Association of built environment characteristics with adiposity and glycaemic measures.

OBJECTIVE: This study examined the cross-sectional and longitudinal relationships of built environment characteristics with adiposity and glycaemic measures. METHOD: Longitudinal study sample consisted of 4,010 Framingham Heart Study Offspring (baseline: 1998-2001; follow-up: 2005-2008) and Generation Three (baseline: 2002-2005; follow-up: 2008-2011) participants (54.8% women, baseline mean age 48.6 years). Built environment characteristics (intersection density, greenspace, recreation land and food stores) at baseline were collected. Adiposity and glycaemic measures (body mass index [BMI], waist circumference, abdominal subcutaneous and visceral adipose tissue, and fasting plasma glucose) at baseline and changes during 6.4-year follow-up were measured. RESULTS: In cross-sectional models, higher intersection density and food store density (total food stores, fast food restaurants and supermarkets) were linearly associated with higher BMI (all p < 0.05). Higher greenspace was associated with lower BMI, waist circumference, fasting plasma glucose, prevalent obesity and prevalent diabetes (all p < 0.05). Longitudinally, higher intersection density and food store density, and lower greenspace were associated with smaller increases in abdominal visceral adipose tissue (all p < 0.05). Higher densities of intersections, fast food restaurants and supermarkets were associated with smaller increases in fasting plasma glucose (all p < 0.05). CONCLUSIONS: Collectively, built environment characteristics are associated with adiposity and glycaemic traits, suggesting the potential mechanisms by which built environment influences cardiometabolic health.

Mobile Health Technology Can Objectively Capture Physical Activity (PA) Targets Among African-American Women Within Resource-Limited Communities-the Washington, D.C. Cardiovascular Health and Needs Assessment.

BACKGROUND: Little is understood about using mobile health (mHealth) technology to improve cardiovascular (CV) health among African-American women in resource-limited communities. METHODS: We conducted the Washington, D.C. CV Health and Needs Assessment in predominantly African-American churches in city wards 5, 7, and 8 with the lowest socioeconomic status based on community-based participatory research (CBPR) principles. The assessment measured CV health factors: body mass index (BMI), fasting blood glucose and cholesterol, blood pressure, fruit/vegetable (F/V) intake, physical activity (PA), and smoking. Participants were trained to use a PA monitoring wristband to measure 30 days of PA, wirelessly upload the PA data to hubs at the participating churches, and access their data from a church/home computer. CV health factors were compared across weight classes. RESULTS: Among females (N = 78; 99 % African-American; mean age = 59 years), 90 % had a BMI categorized as overweight/obese. Across weight classes, PA decreased and self-reported sedentary time (ST) increased (p ≤ 0.05). Diastolic blood pressure and glucose increased across weight classes (p ≤ 0.05); however, cholesterol, glucose, and BP were near intermediate CV health goals. CONCLUSIONS: Decreased PA and increased ST are potential community intervention targets for overweight and obese African-American women in resource-limited Washington D.C. areas. mHealth technology can assist in adapting CBPR intervention resources to improve PA for African-American women in resource-limited communities.

Randomized trial of nutrition education added to internet-based information and exercise at the work place for weight loss in a racially diverse population of overweight women.

OBJECTIVE: Obesity in the United States is highly prevalent, approaching 60% for black women. We investigated whether nutrition education sessions at the work place added to internet-based wellness information and exercise resources would facilitate weight and fat mass loss in a racially diverse population of overweight female employees. METHODS: A total of 199 (average body mass index 33.9±6.3 kg m(-2)) nondiabetic women (57% black) at our institution were randomized to a 6-month program of either internet-based wellness information (WI) combined with dietitian-led nutrition education group sessions (GS) weekly for 3 months and then monthly with shift in emphasis to weight loss maintenance (n=99) or to WI alone (n=100). All were given access to exercise rooms convenient to their work site. Fat mass was measured by dual-energy X-ray absorptiometry. RESULTS: WI+GS subjects lost more weight than WI subjects at 3 months (-2.2±2.8 vs -1.0±3.0 kg, P>0.001). Weight (-2.7±3.9 vs -2.0±3.9 kg) and fat mass (-2.2±3.1 vs -1.7±3.7 kg) loss at 6 months was significant for WI+GS and WI groups (both P<0.001), but without significant difference between groups (both P>0.10); 27% of the WI+GS group achieved 5% loss of initial weight as did 18% of the WI group (P=0.180). Blacks and whites similarly completed the study (67 vs 74%, P=0.303), lost weight (-1.8±3.4 vs -3.3±5.2 kg, P=0.255) and fat mass (-1.6±2.7 vs -2.5±4.3 kg, P=0.532), and achieved 5% loss of initial weight (21 vs 32%, P=0.189), irrespective of group assignment. CONCLUSION: Overweight women provided with internet-based wellness information and exercise resources at the work site lost weight and fat mass, with similar achievement by black and white women. Additional weight loss benefit of nutrition education sessions, apparent at 3 months, was lost by 6 months and may require special emphasis on subjects who fail to achieve weight loss goals to show continued value.