PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of jnmaLink to Publisher's site
 
J Natl Med Assoc. 2000 November; 92(11): 515–523.
PMCID: PMC2568323

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

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

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.3M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Kumanyika SK. Special issues regarding obesity in minority populations. Ann Intern Med. 1993 Oct 1;119(7 Pt 2):650–654. [PubMed]
  • Kumanyika SK, Obarzanek E, Stevens VJ, Hebert PR, Whelton PK, Kumanyaka SK. Weight-loss experience of black and white participants in NHLBI-sponsored clinical trials. Am J Clin Nutr. 1991 Jun;53(6 Suppl):1631S–1638S. [PubMed]
  • Kumanyika SK, 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]
  • Sobal J, Stunkard AJ. Socioeconomic status and obesity: a review of the literature. Psychol Bull. 1989 Mar;105(2):260–275. [PubMed]
  • Kempner W, Newborg BC, Peschel RL, Skyler JS. 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]
  • Ben-Tovim DI, Walker MK. 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. [PubMed]
  • Atkinson RL. Proposed standards for judging the success of the treatment of obesity. Ann Intern Med. 1993 Oct 1;119(7 Pt 2):677–680. [PubMed]
  • Dawson DA. Ethnic differences in female overweight: data from the 1985 National Health Interview Survey. Am J Public Health. 1988 Oct;78(10):1326–1329. [PubMed]
  • Williamson DF. Descriptive epidemiology of body weight and weight change in U.S. adults. Ann Intern Med. 1993 Oct 1;119(7 Pt 2):646–649. [PubMed]
  • Stevens J, Kumanyika SK, Keil JE. Attitudes toward body size and dieting: differences between elderly black and white women. Am J Public Health. 1994 Aug;84(8):1322–1325. [PubMed]
  • Melnyk MG, Weinstein E. Preventing obesity in black women by targeting adolescents: a literature review. J Am Diet Assoc. 1994 May;94(5):536–540. [PubMed]
  • Kumanyika S. Obesity in black women. Epidemiol Rev. 1987;9:31–50. [PubMed]
  • Kumanyika S, Wilson JF, Guilford-Davenport M. Weight-related attitudes and behaviors of black women. J Am Diet Assoc. 1993 Apr;93(4):416–422. [PubMed]
  • Langford HG, Blaufox MD, Oberman A, Hawkins CM, Curb JD, Cutter GR, Wassertheil-Smoller S, Pressel S, Babcock C, Abernethy JD, et al. Dietary therapy slows the return of hypertension after stopping prolonged medication. JAMA. 1985 Feb 1;253(5):657–664. [PubMed]
  • Spielman AB, Kanders B, Kienholz M, Blackburn GL. 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. [PubMed]
  • Gortmaker SL, Must A, Perrin JM, Sobol AM, Dietz WH. Social and economic consequences of overweight in adolescence and young adulthood. N Engl J Med. 1993 Sep 30;329(14):1008–1012. [PubMed]
  • Farrell SW, Kohl HW, Rogers T. The independent effect of ethnicity on cardiovascular fitness. Hum Biol. 1987 Aug;59(4):657–666. [PubMed]
  • Kanders BS, Ullmann-Joy P, Foreyt JP, Heymsfield SB, Heber D, Elashoff RM, Ashley JM, Reeves RS, Blackburn GL. 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. [PubMed]
  • McNabb WL, Quinn MT, 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. [PubMed]
  • Domel SB, Alford BB, Cattlett HN, Gench BE. Weight control for black women. J Am Diet Assoc. 1992 Mar;92(3):346–348. [PubMed]
  • Sullivan J, Carter JP. 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]
  • Goldstein DJ. Beneficial health effects of modest weight loss. Int J Obes Relat Metab Disord. 1992 Jun;16(6):397–415. [PubMed]
  • Blackburn GL. Comparison of medically supervised and unsupervised approaches to weight loss and control. Ann Intern Med. 1993 Oct 1;119(7 Pt 2):714–718. [PubMed]
  • Bennett EM. Weight-loss practices of overweight adults. Am J Clin Nutr. 1991 Jun;53(6 Suppl):1519S–1521S. [PubMed]
  • McGinnis JM, Ballard-Barbash RM. Obesity in minority populations: policy implications of research. Am J Clin Nutr. 1991 Jun;53(6 Suppl):1512S–1514S. [PubMed]
  • Van Itallie TB. Health implications of overweight and obesity in the United States. Ann Intern Med. 1985 Dec;103(6 ):983–988. [PubMed]
  • Stevens J, Keil JE, Rust PF, Tyroler HA, Davis CE, Gazes PC. 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]
  • Stunkard AJ, Wadden TA. Psychological aspects of severe obesity. Am J Clin Nutr. 1992 Feb;55(2 Suppl):524S–532S. [PubMed]
  • Hoiberg A, McNally MS. Profiling overweight patients in the U.S. Navy: health conditions and costs. Mil Med. 1991 Feb;156(2):76–82. [PubMed]
  • Colditz GA. Economic costs of obesity. Am J Clin Nutr. 1992 Feb;55(2 Suppl):503S–507S. [PubMed]
  • Williams DR. Black-White differences in blood pressure: the role of social factors. Ethn Dis. 1992 Spring;2(2):126–141. [PubMed]
  • Levy AS, Heaton AW. Weight control practices of U.S. adults trying to lose weight. Ann Intern Med. 1993 Oct 1;119(7 Pt 2):661–666. [PubMed]
  • Pi-Sunyer FX. Health implications of obesity. Am J Clin Nutr. 1991 Jun;53(6 Suppl):1595S–1603S. [PubMed]
  • Pi-Sunyer FX. Medical hazards of obesity. Ann Intern Med. 1993 Oct 1;119(7 Pt 2):655–660. [PubMed]
  • Pi-Sunyer FX. The role of very-low-calorie diets in obesity. Am J Clin Nutr. 1992 Jul;56(1 Suppl):240S–243S. [PubMed]
  • Hill JO, Drougas H, Peters JC. Obesity treatment: can diet composition play a role? Ann Intern Med. 1993 Oct 1;119(7 Pt 2):694–697. [PubMed]
  • Hyman FN, Sempos E, Saltsman J, Glinsmann WH. 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. [PubMed]
  • Robison JI, Hoerr SL, Strandmark J, Mavis B. Obesity, weight loss, and health. J Am Diet Assoc. 1993 Apr;93(4):445–449. [PubMed]
  • Foreyt JP, Goodrick GK. Evidence for success of behavior modification in weight loss and control. Ann Intern Med. 1993 Oct 1;119(7 Pt 2):698–701. [PubMed]
  • Brownell KD, Wadden TA. Etiology and treatment of obesity: understanding a serious, prevalent, and refractory disorder. J Consult Clin Psychol. 1992 Aug;60(4):505–517. [PubMed]
  • Blair SN. Evidence for success of exercise in weight loss and control. Ann Intern Med. 1993 Oct 1;119(7 Pt 2):702–706. [PubMed]
  • Newborg B. Disappearance of psoriatic lesions on the Rice Diet. N C Med J. 1986 May;47(5):253–255. [PubMed]
  • Fontaine KR, Cheskin LJ, Barofsky I. Health-related quality of life in obese persons seeking treatment. J Fam Pract. 1996 Sep;43(3):265–270. [PubMed]

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