Sub 1: Exercise RCT Targeting African-American Women w Metabolic Syndrome & Hig

乳腺癌是美国女性最常见的癌症。45岁以前黑人妇女的乳腺癌发病率高于白色妇女，45岁以后发病率较低，但在所有年龄段，黑人妇女的乳腺癌死亡率均高于白色妇女。几项流行病学研究表明，肥胖与乳腺癌风险之间存在关联。肥胖与绝经前乳腺癌风险呈负相关，而绝经后乳腺癌风险则相反。特别是腹部肥胖与乳腺癌风险增加有关。超重/肥胖也与乳腺癌预后较差有关。肥胖在美国已经达到流行病的比例，是一个主要的公共卫生问题。此外，每年有280，000人死于肥胖。黑人女性比白人更容易肥胖，超过40岁的黑人女性中有80%超重或肥胖。与白色女性相比，肥胖与黑人乳腺癌诊断时的晚期相关。ACS癌症预防研究II发现，乳腺癌死亡率随着BMI的增加而不断增加。乳腺癌是全世界女性中最常见的癌症，占女性所有癌症病例的约23%。此外，在世界上大多数国家，经年龄调整的乳腺癌发病率正在上升。有趣的是，这种增加与生活方式相关疾病的增加相平行，如2型糖尿病，肥胖和代谢综合征。

Breast cancer is the most commonly occurring cancer in US women. Breast cancer incidence is greater in Black than White women before age 45 and lower at older ages, however mortality from breast cancer is greater in Black women than White women at all ages. Several epidemiological studies have shown an association between obesity and breast cancer risk. Obesity is inversely associated with premenopausal breast cancer risk, while the opposite is true for postmenopausal breast cancer risk. Abdominal obesity in particular is associated with increased breast cancer risk. Being overweight/obese is also associated with poorer breast cancer prognosis. Obesity has achieved epidemic proportions in the US and is a major public health issue. Furthermore, 280,000 deaths/yr are attributed to obesity. Black women are more likely to be obese than Whites, with 80% of Black women >40 yrs of age being overweight or obese. Obesity was associated with an advanced stage of breast cancer at diagnosis in Black compared to White women. The ACS Cancer Prevention Study II found that breast cancer mortality rates increased continually with increasing BMI. Breast cancer is the most common cancer in women worldwide, accounting for -23% of all cancer cases in women. Furthermore, age-adjusted incidence rates for breast cancer are increasing in most countries around the world. Interestingly, the increase parallels the increases in lifestyle-related diseases such as type 2 diabetes, obesity, and metabolic syndrome.