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The Lifestyle Improvement through Food and Exercise (LIFE) study is a community-based randomized-controlled trial to measure the effectiveness of a lifestyle intervention to improve glycemic control among African Americans with type 2 diabetes attending safety net clinics. The study enrolled African American adults with a diagnosis of type 2 diabetes and HbA1c ≥ 7.0 who had attended specific safety net community clinics in the prior year. 210 patients will be enrolled and randomized to either the LIFE intervention or a standard of care control group, which consists of two dietitian-led diabetes self-management classes. The LIFE intervention was delivered in 28 group sessions over 12 months and focused on improving diet through dietitian-led culturally-tailored nutrition education, increasing physical activity through self-monitoring using an accelerometer, increasing ability to manage blood sugar through modifications to lifestyle, and providing social support for behavior change. In addition to the group sessions, peer supporters made regular telephone calls to participants to monitor progress toward behavioral goals and provide social support. The 12-month intervention phase was followed by a six-month maintenance phase consisting of two group sessions. The primary outcome of the study is change in A1C from baseline to 12 months, and an additional follow-up will occur at 18 months. The hypothesis of the study is that the participants in the LIFE intervention will show a greater improvement in glycemic control over 12 months than participants in the control group., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Objective: To assess body size perception among African American women using cultural definitions of body size terms., Methods: Sixty-nine African American women classified Body Image Scale figures as overweight, obese, and too fat, and independently selected the figure they considered closest to their current body size., Results: Body size classifications of figures did not vary by participant weight status. Overweight figures were not considered too fat. For 86% of overweight (body mass index [BMI], 25-29.9) women and 40% of obese (BMI > 30) women, the self figure was not defined as overweight, obese, or too fat. Among participants with BMI ≥ 35, 65% did not classify their self figure as obese and 29% did not classify their self figure as overweight., Conclusions and Implications: The difference between cultural (folk) and medical definitions of body size terms may serve as a barrier to effective communication between patients and providers about health effects of excess adiposity., (Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Objective: Describe beliefs about what makes foods healthful among low-income African American women., Methods: In one-on-one interviews, 28 low-income African American mothers viewed 30 pairs of familiar foods and explained which food in the pair was more healthful and why. Responses were grouped into codes describing concepts of food healthfulness., Results: Nutrient content, physical effects of food, and food categories were used to judge the healthfulness of foods. Fruits, vegetables, and dairy foods were considered the most healthful and starchy foods the least healthful because they were believed to cause weight gain. Beliefs about which foods contain which nutrients and which foods have particular physical effects varied widely across participants., Conclusions and Implications: Participants demonstrated awareness of which foods are healthful but lacked understanding of why those foods are more healthful than others. Knowledge about the health effects of foods may be necessary to motivate individuals to choose healthful foods., (Copyright © 2012 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Objective: Describe lay food group categories of low-income African American women and assess the overlap of lay food groups and MyPyramid food groups., Design: A convenience sample of African American mothers from a low-income Chicago neighborhood performed a card-sorting task in which they grouped familiar food items into food groups., Setting: One-on-one interviews in a neighborhood community center., Participants: Twenty-eight African American mothers., Main Outcome Measure: A hierarchical taxonomy of food groups for each participant, represented as a matrix of distances among food items in the individual sort of each participant., Analysis: Cultural consensus analysis, hierarchical cluster analysis, and coding of food group category labels and sorting justifications., Results: Consensus analysis revealed a consistent cultural model of lay food groups among the women. Lay food groups were systematically different from MyPyramid food groups. Lay food groups were more influenced by how food items are prepared or when and how food items are eaten than are MyPyramid food group categories., Conclusions and Implications: Nutrition messages framed using lay food group categories of low-income African Americans may be more effective for that population than messages using MyPyramid food group categories., (Copyright © 2011 Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.)