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NEW ORLEANS -- A "culturally sensitive" exercise intervention led to weight loss and other benefits in African-American women with obesity at risk for diabetes, researchers reported.

The program tested in the ongoing, single-arm, pilot study included single-sex and tailored social support, along with supervised interventions of cardiovascular exercise and resistance training, noted Henri Parson, PhD, of Eastern Virginia Medical School in Norfolk, in a poster presentation at the American Association of Clinical Endocrinology (AACE) annual meeting.

Among the women who completed 24 weeks of the program, hemoglobin A1c declined from 5.72% at baseline to 5.62% at 12 weeks and 5.55% at 24 weeks (P=0.0235), Parson and colleagues reported.

Parson told MedPage Today that, at baseline, the average weight was 220 lbs, which dropped to 208 lbs (P=0.0027) after 24 weeks on the program.

"African-American women have a hard time focusing healthcare on themselves," Parson said. "They are taking care of their families, they are focusing on their jobs, on their children, and maybe on elderly adults in the family. Then there is cost of going to a gymnasium, and the problems of being oversized in the gymnasium setting."

Parson explained that the program linked African-American women with obesity to virtual and in-person exercise classes at facilities at local historically Black universities. "We partnered with nearby Norfolk State University, and set up a separate gym facility that allowed the women to go to this gymnasium on their own time," Parson said. "We wanted to have the women lose weight and increase exercise, but more importantly we wanted to create sustainability. They came to exercise three times a week initially, and then we had them exercise virtually twice a week, and finally had them make all their exercise virtual so it could be done at home or whenever they had time. They still had the opportunity to use the gymnasium facilities as they wished."

The social support component was used to help the participants overcome common barriers to physical exercise among Black women, such as lack of time and body-image issues. "We have an added social component to this program, which allowed the women to talk with each other," Parson explained. "For instance, if one of the women was having a hard time getting to the gymnasium because they couldn't find a babysitter, one of the other women might say, 'Oh, my neighbor does babysitting.' I do believe that it is the camaraderie of the participants that may have also helped to make this program work. Another point is that these women were made to feel comfortable with their body image in front of their peers. Gyms can be high pressure."

The authors enrolled 50 African-American women (age about 47) with obesity (BMI 36) who had a sedentary lifestyle. At the time of AACE presentation, 35 had completed 12 weeks of therapy, and 27 had completed 24 weeks.

Parson and colleagues also saw improvements in functional mobility from baseline to 12 weeks:

• Timed up and go: 9.5 seconds to 8.8 seconds (P=0.020)
• 6-minute walk distance: 488 meters to 519 meters (P=0.027)

In addition, they found improvement in Norfolk Quality of Life-Fatigue (QOL-F) scores from baseline to 12 weeks (29.7 to 21.8. P=0.0175). Responses to the 35-question QOL-F are graded from 0-4 with higher scores indicating higher degree of fatigue symptoms, problems, or functional limitations; the total score ranges from 0-140.

Parson told MedPage Today that the intervention led to "a decrease in total body fat from 46.5% at baseline to 44.1% at 24 weeks [P=0.0005]. We also saw reductions in body fat in the arms, in the legs, in the trunk, and all the differences were statistically significant."

However, there was no significant change in scores from baseline to 12 or 24 weeks. The next step is to add a nutritional component to the program, which may bolster the results, Parson stated.

Diana Crowley, DO, of Geisinger Health in Danville, Pennsylvania, told MedPage Today the the study findings could be extrapolated to other areas as well, including rural areas of Pennsylvania.

"It would be nice to get people to come together for something like this," said Crowley, who was not involved in the study.

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