The American journal of clinical nutrition
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To examine the relation of obesity to cardiovascular disease in blacks, we analyzed data from two population studies, including young and middle-aged adults. Obesity, defined by using the sum of subscapular and triceps skinfold measurements, was positively associated with atherogenic plasma lipids, systolic blood pressure, serum glucose and insulin, and prevalence of diabetes mellitus. The strength of these associations, for the most part, was similar in blacks and whites. ⋯ Prevalence of cardiovascular disease in 45- to 65-y-old blacks was associated with obesity; the odds ratio (95% confidence interval), adjusted for age and cigarette smoking, was 1.3 (0.9, 1.8) in both black men and black women. Additional analyses showed that abdominal adiposity conferred increased risk. These findings suggest that both blacks and whites should avoid excess adiposity.
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The health risks of obesity increase with its severity and reach significance at a weight greater than 20% above optimal, by using life insurance tables, or at a body mass index greater than 27. Risks include hypertension, insulin resistance and diabetes mellitus, cardiovascular disease, hypertriglyceridemia, low high-density-lipoprotein cholesterol, and, in some studies, high total-and low-density-lipoprotein cholesterol. ⋯ The distribution of body fat is directly related to these health risks. Abdominal obesity is more dangerous than gluteal-femoral obesity because the amount of intraabdominal fat seems to determine much of the increased peril; therefore, risks of cardiovascular disease, stroke, hypertension, and diabetes increase with abdominal obesity, even independently of total fat mass.
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We examined the 10-y change in body mass index (BMI, in kg/m2) of black and white adults who entered the First National Health and Nutrition Examination Survey Epidemiologic Followup Study at ages 25-44 y. In women the mean change in BMI was greater for blacks than for whites despite multiple adjustments. However, the risk of major weight gain (MWG; BMI change greater than or equal to + 5) was nearly identical in black and white women. ⋯ The risk of major weight loss (MWL; BMI change less than or equal to -2.5) was lower in black women than in white women (OR = 0.6). In men mean BMI change, MWG (BMI change greater than or equal to + 4) and MWL (BMI change greater than or equal to -2) were not associated with race, but there were effects associated with low income, low education, and marital changes. Black race does not increase the risk of weight gain; in women it may be associated with a reduced likelihood of weight loss.
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Although the prevalence of obesity in US women is well-described, data are limited on the incidence of major weight gain and obesity. We used data from the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study to estimate the 10-y incidence of major weight gain (greater than or equal to 10 kg) and obesity [body mass index (BMI, in kg/m2) greater than or equal to 29] in a cohort of US women aged 30-55 y (n = 535 blacks and 2976 whites). ⋯ The incidence of major weight gain was 50% higher in blacks than in whites (in blacks, 17.3%; 95% CI = 13.6-21.0; in whites, 11.7%; 95% CI = 10.3-13.1). We estimate that in black and white women, respectively, 16% and 12% of coronary heart disease is attributed to major weight gain whereas 35% and 21% is attributed to being obese.
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Data from the Behavioral Risk Factor Surveillance System, 1985-1988, were used to assess differences in weight-loss practices of overweight adults by sex and race. Data were available for 112,108 respondents from 21 states, aged greater than or equal to 18 y. Overweight was defined as body mass index greater than or equal to 27.3 for women and greater than or equal to 27.8 for men. ⋯ Overweight men most frequently reported not trying to lose weight (blacks, 55%; whites, 49%). Although the prevalence of overweight for black women was twice that for white women, weight-loss practices were similar for both groups. Prevalence of overweight was similar for black and white men but weight-loss practices differed slightly.