New Way To Reduce Type 2 Diabetes Risk in Black Women
Among black women, type 2 diabetes risk and complications associated with the disease are greater than among white women. Attempts to reduce that risk have been less than successful, but now a report published by JAMA Internal Medicine explains a new way to reduce diabetes risk in black women that involves taking a different perspective on body weight.
Forget about weight loss
Among the risk factors for type 2 diabetes, the ones most frequently mentioned are obesity, insulin resistance, high triglycerides, high blood pressure, and family history. The good news is that people can take aggressive, positive steps to prevent the first four of these five items.
Unfortunately, efforts to reduce these risk factors can be challenging, especially obesity. Despite the wealth of different weight loss programs, diets, and medical regimens, most people are unable to lose weight and keep it off, and often gain back more weight in the process.
This is not good news, especially for blacks. Here are some facts to know.
Differences between black and white regarding type 2 diabetes
The US Department of Health and Human Services notes that blacks are nearly twice (1.8 times) as likely to receive a diagnosis of diabetes than are non-Hispanic whites. In addition, blacks were 2.2 times as likely as non-Hispanic whites to die from diabetes in 2009.
Diabetic complications are also more problematic among blacks. Blacks are nearly 50 percent as likely to develop eye problems (diabetic retinopathy) as are non-Hispanic whites and 2.6 to 5.6 times as likely to develop kidney disease associated with diabetes, according to the American Diabetes Association. Amputation of a lower limb is 2.7 times as likely to be necessary among blacks than among whites.
What the new study shows
At Duke University, a research team explored the use of a weight program that focused on maintaining weight rather than striving for weight loss among 194 premenopausal black women ages 25 to 44. Why was this group of women chosen?
Research shows that black premenopausal women who are overweight or mildly obese are less likely to develop chronic diseases such as type 2 diabetes than are their obese counterparts in other racial groups. However, that risk changes significantly as black women get older because they are more likely to become moderately to severely obese, which in turn increases their chances of developing type 2 diabetes and other serious conditions.
Thus the researchers proposed that preventing weight gain could prevent these women from developing type 2 diabetes and other health problems. Since preventing weight gain is less challenging than trying to lose pounds, the chances of success are more likely.
In addition, overweight black women generally are more comfortable with their body image than are overweight white women. A program designed to assist them in maintaining their weight seemed to have a better chance of working than one that encouraged weight loss.
Half of the women (97) received weight-loss counseling from their doctors while the other half (97) participated in a program called Shape. This program involved the use of software that produced personalized behavior-based goals regarding diet and exercise for each woman. Each woman also received automated phone calls every week and was assigned a personal health coach and given a gym membership. They were told the purpose of the program was to feel healthier and to maintain their current body weight.
Monitoring of participants at 12 months and 18 months showed that generally, women in the intervention group maintained their weight while those who saw their doctors continued to gain weight. The authors concluded that “new treatment approaches, such as weight gain prevention, are necessary to contend with the considerable challenge of obesity in this population.”
According to the study’s lead author, Gary Bennett, an associate professor of psychology and neuroscience and global health at Duke, it’s easier to maintain one’s weight than to lose it. “We think this ‘maintain, don’t gain’ approach can help some women reduce their risk of obesity-related chronic disease,” he concluded, such as type 2 diabetes, cardiovascular disease, and some forms of cancer.
American Diabetes Association
Bennett G et al. Behavioral treatment for weight gain prevention among black women in primary care practice: a randomized controlled trial. JAMA Internal Medicine 2013. Online Aug 26. DOI:10.1001/jamainternmed.2013.9263
US Department of Health & Human Services