Obese African American Women Research Articles

Tiered Exercise Intervention Improves Functional Mobility In Obese African American Women

Tiered Exercise Intervention Improves Functional Mobility In Obese African American Women

Abstract A060: Breast cancer-associated leukocyte DNA methylation profile in obese African-American women

Abstract Background: DNA methylation (DNAme) is a stable epigenetic mark leading to reduced gene expression. However, genome-wide DNAme profile is susceptible to disease. Therefore, specific genetic DNAme profiles could potentially serve as biomarkers associated with breast cancer (BC) and obesity as its comorbidity. Incidentally, BC-related mortality is higher in African-American women, causing a significant health disparity. In this study, we profiled obesity and breast cancer-related leukocyte DNAme in African-American women to explore methylation- associated biomarkers in these women. Methods: We used 10 African-American women with confirmed breast cancer diagnosis and 10 otherwise healthy African-American women with known Body Mass Index (BMI) > 30 (Obese). DNA was extracted from the buffy coat of peripheral blood using Qiagen DNA extraction kits. We used the next-generation sequencing technology to perform reduced presentation bisulfite sequencing (RRBS) using the Tecan Ovation RRBS kit. We sequenced the libraries on a NextSeq 550 at our Precision Medicine Unit. Single-end 75bp reads were generated and processed using Bismark and mapped against the GRCh38 human genome, and differentially methylated regions (DMR) were derived using MethylKit using a 1 kb window. Gene Ontology and Disease association studies were conducted using DAVID and relapsed-free survival in Kmplot. Additionally, we compared the gene sets with obese and normal DMRs that had previously been obtained similarly. Results: We found that 83% of the DMRs were in the promoter/upstream regions of the nearest genes, and 96% of DMRs were part of CpG islands, indicating potential regulatory functions of these regions. Gene ontology analysis revealed that the DMR-associated genes were also overrepresented in breast carcinoma, Type 2 Diabetes, Obesity, and Tobacco usage, according to the DisGeNET and GAD disease associations databases. Genes with DMRs in their upstream or promoter regions - include PRDM16, PTBP1, RAB1A (lower methylation in cancer with obesity), and Multiple ribosomal genes along with RRAF, XKR4 (higher methylation in cancer with obesity). We observed lower methylation profiles in multiple genes in samples with cancer, which were higher in obese samples without cancer.Conclusion: Our study suggests that a distinct peripheral DNA methylation profile is associated with minority women suffering from both cancer and obesity. Our data show that showed that breast cancer modulates leucocyte DNA methylation profile in obese individuals towards that of a more normal BMI, causing a partial reversal. This potential reversal is primarily in the upstream regions of the genes detected for methylation. The DMR genes in cancer with obesity are significantly associated with overall survival in breast cancer, thus indicating a potential link in understanding the crosstalk between obesity and cancer. Citation Format: Pranabananda Dutta, Yanyuan Wu, Jaydutt V. Duta. Breast cancer-associated leukocyte DNA methylation profile in obese African-American women [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A060.

A pilot study of Keto Prescribed+: A healthy thinking and eating educational program for African American women.

African American (AA) women have the highest prevalence of obesity in addition to health disparities in preventable diet-related diseases (i.e., diabetes, hypertension), which places them at increased risk for cardiovascular disease. The purpose of this pilot study was to assess the feasibility, acceptability, and preliminary effectiveness of the Keto Prescribed+ (KetoRx+) program on associated physical and psychosocial outcomes among this population. The KetoRx+ program is a healthy eating and thinking educational intervention. The program combined online and in-person community group sessions over 8 weeks. The Keto Prescribed+ was found to be feasible and acceptable with comments on ways to increase acceptability from participants completing program (n = 10). Physical outcomes changed showed an average decrease in weight of 10lbs (SD = 5), baseline average 226lbs. Waist-to-hip ratio and systolic blood pressure also trended down. Psychosocial outcomes showed improvement trends. The KetoRx+ program is feasible and acceptable for overweight or obese AA women. Preliminary efficacy was established for most physical and psychosocial outcomes. However, more research is needed to identify specific program components contributing to healthy lifestyle behavior change and to establish program efficacy and effectiveness. Culturally adapted community-based biopsychosocial interventions using ketogenic nutrition therapy may help improve cardiovascular health of adult AA women.

Understanding Obesity in African American Women Using Leininger's Theory.

In the United States, African American (AA) women suffer from higher rates of obesity as compared with Caucasians or Asians. Unfortunately, most weight management interventions have been unsuccessful in maintaining weight loss. Prior research has revealed that AA women face unique barriers in managing obesity; therefore, more research is warranted to address this problem. Leininger's theory is used to understand obesity through a cultural lens. The constructs of the sunrise model are defined as a means to intervene when providing nursing care through cultural preservation, accommodation, and repatterning. We conclude that culture care theory offers a theoretical framework to assist nurses in providing culturally sensitive care to Black women with obesity. Nurses caring for this population can utilize this theory to tailor interventions specific to the cultural needs of women to improve outcomes in the management of obesity. In this article, we use AA and Black interchangeably to represent Americans whose ancestors originate from Africa.

OBESE AFRICAN AMERICAN OLDER WOMEN’S EFFECT OF EXERCISE TRAINING ON HEALTH CAPABILITIES AND LIFE SATISFACTION

Abstract The purpose of this study is to determine whether a 12-week exercise course influences obese African American older women’s health capabilities and life satisfaction levels. Participants, who passed an initial screening and pre-assessment, were asked to measure current health capabilities and life satisfaction levels both prior to, and following, the 12-week exercise training. Researchers found that improvement in health capabilities, although there were no significant differences following exercise training participation, while obese African American older women had significantly higher life satisfaction levels. The findings suggest that a 12-week exercise training can be beneficial to enhance obese African American older women’s health capabilities and life satisfaction levels. Professionals in the field of gerontology and exercise should provide the appropriate exercise trainings so that obese African American older women would be able to optimize their life satisfaction levels.

Meal timing, distribution of macronutrients, and inflammation among African-American women: A cross-sectional study

ABSTRACT Chronic low-grade inflammation is an underlying risk factor for numerous chronic diseases, including cancer. Eating earlier in the day has been associated with a reduction in levels of inflammatory markers and inflammation-related health outcomes (e.g., obesity, metabolic disorders). This cross-sectional study of 249 obese African-American women examined the effect of various mealtime-related factors associated with macronutrient consumption in relation to chronic inflammation and Breast Imaging Reporting and Data System (BI-RAD) readings. During 2011 and 2013, a single 24-hour dietary recall was administered, blood samples were assayed for c-reactive protein (CRP) and interleukin-6 (IL-6), and BI-RAD ratings were assessed to determine the influence of mealtime on chronic inflammation and breast cancer risk score. Multiple linear and logistic regression models were used to assess these relationships. Higher carbohydrate consumption at breakfast was associated with a significantly lower CRP vs. higher carbohydrate consumption at dinner (6.99, vs. 9.56 mg/L, respectively, p = .03). Additionally, every 1-unit increase in percent energy consumed after 5PM resulted in a BI-RAD reading indicating a possibly suspicious abnormality (OR: 1.053, 95% CI: 1.003–1.105), suggesting an increase in breast cancer risk. Timing of energy and macronutrient intake may have important implications for reducing the risk of diseases associated with chronic inflammation.

Effects of exercise training on health capabilities and life satisfaction among overweight and obese African American women.

More importance has been placed on exercise training due to increase in the overweight and obese population. However, few studies have researched the effects of exercise training on the health capabilities and life satisfaction levels of overweight and obese African American women. This study sought to determine the effect of a 12-week exercise training on health capabilities and life satisfaction levels of overweight and obese African American women. Participants, who passed an initial screening and pre-assessment, were measured current health capabilities and life satisfaction levels both prior to, and following, the 12-week exercise training. The results from this study indicated an improvement in health capabilities, although with no significant differences following exercise training, while a significantly higher life satisfaction levels was observed among the overweight and obese African American women. The findings suggest that exercise training can be beneficial to enhance overweight and obese African American women's health capabilities and life satisfaction levels. Exercise professionals should provide the appropriate exercise trainings so that overweight and obese African American women can optimize life satisfaction levels.

The impact of a randomized dietary and physical activity intervention on chronic inflammation among obese African-American women

ABSTRACT Lifestyle interventions may reduce inflammation and lower breast cancer (BrCa) risk. This randomized trial assessed the impact of the Sistas Inspiring Sistas Through Activity and Support (SISTAS) study on plasma C-reactive protein (CRP), interleukin-6 (IL-6) and Dietary Inflammatory Index (DII). This unblinded, dietary and physical activity trial was implemented in 337 obese (body mass index [BMI] ≥30 kg/m2) African American (AA) women recruited between 2011 and 2015 in South Carolina through a community-based participatory approach with measurements at baseline, 3 months, and 12 months. Participants were randomized into either intervention (n = 176) or wait-list control group (n = 161). Linear mixed-effect models were used for analyses of CRP and IL-6. Baseline CRP was significantly higher in those with greater obesity, body fat percentage, and waist circumference (all p <.01). No difference was observed between groups for CRP or IL-6 at 3 or 12 months; however, improvements in diet were observed in the intervention group compared to the control group (p = .02) at 3 months but were not sustained at 12 months. Although the intervention was not successful at reducing levels of CRP or IL-6, a significant decrease was observed in DII score for the intervention group, indicating short-term positive dietary change.

Obese women's perceptions of weight gain during pregnancy: a theory-based analysis.

Excess gestational weight gain (GWG) in obese women is linked to adverse maternal outcomes and is particularly pervasive among African Americans, who have the highest obesity rates in the USA. A better understanding of culturally relevant attitudes and perceptions of GWG is needed to develop targeted interventions to prevent excess GWG among this group. Using the constructs of Social Cognitive Theory, we explored attitudes and perceptions surrounding diet and exercise among low-income obese African-American pregnant women in Baltimore. We conducted twenty-one semi-structured in-depth interviews with pregnant adult women. Participants were recruited from a referral clinic for obese pregnant women at a large urban hospital in Baltimore, MD, USA. Twenty-one low-income African-American adult females in the first two trimesters of pregnancy with BMI &gt; 30·0 kg/m2. Lack of knowledge was not the main obstacle to healthy behaviours during pregnancy. Rather, food cravings and fatigue, an unhealthy physical food environment, limited self-efficacy for controlling excessive GWG, and a lack of adequate emotional and informational support impacted women's agency. While digital technology was discussed as a vehicle to promote maintenance of a healthy weight in pregnancy, further research is needed to test how it can be used to empower women to engage in healthy behaviours during pregnancy. Interventions to prevent excess GWG among African-American pregnant women should harness support from partners and family and must go beyond sharing of clinical knowledge to also include strategies that improve the food environment, diet quality and self-efficacy.

Abstract P361: Body Image Dissatisfaction Influences Cardiovascular Health in Overweight and Obese African American Women

Introduction: African American women are 5 times less likely than white women to meet at least 5 or more ideal cardiovascular health metrics as defined by the American Heart Association Life’s Simple 7 (LS7) components (smoking, diet, physical activity, BMI, blood pressure, total cholesterol, and glucose). There are few studies probing the influence of sociocultural factors, such as body image dissatisfaction (BID), on these disparities. A better understanding of the impact of BID on cardiovascular health could assist in the design of more effective behavior change interventions for African American women. Hypothesis: We hypothesized that BID would have a negative association with cardiovascular health in overweight and obese African American women. Methods: We enrolled 32 women (mean age 49 years [SD 12.9]), from 5 predominantly African American churches participating in a larger community-based participatory study (FAITH! App Pilot Study) of a mobile health lifestyle intervention among African American women and men. We conducted a cross-sectional analysis of baseline data to evaluate the association between BID and both cardiovascular health and select psychosocial factors (e.g. motivation for healthy eating, diet self-regulation). A LS7 composite score was calculated as a measure of overall cardiovascular health (range 0-14). The Pulvers scale, consisting of images of women across the BMI spectrum, was used to measure perceived current and goal body size (rating of figures, 1-9; underweight to very obese). A BID score was calculated as the difference between perceived current and desired body image (range -8-8; BID &lt; 0 [desire to be heavier], BID &gt; 0 [desire to be thinner], BID = 0 [no dissatisfaction]). The BID score range for our cohort was 0-4. Thus, we categorized BID as no/low BID (BID score 0-1) or high BID (BID score 2-4). Results: Twenty-two percent (7/32) of women were overweight (BMI 25-29.9) and 78% (25/32) were obese (BMI (≥ 30). Forty-four percent (14/32) had no/low BID and 56% (18/32) had high BID. Those with high BID were more likely to be obese as compared to no/low BID (94% (17/18) versus 57% (8/14), p=0.03). Although not statistically significant, the mean LS7 composite score was 1 point higher among those with no/low BID, versus high BID (8.83 versus 7.76, p=0.25). Compared to women with high BID, those with no/low BID were more likely to have greater: intrinsic motivation (P=0.01) and integrated regulation for healthy eating (P=0.007), and self-regulation to reduce fat and caloric intake (P=0.01). Conclusion: Ultimately, although small, our study suggests that African-American women with obesity are more likely to have high BID. High BID was associated with lower motivation and self-regulation, which predict cardiovascular health. BID and other psychosocial factors for behavior change are potential targets for culturally-tailored lifestyle interventions in this group.

Association of Endothelial Function with Parental Hypertension in Normotensive-Obese African-American Women: A Pilot Study.

Obese African-American (AA) women are at high risk of hypertension (HT) and cardiovascular disease (CVD). Flow-mediated dilation (FMD) and arterial augmentation index (AI) are measures of endothelial function and arterial stiffness. Whether endothelial function and arterial stiffness predict risk of HT or CVD in obese African-American women with, versus without, parental histories of HT and whether aerobic exercise is an effective countermeasure remain unclear. The capacity for FMD is partly heritable. Therefore, we tested the hypotheses that less FMD and greater AI may be found in normotensive-obese, young-adult (18-26 year-old) AA women with hypertensive parents (n=10) than in a matched control group with normotensive parents (n=10) and that a single bout of aerobic exercise improves both endothelial function and arterial stiffness, with less improvement in the women with hypertensive parents. We studied each subject while at rest, 20 min before and 20 min after, 30 min of aerobic exercise. The exercise-induced changes and parental hypertension-related differences in AI were not significant. The exercise increased FMD in both of the groups with no significant difference in magnitude between the women with hypertensive and normotensive parents. FMD was significantly less in the women with hypertensive parents than in the women with normotensive parents after, but not before, the exercise (mean ±95% confidence interval of 11.3 ± 4.9% vs. 15.6 ± 4.9%, P=0.05). These findings suggest that a 30-min bout of aerobic exercise may improve FMD and unmask endothelial dysfunction in normotensive-obese, young-adult AA women with parental histories of HT. Future studies should determine whether regular aerobic exercise protects obese AA women from the endothelial dysfunction associated with diabetes and prevents CVD in this high-risk population.

Perceptions and experiences of appetite awareness training among African-American women who binge eat.

Binge eating may contribute to the prevalence of obesity in African-American women. Yet, there has been scant intervention research on the treatment of binge eating in this population. We tested the feasibility of an appetite awareness training (AAT) intervention in a sample of African-American women with binge and overeating behaviors. Participants who completed AAT were recruited to participate in focus groups to elicit information about their perceptions and experiences with this intervention to inform the design of future interventions to treat binge eating and obesity in African-American women. African-American women, aged 18-70years, who had completed an 8-week randomized AAT intervention, were invited to attend a focus group discussion. Session content was recorded and transcribed. Data were analyzed by use of open coding. Themes were identified that described their perceptions and experiences of participating in the intervention. Seventeen women participated in three focus group discussions. Pertinent themes identified included: paying attention to internal cues of hunger and satiety, influence of culture on eating patterns, breaking patterns of disordered eating, and perceptions about weight. Overall, participants were satisfied with their experience of AAT, and reported they found it valuable to learn about listening to biological signals of hunger and satiety and to learn specific strategies to reduce maladaptive eating patterns. AAT was acceptable and provided helpful eating behavior instruction to African-American women with reported binge and overeating behaviors. Future research should examine the potential of AAT to improve weight management in this underserved population. Level V, qualitativedescriptive study.

Abstract P154: Central Acetylcholinesterase Inhibitor, Galantamine, Prevents Lipid-Induced Oxidative Stress in African Americans

African American women (AAW) have one of the highest prevalence of hypertension in the US. Obese AAW have decreased parasympathetic (PNS) activity compared to white women (WW). Continuous lipid infusion that causes cardiovascular autonomic imbalance (decrease in PNS and increase in sympathetic activity) induces a greater increase in oxidative stress in African Americans than in whites. Considering that PNS protects against oxidation and that central acetylcholinesterase inhibitors have been shown to suppress oxidative stress in animal models; we tested the hypothesis that the central acetylcholinesterase inhibitor, galantamine attenuates oxidation in response to lipid infusion in obese AAW compared to WW. We randomized 14 healthy obese AAW (39.5±10.7 yo, BMI 38.8±3.4) and 10 WW (35.9±8.3 yo, BMI 36.3±2.1). All subjects underwent 4-h infusions of Intralipids and heparin. On separate days subjects received either 16 mg galantamine or placebo in a crossover fashion. Lipid-induced oxidative stress and inflammation were assessed with plasma F2-isoprostanes and cytokines at baseline, 2 and 4-h post-intralipid infusion. In AAW, 16 mg of galantamine significantly suppressed the increase in lipid-induced oxidative stress (-3±12 vs. 10±18 pg/mL with placebo, P=0.014), figure . No effect was noted in WW. Galantamine tended to increase IL10 levels (17.3±20.7 vs. 4.8±7.58 pg/mL, P=0.06). We did not observe any effect on blood pressure or heart rate. Conclusion: Increased parasympathetic tone with central acetylcholinesterase inhibitor, galantamine, suppressed lipid-induced oxidative stress in obese African American women.

Abstract P130: Acute Hyperlipidemia Increases Vasodilation in Conduit Arteries but Has No Effect on Microvascular Recruitment in African American Women

African Americans have one of the highest prevalence of hypertension in the United States. Impaired endothelial function has been implicated in the pathophysiology of hypertension in this group. We previously reported that brachial artery diameter increases from 3.9±0.14 to 4.1± 0.14 at 4 hours after ingestion of a high fat meal, suggesting vasodilation of conduit arteries. Considering that oral fat ingestion stimulates the release of gastrointestinal peptides with vasoactive properties, we aimed to isolate the vascular effect of fat on conduit artery and microvasculature by inducing an acute elevation of triglycerides and free fatty acids with an infusion of 20% intralipid® and heparin. To assess endothelial function we measured changes in the diameter of the brachial artery to hyperemia with a continuous edge detection and wall tracking software. Effect on microvasculature was obtained with contrast-enhanced ultrasonography (CEU) of the brachioradialis muscle with lipid-perflutren microbubbles infusion. We studied 14 obese healthy African American women, age 39± 10, BMI 38.7± 3.4 kg/m. 2 Triglycerides increased from 60.7±30.5 to 523.3±231 mg/dL at the end of the 4 h infusion. Brachial artery diameters were 3.6±0.16 and 3.9±0.18 mm at baseline, and 4-h, P=0.109, respectively. Flow mediated dilation improved at the end of the 4-h infusion period (4.3±0.95 to 6.2±1.21%, P=0.016), figure . Microvascular blood volume did not change with the intervention 5.8±4.9 vs. 5.9±3.6, P=0.55. In conclusion, IV acute hyperlipidemia did not increase brachial artery diameter nor microvascular circulation, however it potentiates vascular reactivity in conduit arteries.

Pathogenic Mechanisms of Prediabetes in Obese vs. Very Obese African American Women: Implications for Diabetes Prevention

BackgroundThe influence of obesity on the development of prediabetes among African American women (AAW) remains uncertain. Thus, we investigated whether the pathogenic mechanisms of prediabetes differ in obese (OB, BMI<35 kg/m2) and very obese (VOB, BMI>35 kg/m2) AAW. Subjects/MethodsWe recruited 26-OB and 41-VOB, AAW with prediabetes, mean age (46.3 ± 10.3 years), A1C (5.9 ± 0.4%) and BMI (38.3 ± 8.2 kg/m2). OGTT and FSIVGT were performed in each subject. Body composition (% body fat) was measured using DEXA. Si, Sg acute insulin response to glucose (AIRg) and disposition index (DI) were calculated using minimal model method. ResultsMean BMI (32.6 ± 1.9 vs. 42.8 ± 5.5 kg/m2) and %body fat (44.7 ± 2.0 vs. 49.6 ± 2.2%) were significantly (p = 0.0001) lower in OB vs VOB. Mean fasting and post-glucose challenge, (glucose, insulin, c-peptide) levels were significantly (p = 0.03–0.0001) lower in OB vs VOB. Mean Si and Sg was not different. Mean AIRg tended to be higher (808 ± 776 vs. 535 ± 443 (x min [uU/L] −1), p = 0.106) whereas DI was greater (1999 ± 1408 vs. 1511 ± 1033, (×10−2 x min−1), p = 0.01) in OB vs VOB subjects. ConclusionWe found that OB and VOB AAW had similar Si and Sg, but VOB showed attenuated AIRg and DI. These parameters should be considered when developing primary prevention programs in AAW with prediabetes.

Mitochondrial Respiration is Associated with Lower Energy Expenditure and Lower Aerobic Capacity in African American Women.

ObjectiveReasons for the higher obesity prevalence in African American women (AAW) compared to Caucasian women (CW) are unknown. Energy expenditure and maximal aerobic capacity (VO2max) are lower in AAW. We hypothesized these differences are explained by skeletal muscle characteristics, particularly mitochondrial content and function.MethodsMultivariate regression analyses were used to examine the relationships between energy expenditure (resting and during a hyperinsulinemic-euglycemic clamp) and VO2max vs. body composition, physical activity, and skeletal muscle mitochondrial measurements in AAW and CW.ResultsIn AAW, VO2max was lower (p<0.0001). Body-composition-adjusted energy expenditure during the clamp was lower in AAW (p<0.002). Physical activity was similar in both groups. After adjusting for mitochondrial respiration, racial differences in energy expenditure and VO2max were no longer present. Another novel finding was that a thermogenic response to the clamp was observed in CW (+53±22 kcal/d; p<0.03) but not in AAW (−19±24 kcal/d; p=0.43).ConclusionsAAW and CW show differences in adjusted energy expenditure and aerobic capacity that are largely accounted for by differences in skeletal muscle mitochondrial oxidative characteristics. Further research is needed to determine if lower mitochondrial respiration and lower thermogenesis are risk factors for obesity in AAW.

Racial Differences in Weight Loss Mediated by Engagement and Behavior Change.

We set out to determine if a primarily Internet-delivered behavioral weight loss intervention produced differential weight loss in African American and non-Hispanic White women, and to identify possible mediators. Data for this analysis were from a randomized controlled trial, collected at baseline and 4-months. The intervention included monthly face-to-face group sessions and an Internet component that participants were recommended to use at least once weekly. We included overweight or obese African American and non-Hispanic White women (n=170), with at least weekly Internet access, who were able to attend group sessions. Monthly face-to-face group sessions were delivered in large or small groups. The Internet component included automated tailored feedback, self-monitoring tools, written lessons, video resources, problem solving, exercise action planning tools, and social support through message boards. Multiple linear regression was used to evaluate race group differences in weight change. Non-Hispanic White women lost more weight than African American women (-5.03% vs.-2.39%, P=.0002). Greater website log-ins and higher change in Eating Behavior Inventory score in non-Hispanic White women partially mediated the race-weight loss relationship. The weight loss disparity may be addressed through improved website engagement and adoption of weight control behaviors.

A randomized controlled trial to prevent excessive gestational weight gain and promote postpartum weight loss in overweight and obese women: Health In Pregnancy and Postpartum (HIPP)

BackgroundInterventions to prevent excessive gestational weight gain and promote postpartum weight loss have yielded modest results, particularly in overweight and obese women. ObjectivesTo examine the impact of a theory-based lifestyle intervention on gestational weight gain, postpartum weight loss, and related maternal and child outcomes and to examine race differences in these outcomes. DesignA randomized controlled trial (target N=400; 200 intervention, 200 standard care; 200 African American, 200 white). MethodsOverweight and obese African American and white women ≤16weeks gestation are recruited from obstetrics and gynecology clinics in South Carolina. Intervention participants receive two in-depth counseling sessions (early pregnancy and postpartum), telephone counseling, behavioral podcasts, and social media support that target weight self-monitoring and increasing physical activity and healthy dietary behavior practices, guided by Social Cognitive Theory. Standard care participants receive monthly mailings and a matched number of podcasts on non-weight related topics. All intervention activities last from ≤18weeks gestation to 6months after delivery. Gestational weight gain is the primary outcome. Secondary outcomes are meeting gestational weight gain guidelines (inadequate, adequate, excessive), weekly rate of gestational weight gain, postpartum weight retention, physical activity and dietary behaviors, health-related quality of life, and offspring adiposity. Participants are assessed at baseline (≤16weeks gestation), 32weeks gestation, and 6 and 12months postpartum, and offspring are assessed at 6 and 12months. SummaryHIPP is an innovative study that addresses significant gaps in the literature. Primary outcome results are expected in 2019.

Hair As a Barrier to Physical Activity among African American Women: A Qualitative Exploration.

African American (AA) women face unique sociocultural barriers to physical activity (PA) engagement. Such barriers may contribute to their low PA levels and high cardiometabolic disease burden. One particular barrier reported among AA women in recent research is that being physically active can have an undesirable effect on the hairstyles and hair maintenance of many AA women. However, the underlying mechanisms contributing to this barrier have not been fully elucidated. The purpose of this study is to explore hairstyle maintenance as a barrier to PA among AA women and to identify effective strategies to overcome this barrier in the design of a culturally relevant PA intervention. A qualitative study design was used. Data were collected from the focus groups comprising 23 sedentary and obese AA women (median age = 38.1 years, median body mass index = 39.8 kg/m2). Content analysis was used to analyze these focus group data. Three key themes emerged from the qualitative narratives of participants: (1) impact of perspiration on hair and hairstyle maintenance, (2) image and social comparisons, and (3) solutions to overcome hair-related barriers to PA. For impact of perspiration and hairstyle maintenance, participants described how perspiring while engaging in PA negatively impacts many of their hairstyles. Participants further discussed how time and monetary burdens associated with PA-related hairstyle maintenance further contributed to this issue. Findings for the theme of image and social comparison focused on how an AA woman's hairstyle is an important part of the image and the social comparisons made by non-AAs regarding the hairstyles and maintenance practices of AA women. For solutions to hairstyle maintenance barriers, participant described a variety of potential styling techniques that may help alleviate PA-related maintenance concerns, including braids, locks, and natural hairstyles. However, no styling technique was uniformly endorsed by all study participants. Findings highlight the significance of hair in the AA community and provide further insight on appropriate intervention design strategies to overcome this sociocultural barrier to PA. Future research is needed to corroborate and further expand on our findings.

Perceptions of Obese African American Women Regarding Altering Traditional Soul Food Preparation

The obesity epidemic continues to be a major concern in the United States. The World Health Organization reported that 1.4 billion adults were either obese or overweight African American (AA) women have the highest incidence of obesity worldwide. A qualitative descriptive study was used to explore the perceptions of obese AA women about altering how they prepare soul food to make it healthier. The empowerment model and the health belief model were used to frame this study. Data were collected using a nonprobability purposeful sampling strategy. The sample for this study consisted of four focus groups with six to seven obese AA women ages 21–90 who prepared and consumed high-calorie soul foods and had a body mass index ³30. Focus group transcripts were analyzed using a constant comparative analysis. It was found that obese AA women were willing to alter their traditional soul food preparation only if it tastes good, recipes are available, it is cost effective, and it produces minimum food waste. Barriers that could limit participation in an intervention as well as recommendations for designing interventions are discussed.