EATRIGHT FOR LIFE

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The number of obese individuals in the United States is increasing. For African Americans, the increase in obesity has been disproportionate. This is very concerning, particularly given the preventable health disparities that plague the African American community. Fortunately, we have tools that could be used to lead to healthier lifestyles. Historically, the effectiveness of these interventions has not been optimal for African Americans. For example, typical weight loss interventions routinely show less weight loss for African Americans compared to Caucasians. Weight loss improves cholesterol, blood pressure, risk of hypertension, blood glucose, and can prevent the development of type 2 diabetes. Therefore, many of the benefits that African Americans could receive from weight loss are not realized. Our research team believes that the ineffectiveness of weight loss interventions in African Americans can be overcome by developing tailored approaches that consider the cultural framework of African Americans. Utilizing a systematic approach to understand how African American cultural perspectives influence the adoption of new dietary behaviors related to body weight is hypothesized to lead to more effective weight loss interventions. Using a period of formative assessment to gather information regarding the key cultural variables, we propose to develop and implement a culturally appropriate behavioral intervention for weight control based on the EatRight dietary pattern. EatRight is a 12-week lifestyle-oriented weight control program based on the concept of "time-calorie displacement," which emphasizes the ingestion of large quantities of high-bulk, low-energy-density foods (primarily vegetables, fruits, high-fiber grains, and cereals) and moderation in high-energy-density foods (meats, cheeses, sugars, and fats). We will use qualitative methodologies to inform our development of the tailored dietary intervention. Following the formative assessment, using a cross-over study design, the intervention will be delivered in a group of African American employees of the Jefferson County Committee for Economic Opportunity. The primary outcome is change in weight, with secondary measures of markers of cardiovascular risk including blood pressure, lipids, glucose, and insulin. The successful completion of this project will lead to a widely usable dietary intervention with demonstrated effectiveness in African Americans. To complete our study, we will require additional nursing resources for patient measurements and specimen collection and lab analysis. The nursing resources will be used for collection of blood for glucose, insulin, lipids, and measurement of height, weight, waist circumference, and blood pressure in a community setting. Measures of glucose, insulin, and lipids are used to estimate cardiovascular and metabolic disease risk. The physiology and metabolic core laboratory will be utilized for analysis of the blood specimens. We will request analysis of 40 serum samples for glucose, insulin, and lipids at 3 points over the duration of the study (at baseline, 6 and 12 month follow-up). The informatics core will be used to assist in data collection and management. The biostatistical core will be helpful in providing analysis support when testing the primary and secondary hypotheses. With the resources provided by the GCRC, we are confident that this pilot study can be used to generate quality data and outcomes that can be parlayed into larger research projects.