Community energy balance: A framework for contextualizing cultural influences on high risk of obesity in ethnic minority populations

Introduction: Increases in the availability, affordability, and promotion of high-calorie foods and beverages and decreased obligations for routine physical activity have fostered trends of increased obesity worldwide. In high-income, plural societies, above average obesity prevalence is often observed in ethnic minority communities, suggesting that obesity-promoting influences are more prevalent or potent in these communities. Methods: An interdisciplinary group of scholars engaged in multiple rounds of focused discussion and literature review to develop a Community Energy Balance Framework (CEB). The objective was to explore the nature of the excess obesity risk in African descent and other ethnic minority populations and identify related implications for planning and evaluating interventions to prevent obesity. Results: A key principle that emerged is that researchers and programmers working with ethnic minority communities should contextualize the food- and physical activity-related sociocultural perspectives of these communities, taking into account relevant historical, political, and structural contexts. This perspective underscores the fallacy of approaches that place the entire burden of change on the individual, particularly in circumstances of social disadvantage and rapid cultural shifts. Conclusion: The CEB framework is proposed for use and further development to aid in understanding potential health-adverse effects of cultural-contextual stresses and accommodations to these stresses.