Skip to main content
NCBI home page
Journal of the National Medical Association logoLink to Journal of the National Medical Association
. 2000 Nov;92(11):515–523.

Culturally-sensitive weight loss program produces significant reduction in weight, blood pressure, and cholesterol in eight weeks.

J D Ard 1, R Rosati 1, E Z Oddone 1
PMCID: PMC2568323  PMID: 11152083

Abstract

Dietary and behavioral needs of special populations are rarely considered in traditional weight loss programs. This study assessed the impact of culturally-sensitive modifications to the Duke University Rice Diet weight loss program for African-American dieters. The study was a randomized modified cross-over study in which volunteers received either early or delayed weight loss intervention. Final outcomes were measured at 8 weeks. At the onset of the study, there were 56 African American participants, however, only 44 (79%) completed the study. The eight-week intervention was a modified 1000-calorie/day version of the Rice Diet. Modifications to the program included decreased cost, culturally-sensitive recipes, addressing attitudes about exercise, and including family members in weight loss efforts. Average weight loss for subjects completing the program was 14.8 pounds (SD = 6.8 pounds). BMI decreased from 37.8 kg/m2 to 35.3 kg/m2 (p < 0.01). Total cholesterol levels decreased from 199.2 mg/dL to 185.4 mg/dL (p < 0.01); systolic and diastolic blood pressure decreased by 4.3 mmHg (p < 0.01) and 2.4 mmHg (p < 0.05), respectively. The control group showed no significant change in any outcome measures. We found that diet programs can be successfully tailored to incorporate the needs of African-Americans. Most importantly, these dietary program changes can lead to significant improvement in clinical parameters. Additional studies are necessary to determine the permanence of these short-term changes.

Full text

PDF
515

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Atkinson R. L. Proposed standards for judging the success of the treatment of obesity. Ann Intern Med. 1993 Oct 1;119(7 Pt 2):677–680. doi: 10.7326/0003-4819-119-7_part_2-199310011-00010. [DOI] [PubMed] [Google Scholar]
  2. Ben-Tovim D. I., Walker M. K. The development of the Ben-Tovim Walker Body Attitudes Questionnaire (BAQ), a new measure of women's attitudes towards their own bodies. Psychol Med. 1991 Aug;21(3):775–784. doi: 10.1017/s0033291700022406. [DOI] [PubMed] [Google Scholar]
  3. Bennett E. M. Weight-loss practices of overweight adults. Am J Clin Nutr. 1991 Jun;53(6 Suppl):1519S–1521S. doi: 10.1093/ajcn/53.6.1519S. [DOI] [PubMed] [Google Scholar]
  4. Blackburn G. L. Comparison of medically supervised and unsupervised approaches to weight loss and control. Ann Intern Med. 1993 Oct 1;119(7 Pt 2):714–718. doi: 10.7326/0003-4819-119-7_part_2-199310011-00017. [DOI] [PubMed] [Google Scholar]
  5. Blair S. N. Evidence for success of exercise in weight loss and control. Ann Intern Med. 1993 Oct 1;119(7 Pt 2):702–706. doi: 10.7326/0003-4819-119-7_part_2-199310011-00015. [DOI] [PubMed] [Google Scholar]
  6. Brownell K. D., Wadden T. A. Etiology and treatment of obesity: understanding a serious, prevalent, and refractory disorder. J Consult Clin Psychol. 1992 Aug;60(4):505–517. doi: 10.1037//0022-006x.60.4.505. [DOI] [PubMed] [Google Scholar]
  7. Colditz G. A. Economic costs of obesity. Am J Clin Nutr. 1992 Feb;55(2 Suppl):503S–507S. doi: 10.1093/ajcn/55.2.503s. [DOI] [PubMed] [Google Scholar]
  8. Dawson D. A. Ethnic differences in female overweight: data from the 1985 National Health Interview Survey. Am J Public Health. 1988 Oct;78(10):1326–1329. doi: 10.2105/ajph.78.10.1326. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Domel S. B., Alford B. B., Cattlett H. N., Gench B. E. Weight control for black women. J Am Diet Assoc. 1992 Mar;92(3):346–348. [PubMed] [Google Scholar]
  10. Farrell S. W., Kohl H. W., Rogers T. The independent effect of ethnicity on cardiovascular fitness. Hum Biol. 1987 Aug;59(4):657–666. [PubMed] [Google Scholar]
  11. Fontaine K. R., Cheskin L. J., Barofsky I. Health-related quality of life in obese persons seeking treatment. J Fam Pract. 1996 Sep;43(3):265–270. [PubMed] [Google Scholar]
  12. Foreyt J. P., Goodrick G. K. Evidence for success of behavior modification in weight loss and control. Ann Intern Med. 1993 Oct 1;119(7 Pt 2):698–701. doi: 10.7326/0003-4819-119-7_part_2-199310011-00014. [DOI] [PubMed] [Google Scholar]
  13. Goldstein D. J. Beneficial health effects of modest weight loss. Int J Obes Relat Metab Disord. 1992 Jun;16(6):397–415. [PubMed] [Google Scholar]
  14. Gortmaker S. L., Must A., Perrin J. M., Sobol A. M., Dietz W. H. Social and economic consequences of overweight in adolescence and young adulthood. N Engl J Med. 1993 Sep 30;329(14):1008–1012. doi: 10.1056/NEJM199309303291406. [DOI] [PubMed] [Google Scholar]
  15. Hill J. O., Drougas H., Peters J. C. Obesity treatment: can diet composition play a role? Ann Intern Med. 1993 Oct 1;119(7 Pt 2):694–697. doi: 10.7326/0003-4819-119-7_part_2-199310011-00013. [DOI] [PubMed] [Google Scholar]
  16. Hoiberg A., McNally M. S. Profiling overweight patients in the U.S. Navy: health conditions and costs. Mil Med. 1991 Feb;156(2):76–82. [PubMed] [Google Scholar]
  17. Hyman F. N., Sempos E., Saltsman J., Glinsmann W. H. Evidence for success of caloric restriction in weight loss and control. Summary of data from industry. Ann Intern Med. 1993 Oct 1;119(7 Pt 2):681–687. doi: 10.7326/0003-4819-119-7_part_2-199310011-00011. [DOI] [PubMed] [Google Scholar]
  18. Kanders B. S., Ullmann-Joy P., Foreyt J. P., Heymsfield S. B., Heber D., Elashoff R. M., Ashley J. M., Reeves R. S., Blackburn G. L. The black American lifestyle intervention (BALI): the design of a weight loss program for working-class African-American women. J Am Diet Assoc. 1994 Mar;94(3):310–312. doi: 10.1016/0002-8223(94)90374-3. [DOI] [PubMed] [Google Scholar]
  19. Kempner W., Newborg B. C., Peschel R. L., Skyler J. S. Treatment of massive obesity with rice/reduction diet program. An analysis of 106 patients with at least a 45-kg weight loss. Arch Intern Med. 1975 Dec;135(12):1575–1584. [PubMed] [Google Scholar]
  20. Kumanyika S. K., Morssink C., Agurs T. Models for dietary and weight change in African-American women: identifying cultural components. Ethn Dis. 1992 Spring;2(2):166–175. [PubMed] [Google Scholar]
  21. Kumanyika S. K., Obarzanek E., Stevens V. J., Hebert P. R., Whelton P. K., Kumanyaka S. K. Weight-loss experience of black and white participants in NHLBI-sponsored clinical trials. Am J Clin Nutr. 1991 Jun;53(6 Suppl):1631S–1638S. doi: 10.1093/ajcn/53.6.1631S. [DOI] [PubMed] [Google Scholar]
  22. Kumanyika S. K. Special issues regarding obesity in minority populations. Ann Intern Med. 1993 Oct 1;119(7 Pt 2):650–654. doi: 10.7326/0003-4819-119-7_part_2-199310011-00005. [DOI] [PubMed] [Google Scholar]
  23. Kumanyika S. Obesity in black women. Epidemiol Rev. 1987;9:31–50. doi: 10.1093/oxfordjournals.epirev.a036307. [DOI] [PubMed] [Google Scholar]
  24. Kumanyika S., Wilson J. F., Guilford-Davenport M. Weight-related attitudes and behaviors of black women. J Am Diet Assoc. 1993 Apr;93(4):416–422. doi: 10.1016/0002-8223(93)92287-8. [DOI] [PubMed] [Google Scholar]
  25. Langford H. G., Blaufox M. D., Oberman A., Hawkins C. M., Curb J. D., Cutter G. R., Wassertheil-Smoller S., Pressel S., Babcock C., Abernethy J. D. Dietary therapy slows the return of hypertension after stopping prolonged medication. JAMA. 1985 Feb 1;253(5):657–664. [PubMed] [Google Scholar]
  26. Levy A. S., Heaton A. W. Weight control practices of U.S. adults trying to lose weight. Ann Intern Med. 1993 Oct 1;119(7 Pt 2):661–666. doi: 10.7326/0003-4819-119-7_part_2-199310011-00007. [DOI] [PubMed] [Google Scholar]
  27. McGinnis J. M., Ballard-Barbash R. M. Obesity in minority populations: policy implications of research. Am J Clin Nutr. 1991 Jun;53(6 Suppl):1512S–1514S. doi: 10.1093/ajcn/53.6.1512S. [DOI] [PubMed] [Google Scholar]
  28. McNabb W. L., Quinn M. T., Rosing L. Weight loss program for inner-city black women with non-insulin-dependent diabetes mellitus: PATHWAYS. J Am Diet Assoc. 1993 Jan;93(1):75–77. doi: 10.1016/0002-8223(93)92138-n. [DOI] [PubMed] [Google Scholar]
  29. Melnyk M. G., Weinstein E. Preventing obesity in black women by targeting adolescents: a literature review. J Am Diet Assoc. 1994 May;94(5):536–540. doi: 10.1016/0002-8223(94)90218-6. [DOI] [PubMed] [Google Scholar]
  30. Newborg B. Disappearance of psoriatic lesions on the Rice Diet. N C Med J. 1986 May;47(5):253–255. [PubMed] [Google Scholar]
  31. Pi-Sunyer F. X. Health implications of obesity. Am J Clin Nutr. 1991 Jun;53(6 Suppl):1595S–1603S. doi: 10.1093/ajcn/53.6.1595S. [DOI] [PubMed] [Google Scholar]
  32. Pi-Sunyer F. X. Medical hazards of obesity. Ann Intern Med. 1993 Oct 1;119(7 Pt 2):655–660. doi: 10.7326/0003-4819-119-7_part_2-199310011-00006. [DOI] [PubMed] [Google Scholar]
  33. Pi-Sunyer F. X. The role of very-low-calorie diets in obesity. Am J Clin Nutr. 1992 Jul;56(1 Suppl):240S–243S. doi: 10.1093/ajcn/56.1.240S. [DOI] [PubMed] [Google Scholar]
  34. Robison J. I., Hoerr S. L., Strandmark J., Mavis B. Obesity, weight loss, and health. J Am Diet Assoc. 1993 Apr;93(4):445–449. doi: 10.1016/0002-8223(93)92293-7. [DOI] [PubMed] [Google Scholar]
  35. Sobal J., Stunkard A. J. Socioeconomic status and obesity: a review of the literature. Psychol Bull. 1989 Mar;105(2):260–275. doi: 10.1037/0033-2909.105.2.260. [DOI] [PubMed] [Google Scholar]
  36. Spielman A. B., Kanders B., Kienholz M., Blackburn G. L. The cost of losing: an analysis of commercial weight-loss programs in a metropolitan area. J Am Coll Nutr. 1992 Feb;11(1):36–41. doi: 10.1080/07315724.1992.10718194. [DOI] [PubMed] [Google Scholar]
  37. Stevens J., Keil J. E., Rust P. F., Tyroler H. A., Davis C. E., Gazes P. C. Body mass index and body girths as predictors of mortality in black and white women. Arch Intern Med. 1992 Jun;152(6):1257–1262. [PubMed] [Google Scholar]
  38. Stevens J., Kumanyika S. K., Keil J. E. Attitudes toward body size and dieting: differences between elderly black and white women. Am J Public Health. 1994 Aug;84(8):1322–1325. doi: 10.2105/ajph.84.8.1322. [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. Stunkard A. J., Wadden T. A. Psychological aspects of severe obesity. Am J Clin Nutr. 1992 Feb;55(2 Suppl):524S–532S. doi: 10.1093/ajcn/55.2.524s. [DOI] [PubMed] [Google Scholar]
  40. Sullivan J., Carter J. P. A nutrition-physical fitness intervention program for low-income black parents. J Natl Med Assoc. 1985 Jan;77(1):39–43. [PMC free article] [PubMed] [Google Scholar]
  41. Van Itallie T. B. Health implications of overweight and obesity in the United States. Ann Intern Med. 1985 Dec;103(6 ):983–988. doi: 10.7326/0003-4819-103-6-983. [DOI] [PubMed] [Google Scholar]
  42. Williams D. R. Black-White differences in blood pressure: the role of social factors. Ethn Dis. 1992 Spring;2(2):126–141. [PubMed] [Google Scholar]
  43. Williamson D. F. Descriptive epidemiology of body weight and weight change in U.S. adults. Ann Intern Med. 1993 Oct 1;119(7 Pt 2):646–649. doi: 10.7326/0003-4819-119-7_part_2-199310011-00004. [DOI] [PubMed] [Google Scholar]

Articles from Journal of the National Medical Association are provided here courtesy of National Medical Association

RESOURCES