Lower Serum Adiponectin Levels in African‐American Boys

Objective: To examine adiponectin, an adipocyte‐secreted hormone with anti‐inflammatory and insulin‐sensitizing effects, in relation to race or gender in younger subjects. Research Methods and Procedures: The relationship of adiponectin, quantitated by radioimmunoassay, to anthropometric and metabolic factors (fasting insulin, glucose, and leptin) and reproductive hormones was examined in 46 healthy African Americans (25 girls/21 boys) and 40 whites (20 girls/20 boys) ranging in age from 12 to 21 years. Results: There was no statistical difference in BMI or in BMI percentile among the four groups. Sums of skinfolds, but not skinfold percentile, were significantly lower in boys than girls (p = 0.001 and p = 0.896, respectively), whereas there was no difference between racial groups. Leptin was significantly greater in girls (p = 0.0002). There was no difference in fasting serum glucose, insulin, or homeostasis model assessment score among any of the groups. There was a significant negative univariate relationship between serum adiponectin and both BMI and BMI percentile for the entire group (p = 0.006 and p = 0.005). In a multivariate model, BMI percentile (p = 0.005) and the interaction between race and gender (p = 0.026) were significant predictors of serum adiponectin. In this model, African‐American boys had the lowest serum adiponectin level, 37% less than white boys, who had the highest adiponectin levels. Discussion: Serum adiponectin levels are reduced in young obese subjects (African Americans and whites) and are lower in African‐American boys than white boys. A lower adiponectin level in African‐American boys may predispose this group to a greater risk of diabetes and cardiovascular disease.     

Developmental Trajectories of Girls' BMI Across Childhood and Adolescence

This study describes qualitatively distinct trajectories of BMI change among girls participating in a longitudinal study of non‐Hispanic, white girls (n = 182) and their parents, assessed at daughters' ages 5, 7, 9, 11, 13, and 15 years. Height, weight, body fat, fasting blood glucose and lipids, blood pressure, waist circumference, and pubertal status were measured, and participants self‐reported dietary, physical activity, and television (TV) viewing patterns. Growth mixture models were used to model heterogeneity in girls' BMI trajectories over 10 years. Statistical support was strongest for four distinct BMI trajectories: (i) upward percentile crossing (UPC; n = 25, 14%); (ii) delayed downward percentile crossing (DDPC; n = 37, 20%); (iii) 60th percentile tracking (60PT; n = 52, 29%); and (iv) 50th percentile tracking (50PT; n = 68, 37%). Girls in the UPC group had more metabolic risk factors at age 15 years, even after adjusting for concurrent weight status. Girls in the UPC group had mothers with the highest BMIs at study entry and were breast‐fed for a shorter duration. This novel approach for examining differences in growth trajectories revealed four distinct BMI trajectories that predicted adolescent metabolic health outcomes in girls. The present study provides support for BMI monitoring in girls and for the potential utility of combining data on BMI tracking with data on familial characteristics for the early identification of girls at elevated risk for obesity and metabolic syndrome.     

Body mass, DRD4, physical activity, sedentary behavior, and family socioeconomic status: the add health study

Objective: To investigate the joint role of the 48‐base pair repeat polymorphism of the dopamine receptor 4 gene (DRD4) and environmental factors in body mass variation among an ethnically diverse sample of U.S. adolescents and young adults. Research Methods and Procedures: Approximately 2600 adolescent and young adults in the National Longitudinal Study of Adolescent Health (Add Health) who provided DNA measures and measures of height and weight were included in the analysis. Mixed regression modeling was used to investigate the effects of the 7R/7R and any5R variants in the DRD4 gene simultaneously with the effects of physical activity (PA), sedentary behavior (SB), and family socioeconomic status (SES) on body mass variation. European Americans, African Americans, and Hispanic Americans were modeled separately. Results and Discussion: Both the 7R/7R and any5R genotypes of the DRD4 gene were associated with age‐ and sex‐specific BMI percentile score (BMI‐P) based on the Centers for Disease Control and Prevention/National Center for Health Statistics 2000 reference curves among African Americans and only among African Americans (N = 413) 20 years old or younger. Neither genetic variants are associated with the BMI measure among white (N = 1386) and Hispanic‐American (N = 331) adolescents. The presence of the 7R/7R genotype was associated with a reduction of 15.1 in BMI percentile (p = 0.005), and the presence of any5R was associated with an increase of 15.5 in BMI percentile (p = 0.003), after adjusting for PA, SB, and family SES. Neither PA nor SB as measured in Add Health is importantly associated with BMI‐P, suggesting a complex relationship between body mass and PA/SB among adolescents and young adults. Family SES is negatively related to BMI‐P in the European‐American sample.     

Racial/ethnic differences in body fatness among children and adolescents

Background: Although the BMI is widely used as a measure of adiposity, it is a measure of excess weight, and its association with body fatness may differ across racial or ethnic groups. Objective: To determine whether differences in body fatness between white, black, Hispanic, and Asian children vary by BMI‐for‐age, and whether the accuracy of overweight (BMI‐for‐age ≥ Centers for Disease Control and Prevention (CDC) 95th percentile) as an indicator of excess adiposity varies by race/ethnicity. Methods and Procedures: Total body dual‐energy X‐ray absorptiometry (DXA) provided estimates of %body fat among 1,104 healthy 5‐ to 18‐year‐olds. Results: At equivalent levels of BMI‐for‐age, black children had less (mean, 3%) body fatness than white children, and Asian girls had slightly higher (1%) levels of %body fat than white girls. These differences, however, varied by BMI‐for‐age, with the excess body fatness of Asians evident only among relatively thin children. The ability of overweight to identify girls with excess body fatness also varied by race/ethnicity. Of the girls with excess body fatness, 89% (24/27) of black girls, but only 50% (8/16) of Asian girls, were overweight (P = 0.03). Furthermore, the proportion of overweight girls who had excess body fatness varied from 62% (8/13) among Asians to 100% (13/13) among whites. Discussion: There are racial or ethnic differences in body fatness among children, but these differences vary by BMI‐for‐age. If race/ethnicity differences in body fatness among adults also vary by BMI, it may be difficult to develop race‐specific BMI cut points to identify equivalent levels of %body fat.     

Parental recognition of overweight in school-age children

Objective: Examine the accuracy of parental weight perceptions of overweight children before and after the implementation of childhood obesity legislation that included BMI screening and feedback. Methods and Procedures: Statewide telephone surveys of parents of overweight (BMI ≥ 85th percentile) Arkansas public school children before (n = 1,551; 15% African American) and after (n = 2,508; 15% African American) policy implementation were examined for correspondence between parental perception of child's weight and objective classification. Results: Most (60%) parents of overweight children underestimated weight at baseline. Parents of younger children were significantly more likely to underestimate (65%) than parents of adolescents (51%). Overweight parents were not more likely to underestimate, nor was inaccuracy associated with parental education or socioeconomic status. African‐American parents were twice as likely to underestimate as whites. One year after BMI screening and feedback was implemented, the accuracy of classification of overweight children improved (53% underestimation). African‐American parents had significantly greater improvements than white parents (P < 0.0001). Discussion: Parental recognition of childhood overweight may be improved with BMI screening and feedback, and African‐American parents may specifically benefit. Nonetheless, underestimation of overweight is common and may have implications for public health interventions.     

Racial and ethnic differences in secular trends for childhood BMI, weight, and height

Objectives: The prevalence of childhood overweight in the United States has markedly increased over the last 30 years. We examined differences in the secular trends for BMI, weight, and height among white, black, and Mexican‐American children. Research Methods and Procedures: Analyses were based on nationally representative data collected from 2 to 17 year olds in four examinations (1971–1974 through 1999–2002). Results: Overall, black children experienced much larger secular increases in BMI, weight, and height than did white children. For example, over the 30‐year period, the prevalence of overweight increased ～3‐fold (4% to 13%) among 6‐ to 11‐year‐old white children but 5‐fold (4% to 20%) among black children. In most sex‐age groups, Mexican‐American children experienced increases in BMI and overweight that were between those experienced by blacks and whites. Race/ethnicity differences were less marked among 2 to 5 year olds, and in this age group, white children experienced the largest increase in overweight (from 4% to 9%). In 1999–2002, the prevalence of extreme BMI levels (≥99th percentile) reached 6% to 7% among black girls and Mexican‐American boys. Discussion: Because of the strong tracking of childhood BMI levels into adulthood, it is likely that the secular increases in childhood overweight will greatly increase the burden of adult disease. The further development of obesity interventions in different racial/ethnic groups should be emphasized.     

Racial Differences in the Tracking of Childhood BMI to Adulthood

Objective: The possibility that there are racial differences in the patterns of BMI (kilograms per meter squared) change throughout life has not been examined. For example, the high prevalence of obesity among black women could result from a higher prevalence of obesity among black girls or because normal‐weight black girls experience larger BMI increases in adolescence or adulthood than do their white counterparts. Therefore, we examined the tracking of childhood BMI into adulthood in a biracial (36% black) sample. Research Methods and Procedures: Five‐ to 14‐year‐old children (2392) were followed for (mean) 17 years. Childhood overweight was defined as BMI ≥ 95th percentile, and adult obesity was defined as BMI ≥ 30 kg/m². Results: The tracking of childhood BMI differed between whites and blacks. Among overweight children, 65% of white girls vs. 84% of black girls became obese adults, and predictive values among boys were 71% (whites) vs. 82% (blacks). These racial differences reflected contrasting patterns in the rate of BMI change. Although the initial BMI of black children was not higher than that of white children, BMI increases with age were larger among black girls and overweight black boys than among their white counterparts. In contrast, relatively thin (BMI < 50th percentile) white boys were more likely to become overweight adults than were their black counterparts. Discussion: These findings emphasize the black/white differences in BMI changes with age. Because of the adult health consequences of childhood‐onset obesity, early prevention should be given additional emphasis.     

The Relationship of Ethnicity,Socioeconomic Factors,and Overweight in U.S. Adolescents

Objective: To examine the extent to which race/ethnic differences in income and education account for sex‐specific disparities in overweight prevalence in white, African American, Hispanic, and Asian U.S. teens. Research Methods and Procedures: We used nationally representative data collected from 13,113 U.S. adolescents enrolled in the National Longitudinal Study of Adolescent Health. Logistic regression models were used to examine the relationship of family income and parental education to overweight prevalence (body mass index ≥ 85th percentile of age and sex‐specific cutoff points from the 2000 Centers for Disease Control and Prevention/National Center for Health Statistics growth charts). In addition, we used coefficients from our logistic regression models to project the effects on overweight prevalence of equalizing the socioeconomic status (SES) differences between race/ethnic groups. Results: Keeping adolescents in their same environments and changing only family income and parental education had a limited effect on the disparities in overweight prevalence. Ethnicity‐SES‐overweight differences were greater among females than males. Given that overweight prevalence decreased with increasing SES among white females and remained elevated and even increased among higher SES African‐American females, African‐American/white disparity in overweight prevalence increased at the highest SES. Conversely, disparity was lessened at the highest SES for white, Hispanic, and Asian females. Among males, disparity was lowest at the average SES level. Discussion: One cannot automatically assume that the benefits of increased SES found among white adults will transfer to other gender‐age‐ethnic groups. Our findings suggest that efforts to reduce overweight disparities between ethnic groups must look beyond income and education and focus on other factors, such as environmental, contextual, biological, and sociocultural factors.     

Weight‐Bearing Physical Activity among Girls and Mothers: Relationships to Girls’ Weight Status

Objective: To assess weight‐bearing physical activity (WBPA) barriers, benefits, self‐efficacy, social influence, and behaviors [WBPA and physical activity (PA)] among girls and their mothers according to girls’ weight status (nonoverweight vs. overweight). Research Methods and Procedures: Participants were 9‐ to 11‐year‐old girls (n = 295) and their mothers who participated in the baseline assessment of a nutrition and PA intervention trial. Girls’ and mothers’ WBPA attitudes and mothers’ WBPA behaviors were self‐reported on questionnaires. Girls’ WBPA and total PA behaviors were self‐reported using a structured interview (Physical Activity Checklist Interview). Stature and weight were measured by standardized anthropometrics. Overweight status was based on BMI. Results: Compared with nonoverweight girls, overweight girls were significantly more likely to report barriers to WBPA participation and perceive social influence from family and friends to do more WBPA. They were also significantly less likely to report self‐efficacy regarding WBPA and to believe that they did enough WBPA. Compared with mothers of nonoverweight girls, mothers of overweight girls were significantly more likely to report that it is difficult to persuade their daughters to do more WBPA and significantly less likely to report that WBPA was fun for their daughters. Girls’ overweight status was not associated with girls’ reports of minutes spent per week in PA or WBPA. Discussion: The present study's findings of lower WBPA self‐efficacy, lack of enjoyment of WBPA, and higher perceived social influence to do WBPA among overweight girls suggest that efforts are needed to promote physical competencies and positive perceptions of PA among overweight girls.     

Reference Growth Curves for Cypriot Children 6 to 17 Years of Age

Objective: The purpose of the study was to present smoothed percentiles for body weight and height, waist circumference, and body mass index (BMI) in Cypriot children and to compare their BMI 85th and 95th percentiles with those of children in other countries. Research Methods and Procedures: The study was a cross‐sectional study, including a representative sample of 2472 healthy children (49.1% boys) in Cyprus ages 6 to 17 years, who were evaluated during the 1999–2000 school year. Body weight and height and waist circumference were measured using standard procedures. BMI was calculated as weight in kilograms per height in square meters. Smoothed, sex‐specific percentiles for these variables were calculated using polynomial regression models. Crude weight, height, waist, and BMI percentile values are presented in sex‐specific tables and smoothed percentile curves are presented in charts. The 85th and 95th percentiles for BMI were compared with measurements from other countries, because of the concern of the upper limits of BMI in respect to the evaluation of obesity. Results: The 85th and 95th BMI percentile values are higher in Cypriot boys than in Swedish and Iranian boys through all ages and in girls ages 6 to 15 years, whereas after the age of 15 years, both Swedish and Iranian girls’ percentiles are equalized with their Cypriot peers. Discussion: Weight, height, waist circumference, and BMI values and charts are presented for the first time for Cypriot children and adolescents. Much concern should be addressed to the observation that for the majority of the Cypriot sample, the upper BMI limits are higher than the peers of developing and developed countries.     

Accuracy of self-reported weight among bariatric surgery candidates: the influence of race and weight cycling

Objective: Research on the accuracy of self‐reported weight has indicated that the degree of misreporting (underestimating) weight is associated with increasing weight but is variable across patient groups. We examined the degree of discrepancy between actual and self‐reported BMI in severely obese bariatric surgery candidates, and whether the degree of accuracy varied by race and by eating‐related and psychological factors. Research Methods and Procedures: Participants were 179 obese female gastric bypass surgery candidates (31 black, 22 Hispanic, 126 white) who were asked to self‐report height and weight as part of a larger assessment battery. Actual height and weight were then measured and a discrepancy score was generated (actual BMI ? reported BMI). Results: In this group of severely obese patients, degree of misreporting was unrelated to BMI. The race groups did not differ in actual or self‐reported BMI but differed significantly in the degree of misestimation between self‐reported and actual BMI. Post hoc tests indicated that black women underestimated their BMI significantly more than white women; Hispanic women did not differ from the other race groups. No eating‐related or psychological variables assessed predicted percentage discrepancy; however, the accuracy in self‐reported weight was related to history of weight cycling. Discussion: Overall, obese bariatric surgery candidates were accurate in self‐report of weight, although the degree of accuracy differed by race and weight cycling history.     

Two-year internet-based randomized controlled trial for weight loss in African-American girls

Objective: A randomized controlled trial tested the efficacy of an internet‐based lifestyle behavior modification program for African‐American girls over a 2‐year period of intervention. Research Methods and Procedures: Fifty‐seven overweight (mean BMI percentile, 98.3) African‐American girls (mean age, 13.2 years) were randomly assigned to an interactive behavioral internet program or an internet health education program, the control condition. Overweight parents were also participants in the study. Forty adolescent‐parent dyads (70%) completed the 2‐year trial. Outcome data including BMI, body weight, body composition, and weight loss behaviors were collected at baseline and at 6‐month intervals. A computer server tracked use of the web sites. Results: An intention‐to‐treat statistical approach was used, with the last observation carried forward. In comparison with the control condition, adolescents in the behavioral program lost more mean body fat (BF) (?1.12 ± 0.47% vs. 0.43 ± 0.47% BF, p < 0.05), and parents in the behavioral program lost significantly more mean body weight (?2.43 ± 0.66 vs. ?0.35 ± 0.64 kg, p < 0.05) during the first 6 months. This weight loss was regained over the next 18 months. After 2 years, differences in fat for adolescents (?0.08 ± 0.71% vs. 0.84 ± 0.72% BF) and weight for parents (?1.1 ± 0.91 vs. ?0.60 ± 0.89 kg) did not differ between the behavioral and control programs. Discussion: An internet‐based weight management program for African‐American adolescent girls and their parents resulted in weight loss during the first 6 months but did not yield long‐term loss due to reduced use of the web site over time.     

Sex‐Specific Fat Distribution Is Not Linear Across Pubertal Groups in a Multiethnic Study

Objective: To investigate sexual dimorphism and race differences in fat distribution (android/gynoid) before and during puberty. Research Methods and Procedures: Fat distribution was measured by skinfold thickness and DXA in healthy African‐American, Asian, and white subjects (n = 920), divided into pre‐, early, and late pubertal groups. Results: Gynoid fat masses adjusted for covariates were lower in late pubertal compared with prepubertal boys, but were not consistently greater in late pubertal compared with prepubertal girls. Progression of sex‐specific fat distribution with increasing maturation was present in Asians only. Among African‐American and white subjects, early pubertal boys had greater gynoid fat mass compared with the prepubertal group, whereas early pubertal girls had less gynoid fat mass compared with the prepubertal group. Sexual dimorphism in fat distribution was present in all pubertal groups, except among whites at early puberty. Among girls, Asians had lower gynoid fat than whites and African Americans in all pubertal groups. Among boys, Asians had less gynoid fat by DXA in early puberty and late puberty. Discussion: Comparison among races demonstrated differences in sexual dimorphism and sex‐specific fat distribution with progression in pubertal group. However, in all race groups, the fat distribution of late pubertal boys was more “male” or “android” than prepubertal boys, but late pubertal girls did not differ consistently from prepubertal girls. These findings suggested that the greater sexual dimorphism of fat distribution in late puberty compared with prepuberty may be attributable to larger changes in boys with smaller changes in girls.     

Obesity and C-reactive protein levels among white, black, and hispanic US adults

Objective: Studies suggest that obesity's adverse impact on cardiovascular mortality may be reduced in African Americans relative to white Americans. We examined whether obesity's association with novel cardiovascular risk factors such as C‐reactive protein (CRP) also varies by race and ethnicity. Methods and Procedures: We analyzed data from 10,492 white, African‐American, and Hispanic‐American participants of the 1999–2004 National Health and Nutrition Examination Survey, who were aged 20 years and older, with a BMI ≥18.5 kg/m² and CRP ≤10 mg/l. We fit sex‐specific multivariable models of the association of BMI or waist circumference with log CRP levels and tested for interactions of BMI or waist circumference with race/ethnicity. Results: Higher BMI was significantly associated with higher CRP in all racial/ethnic groups for both men and women (P > 0.05 for BMI–race/ethnicity interaction) before and after adjustment for age, education, and health behaviors. Larger waist circumference was also associated with higher CRP levels in all racial/ethnic groups before and after adjustment; among women, the relationship was strongest for Mexican Hispanics (P < 0.01 for waist circumference–race/ethnicity interaction). Results were similar after additional adjustment for medications that might affect CRP levels. Discussion: The association between obesity and CRP is at least as strong in African Americans and Hispanic Americans as in white Americans. Racial differences in the relationship between obesity and cardiovascular mortality are unlikely to be due to racial differences in obesity's impact on CRP.     

Prevalence and characteristics of energy underreporting in African-American girls

Objective: To determine the frequency and characteristics of energy intake underreporting in African‐American preadolescent girls as part of the Girls health Enrichment Multi‐site Studies (GEMS). Methods and Procedures: Energy intake was summarized using the Nutrition Data System for Research software and computed as a 3‐day average of 24‐h dietary recalls. Physical activity was assessed by an accelerometer, basal metabolic rate (BMR) was estimated using the World Health Organization's prediction equation, and underreporting of caloric intake was based on the Goldberg equation. Results: Using a conservative criterion for determining energy underreporting, we classified 54.8% of the girls as underreporters; 45.2% were classified as plausible reporters. Factors related to underreporting included higher BMI (β = ?0.506, P ≤ 0.001), older age (β = ?0.159, P = 0.001), greater unhealthy eating behaviors (β = ?0.118, P = 0.025), and higher self‐efficacy for diet (β = ?0.098, P = 0.033). Discussion: Underreporting of dietary intake, specifically energy, is common in African‐American preadolescent girls and can be partially explained by weight status and psychosocial variables. The extent of dietary underreporting in specific and high‐risk populations is largely unknown and could be evaluated by routinely including a report of such an index in future research studies.     

Associations of Aging and Birth Cohort with Body Mass Index in a Biethnic Cohort

Objective: To examine associations of aging and birth cohort with body mass index (BMI) in a biethnic cohort. Research Methods and Procedures: This was a longitudinal closed cohort study of 14, 500 white and African‐American men and women, 45 to 64 years of age, followed for 9 years. Aging was defined as the length of the interval in years between baseline and following visits. Birth cohort was defined by the year in which participants were born. Mixed model analyses were used to examine associations of aging, birth cohort, and BMI in four ethnicity‐gender groups. Results: We found that aging was associated with an increase in BMI in white and African‐American men and women. The associations between aging and BMI were stronger in the younger birth cohorts. Except for white women, younger birth cohort was associated with a higher BMI. After adjusting for aging, birth cohort was associated with an increase in BMI of 0.1 kg/m² [95% confidence interval (95% CI): ?0.1, 0.3] among white women. The corresponding values for African‐American women, white men, and African‐American men are 0.5 kg/m² (95% CI: 0.1, 0.9), 0.6 kg/m² (95% CI: 0.4, 0.8), and 0.6 kg/m² (95% CI: 0.2, 1.0), respectively. Discussion: Our analyses show that, in all except white women, people in this age range who were born later have a higher BMI at the same attained age. In all groups, people who are born later gained more weight as they aged. In general, subjects ages 45 to 64 years gained weight as they aged 9 years.     

Associations of Fat Distribution and Obesity with Hypertension in a Bi‐ethnic Population: The ARIC Study

Objective: To examine associations of hypertension with obesity and fat distribution among African American and white men and women. Research Methods and Procedures: The analysis sample included 15,063 African American and white men and women between the ages of 45 and 64 years who were participants in the 1987 through 1989 examination of the Atherosclerosis Risk in Communities Study (ARIC). Odds ratios and adjusted prevalences of hypertension were calculated across sexspecific quintiles of body mass index (BMI), waist‐to‐hip ratio (WHR), waist circumference, and waist‐to‐height ratio (waist/height) and adjusted for age, research center, smoking, education, physical activity, alcohol consumption, hormone replacement therapy, and menopausal status. Results: The prevalence of hypertension was higher among African Americans than whites. In the lowest quintile of BMI, 41% of African American women and 43% of African American men had hypertension compared with 14% of white women and 19% of white men. Elevated BMI, WHR, waist circumference, and waist/height were associated with increased odds of hypertension in African American and white men and women. In women, but not in men, there were significant interactions between ethnicity and the anthropometric variables studied here. The direction of the interaction indicated larger odds ratios for hypertension with increasing levels of anthropometric indices in white compared with African American women. Discussion: Obesity and abdominal fat preponderance were associated with increased prevalence of hypertension in African American and white men and women. Associations were similar among African American and white men, but obesity and fat patterning were less strongly associated with hypertension in African American than in white women.     

Asthma and Maternal Body Mass Index Are Related to Pediatric Body Mass Index and Obesity: Results from the Third National Health and Nutrition Examination Survey

Objective: Clinical research has shown an increased prevalence of obesity in children with asthma. This study was designed to assess the relationship between asthma and pediatric body mass index (BMI) in a national database and to examine factors that may modify this relationship. Design: The cross‐sectional relationship between asthma and pediatric BMI and obesity (BMI ≥ 85th percentile) was studied. Variables that may influence the relationship between asthma and pediatric BMI, such as race/ethnicity and television watching were included in the model for the total sample. A smaller sample of 3009 white and African American youth were studied in regression models including maternal BMI. Study Population: A nationally representative crosssectional sample of 5154 children and adolescents of 6 to 16 years of age from the Third National Health And Nutrition Examination Survey. Results: In the full sample, asthma and television watching were related to BMI, accounting for 3% of the variance in BMI. When maternal BMI was included in the nonHispanic sample, television watching, maternal BMI, and the interaction of maternal BMI and asthma were related to youth BMI, accounting for 15% of the variance. The standardized BMI z‐score for those youth without asthma and no maternal obesity was 0.06, which increased to 0.33 if the youth had asthma, to 0.70 if the youth did not have asthma but the mother was obese, and to 1.71 if the youth had asthma and the mother was obese. Asthma, television watching, and maternal BMI were independent predictors of youth obesity. Conclusions: BMI and prevalence of obesity is higher in youth with asthma. Pediatric BMI, but not obesity, is also related to the interaction of asthma and maternal BMI in white and African American youth. Comorbidity of asthma and obesity may complicate treatment of either condition, and prevention of obesity should be encouraged for asthmatic children.     

Weight loss of black, white, and Hispanic men and women in the Diabetes Prevention Program

Objective: To provide the specific weight loss outcomes for African‐American, Hispanic, and white men and women in the lifestyle and metformin treatment arms of the Diabetes Prevention Program (DPP) by race‐gender group to facilitate researchers translating similar interventions to minority populations, as well as provide realistic weight loss expectations for clinicians. Methods and Procedures: Secondary analyses of weight loss of 2,921 overweight participants (22% black; 17% Hispanic; 61% white; and 68% women) with impaired glucose tolerance randomized in the DPP to intensive lifestyle modification, metformin or placebo. Data over a 30‐month period are examined for comparability across treatment arms by race and gender. Results: Within lifestyle treatment, all race‐gender groups lost comparable amounts of weight with the exception of black women who exhibited significantly smaller weight losses (P < 0.01). For example, at 12 months, weight losses for white men (?8.4%), white women (?8.1%), Hispanic men (?7.8%), Hispanic women (?7.1%), and black men (?7.1%) were similar and significantly higher than black women (?4.5%). In contrast, within metformin treatment, all race‐gender groups including black women lost similar amounts of weight. Race‐gender specific mean weight loss data are provided by treatment arm for each follow‐up period. Discussion: Diminished weight losses were apparent among black women in comparison with other race‐gender groups in a lifestyle intervention but not metformin, underscoring the critical nature of examining sociocultural and environmental contributors to successful lifestyle intervention for black women.     

Baseline Correlates of Insulin Resistance in Inner City High‐BMI African‐American Children

To characterize the influence of diet‐, physical activity–, and self‐esteem‐related factors on insulin resistance in 8–10‐year‐old African‐American (AA) children with BMI greater than the 85th percentile who were screened to participate in a community‐based type 2 diabetes mellitus (T2DM) prevention trial. In 165 subjects, fasting glucose‐ and insulin‐derived values for homeostasis model assessment of insulin resistance (HOMA‐IR) assessed insulin resistance. Body fatness was calculated following bioelectrical impedance analysis, and fitness was measured using laps from a 20‐m shuttle run. Child questionnaires assessed physical activity, dietary habits, and self‐esteem. Pubertal staging was assessed using serum levels of sex hormones. Parent questionnaires assessed family demographics, family health, and family food and physical activity habits. Girls had significantly higher percent body fat but similar anthropometric measures compared with boys, whereas boys spent more time in high‐intensity activities than girls. Scores for self‐perceived behavior were higher for girls than for boys; and girls desired a more slender body. Girls had significantly higher insulin resistance (HOMA‐IR), compared with boys (P < 0.01). Adjusting for age, sex, pubertal stage, socioeconomic index (SE index), and family history of diabetes, multivariate regression analysis showed that children with higher waist circumference (WC) (P < 0.001) and lower Harter's scholastic competence (SC) scale (P = 0.044) had higher insulin resistance. WC and selected self‐esteem parameters predicted insulin resistance in high‐BMI AA children. The risk of T2DM may be reduced in these children by targeting these factors.