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

乳腺癌是美国女性中最常见的癌症。45岁以前黑人妇女的乳腺癌发病率高于白人妇女，年龄越大发病率越低，然而在所有年龄段黑人妇女的乳腺癌死亡率都高于白人妇女。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，而与绝经后乳腺癌风险相反。腹部肥胖尤其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。肥胖在美国已经成为一种流行病，是一个主要的公共卫生问题。此外，每年有28万人死于肥胖。黑人女性比白人更容易肥胖，40岁以上的黑人女性中有80%超重或肥胖。与白人妇女相比，黑人妇女在诊断时肥胖与乳腺癌晚期有关。美国癌症协会癌症预防研究II发现，随着体重指数的增加，乳腺癌死亡率持续上升。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-23%。此外，在世界上大多数国家，年龄调整后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的疾病，如2型糖尿病、肥胖和代谢综合征的增加是平行的。

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.