Modest Lifestyle Intervention and Glucose Tolerance in Obese African Americans
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Objective: Previous studies have demonstrated the benefit of short‐term diets on glucose tolerance in obese individuals. The purpose of this study was to evaluate the effectiveness of modest lifestyle changes in maintaining improvements in glucose tolerance induced by short‐term energy restriction in obese African Americans with impaired glucose tolerance or type 2 diabetes mellitus. Research Methods and Procedures: An intervention group (n = 45; 47 ± 1 year [mean ± SE]), 105 ± 4 kg; body mass index: 39 ± 1 kg/m 2) received an energy‐restricted diet (943 ± 26 kcal/d) for 1 week, followed by a lifestyle program of reduced dietary fat (−125 kcal/d) and increased physical activity (+125 kcal/d) for 1 year. Body weight and plasma concentrations of glucose, insulin, and C‐peptide during an oral glucose tolerance test were measured at baseline, 1‐week, and 4‐month intervals. A control group (n = 24; 48 ± 1 year; 110 ± 5 kg; body mass index: 41 ± 2 kg/m 2) underwent these measurements at 4‐month intervals. Results: No changes in weight or glucose tolerance were observed in the control group. The intervention group had significant (p < 0.05) improvements in body weight and glucose tolerance in response to the 1‐week diet, which persisted for 4 months (p < 0.001 vs. control for change in weight). A total of 19 subjects (42%) continued the intervention program for 1 year, with sustained improvements (weight: −4.6 ± 1.0 kg; p < 0.001 vs. control; oral glucose tolerance test glucose area: −103 ± 44 mM · min; p < 0.05 vs. control). Discussion: A modest lifestyle program facilitates weight loss and enables improvements in glucose tolerance to be maintained in obese individuals with abnormal glucose tolerance. However, attrition was high, despite the mild nature of the program.
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Five of the 6 trials with self-monitoring led to positive lifestyle behavior changes, compared with 13 of the 19 trials without self-monitoring.
“Five of these 6 trials that included self-monitoring42,46,50–52 led to positive lifestyle behavior changes, compared with 13 of the 19 trials that did not include self-monitoring.”
Among the 25 trials with sizable minority representation in Table 3, only 6 included interventions that described self-monitoring.
“Among the 25 trials with sizable minority representation in Table 3, only 6 included interventions that described self-monitoring.42,46,50–52,59”
In studies with minority samples, individual-only approaches appear to produce smaller or fewer changes in total diet or physical activity than group-only or combined individual-and-group approaches.
“individual intervention approaches to promoting change seem to result in smaller or fewer changes in total diet or PA compared with group-only55 or combined individual- and group-based approaches.26,38,47,51”
Among 16 multicomponent intervention trials involving minority populations, most showed some positive changes in dietary and/or physical activity behavior.
“Among the 16 multicomponent intervention trials involving minority populations (Table 3), most 47–53,55,74–76,81,102,112 demonstrated some positive changes in either dietary and/or PA behavior.”
Trials that did not include culturally sensitive interventions showed within-group and/or between-group differences in diet, physical activity, or related metabolic or vascular biomarkers.
“the results of the trials not including culturally sensitive interventions42,48,49,51,53,54,112 demonstrated within-and/or between-group differences in diet, PA, or related metabolic/vascular biomarkers.”
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References 41 · Cited by 46
Research works printed but not linked: 3
- Karter AJ, Mayer-Davis EJ, Selby JV, et al. Insulin sensi- tivity and abdominal obesity in African-American, Hispanic, and non-Hispanic white men and women. Diabetes. 1996;45: 1547-55.
- Edelstein SL, Knowler WC, Bain RP, et al. Predictors of progression from impaired glucose tolerance to NIDDM. Di- abetes. 1997;46:701-10.
- Morgan DR, Lazarow A. Immunoassay of insulin: two an- tibody system. Diabetes. 1963;12:115-26.
- Authors
- Racette, S. B., Weiss, E. P., Obert, K. A., Kohrt, W. M., & Holloszy, J. O.
- Affiliations
- Washington University in St. Louis (US)
- Corresponding author
- Racette, Susan B.
- ORCID
- Racette, Susan B.
- Venue
- Obesity Research
- Publisher
- Wiley
- Published
- 2001-06
- Volume
- 9
- Issue
- 6
- Pages
- 348-355
- ISSN
- 1071-7323 (ISSN-L)
- 1550-8528
- OpenAlex
- W1977751270
- Cited by
- 46
- References
- 41
- Citations by year
- 2021: 1 · 2020: 2 · 2017: 1 · 2016: 3 · 2014: 2 · 2013: 2 · 2012: 3
- FWCI
- 0.91
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Obesity Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (1k04ag000663-01, 5r01dk048128-03, DK20579)
- National Institute on Aging (AG00663, AG 00078)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK20579, DK48128)
- National Center for Research Resources (M01RR000036)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Keywords
- lifestyle intervention, glucose tolerance, obesity, African Americans, caloric restriction, type 2 diabetes, impaired glucose tolerance, weight loss, dietary fat reduction, physical activity, insulin, C-peptide, attrition
- MeSH terms
- Adult, Aged, Black or African American, Blood Glucose, Diabetes Mellitus, Type 2, Diet, Reducing, Dietary Fats, Female, Glucose Tolerance Test, Humans, Life Style, Lipids, Male, Middle Aged, Obesity, Weight Loss, Exercise, Case-Control Studies, Glucose Intolerance, Area Under Curve
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