A nutrition-based approach to reduce heart disease risk among overweight African Americans: Use of soul food plant-based or omnivorous diets to address cardiovascular disease

非裔美国人（AAs）不成比例地受到心血管疾病（CVD）的影响， 与其他种族/族裔群体相比，CVD的死亡率最高。 此外，AA具有最高 肥胖率与白人和西班牙裔相比。遵循植物性饮食方法的人， 特别是纯素或素食者，患心血管疾病的风险较低，体重也比杂食者轻。素食 和素食饮食已被有效地用于减肥和维持以及逆转CVD。 虽然干预试验表明，采用 植物性饮食，t 迄今为止，大多数大型随机试验的AA参与有限 参与者在行为干预过程中，AA比他们的白色同行倾向于减少体重。在 此外，大多数研究表明，AA更有可能停止参与行为饮食 干预措施。这种较高的磨损和较低的体重减轻的组合可能是由于未能解决 与AA人群相关的文化问题。我们最近6个月的试验检查了素食者的使用 与其他4种植物性饮食方法（素食、鱼素食、半素食或 杂食性）。纯素饮食中AA的体重减轻显著大于AA（-8.5至3.3%，n=3） 随机分配到饮食方法，这将是类似于杂食性的方法，在我们提出的研究（半， 素食/杂食组，1.4± 1.8%，n=3）。在12名开始这项研究的AA参与者中，只有一人做到了 没有完成研究（8%的损耗率），而49名白色参与者中有12名（24%的损耗率）。在 总的来说，这些结果指出了完全以植物为基础的饮食干预克服两个障碍的潜力 在以前的研究中遇到的，旨在改善超重AA的饮食摄入和体重减轻， CVD预防：低体重减轻结果和高磨损率。 这项拟议研究的目标是将这些发现应用于心血管疾病预防干预， 生活在美国东南部的AAs我们已经与两家灵魂食品餐厅的老板建立了合作关系 在南卡罗来纳州的哥伦比亚（一个素食，其他传统）。这些餐厅，其中重点是南方美食， 由当地AA家庭拥有和经营，并将协助开发适合我们文化的食谱， 干预W e将在超重AA成人（N=130）中进行为期两年的饮食试验，随机分配至 遵循两种饮食之一，都强调南方饮食文化和低血糖指数和低脂肪食物： 纯素或杂食（omni）饮食。这项研究将比较这些饮食模式对心血管疾病变化的影响。 危险因素，包括低密度脂蛋白胆固醇和血压，以及体重。如果这次干预被证明是 成功地降低了AA中的体重和CVD风险因素，它有可能通过以下途径传播： 美国各地的各种场所，包括餐馆、联邦合格的诊所、教堂或 邻里社区中心。

African Americans (AAs) are disproportionately affected by cardiovascular disease (CVD), having the highest death rates from CVD as compared with other racial/ethnic groups. In addition, AAs have the highest rates of obesity as compared to whites and Hispanics. People following plant-based dietary approaches, particularly vegan or vegetarian diets, have lower risks of CVD and lower body weights than omnivores. Vegan and vegetarian diets have been used effectively for weight loss and maintenance and for reversing CVD. Although intervention trials have shown a significant weight-loss and cholesterol-lowering effect of adoption of plant-based diets, t o date, most of these large randomized trials have had limited participation from AA participants. AAs tend to lose less weight during behavioral interventions than their white counterparts. In addition, most research has shown that AAs are more likely to discontinue participation in behavioral dietary interventions. This combination of higher attrition and lower weight loss may be due to a failure to address issues that are culturally relevant to the AA population. Our recent 6-month trial examined the use of a vegan diet as compared to 4 other plant-based dietary approaches (vegetarian, pesco-vegetarian, semi-vegetarian, or omnivorous). Weight loss among AAs in the vegan diet was significantly greater (-8.5±3.3%, n=3) than AAs randomized to diet approaches that will be similar to the omnivorous approach in our proposed study (semi- vegetarian/omnivorous groups, 1.4±1.8%, n=3). Of the 12 AA participants who began the study, only one did not complete the study (8% attrition rate) compared to 12 out of the 49 white participants (24% attrition). In total, these results point to the potential of an entirely plant-based dietary intervention to overcome two barriers encountered in previous studies aiming to improve dietary intake and weight loss among overweight AAs for CVD prevention: low weight loss results and high attrition rates. The goal of this proposed study is to apply these findings in a CVD prevention intervention specifically for AAs living in the southeast U.S. We have developed a partnership with the owners of two soul food restaurants in Columbia, SC (one vegan, the other traditional).These restaurants, which focus on southern cuisine, are owned and operated by local AA families, and will assist with developing culturally-appropriate recipes for our intervention. W e will conduct a two-year dietary trial among overweight AA adults (N=130) randomized to follow one of two diets both emphasizing southern food culture and low-glycemic index and low-fat foods: Vegan or Omnivorous (omni) diet. This study will compare the impact of these diet patterns on changes in CVD risk factors, including LDL cholesterol and blood pressure, and body weight. If this intervention proves to be successful at reducing weight and CVD risk factors among AAs, it has the potential to be disseminated through a variety of locations throughout the US, including restaurants, federally qualified health clinics, churches, or neighborhood community centers.