Ethnic comparison of weight loss in the trial of nonpharmacologic interventions in the elderly
Ethnic comparison of weight loss in the trial of nonpharmacologic interventions in the elderly
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DOI：
10.1038/oby.2002.16
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发表时间：
2002-02-01
期刊：
影响因子：
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通讯作者：
Whelton, PK
中科院分区：
文献类型：
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作者：
Kumanyika, SK;Espeland, MA;Whelton, PK
目的：在老年人非药物干预试验（TONE）中比较黑人和白人的体重减轻情况。研究方法和程序：TONE纳入了421名超重白人和164名超重黑人成年人，年龄在60至79岁之间，血压控制良好，服用单一抗高血压药物。随机分组后3个月尝试停药，接受减肥、减钠咨询，减钠和减钠同时进行，或接受常规治疗，入组后随访15 - 36个月。统计程序包括重复测量分析、协方差分析、逻辑回归和比例风险回归。结果：减肥组6个月时黑人和白人的净重变化（kg）分别为-2.7和-5.9 (p < 0.001；种族差异，p = 0.0002)；随访结束时黑人和白人的净重变化（kg）分别为-2.0和-4.9 (p < 0.001)（种族差异，p = 0.007）。在体重/钠方面，6个月时黑人的净重变化为-2.1 (p < 0.01)，白人的净重变化为-2.8 (p < 0.001)，随访结束时黑人的净重变化为-1.9，白人的净重变化为-1.7 （p < 0.05；种族差异，p < 0.05）。探索性分析表明，6个月后，黑人的体重变化模式比白人更有利。在血压结果上没有种族差异。讨论：如果不同时关注钠的减少，白人比黑人减重更多。
Objective: To compare weight loss in blacks and whites in the Trial of Nonpharmacologic Interventions in the Elderly (TONE).Research Methods and Procedures: TONE enrolled 421 overweight white and 164 overweight black adults, 60 to 79 years old, with blood pressure well-controlled on a single, antihypertensive drug. Drug therapy withdrawal was attempted 3 months after randomization to counseling for weight loss, sodium reduction, both weight loss and sodium reduction, or to usual care, with follow-up for 15 to 36 months after enrollment. Statistical procedures included repeated measures analysis of covariance and logistic and proportional hazards regression.Results: In the weight-loss condition, net weight change (in kilograms) was -2.7 in blacks and -5.9 in whites (p < 0.001; ethnic difference, p = 0.0002) at 6 months and -2.0 (P < 0.05) in blacks and -4.9 (p < 0.001) in whites at the end of follow-up (ethnic difference, p = 0.007). In weight/sodium, net weight change was -2.1 (p < 0.01) in blacks and -2.8 (p < 0.001) in whites at 6 months, and -1.9 in blacks and -1.7 in whites at the end of follow-up (p < 0.05; ethnic difference, p > 0.5). Exploratory analyses suggested a more favorable pattern of weight change in blacks than in whites from 6 months onward. There was no ethnic difference in blood pressure outcomes.Discussion: Whites lost more weight than blacks without, but not with, a concurrent focus on sodium reduction.