Overweight, Elevated Blood Pressure, Acanthosis Nigricans and Adherence to Recommended Dietary and Physical Activity Guidelines Among Hmong and White Middle School Students


This cross-sectional study was conducted among low-income middle-school students (N = 426) in rural northern California to compare rates of overweight, elevated blood pressure and acanthosis nigricans (AN) between Hmong and white students. Associations among rates of overweight, elevated blood pressure, AN, and scores for adherence to recommended dietary guidelines were also examined. Fifty-two percent (52 %) of white students were overweight/obese compared to 38 % of Hmong students. Higher fruit consumption was associated with a lower BMI among white, but not Hmong students. Whereas 7 % of white students were classified as pre-hypertensive/hypertensive, the rate for Hmong students was 17 %. Additionally, at 13 versus 2 %, six-fold more Hmong students had an elevated blood pressure with a normal BMI compared to white students, respectively. Ethnicity was also an independent predictive factor for AN. Hmong students appear to be at higher risk for both hypertension and AN than white students irrespective of BMI.

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Correspondence to Keiko Goto.

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Voorhees, J., Goto, K. & Wolff, C. Overweight, Elevated Blood Pressure, Acanthosis Nigricans and Adherence to Recommended Dietary and Physical Activity Guidelines Among Hmong and White Middle School Students. J Immigrant Minority Health 16, 273–279 (2014). https://doi.org/10.1007/s10903-012-9739-7

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  • Adolescents
  • Overweight
  • Elevated blood pressure
  • Acanthosis nigricans
  • Hmong