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Purpose: Body image affects health practices. With acculturation superimposed on globalization, 21st century body size preferences of African immigrants, one of the fasting growing populations in the United States, are unknown. Therefore, in African immigrants living in America we assessed: 1) body size preference; and 2) body size dissatisfaction. Methods: Participants chose two silhouettes from the Stunkard Figure Rating Scale: one for body size preference and one for perceived body size. Each silhouette corresponds to a BMI category: (a) Underweight: 1 and 2; (b) Normal weight: 3 and 4; (c) Overweight: 5, 6 and 7; (d) Obesity: 8 and 9. Dissatisfaction was defined as the difference between silhouette numbers for perceived and preferred body size. Results: Characteristics of the 412 participants were: women: 42% (174/412), age 40± 11y (mean±SD), range 20– 69 y, BMI 27.9± 4.6, range 19.5– 47.3 kg/m2. As a body size of preference, no one (0/412) chose obese silhouettes. Normal weight silhouettes were chosen as their body size of preference by 75% (131/174) of women and 60% (143/238) of men. Overweight silhouettes were chosen as their preferred body size by 11% (19/174) of women and 26% (62/238) of men. Combining normal and overweight silhouettes into one group, 86% (150/174) of women and 86% (205/238) of men preferred to be either normal or overweight. Underweight silhouettes were preferred by 14% (24/174) of women and 14% (33/238) of men. Dissatisfaction because body size was too large occurred in 78% (135/174) of women and 53% (126/238) of men. Dissatisfaction because body size was too small occurred in 6% (11/174) of women and 16% (38/238) of men. Conclusion: African immigrants prefer body sizes which are normal or overweight. However, and presumably attributable to the combined influence of globalization and acculturation, a worrisome fraction of African immigrants favor an underweight silhouette. Plain Language Summary: Understanding the attitudes of Africans towards body size is important because these attitudes affect health behaviors. The 20th century consensus was that Africans viewed large body sizes as a sign of the health, beauty, fertility, and prosperity. In addition, underweight silhouettes were viewed with fear and considered to be a sign of poverty, malnutrition, and HIV infection. In the 21st century, African attitudes towards body size are unknown. African immigrants are a rapidly growing segment of the American population. Their attitudes toward body size are influenced by both globalization and acculturation. In our cohort, we found 86% of the Africans living in America wanted to be either normal or low range overweight. However, and very concerning, 14% of African immigrants chose underweight silhouettes to represent their body size of preference. As weight loss programs are brought forward in and by African communities living in the United States, the emphasis must be on achieving a healthy weight and not glorification of underweight silhouettes. [ABSTRACT FROM AUTHOR]

Efficient and accurate methods to estimate insulin sensitivity (SI) and b-cell function (BCF) are of great importance for studying the pathogenesis and treatment effectiveness of type 2 diabetes (T2D). Existing methods range in sensitivity, input data, and technical requirements. Oral glucose tolerance tests (OGTTs) are preferred because they are simpler and more physiological than intravenous methods. However, current analytical methods for OGTT-derived SI and BCF also range in complexity; the oral minimal models require mathematical expertise for deconvolution and fitting differential equations, and simple algebraic surrogate indices (e.g., Matsuda index, insulinogenic index) may produce unphysiological values. We developed a new insulin secretion and sensitivity (ISS) model for clinical research that provides precise and accurate estimates of SI and BCF from a standard OGTT, focusing on effectiveness, ease of implementation, and pragmatism. This model was developed by fitting a pair of differential equations to glucose and insulin without need of deconvolution or C-peptide data. This model is derived from a published model for longitudinal simulation of T2D progression that represents glucose-insulin homeostasis, including postchallenge suppression of hepatic glucose production and first- and second-phase insulin secretion. The ISS model was evaluated in three diverse cohorts across the lifespan. The new model had a strong correlation with gold-standard estimates from intravenous glucose tolerance tests and insulin clamps. The ISS model has broad applicability among diverse populations because it balances performance, fidelity, and complexity to provide a reliable phenotype of T2D risk. [ABSTRACT FROM AUTHOR]

To improve detection of abnormal glucose tolerance (Abnl-GT), attention has moved beyond the oral glucose tolerance test (OGTT), to non-fasting markers of glycemia, specifically, HbA1c, fructosamine (FA) and glycated albumin (GA). Emerging data suggest that in African descent populations, the combination of HbA1c and GA is superior to the combination of HbA1c and FA. However, the diagnosis of Abnl-GT is usually based on tests which are performed only once. As reproducibility of Abnl-GT diagnosis by HbA1c, fructosamine (FA) and glycated albumin (GA) is unknown, reproducibility of Abnl-GT diagnosis by HbA1c, FA and GA were assessed in 209 African-born Blacks living in America.Methods: At Visits 1 and 2 (9 ± 4 days apart), samples were obtained for HbA1c, FA and GA levels. Glucose tolerance status was determined at Visit 1 by OGTT. Reproducibility was based on the -statistic and paired t-tests. Thresholds for the diagnosis of Abnl-GT by FA and GA which corresponded to an HbA1c of 5.7% were 235umol/L and 14.6%, respectively.Results: Abnl-GT occurred in 38% (80/209). Diagnostic reproducibility was excellent for HbA1c (≥ 0.86) and GA (≥ 0.89), but only moderate for FA (=0.59). Neither HbA1c nor GA levels varied between visits (both P≥ 0.3). In contrast, FA was significantly lower at Visit 2 than Visit 1(P< 0.01).Conclusion: As HbA1c and GA provided similar diagnostic results on different days and FA did not, HbA1C and GA are superior to FA in both clinical care settings and epidemiologic studies.Plain Language Summary: Beyond the monitoring of blood glucose levels, HbA1c is now used to diagnose hyperglycemia, but fructosamine and glycated albumin are being evaluated as alternatives when red blood cell factors cause inaccurate HbA1c results.Studies suggest glycated albumin may be a better diagnostic test than fructosamine, but these investigations were poorly designed as conclusions were based on studies done once on a single day.Therefore, in our study, each participant was studied twice with samples drawn one to two weeks apart. We found that the reproducibility of the diagnosis of hyperglycemia made by glycated albumin was excellent but only moderate for fructosamine. This could explain why glycated albumin may be superior to fructosamine in both the care of patients and the design of large population studies. [ABSTRACT FROM AUTHOR]