African American women exhibit similar adherence to intervention but lose less weight due to lower energy requirements

• Published in: International Journal of Obesity 2014-09, Vol.38 (9), p.1147-1152
• Main Authors: DeLany, J P, Jakicic, J M, Lowery, J B, Hames, K C, Kelley, D E, Goodpaster, B H
• Format: Article
• Language: English
• Subjects: 631/443/319; 692/699/2743/393; 692/700/2817; Absorptiometry, Photon; African American women; African Americans; African Americans - statistics & numerical data; Basal Metabolism; Behavior modification; Behavior Therapy - methods; Bioenergetics; Biological and medical sciences; Black people; Body Composition; Body Mass Index; Body weight; Body weight loss; Caloric Restriction - methods; Demographic aspects; Diabetes; Dietary restrictions; Endocrinology; Energy; Energy expenditure; Energy intake; Energy Metabolism; Energy requirements; Environmental aspects; Epidemiology; European Continental Ancestry Group - statistics & numerical data; Exercise; Female; Health aspects; Health care disparities; Health Promotion and Disease Prevention; Humans; Hypertension; Inequality; Internal Medicine; Intervention; Medical sciences; Medicine; Medicine & Public Health; Metabolic Diseases; Metabolic rate; Metabolism; Middle Aged; Minority & ethnic groups; Miscellaneous; Nutrient deficiency; Obesity; Obesity, Morbid - ethnology; Obesity, Morbid - metabolism; Obesity, Morbid - prevention & control; original-article; Patient Compliance; Physical activity; Physiological aspects; Public Health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Racial differences; Self report; Social aspects; Treatment Outcome; United States - epidemiology; Weight control; Weight loss; Weight Loss - ethnology; Weight reduction; Weight Reduction Programs - methods; White people; Womens health
• ISSN: 0307-0565; 1476-5497
• DOI: 10.1038/ijo.2013.240

Background: African American (AA) women have been shown to lose less weight than Caucasian women in response to behavioral interventions. Our objective was to examine adherence to intervention and metabolic factors that may explain this difference. Design and subjects: We examined longitudinal changes in body weight and energy expenditure (EE), and objective assessment of physical activity (PA) and energy intake (EI) during 6 months of a weight-loss intervention program, including prescribed calorie restriction and increased PA in 66 Caucasian and 39 AA severely obese women. Comparisons were also made in 25 Caucasian and 25 AA women matched for initial body weight. Results: The AA women lost 3.6 kg less weight than Caucasian women. Total daily EE (TDEE) and resting metabolic rate (RMR) adjusted for fat free mass (FFM) were significantly lower in the AA women, whereas the decrease in RMR in response to weight loss was greater in Caucasian women. Adherence to the prescribed PA and change in PA in response to intervention were similar in AA and Caucasian women. Prescribed EI (1794±153 and 1806±153 kcal per day) and measured EI during intervention (2591±371 vs 2630±442 kcal per day) were nearly identical in matched AA and Caucasian women. However, the AA women lost significantly less body weight due to lower energy requirements (2924±279 vs 3116±340 kcal per day; P