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Objectives: The purpose of this study was to determine if central anthropometric vari­ables that best estimate blood pressure risks in European Americans also best estimate blood pressure risks in African Americans.Design: The participants were 357 nor­motensive African and European American volunteers with a mean age of 32.6 ± 12.4 years. Participants were evaluated for central adiposity with dual energy X-ray ab­sorptiometry, abdomen and thigh skinfolds, waist and hip circumferences, waist/hip ratio, waist/height ratio, body mass index, and systolic and diastolic blood pressures. Descriptive statistics, partial correlations, ANOVA and stepwise regressions were used to analyze the data.Results: Central adiposity anthropometric indices made different contributions to blood pressure in African and European American men and women. When weight was held constant, waist circumference shared stronger partial relationships with blood pressure in African Americans (r = .30 to .47) than in European Americans (r = .11 to .32). Waist circumference in com­bination with other indices was a predictor of systolic and diastolic blood pressures in European American men (P

Objectives Individuals of African origin in Europe and the Caribbean have a lower prevalence of coronary heart disease (CHD) than do Europeans and European Americans; however, African Americans, especially women, do not possess the same low CHD prevalence as Africans. As such, this study was designed to determine whether highly sensitive C-reactive protein (hsCRP) and fitness (V˙O2max) cluster with other cardiometabolic risks (CMRs) or whether their influence is independent of other CMRs in African American women. Methods Fifty African American women were compared on fasting glucose, triglyceride, high-density lipoprotein cholesterol, blood pressure, and adiposity-based hsCRP classifications (low 1, group 2). Participants were obese but metabolically healthy. Results Oxygen uptake (V˙O2max) was correlated with systolic blood pressure, and percentage of fat in group 1. V˙O2max was related to systolic blood pressure, diastolic blood pressure, low-density lipoprotein-cholesterol, and percentage of fat, and hsCRP was related to triglycerides, and percentage of fat was related to diastolic blood pressure in group 2. These data indicate that CMRs are inversely related to V˙O2max at moderate hsCRP values in African American women. Inflammation and obesity are relatively independent of other CMRs. Conclusions Inflammation along with sedentary lifestyles may contribute to the disparity observed for CHD morbidity and mortality in African American women. Adding the CMR profile may improve the prediction of CHD in African American women.

Objective: The relationships among skeletal muscle lipid peroxidation, intramyocellular lipid content (IMCL), and insulin sensitivity were evaluated in nine insulin-sensitive (IS), 13 insulin-resistant (IR), and 10 adults with type 2 diabetes (T2DM). Design: Insulin sensitivity was assessed by hyperinsulinemic-euglycemic clamp [glucose disposal rate (GDR)]. Lipid peroxidation was assessed by 4-hydroxynonenal (HNE)-protein adducts and general oxidative stress by protein carbonyl content. All patients were sedentary. Results: Protein-HNE adducts were elevated 1.6-fold in T2DM compared with IS adults, whereas IR showed intermediate levels of HNE-modified proteins. Protein-HNE adducts correlated with GDR, waist circumference, and body mass index. IMCL was increased by 4.0- and 1.9-fold in T2DM and IR patients, respectively, compared with IS, and was correlated with GDR and waist circumference but not BMI. Protein carbonyls were not different among groups and did not correlate with any of the measured variables. Correlations were detected between IMCL and protein-HNE. Conclusion: Our data show for the first time that skeletal muscle protein-HNE adducts are related to the severity of insulin resistance in sedentary adults. These results suggest that muscle lipid peroxidation could be involved in the development of insulin resistance.

This study was designed to compare the health perceptions of adults based on race (African American and Caucasian) and gender in the southern United States to determine if health perception contributed to health disparity between African Americans and Caucasians.A between-groups design was used in this study where African Americans and Caucasians completed an extensive health questionnaire and were compared for health perceptions and self-reported health status differences.Fewer African Americans (p.05; males, 55.8%; females, 68%) perceived their health to be good to excellent compared with Caucasians (males, 76.6%; females, 77.1%) and more had been diagnosed with 1 or more chronic diseases. Yet, more than three-quarters of all groups thought that their health care provider shared with them good to excellent information about their health, and 75.0% of the African American males and 71.5% of the Caucasian males and more than 62.0% of the African American and Caucasian females stated that medication cost was not a reason they did not take prescribed medications.Health perceptions of African Americans are often not consistent with their actual health, and this is especially true for African American males. Their perceptions appear to influence the value they place on health behaviors which may result in a reduced health status.

Studies have yielded discrepant results concerning whether the thermic effect of food (TEF) is reduced in obesity. Methodological variations among published studies make understanding the discrepant results very difficult. Although methodological differences are often noted as contributing to the discrepant results, little work has been done to address these differences and standardize experimental protocols. This paper reviews 50 studies that have investigated TEF in obesity and focuses on factors related to experimental protocol and subject control that reportedly affect measurements of resting energy expenditure, postprandial energy expenditure, and the calculation of TEF.

African American women (AAW) have increased odds of developing cardiometabolic (CME) risks and cardiovascular diseases (CVD) compared with European American women (EAW). The influence of obesity on other CME risks and the CVD disparity is unclear. The purpose of our study was to develop a CME index and evaluate the obesity and CME risk index relationships based on race.A comparative research design was employed in our study as 213 women (132 AAW; 81 EAW) from the Louisiana Delta were evaluated for CME risk clustering patterns by race, based on BMI, dual energy X-ray absorptiometry % body fat and waist conference. Fasting glucose, triglyceride (TC), high density lipoprotein cholesterol (HDL-C), systolic (SBP) and diastolic blood pressure (DBP) were the measured CME risks.In summary, when the CME indexes were evaluated by obesity classification categories the ones that were CVD risk or near risk for the AAW were SBP and TG. The trend of CME index risk for the EAW was SBP and glucose. The stepwise regression equations indicate that HDL-C and SBP/DBP were the best indicators of the effects of obesity on CME risks in AAW and that SBP/DBP and glucose were the best indicators of CME risks in EAW.Our results indicate that CME risks as evaluated based on obesity categories are different for AAW than for EAW.

Several empirical challenges arise in estimating the health status of racial/ethnic populations and especially African Americans. African Americans are citizens or residents of the United States who have at least partial ancestry from any of the native populations of sub-Saharan Africa. There are racial/ethnic health disparities that appear to result from genetics, environment, and access to health care and cultural preferences. African Americans have higher relative morbidity and mortality rates than other racial/ethnic groups in the United States across all health areas: chronic disease, communicable disease, injury, and child health. A further indication of health disparity is that the average life expectancy for European Americans in 2007 was 4.8 years greater than for African Americans. However, the difference was down from 5.5 years in 2000. African Americans account for a higher proportion of HIV infections at all stages of the disease from new infections to deaths. The number of new HIV/AIDS cases in African Americans is slowly decreasing. In conclusion, on a relative basis, the health of African Americans is not good, but the good news is that their health is improving. Keywords: African American; disease; ethnicity and culture; health; United States of America

This study evaluated the effects of a 4-month lower extremity strength-training program on mobility in older adults. Eighty-five older adults (43 experimental, ES, and 42 comparison, CS) with a mean age of 72.3 years served as participants. The ES strength-trained plantar flexors (PF), knee flexors (KF), and knee extensors (KE) 1 hr/day, 3 days a week for 4 months. Both the ES and CS were evaluated for PF, KF, and KE strength (1 RM) and the time required to complete floor rise, chair rise, 50-ft walk, and walking up and down stairs before and after the training intervention. The ES increased (p < .05) both absolute (51.9%) and relative strength (1 RM/body weight, 52.4%) after training. Only chair-rise and floor-rise tasks improved significantly after training. Baseline and posttraining mobility tasks predicted from 1 RMs had low to moderate R values. These results suggest that strength is necessary for mobility, but increasing strength above baseline provides only marginal improvement in mobility for reasonably fit older adults.

The purpose of this study was to compare health fitness profiles of normotensive (blood pressure < 108/76) and elevated normotensive (blood pressure ≥ 108/76) children and to evaluate the health fitness training responses of children with higher and lower blood pressures to a regular program of exercise over an eight month period. The subjects were 386 fourth grade students (lower blood pressures = 305; higher blood pressures = 81). They were measured for height and weight and evaluated before and after an exercise intervention program for flexibility, muscular endurance, cardiovascular endurance, and body fat levels. The results show that children with higher blood pressures were fatter and had lower cardiovascular fitness levels before and after the intervention. They had health fitness profiles similar to hypertensive adults. Their rate of health fitness improvement, with training, was similar to children with lower blood pressures. Therefore, elevated normotensive children have an increased risk of cardiovascular disease but can change their risk profile with regular exercise.

Background: The number of African American (AA) patients living with heart failure (HF) has been increasing, especially among the economically disadvantaged. Yoga therapy has been found to improve physical and psychological parameters among healthy individuals, but its effect in patients with HF remains unknown. The purpose of this study was to examine the effects of yoga therapy on cardiovascular endurance (V[spacing dot above]O2peak), flexibility, quality of life (QoL), and inflammatory markers on medically stable HF patients. Methods: Forty patients (38 AA, 1 Asian, and 1 Caucasian) with systolic or diastolic HF were randomized to the yoga group (YG, n = 21) or the control group (CG, n = 19). All patients were asked to follow a home walk program. Premeasurement and postmeasurement included a treadmill stress test to peak exertion, flexibility, interleukin-6 (IL-6), C-reactive protein (CRP), and extracellular superoxide dismutase (EC-SOD). QoL was assessed by the Minnesota Living with Heart Failure Questionnaire (MLwHFQ). Results: The statistical analyses (assessed by ANOVA and t-tests) were significant for favorable changes in the YG, compared with those in the CG, for flexibility (P = 0.012), treadmill time (P = 0.002), V[spacing dot above]O2peak (P = 0.003), and the biomarkers (IL-6, P = 0.004; CRP, P = 0.016; and EC-SOD, P = 0.012). Within the YG, pretest to posttest scores for the total (P = 0.02) and physical subscales (P < 0.001) of the MLwHFQ were improved. Conclusions: Yoga therapy offered additional benefits to the standard medical care of predominantly AA HF patients by improving cardiovascular endurance, QoL, inflammatory markers, and flexibility.

Sixteen African American females were evaluated for body fat to assess the accuracy of several practical methods of estimation: near-infrared interactance, bioelectrical impedance, and Sloan and Jackson skinfold equations. Most methods produced different results from hydrostatic weighing and produced different body fat values from each other suggesting that practical methods do not provide accurate measurements.

The purpose of this study was to evaluate body composition and blood pressure (BP) responses to a 16-week dose of brisk walking in sedentary and obese African American (AA) and White women.Seventy-five sedentary women (45 AA and 30 White) between the ages of 18 and 50 years and body fator =27% signed institutional approved informed consent forms and volunteered to participate in this study. The participants were divided into four groups (AA exercisers [AAE], AA control [AAC], White exercisers [WE], White controls [WC]). The exercisers walked three miles a day, three days a week. Body composition and BP were measured before and after the training intervention. Food records were collected before, during, and after the intervention.Following training, only the WE experienced a reduction in body weight and body fat (P.05). However, the energy intake of the AAE increased 4.7% during and 16% at the conclusion of the intervention and contributed to them neither losing nor gaining weight or fat. Both exercise groups experienced reductions (P.05) in systolic (AAE 5.7 mm Hg, WE 11.3 mm Hg) and diastolic BPs (AAE 3.0 mm Hg, WE 3.6 mm Hg) following training, but the reductions for the WE were greater (P.05) than for the AAE. There were no changes in body composition or BP for either AAC or WC.These results indicate that a 16-week walking intervention provides body composition and BP benefits for both AA and White women, but the benefits are greater for White women.

Background . Body mass index (BMI) is believed to be associated with coronary heart disease (CHD) risks. A major question is whether each BMI category provides independent risk information and whether the BMI categories provide similar results for African-American (AA) men and women relative to lipid, lipoproteins, and blood pressure. Methods . A descriptive research design was used to evaluate the effects of BMI categories on lipoproteins, lipids, and blood pressure, and to determine if similar CHD risks related to these variables were observed in AA men and women. The 358 (108 men and 250 women; 40–70 year of age) participants were recruited from churches in a southeastern metropolitan area. Results . The results indicate that BMI is positively associated with lipoproteins, lipids, and blood pressure in both AA men and women. Relative risks for CHD were higher for obese (BMI > 30 kg/m 2 ) men and women, but the overweight (OW) category provided the same information as the normal weight (NW) category for men, but not for women. Conclusions . This suggests that the same BMI standards provide different CHD risk information for AA men than for AA women and that gender-specific BMI standards may be warranted for more effective CHD risk stratification in AA adults.

The purpose of this study was to evaluate the effects of a 24-month moderate-intensity resistive-training intervention on strength and function in older adults. A repeated-measures experimental research design was employed as a sample of 55 apparently healthy, older, community-dwelling volunteers (30 exercisers—25 women and 5 men; 25 comparisons—16 women and 9 men) were evaluated for strength of 5 muscle groups that influence lower extremity movement and physical function. Strength and function were evaluated at 6-month intervals. The findings from this study indicate that a moderate-intensity resistive-training program increases strength in older adults and that the strength benefits are retained for the duration of the intervention. Furthermore, a long-term strength-training program can increase independent-function skills in older adults and might therefore aid in prolonging functional independence.

BACKGROUND Strength training has been shown to be beneficial in older adults. However, very little data exist on the effects of strength training in older diabetics. METHODS 31 community-dwelling older adults with diabetes (mean age = 66.1 years) were randomly assigned to either an exercise (EX) or control (CO) group. The EX group trained the plantar flexors, knee extensors, knee flexors, hip extensors, and hip flexors muscle groups at 50%, 60%, and 70% of 1-repetition maximum, 2.6 days a week, for 24 months. Mobility tests included the timed up and go, 50-foot walk, and walking up and down 8 stairs. Strength and mobility for both groups were evaluated at 6-month intervals. RESULTS There was a group and time effect as the EX group increased 31.4% (p

The purpose of this study was to compare the accuracy of dual energy X-ray absorptiometry (DEXA) to field-based procedures for the estimation of obesity in 27 sedentary and obese African-American (AA) (34.8, +/- 7.7 yr) and 25 sedentary and obese White women (41.1, +/- 8.3 yr). Body fat was estimated by DEXA and skinfolds equations. Obesity was also estimated from BMI and percent of ideal body weight (greater than 120% of ideal body weight based on height and weight tables). All of the procedures classified the subjects as obese. Results from each procedure were compared with minimal obesity standards to determine the percentage by which each mean exceeded the minimal standard (percent difference). The percent difference was smaller for BMI and percent ideal body weight than for the 2 body fat assessment procedures. Although DEXA percent body fat did not differ by race, BMI and percent ideal body weight tended to be greater in AA women compared to White women, and more AA women were classified as obese. Therefore, field-based procedures that do not include percent body fat assessments are not as accurate for AA women. This finding suggests that obesity can be more effectively assessed in AA women if the standards for classifications are population-specific.

Long-term exercise participation among older adults will result in healthier lifestyles and reduced need for health care. A better understanding, therefore, of what influences older individuals to start and maintain exercise plans would be beneficial. The twofold purpose of this study was (1) to create a knowledge base of determinants that influence exercise behavior in older adults and (2) to have health professionals prioritize determinants that affect exercise initiation and adherence in older adults. The expert panel examined nine determinants within the category of personal characteristics: age, gender, ethnicity, occupation, educational level, socioeconomic status, biomedical status, smoking status, and past exercise participation. The experts rated the determinants on importance for influencing exercise behavior of older adults. This expert panel concluded that older adults who are in good health and have a history of exercise activity might be more likely to participate in long-term exercise programs.

Assessing physical activity in older adults has proven to be difficult but important, because regular participation has a protective and rehabilitative effect against disability and morbidity. Commercially available physical activity monitors measure waist movements and have not been validated for older adults. This study developed a model for establishing prediction equations to estimate older adults physical activity levels based on lower-limb accelerometer measures. Oxygen uptake and lower-limb accelerometer data were simultaneously recorded from treadmill and stair-climbing exercises. The best stepwise regression equations were obtained when accelerometer and weight measures were regressed on oxygen uptake when subjects walked 1, 2, and 3 miles per hour (R = 0.69 with accelerometer on back of the heel) and for accelerometer measures and gender when subjects climbed stairs (R = 0.77 with accelerometer on mid-ankle). These findings illustrate that physical activity can be effectively predicted in older adults from lower-limb accelerometer measurements.