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Physicians Together -

A Commitment to
Health & Well Being


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By: Dexter Louie, MD, JD, MPA


Being at a healthy weight should be a goal for all of us as we start a New Year. Here in America, we are some of the unhealthiest people in the world, largely because of what we eat, how we eat, and how physically inactive we are.

  • America is home to the most obese people IN THE WORLD. It is a national epidemic. Two-thirds of adults and one-third of children are overweight or obese. The majority of these children remain so as adults.
  • Related to this epidemic are high rates of heart disease, diabetes, stroke, arthritis, and certain cancers.

Why is this happening?

It's very simple. Weight gain occurs when we eat too much food and food of a certain kind, and get too little physical activity.

  • The foods we eat have changed from 2 generations ago:
    • Fast food, junk food, and snack foods are more prevalent and more accessible, especially in minority and lower-income neighborhoods.
    • Fruits and vegetables and whole grains are least accessible in certain neighborhoods.
    • We ingest more refined sugar in sodas, in snacks, and/or desserts.
    • Food products high in sugar, fat, and salt are highly advertised and marketed, especially to children.
    • Food products have become highly processed and refined, and less nutritious.
    • Portions have gotten larger at home, at restaurants, and at fast food outlets.
  • Physical activity has decreased:
    • We have too much "screen time": watching TV, playing video games, using computers & smart phones.
    • There is less access to parks and recreation centers.
    • Safe routes for walking or biking to school, work, or play may not exist.
    • There is less quality and quantity in physical education in school for students.
    • We do not make exercise a regular part of our daily routine. We spend much more time eating than exercising!

Three Strategies to Get to a Healthy Weight:

  • Understand what you eat:
    • Generally, junk food, fast foods, and snack foods are calorie dense and nutrition poor that add body weight but not the nutrients to be healthy, i.e., hamburgers, double cheeseburgers, fries, sodas, desserts, donuts, potato chips, sugared cereals, pizza, candy bars, cookies.
    • Highly processed foods usually have more calories and fewer nutrients, versus fresh fruit, vegetables, and whole grains, which have fewer calories and more nutrients.
  • Change certain eating habits and behaviors:
    • Portions should be small.
    • Large servings should be split in half and saved or shared.
    • No second helpings.
    • Limit desserts to once a week, and only eat half of it. Save or share the rest.
    • Avoid fast food outlets as much as possible, and only eat half of what is served. Save or share the rest.
    • No sodas or junk food. By eliminating one 12 oz. soda a day (150 calories) or its junk food equivalent (potato chips, donuts, cookies), you can lose about 15 pounds in a year.
  • Increase physical activity:
    • Make physical activity a regular part of your day, at least 30 minutes, a few times a week. Look for opportunities, such as walking at least part of the way to your destination, climbing 1 or 2 flights of stairs, taking a longer route, or taking up a sport.
    • Find a partner or group for walking, running, or other physical activity. It makes the activity easier and more likely to be a regular activity.
    • Reduce "screen time". This is especially important for children, many of whom spend 4 or more hours a day in front of a screen.


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By: Ricky Y. Choi, MD, MPH
Pediatrics Department Head
Asian Health Services Community Health Center


When I tell physician colleagues about the many overweight children I see in the Asian Pacific Islander community, I often get a look of surprise.  While there is growing national concern about the obesity epidemic in childhood, it is commonly assumed that API children are the exception, as if they are genetically protected.  However, the limited studies of API-American children and observations from providers in these communities tell a different story.

  • According to a study of  body composition among 5th graders published in the State of Asian American, Native Hawaiian and Pacific Islander Health in California Report, Pacific Islanders had the highest rates of children in the unhealthy zone of all ethnic groups in the state.
  • In Hawaii, Samoan children had the highest prevalence of being overweight, and 29% of all 4 and 5 year olds in Hawaii (multiethnic cohort) were either overweight or obese.
  • A study conducted at a large community health center in New York City reported that 40% of Chinese US born boys, aged 6-11 years, were identified as overweight or obese.
  • The Los Angeles County Department of Public Health with data retrieved from the California Dept. of Education program called Fitnessgram found that 48.6% of Samoans in 5th, 7th, and 9th grades were obese [6].
Interestingly, nutritionists and parents in my health center report that excessive weight gain in the API population is less the result of common culprits such as juice and fast food. Unhealthy weight in API children are often the consequence of a diet high in salty meats and rice and low in fruit and vegetables coupled with inactivity and excessive screen time.  According to California Department of Public Health data, only one out of three Asian American children eat the recommended daily portion of fruits and vegetables.  Based on the U.S. Department of Education, only 39 % of tenth-grade Asian boys participated in after-school sports, the lowest participation rate of any ethnic group.  Similarly, only 34% of tenth-grade Asian girls participated in sports, second only to Hispanic girls at 32 %.  In my clinic, many parents work long hours and are unable to keep their children in activities after school and on weekends.  Some families focus on academics to the exclusion of most everything else, leaving little room for physical activity which, arguably, is just as important.

There are some steps we can take.  Below is a two pronged strategy that could make a difference.

I. Data collection of API children
  1. Develop a network of providers that serve large API communities to establish databases and registries to monitor the growth trends of API children.
  2. Promote sampling methodology for national surveys that includes representation of API subgroups in adequate numbers to produce reliable estimates.
  3. Develop measures and obesity definitions which are validated in API populations.
II. Community-based advocacy interventions
  1. Mobilize medical resources around obesity identification, prevention, and treatment.
  2. Promote healthy and culturally appropriate food choices in restaurants, schools and neighborhoods.
  3. Coordinate linguistically accessible and culturally competent health education messaging about obesity.

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