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(AA)受心血管疾病(CVD)的影响不成比例， 与其他种族/民族相比，心血管疾病的死亡率最高。 此外，AAS拥有最高的 与白人和西班牙裔相比，肥胖率。遵循植物性饮食方法的人， 尤其是纯素或素食饮食，与杂食动物相比，患心血管疾病的风险更低，体重更轻。纯素 素食已经被有效地用于减肥和维持体重，以及逆转心血管疾病。 尽管干预试验表明，采用 植物性饮食，t 到目前为止，这些大型随机试验中的大多数都只有有限的AA参与 参与者。在行为干预期间，AAS的体重往往比他们的白人同行减轻得少。在……里面 此外，大多数研究表明，AAA更有可能停止参与行为饮食 干预措施。这种更高的自然减员和更低的体重减轻的组合可能是由于未能解决 与再生障碍性贫血人群相关的文化问题。我们最近进行了为期6个月的试验，检查了素食者的使用情况 饮食与其他4种植物性饮食方法(素食、准素食、半素食或 杂食性)。纯素饮食中AAs的体重减少量(-8.5±3.3%，n=3)显著高于AAs 随机选择饮食方法，类似于我们建议的研究中的杂食性方法(半 素食/杂食组，1.4±1.8%，n=3)。在开始这项研究的12名AA参与者中，只有一人这样做了 没有完成研究(8%的流失率)，而49名白人参与者中有12人(24%的流失率)。在……里面 总而言之，这些结果表明完全以植物为基础的饮食干预有可能克服两个障碍 在先前旨在改善超重AA饮食摄入量和体重减轻的研究中遇到 预防心血管疾病：减肥效果低，流失率高。 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中，特别是在 AAS住在美国东南部。我们已经与两家灵魂食品餐厅的老板建立了合作关系 在哥伦比亚，南卡罗来纳州(一个是素食主义者，另一个是传统的)。这些餐厅专注于南方菜肴，是 由当地AA家族拥有和运营，并将帮助开发适合我们文化的食谱 干预。W E将在超重的AA成年人(N=130)中进行为期两年的饮食试验，随机分为 遵循两种饮食中的一种，这两种饮食都强调南方饮食文化和低血糖指数和低脂肪食物： 纯素食或杂食(杂食)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。 风险因素，包括低密度脂蛋白、血压和体重。如果这次干预被证明是 它成功地减轻了AA中的体重和心血管疾病风险因素，并有可能通过 美国各地的各种地点，包括餐馆、联邦合格的医疗诊所、教堂或 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.