EATRIGHT FOR LIFE

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 美国的肥胖者人数正在增加。对于非裔美国人来说，肥胖症的增加是不成比例的。这非常令人担忧，特别是考虑到困扰非裔美国人社区的可预防的健康差距。幸运的是，我们有工具可以用来引领更健康的生活方式。从历史上看，这些干预措施的有效性对非裔美国人来说并不是最佳的。例如，典型的减肥干预措施通常显示，与高加索人相比，非裔美国人的体重减轻更少。减肥可以改善胆固醇、血压、高血压风险、血糖，并可以预防2型糖尿病的发展。因此，非洲裔美国人可能从减肥中获得的许多好处并没有实现。我们的研究团队认为，通过开发考虑非裔美国人文化框架的量身定做的方法，可以克服非裔美国人减肥干预措施的无效。利用系统的方法来理解非裔美国人的文化观点如何影响与体重相关的新饮食行为的采用，假设会导致更有效的减肥干预措施。利用形成性评估期收集有关关键文化变量的信息，我们建议开发和实施基于EatRight饮食模式的适合文化的行为干预措施，以控制体重。EatRight是一项为期12周的以生活方式为导向的体重控制计划，基于“时间-卡路里置换”的概念，强调摄入大量高体积、低能量密度的食物(主要是蔬菜、水果、高纤维谷物和谷类)，适量摄入高能量密度的食物(肉类、奶酪、糖和脂肪)。我们将使用定性方法来为我们定制饮食干预的发展提供信息。在形成性评估之后，使用交叉研究设计，干预将在杰斐逊县经济机会委员会的一组非裔美国人员工中进行。主要结果是体重的变化，其次是心血管风险标记物的测量，包括血压、血脂、血糖和胰岛素。该项目的成功完成将导致广泛使用的饮食干预，并在非裔美国人中证明有效。 为了完成我们的研究，我们将需要额外的护理资源来进行患者测量、标本采集和实验室分析。护理资源将用于采集血液中的葡萄糖、胰岛素、血脂，并在社区环境中测量身高、体重、腰围和血压。血糖、胰岛素和血脂的测量用于评估心血管和代谢性疾病的风险。生理学和代谢核心实验室将用于血液样本的分析。我们要求在研究期间的3个时间点(基线、6个月和12个月的随访)对40个血清样本进行血糖、胰岛素和血脂的分析。信息学核心将用于协助数据收集和管理。生物统计学核心将有助于在检验主要假设和次要假设时提供分析支持。有了GCRC提供的资源，我们有信心这项初步研究可以用来产生高质量的数据和结果，这些数据和结果可以用于更大的研究项目。

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.