Obesity control in Latin American and U.S. Latinos: a systematic review.

CONTEXT Latinos are the largest and fastest-growing ethnically diverse group in the U.S.; they are also the most overweight. Mexico is now second to the U.S. in experiencing the worst epidemic of obesity in the world. Objectives of this study were to (1) conduct a systematic review of obesity-related interventions targeting Latinos living in the U.S. and Latin America and (2) develop evidence-based recommendations to inform culturally relevant strategies targeting obesity. EVIDENCE ACQUISITION Obesity-related interventions, published between 1965 and 2010, were identified through searches of major electronic databases in 2010-2011. Selection criteria included evaluation of obesity-related measures; intervention conducted in a community setting; and at least 50.0% Latino/Latin American participants, or with stratified results by race/ethnicity. EVIDENCE SYNTHESIS Body of evidence was based on the number of available studies, study design, execution, and effect size. Of 19,758 articles, 105 interventions met final inclusion criteria. Interventions promoting physical activity and/or healthy eating had strong or sufficient evidence for recommending (1) school-based interventions in the U.S. and Latin America; (2) interventions for overweight or obese children in the healthcare context in Latin America; (3) individual-based interventions for overweight or obese adults in the U.S.; (4) individual-based interventions for adults in Latin America; and (5) healthcare-based interventions for overweight or obese adults in Latin America. CONCLUSIONS Most intervention approaches combined physical activity and healthy eating to address both sides of the energy-balance equation. Results can help guide comprehensive evidence-based efforts to tackle the obesity epidemic in the U.S. and Latin America.