Body Image, Physical Activity and Cultural Variables Underlying Race and Ethnicity among Latino Men

Abstract

Background:

Overweight and obesity is a significant public health concern among Latino men. Common correlates of obesity that have been examined in previous studies are diet, physical activity, and body image.

Objectives:

The aim of this study was to examine whether or not there are differences in body image, physical activity and cultural variables between Mexican and Puerto Rican men.

Methods:

Participants completed a health and culture interview, anthropometric measures, a dietary assessment, and an objective measure of physical activity. The results are from the 203 participants who completed the health and culture interview.

Results:

Mexicans and Puerto Ricans did not differ in their current and ideal body image, body image discrepancy, body satisfaction or how they described their weight. Puerto Ricans watched a greater number of hours of television per day than Mexicans (p < .01). There were no significant differences in their participation in any regular activity designed to improve or maintain their physical fitness, the number of times or length they engaged in this activity, or in their perceived exertion during this activity. Puerto Ricans reported a higher level of familism (p < .01) and machismo (p < .05) than Mexicans. There were no ethnic differences in folk illness beliefs, fatalism or personalism, acculturation level, acculturative stress, or ethnic identity.

Conclusions:

Results are discussed in relation to the development of healthy eating, physical activity and body image interventions for Puerto Rican and Mexican men.

The health of Latino men is an understudied area¹ and overweight and obesity is a significant public health concern among Latino men. In the Hispanic Community Health Study/Study of Latinos, there was a 37% rate of obesity rate among Hispanic/Latino men, with rates differing across Hispanic/Latino background.² For example, among men, obesity rates were 40.9% among Puerto Ricans, 36.8% among Mexicans, and 27% among South Americans.²

Previous studies of obesity have examined common correlates such as diet, physical activity and body image.^3,4 Overall, there is a relative dearth of research examining body image and physical activity between subgroups of Latino men, which is the focus of this study. In general, Latinos report engaging in less leisure time physical activity than non-Hispanic Whites.⁵ After controlling for age and socioeconomic status, one study found that Latinos were less likely to engage in any exercise activity and were more likely to have a high body mass index (BMI) compared with non-Latino Whites.⁶

In terms of body image, results from a review article found that Hispanics’ body image did not differ from Whites, but that Hispanic men engaged in normative and more extreme weight loss strategies than Whites.⁷ An additional review emphasized the need for research about body image in men in general and also among men who are obese.⁸ It is also important to examine body image in Latino men because having a favorable body image at a higher weight may be associated with obesity and this may cause men to be unwilling or unmotivated to engage in efforts to lose weight to decrease their health risks.

Mexicans and Puerto Ricans are two of the largest Latino groups in the United States.⁹ Therefore, it is important to examine whether there are differences in body image and physical activity within these ethnic groups so that culturally tailored weight loss interventions can be developed. It is also critical to explore deeper aspects of Latino ethnic background by examining cultural factors (acculturation, acculturative stress, ethnic identity, and cultural values) that may underlie race and ethnicity in Latinos. These cultural factors are described herein.

Acculturation refers to the changes in behaviors and/or attitudes that occur in individuals from one culture due to their contact with a different culture.¹⁰ Numerous studies have found an association between acculturation and obesity.⁶ Moreover, one study in adult Latino men and women found that Latino men engaged in greater occupational and overall activity than Latina women.¹¹ More acculturated Latinos, as compared with those who were less acculturated, also reported less occupational activity and overall activity.¹¹ However, acculturation was not related to recreational physical activity.¹¹ Overall, there is a need for additional research on body image in adult Latino males, as well as on acculturation and health behaviors among Latino men.

Acculturative stress describes the stress that individuals experience as they undergo the process of cultural change associated with acculturation.¹² This stress may affect both immigrants and those in later generations. In one study, adults of Mexican origin were found to experience acculturative stress from different sources and the predominant source of acculturative stress was language competency.¹² However, little research has examined differences in acculturative stress between Mexicans and Puerto Ricans.

Ethnic identity is a multidimensional construct that reflects one’s identity or sense of self as a member of an ethnic group.¹³ Ethnic identity is related to the concept of acculturation, but it is distinguishable from acculturation owing to its focus on the subjective feelings about one’s ethnicity.¹³ Overall, there is little research that examines differences in ethnic identity between Mexicans and Puerto Ricans.

Cultural values may affect correlates of obesity and a number of Latino cultural values have been described in the literature. These include familism (family), personalismo (personalism, or personal relationships), fatalism (fatalistic beliefs), folk illness beliefs, spirituality, and machismo (an exaggerated sense of masculinity).¹⁴ For example, in terms of familism, the beliefs and values held by Latinos tend to be affected by their family, who may also influence their body type preferences, and diet/physical activity choices. Latinos may also be less likely to question the values of their own culture to preserve their personal relationships (personalismo).

The Latino Men’s Health Initiative was an National Institutes of Health–funded study (R21CA143636)¹⁵ designed to explore the role of cultural variables (acculturation, acculturative stress, ethnic identity, and cultural values) underlying race and ethnicity as it relates to correlates of overweight/ obesity (diet, physical activity, and body image) among normal weight, overweight and obese Mexican and Puerto Rican men. This study used a community-based participatory research framework in which community partners collaborated throughout various phases of the research process and in the dissemination of results.¹⁶ This framework allowed us to integrate the expertise and input of community partners who were willing to share their knowledge, skills, and experience in working with Latinos.^15,17 The goal was to use these findings as preliminary data for the development of community-engaged, culturally targeted healthy eating, body image, and physical activity interventions for Latino men. The aim of the current study was to examine whether or not there are differences in body image, physical activity and cultural variables between Mexican and Puerto Rican men.

METHODS

The sample included 203 Latino men (99 Mexicans and 104 Puerto Ricans), with the following breakdown of weight categories: Puerto Ricans: 35.58% (n = 37) normal weight (BMI = 18.5–24.99); 32.69% (n = 34) overweight (BMI = 25–29.99); and 31.73% (n = 33) Obese (BMI ≥ 30); Mexicans: 31.31% (n = 31) normal weight (BMI = 18.5–24.99); 36.36% (n = 36) overweight (BMI = 25–29.99); and 32.32% (n = 32), obese (BMI ≥ 30).

Inclusion criteria were as follows: a) Mexican and Puerto Rican men, who may be biracial, but must identify as Mexican or Puerto Rican; b) adult men between the ages of 18 and 65 because of their high overweight and obesity rates; and c) those who agree to provide informed consent. Exclusion criteria were as follows: a) those with a lower BMI limit (< 18.5 kg/m²), because this study included only those who were normal weight or overweight (there was no upper BMI limit); b) those who are not able to speak/read English or Spanish; c) those with an eating disorder (bulimia nervosa, anorexia nervosa, binge eating disorder); and d) those who had plans to move from the Illinois area during the course of the study (i.e., 6 weeks).

Recruitment

A detailed description of the recruitment strategies and procedures can be found elsewhere.¹⁵ This study used both direct (in-person) and indirect recruitment methods. Direct recruitment was conducted at Hispanic/Latino organizations, churches, festivals, and health fairs where flyers were distributed and publicized a free culture and health research study for Latino males. Flyers were also given to health care professionals, community members, and others, and posted in various locations in the Chicagoland area. Indirect recruitment was conducted via newspaper advertisements, newsletters of various organizations, letters to doctors, and other organizations focused on Latino and/or health issues, postings to email listserves and websites, and at the University of Illinois at Chicago.

Study Procedures

Research assistants obtained oral consent to determine an individual’s initial eligibility prior to conducting the 30-minute initial eligibility interview on the telephone or in person. For those who met the initial eligibility criteria, an in-person visit was scheduled to complete the written consent. After informed consent was obtained, height was measured using a stadiometer and weight was measured using a Seca company digital scale. BMI [weight (kg)/height (m)²)]¹⁸ was calculated to determine eligibility. Eligible participants completed a 90-minute health and culture interview. Measures of body fat, via bioelectrical impedance analysis, using a Tanita BF 682 scale and fat distribution (waist and hip circumference) were also obtained. Participants received the following incentives: $50 for completing the health/culture interview; $10 for completing a 1-hour diet questionnaire; and $15 for using an accelerometer for 7 days and recording the results. This study was approved by the Institutional Review Board at the University of Illinois at Chicago (2011–0187) and by the Research Review Board at Alivio Medical Center.

Community Partners

This study used a community-based participatory research framework in which community partners collaborated throughout various phases of the research process. The first author convened a Hispanic/Latino Health Community Advisory Board (HLH-CAB) and members helped to tailor the methodology, assessments and measures before the recruitment of participants (for additional details, see Sanchez-Johnsen et al¹⁵ and Sanchez-Johnsen et al¹⁷). Certain HLH-CAB members continued to remain active collaborators even after the study ended (e.g., helped with the dissemination of the study results and in the preparation of grant applications focused on obesity in Latino men).

Measures

Measures were adapted and translated as recommended by prior guidelines and all translations were reviewed by select members of the HLH-CAB and bilingual research assistants. This process has been described previously.¹⁷ Participants answered questions assessing demographics, health, diet, weight, culture, and psychosocial measures as part of the larger study. Measures assessing body image, physical activity and cultural variables are described below.

Body image.

Participants were presented with two sets of body image silhouettes/drawings (card A and card B) and asked the same series of questions pertaining to card A and B, respectively. The Figure Rating Scale was presented on card A and it is a visual scale that displayed nine schematic figures of men ranging from underweight to overweight.¹⁹ This scale was used to assess current and ideal body image and has been used in studies with Latinos and other ethnic groups.^20,21 A body image discrepancy score was calculated by subtracting ideal body image minus current body image. Card B silhouettes were developed for a prior research study on African Americans²² and used as an initial step as part of the first authors’ plan to develop Latino-centered body image silhouettes/drawings. Both cards were shown to men to assess preference of the images on card A versus B, as well as to assess which drawings they thought looked most like them, and other questions pertaining to body image.

Body image was assessed with the Body Areas Satisfaction Subscale of the Multidimensional Body-Self Relations Questionnaire (reliability of 0.73–0.86).²³ The Multidimensional Body-Self Relations Questionnaire measures body image, defined as personal attitudes toward one’s physical self, which includes evaluative, cognitive, and behavioral components.²³ Responses ranged from 1 (very dissatisfied) to 5 (very satisfied). Participants were also asked to describe their current weight and given a choice of responses that ranged from 1 (very underweight) to 5 (very overweight).

Physical Activity.

Participants were asked to report the average number of hours per day that they watched television. Physical activity was assessed by asking participants whether they currently engaged in any regular activity designed to improve or maintain their physical fitness, independently or in a class. The frequency of engaging in an activity designed to improve physical fitness during the last week and the average duration of this activity at one time during the last week was also assessed. Prior studies have used these questions to assess physical activity in Latinos and other ethnic minority groups.^24,25 Exercise intensity was assessed by the Borg Exercise Intensity scale.²⁶

Acculturation.

Acculturation was assessed by the bi-directional Acculturation Rating Scale for Mexican Americans-II.²⁷ Acculturation was assessed through a multidimensional approach by measuring cultural orientation toward the Mexican and Anglo culture independently. For purposes of this research, “Mexican” was replaced with the word “Latino” so that all participants could respond appropriately to this scale. Participants answered each question with responses that ranged from 1 (not at all), 2 (very little/not very much), 3 (moderately), 4 (much/very often), to 5 (almost always/extremely often). The Anglo Orientation scale (AOS; reliability of 0.86²⁷), Latino Orientation Scale (LOS; reliability of 0.88²⁷), and the overall score (AOS mean minus LOS mean) were used.

Cultural Values.

Cultural values were assessed by the Multiphasic Assessment of Cultural Constructs, which measures familism (reliability of 0.65), fatalism (reliability of 0.63), personalism (reliability of 0.47), machismo (reliability of 0.78), and folk illness beliefs (reliability of 0.75).²⁸ Participants responded to statements with true or false based on their beliefs. High scores indicate greater adherence to Latino cultural values.

Acculturative Stress.

Acculturative stress was assessed by the Multidimensional Acculturative Stress Inventory (reliability of 0.77–0.93), which measures stress associated with the acculturation process.²⁹ Participants first respond to whether a particular event occurred in the past 3 months. If the event occurred, they were asked to respond to how stressful the event was from 1 (not at all stressful) to 5 (extremely stressful). This questionnaire has four factors: Spanish competency pressures, English competency pressures, pressure to acculturate, and pressure against acculturation.

Ethnic Identity.

Ethnic identity was assessed by the Multigroup Ethnic Identity Measure,³⁰ which assesses feelings about the ethnic group with which they identify. The scale comprises two factors: ethnic identity search (a developmental and cognitive component) and affirmation, belonging, and commitment (an affective component). The overall mean and the mean of the two factors were used. Reponses to items ranged from 1 (strongly disagree) to 4 (strongly agree; reliability of 0.81–0.90).³⁰

Continuous variables were compared between ethnic groups using the independent two-sample t-test. Categorical variables were compared between groups using the chi-square test. Adjusted comparisons were done using analysis of covariance. SAS 9.4 (SAS Institute, Cary, NC) was used to perform the analyses.

RESULTS

Sample Characteristics

Results from the enrollment and initial analyses of participant characteristics can be found elsewhere¹⁵ and are briefly described. Four-hundred thirty-five participants contacted the study staff members, and 344 completed the oral script and initial eligibility interview. A total of 211 completed the written consent, with 203 completing the Health and Culture interview and 193 completing all study components. Data reported here are from the 203 participants who completed the Health and Culture interview. There were no significant differences in weight categories between Mexicans and Puerto Ricans. There were significant differences in age, marital status, country of birth, smoking status, and work status. Puerto Ricans were older, less likely to be single, less likely to be working, and more likely to be currently smoking. There were no significant differences in BMI, body fat, hip and waist measurements, highest school grade completed, percent who had health insurance, religion, and the language in which the interview was completed.

Body Image

As seen in Table 1, results for cards A and B were similar: While viewing the silhouettes on cards A and B, Puerto Rican and Mexican men did not differ in their current or ideal body image or in their body image discrepancy for both card A and B. In addition, there were no significant ethnic differences in their preference of card A versus B nor were there significant ethnic differences in terms of the set of drawings that they reported looked most like them. Finally, there were no significant ethnic differences in their overall body satisfaction or how they described their current weight.

Table 1.

Body Image^a

	Mexican	Puerto Rican	p Value
Current body image: card A, mean (SD)	5.66 (1.57)	5.33 (1.52)	.13
Ideal body image: card A, mean (SD)	4.48 (0.90)	4.41 (1.01)	.60
Body image discrepancy: card A, mean (SD)	−1.17 (1.63)	−0.91 (1.75)	.28
Current body image: card B, mean (SD)	4.41 (1.39)	4.12 (1.52)	.15
Ideal body image: card B, mean (SD)	3.46 (0.69)	3.45 (0.76)	.90
Body image discrepancy: card B, mean (SD)	−0.95 (1.29)	−0.66 (1.52)	.15
Drawing preference, n (%)			.98
Card A	17 (17.17%)	18 (17.31%)
Card B	82 (82.83%)	86 (82.69%)
Drawings—looks most like you, n (%)			.96
Card A	26 (26.26%)	27 (25.96%)
Card B	73 (73.74%)	77 (74.04%)
Body Satisfaction Questionnaire, mean (SD) (total score)	3.31 (0.66)	3.43 (0.71)	.24
Describe current weight, n (%)			.27
Very underweight	2 (2.02%)	7 (6.73%)
A little underweight	8 (8.08%)	15 (14.42%)
Neither underweight nor overweight	23 (23.23%)	20 (19.23%)
A little overweight	49 (49.49%)	47 (45.19%)
Very overweight	17 (17.17%)	15 (14.42%)

^aPercentage reported is percent within each ethnic group.

Physical Activity

As seen in Table 2, Puerto Ricans watched a greater number of hours of television per day than Mexicans (p < .01). This result became nonsignificant when adjusted for age, marital status, smoking status, and work status. There were also no significant differences between Mexicans and Puerto Ricans in whether they participated in any regular activity designed to improve or maintain their physical fitness, the average length of this activity, their perceived exertion during this activity, or the number of times they engaged in an activity designed to improve their physical fitness during the last week.

Table 2.

Physical Activity^a

	Mexican	Puerto Rican	p Value
Average number of hours of television per day, mean (SD)	2.92 (2.23)	3.91 (2.91)	.007*
Currently participate in any regular activity designed to improve or maintain your physical fitness, n (%)			.96
Yes	67 (67.68%)	70 (67.31%)
No	32 (32.32%)	34 (32.69%)
Number of times during the last week engaged in an activity designed to improve your physical fitness, mean (SD)	4.27 (1.76)	4.79 (2.10)	.12
Average length of physical activity at one time during the last week, mean (SD)	64.40 (35.48)	72.37 (45.70)	.26
Average level of exertion or effort, mean (SD)	8.34 (2.43)	7.81 (2.61)	.22

^aPercentage reported is percent within each ethnic group.

^*p < .01.

Cultural Variables

As seen in Table 3, Puerto Ricans and Mexicans did not differ in their overall level of acculturation, nor in the AOS or the LOS. In terms of acculturative stress, there were no significant differences between Mexicans and Puerto Ricans in terms of their pressure or stress associated with developing competency in the English (English competency pressure) or Spanish language (Spanish competency pressure). There were also no significant ethnic differences in pressures to or pressures against acculturation. Furthermore, results revealed that there were no ethnic differences in the degree to which Mexicans and Puerto Ricans identified with their ethnic group, nor in their ethnic identity search or affirmation, belonging, and commitment.

Table 3.

Cultural Variables^a

	Mexican	Puerto Rican	Significance Level
Acculturation Rating Scale for Latino Americansb, mean (SD)
Anglo Orientation Scale (AOS)	3.47 (0.66)	3.45 (0.71)	p = .90
Latino Orientation Scale (LOS)b	3.75 (0.60)	3.76 (0.57)	p = .89
Total score	−0.29 (0.98)	−0.30 (1.03)	p = .94
Multidimensional Acculturative Stress Inventory (MASI), mean (SD)
English competency pressure	0.34 (0.57)	0.28 (0.64)	p = .48
Spanish competency pressure	0.39 (0.77)	0.31 (0.63)	p = .40
Pressure to acculturate	0.56 (0.63)	0.54 (0.67)	p = .78
Pressure against acculturation	0.33 (0.57)	0.29 (0.53)	p = .58
Multigroup Ethnic Identity Measure (MEIM), mean (SD)
Total score	3.24 (0.45)	3.32 (0.44)	p = .18
Ethnic identity search	2.81 (0.67)	2.96 (0.59)	p = .10
Affirmation, belonging, and commitment	3.54 (0.44)	3.59 (0.48)	p = .47
Multiphasic Assessment of Cultural Constructs, mean (SD)
Familism	0.55 (0.21)	0.64 (0.20)	p = .002*
Machismo	0.33 (0.21)	0.41 (0.21)	p =.014**
Folk illness beliefs	0.29 (0.17)	0.24 (0.18)	p = .09
Fatalism	0.40 (0.23)	0.44 (0.26)	p = .34
Personalism	0.61 (0.17)	0.61 (0.18)	p = .96

^aPercentage reported is % within each ethnic group.

^bFor purposes of this research, “Mexican” was replaced with the word “Latino” so that all participants could respond appropriately to this scale.

^{* =}p < .01

^{** =}p < .05

Finally, in terms of Latino cultural values, Puerto Ricans reported a higher level of familism (p < .01) and adherence to traditional gender role behaviors and attitudes (machismo) (p < .05) than Mexicans. There were no differences between Mexicans and Puerto Ricans in folk illness beliefs, fatalism, or personalism.

DISCUSSION

This study examined ethnic differences in body image, physical activity and cultural variables between Mexican and Puerto Rican men. Body image is important to assess because body image interventions have been noted to be beneficial in the management of obesity and psychological well-being.⁸ Results revealed that there were no significant ethnic differences in current body image, ideal body image, body image discrepancy, or in how participants described their current weight. Although there were no significant ethnic differences in body image, future research is warranted to investigate the relationships between body image and acculturation and ethnic identity, as Mexican and Puerto Rican men may vary in their body image as a function of acculturation. Moreover, a visual inspection revealed that combined, over half of the sample either described their current weight as a little overweight or very overweight. Mexicans and Puerto Ricans also did not differ in their body satisfaction, but their overall ratings fell within the range of being neither satisfied nor dissatisfied.

Results also showed a gap between perceptions of current weight and actual BMI. In particular, approximately 10% of Mexicans and 22% of Puerto Ricans described their current weight as either very underweight or a little underweight. This finding is interesting because an exclusion criteria for this study was a BMI of less than 18.5 kg/m² (underweight). In a population-based sample of Hispanics/Latinos, those who were underweight, as compared with those who were normal weight, were more likely to over-report their weight.³¹ Future research will examine whether descriptions of current weight or degree of satisfaction with ones’ body translates into efforts to lose weight or prevent further weight gain. The correlation between current weight descriptions and subjective or objective ratings of weight and/or body image are additional areas of examination.

Mexicans and Puerto Ricans also did not differ in their preference of the images on two versions of the body image silhouettes, nor did they differ in the set of drawing that they thought looked most like them. However, a greater percentage of both Mexicans and Puerto Ricans preferred card B versus A, and a greater percentage reported that the set of drawings in card B looked most like them. These findings provide support for notion that culturally appropriate body image measures should be developed, which our research team will be developing in the future.

Puerto Ricans watched television for a greater number of hours per day than Mexicans. This difference could be explained in part by differences in age, marital status, smoking status. and work status which were significantly different between the groups.¹⁷ Future studies should investigate other types of sedentary behaviors among Latinos, as this type of assessment will be helpful in developing interventions to decrease sedentary behaviors.

Rates of physical activity were higher compared with prior studies. One study found that a large proportion of Latino men (>73%) did not engage in regular exercise.³² In the current study, there were no significant ethnic differences in participation, frequency, duration, or exertion during this activity. Future analyses will examine nonleisure and leisure time physical activity, and analyze results from an objective measure of physical activity.

Acculturation, acculturative stress, and ethnic identity did not differ between Mexicans and Puerto Ricans. Acculturative stress was important to examine because eating patterns may be influenced by stress. For example, one study found that regardless of gender or dieting status, stress is perceived as changing intake patterns toward more snacks, and more high energy-dense, snack-type foods among young adults.³³ Previous studies have emphasized the need for future studies to examine cultural factors as it relates to exercise.³⁴ In terms of cultural values, results revealed that Puerto Ricans reported a higher level of machismo and familism (the importance placed on the family and their attitudes toward the family²⁷) than Mexicans.

Culture-Based Intervention.

One of the overall goals of the initial National Institutes of Health–funded study was to use the data to help inform the development of culture-based overweight/obesity interventions for Latino men. The current findings will be integrated into the development of diet, physical activity and body image interventions for overweight/obese Latino men in the following ways. First, this study found that Puerto Ricans watched television for a greater number of hours per day than Mexicans. Although increases in physical activity will be emphasized in a future intervention, attention will also be placed on reducing sedentary behavior in all Latino male participants. In addition, strategies for reducing sedentary behavior in Puerto Rican males will be highlighted.

Second, in terms of the role of familism, although we will discuss the role of the family and traditional gender roles with Mexicans and Puerto Ricans, we will highlight these discussions when working with Puerto Ricans. Specifically, family members will be invited to attend certain sessions of the diet and physical activity intervention, such as when the grocery store tours are conducted. Similarly, when the session is focused on the role of social support in diet and physical activity, family members will be invited to attend to learn ways that they can be supportive of their loved ones. Inviting family members to participate in the intervention allows participants to take advantage of social support which has been linked to improved physical health (e.g., Kassavou et al.³⁵) and, in this case, is a culturally tailored and an empirically based consideration based on the present study. Social support has also been demonstrated to be important in social disadvantaged neighborhoods (e.g., Cleland et al.³⁶), suggesting that family members may serve a crucial role in maintenance to and promotion of the intervention for this subpopulation. Third, traditional gender roles will be integrated into the intervention by emphasizing the role of Latino men in taking care of their families and how taking care of their health and body is one way that they can take care of their family. Finally, there were no ethnic differences in fatalism, that is, the extent to which they feel their destinies are beyond their control,²⁷ folk illness beliefs, or in the value placed on personalism, which is an orientation that emphasizes personal interactions of people.³⁷

CONCLUSIONS

Research (e.g., Beck et al.³⁸) has demonstrated that tailored interventions are preferred by both practitioners and participants. Further, many targeted interventions (e.g., targeted toward Latino men) often fail to take into account the preferences of the participants in the sample. The results of this study revealed important information about Latino men’s body image, physical activity and cultural values/preferences that will be used in the development of weight loss interventions. The targeted intervention is expected to lead to greater intervention fidelity than interventions that have not accounted for the values and preferences of potential participants. Further, the intervention is expected to lay the groundwork for identifying important personal characteristics on which to base an intervention. The present study identified key characteristics (e.g., cultural variables) that were expected to influence the efficacy of the intervention. Future studies may identify additional individual characteristics thus allowing for greater adherence than a “one size fits all” approach. For example, Puerto Rican men reported higher levels of sedentary behavior and greater adherence to certain Latino cultural values than Mexicans. Thus, decreasing sedentary behavior, and emphasizing familism and Latino gender roles may be particularly important for Puerto Rican men. Our future research will also explore the relationships between body image, physical activity, and diet as a function of acculturation, acculturative stress, ethnic identity, and cultural values in Latino men. Finally, this research adds to the growing literature emphasizing the importance of examining health behaviors in Latino men. Both similarities and differences exist in health behaviors and cultural values across Latino ethnic groups and should be examined and integrated into culture-based interventions.