Lifestyle Factors and Type 2 Diabetes in Black Women

描述(申请人提供)：虽然肥胖、饮食和体力活动都与2型糖尿病的发病率有关，但关于这些因素对这种疾病风险的相互作用仍有许多悬而未决的问题。此外，缺乏关于饮食和体力活动与黑人女性患2型糖尿病风险之间关系的信息数据。人们迫切需要来自黑人女性的数据。美国黑人女性的2型糖尿病发病率比白人女性高得多，而且这种差异似乎不能用不同的风险因素来解释。在身体质量指数的各个水平上，黑人女性的发病率都高于白人女性，在最肥胖的女性中，相对增幅甚至更高。这是否反映了新陈代谢的差异或其他环境因素的差异尚不得而知。饮食和身体活动模式受到文化的影响，在黑人女性和白人人群之间存在差异，这一点已经得到了广泛的研究。在一大群黑人女性中研究这些因素将允许评估美国黑人女性特有的饮食和活动模式，并可能为干预计划提供更多有用的数据。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，研究对象是1995年登记的59,000名美国黑人妇女，随后是两年一次的邮寄调查问卷。到拟议的研究期结束时，队列中估计将有3150例经核实的2型糖尿病病例，其中大部分将发生在超重或肥胖的参与者中。我们建议使用BWHS数据来检查饮食、体力活动和肥胖与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、食物摄入量中的血糖负荷、酒精摄入量、咖啡摄入量、散步、适度活动、剧烈体力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赠款资助的，拟议中的关于2型糖尿病可改变风险因素的大型研究可以以相对较低的成本进行。

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.