys and girls. International Journal of Eating Disorders, 29, 216–223.;2-v CrossRefPubMedGoogle Scholar
  52. Sorlie, P. D., Aviles-Santa, L. M., Wassertheil-Smoller, S., Kaplan, R. C., Daviglus, M. L., Giachello, A. L., et al. (2010). Design and implementation of the Hispanic Community Health Study/Study of Latinos. Annals of Epidemiology, 20, 629–641. CrossRefPubMedPubMedCentralGoogle Scholar
  53. Stokes, D. M., Clemens, C. F., & Rios, D. I. (2016). Brown beauty: Body image, Latinas, and the media. Journal of Family Strengths, 16, 8.Google Scholar
  54. Taylor, Z. E., Conger, R. D., Robins, R. W., & Widaman, K. F. (2015). Parenting practices and perceived social support: Longitudinal relations with the social competence of Mexican-origin children. Journal of Latina/o Psychology, 3, 193–208. CrossRefPubMedPubMedCentralGoogle Scholar
  55. Vanderwater, E. A., Park, S. E., Hébert, E. T., & Cummings, H. M. (2015). Time with friends and physical activity as mechanisms linking obesity and television viewing among youth. International Journal of Behavioral Nutrition and Physical Activity, 12, S6. CrossRefGoogle Scholar
  56. Vaux, A. (1988). Social support: Theory, research, and intervention. New York, NY: Praeger Publishers.Google Scholar
  57. Voelker, D. K., Reel, J. J., & Greenleaf, C. (2015). Weight status and body image perceptions in adolescents: Current perspectives. Adolescent Health, Medicine and Therapeutics, 6, 149–158. CrossRefPubMedPubMedCentralGoogle Scholar
  58. Webb, H. J., & Zimmer-Gembeck, M. J. (2014). The role of friends and peers in adolescent body dissatisfaction: A review and critique of 15 years of research. Journal of Research on Adolescence, 24, 564–590. CrossRefGoogle Scholar
  59. Wu, Y. P., Reiter-Purtill, J., & Zeller, M. H. (2014). The role of social support for promoting quality of life among persistently obese adolescents: Importance of support in schools. Journal of School Health, 84, 99–105. CrossRefPubMedGoogle Scholar
  60. Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The multidimensional scale of perceived social support. Journal of Personality Assessment, 52, 30–41. CrossRefGoogle Scholar
  61. Zimet, G. D., Powell, S. S., Farley, G. K., Werkman, S., & Berkoff, K. A. (1990). Psychometric characteristics of the multidimensional scale of perceived social support. Journal of Personality Assessment, 55, 610–617. CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Julia I. Bravin
    • 1
    Email author
  • Angela P. Gutierrez
    • 1
  • Jessica L. McCurley
    • 2
  • Scott C. Roesch
    • 3
  • Carmen R. Isasi
    • 4
  • Alan M. Delamater
    • 5
  • Krista M. Perreira
    • 6
  • Linda Van Horn
    • 7
  • Sheila F. Castañeda
    • 8
  • Elizabeth R. Pulgaron
    • 5
  • Gregory A. Talavera
    • 8
  • Martha L. Daviglus
    • 9
    • 10
  • Maria Lopez-Class
    • 11
  • Donglin Zeng
    • 12
  • Linda C. Gallo
    • 3
  1. 1.Joint Doctoral Program in Clinical PsychologySan Diego State University/University of California, San Diego, South Bay Latino Research CenterChula VistaUSA
  2. 2.Harvard Medical School/Massachusetts General HospitalBostonUSA
  3. 3.Department of PsychologySan Diego State UniversitySan DiegoUSA
  4. 4.Department of Epidemiology and Population HealthAlbert Einstein College of MedicineBronxUSA
  5. 5.University of Miami Miller School of MedicineMiamiUSA
  6. 6.Department of Social MedicineUniversity of North Carolina at Chapel HillChapel HillUSA
  7. 7.Department of Preventive MedicineNorthwestern UniversityChicagoUSA
  8. 8.School of Public HealthSan Diego State UniversitySan DiegoUSA
  9. 9.Institute for Minority Health ResearchUniversity of Illinois at ChicagoChicagoUSA
  10. 10.Department of Preventive MedicineFeinberg School of MedicineChicagoUSA
  11. 11.National Institute of Environmental Health SciencesResearch Triangle ParkUSA
  12. 12.University of North Carolina at Chapel HillChapel HillUSA

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