Lifestyle Factors and Type 2 Diabetes in Black Women

描述（由申请人提供）：尽管肥胖、饮食和体育活动都与2型糖尿病的发病率有关，但这些因素在2型糖尿病风险中的相互作用仍有许多未解之谜。此外，饮食和体育活动与黑人女性患2型糖尿病风险之间的关系缺乏信息数据。我们迫切需要黑人女性的数据。美国黑人女性的2型糖尿病发病率明显高于白人女性，这种差异似乎不能用不同的风险因素患病率来解释。在每一个身体质量指数的水平上，黑人妇女的发病率都高于白人妇女，在最肥胖的妇女中，相对增加的比例甚至更高。这是否反映了代谢差异或其他环境因素的差异尚不清楚。饮食和体育活动模式受到文化的影响，黑人妇女和白人人口之间存在差异，这已经得到了广泛的研究。在一大批黑人妇女中检查这些因素，将有助于评估美国黑人妇女特有的饮食和活动模式，并可能为干预计划提供更有用的数据。来自黑人女性的数据也可能对激励黑人女性改变自己的行为产生更大的影响。黑人妇女健康研究（BWHS）是一项正在进行的队列研究，于1995年招募了59000名美国黑人妇女，随后每两年邮寄一次问卷。在研究期结束时，估计将有3150例2型糖尿病确诊病例，其中大多数发生在超重或肥胖的参与者身上。我们建议使用BWHS数据来研究饮食、体育活动和肥胖与2型糖尿病发病率之间的相互作用。需要研究的具体生活方式因素包括饮食中的脂肪类型、食物摄入的血糖负荷、酒精摄入量、咖啡摄入量、步行、适度活动、剧烈体育活动和看电视的时间。此外，在一个新的目标下，人口普查局的数据将与问卷数据联系起来，以便分析与肥胖和2型糖尿病有关的社区特征。由于随访和数据收集是由另一笔拨款资助的，因此拟议的2型糖尿病可改变风险因素的大型研究可以以相对适度的成本进行。

DESCRIPTION (provided by applicant): Although obesity, diet, and physical activity have all been linked to incidence of type 2 diabetes, there are many unanswered questions about the interactions of these factors on risk of this disease. Furthermore, there is a lack of informative data on the relation of diet and physical activity to risk of type 2 diabetes in black women. Data from black women are sorely needed. US black women have a considerably higher incidence of type 2 diabetes than white women and the difference does not appear to be explained by different prevalences of risk factors. At every level of body mass index black women have a greater incidence than white women, and the relative increase is even higher among the most obese women. Whether this reflects metabolic differences or differences in other environmental factors is unknown. Diet and physical activity patterns are culturally influenced and differ between black women and the white populations that have been extensively studied. Examining these factors in a large cohort of black women will permit the evaluation of dietary and activity patterns specific to US black women and may yield more useful data for intervention programs. Data from black women may also have a greater impact on motivating black women to modify their behaviors. The Black Women's Health Study (BWHS) is an ongoing cohort study of 59,000 US black women enrolled in 1995 and followed by biennial mailed questionnaire. By the end of the proposed study period there will be an estimated 3150 verified incident cases of type 2 diabetes in the cohort, the majority of which will have occurred in participants who are overweight or obese. We propose to use BWHS data to examine interactions of diet, physical activity and obesity in relation to incidence of type 2 diabetes. Specific lifestyle factors to be studied include types of fat in the diet, glycemic load of food intake, alcohol intake, coffee intake, walking, moderate activity, vigorous physical activity, and number of hours watching TV. In addition, under a novel aim, census bureau data will be linked with questionnaire data to permit analyses of neighborhood characteristics in relation to obesity and type 2 diabetes. Because the follow-up and data collection are funded by another grant, the proposed large study of modifiable risk factors for type 2 diabetes can be carried out at a relatively modest cost.