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Background Promoting long-term exercise adherence should be a key focus for health and fitness professionals working to reduce obesity and cardiometabolic health disparities, and all-cause mortality in inactive African-American (AA) adults. Data have suggested that romantic partners can improve long-term exercise adherence and that this dyadic approach should be examined in exercise interventions. Therefore, the purpose of this study was to conduct a qualitative evaluation of a pilot exercise intervention conducted in older AA couples. Methods Two semi-structured focus groups were utilized to compare participants’ perceptions of and experiences during the pilot intervention across two randomly assigned treatment conditions (exercising together with partner [ET; n = 8] versus exercising separately [ES: n = 6]). Participants (mean age: 64.7 ± 6.8 years) of a previous 12-week pilot exercise intervention (walking ≥3 days/week, 30 min/day plus supervised resistance training 2 days/week) were interviewed. Verbatim transcripts were coded using an open coding approach. Results Three key themes (intervention value/benefits, intervention difficulties, and suggested improvements) emerged. Although all couples identified health and relationship benefits of the intervention, some differences surfaced within themes across the two intervention groups. Conclusions Overall, these qualitative data suggest that couples had a positive experience while participating in the pilot study. In addition, key learning points to improve the intervention were identified including a more gradual transition to independent exercise, more flexibility training, and the incorporation of tangential education. These data will help investigators continue to develop the intervention, which is ultimately designed to promote long-term exercise adherence to reduce cardiometabolic health disparities in the AA community.

While literature has shown that some Black Americans cite safety concerns as a barrier to outdoor activity in their neighborhoods for reasons related to violence, limitations in the built environment (e.g., lack of sidewalks), and even unleashed dogs, recent national events suggest that attention should also be directed toward the safety concerns of Black Americans living in neighborhoods that do not involve the commonly referenced issues above. In this timely commentary, the unique personal perspectives and internal dialogue of Black exercisers while navigating predominantly White neighborhoods, particularly those of higher socioeconomic status are discussed. This piece also includes discussion of how racial profiling incites hypervigilance and often fear in Black Americans attempting to exercise outdoors in White spaces. This is problematic, as it can discourage this incredibly positive health behavior that has been shown to mitigate obesity, cardiometabolic risk, and several other health disparities that continue to afflict Black communities. A collaborative effort inclusive of physical activity, public health/health disparity, and social science researchers is warranted to build a body of current scientific literature that elucidates and explores this particular safety concern in various Black outdoor enthusiasts.

Background African-Americans (AAs) have higher rates of inactivity, obesity, and cardiometabolic risk compared to other races/ethnicities. Romantic partners can positively influence health habits, yet whether or not couples have to exercise together in order to adopt regular exercise remains unclear. This study examined whether exercising together influences exercise adherence and cardiometabolic risk in AA couples. Methods Nine AA romantic couples (age 62.8 ± 7.7 years; body mass index 31.0 ± 4.4 kg/m2; 6105 ± 1689 average steps/day) completed a 12-week walking (≥ 30 min, 3 days/week) plus resistance training (RT; 2 days/week) pilot intervention. Couples were randomized to either exercise together (ET) or separately (ES). Waist and hip circumferences, iDXA-measured body composition, blood pressure, and blood biomarkers (glucose, hemoglobin A1c (HbA1c), total cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, C-reactive protein, and fibrinogen) were assessed pre- and post-intervention. Independent-sample t tests and generalized linear mixed models, controlling for gender, were used to analyze data. Significance was accepted at P

This paper describes our approach to forming and engaging a community advisory board (CAB) to assist in the development of a proposed exercise intervention pilot study. The intervention aimed to examine the effects of exercise on exercise adherence, the provision of partner support and receptivity to partner health influence, and cardiometabolic risk in older African-American romantic couples. CAB invitations were extended to local community members and leaders who had a stake in the health of the target population. Seven individuals accepted the invitation and attended at least one of two CAB meetings during which we proposed ideas for the exercise intervention pilot study, then solicited CAB input in four key areas related to the study including: (1) priority health concerns of the target population, (2) the intervention protocol and methodologies, (3) cultural relevance, and (4) sustainability. Two investigators jointly led both CAB meetings, which lasted approximately 3 h each. Recorded community feedback was summarized and coded using a thematic analysis approach. Themes were identified and agreed upon within the four areas identified above. Overall, the proposed study was well-received by the CAB and considered beneficial for and relevant to the target population. Although not all suggestions put forth by the CAB were feasible given the inherent limitations of pilot work, we made multiple study modifications as a result of CAB recommendations. Further, all CAB feedback helped inform plans to launch the intervention on a larger scale and were vital in ensuring that the pilot study was valued in the local community. Although community-based participatory research that originates within a community may be preferable, we demonstrate the utility of a community-partnered approach to intervention design in a vulnerable population. This model could assist researchers who wish to engage the local community to help develop a preliminary idea for a health-related intervention.

Introduction: Older African-Americans (AA) are vulnerable to cardiometabolic health disparities. As physical inactivity is highly prevalent in this population and regular exercise can help mitigate cardiometabolic disease, collaborations between the local community and academic researchers are needed to create sustainable exercise interventions. To this end, the current investigators formed a community advisory board (CAB) to consult on an interdisciplinary pilot intervention study that would examine the effects of couples-based resistance training plus walking on: 1) exercise adherence; 2) cardiometabolic risk factors (abdominal obesity, blood pressure, insulin resistance, hemoglobin A1c, high-density lipoprotein and total cholesterol, triglycerides, C-reactive protein, fibrinogen); and 3) the provision of partner support and receptivity to partner health influence in older AA romantic couples. Hypothesis: CAB consultation would enhance the proposed pilot study methods and facilitate community engagement. Methods: Seven local community members/leaders with a stake in the health of the AA community were invited to participate in two CAB meetings. In the meetings, investigators proposed ideas to pilot a novel exercise intervention in older AA couples and solicited input in four key areas: 1) priority health concerns of the target population; 2) the proposed study protocol; 3) cultural relevance; 4) and sustainability. Recorded responses were summarized and coded using a qualitative thematic analysis approach. Results: Multiple themes surfaced within each of the four focus areas including confirmation of the need to study cardiometabolic disease risk (e.g. hypertension, diabetes) in this population, potential recruitment challenges and suggestions to relax exclusion criteria, exclusion of potentially beneficial program components (e.g. flexibility training, education), the need for culturally-specific adaptations (e.g. incorporating music, providing AA role models), and long-term community engagement (i.e. future efforts to launch the intervention at the community level). Investigators made multiple study modifications per CAB recommendations. Conclusions: CAB feedback suggested the proposed intervention would be well-received and considered both beneficial and relevant by the community. CAB-recommended study modifications underscore the value of a community-partnered approach to intervention design that promotes cultural relevance and sustainability. These characteristics support the ultimate goal of reducing cardiometabolic health disparities in AA communities. Although the investigators recognize the current method deviates from true community-based participatory research that originates within a community, the model presented is beneficial as it engages the community in the developmental stage of evidence-based research.

To determine the influence of health-related fitness on cardiometabolic risk factors in college students.75 traditional students (33 men and 42 women, 21.8±1.8 years old) at a university in southeastern U.S.Height, weight, waist circumference, body composition, blood pressure, lipids, glucose, insulin, c-reactive protein, and glucose tolerance were measured. Indices of insulin sensitivity were calculated. Aerobic and muscular fitness were measured. Regression and correlation analyses, and comparisons of cardiometabolic markers in low- vs high-fit participants were performed.Men and women with low muscular fitness exhibited higher fasting insulin, and poorer insulin sensitivity index scores than those with high muscular fitness. In addition, women with high body fat percentage exhibited higher fasting and 2-hour insulin levels and lower insulin sensitivity index scores than those with low body fat percentages.College students possessing low levels of health-related physical fitness exhibited less favorable cardiometabolic risk profiles.

IntroductionResting energy expenditure (REE) increases after an intense exercise; however, little is known concerning mechanisms.PurposeThe purpose of this study was to determine effects of a single bout of moderate-intensity continuous (MIC) aerobic exercise, or high-intensity interval (HII

Background It is well known physical activity (PA) plays a role in the prevention of type 2 diabetes (T2D). However, the extent to which PA may impact T2D risk among different race-ethnic groups is unknown. Therefore, the purpose of this study was to systematically examine the effect modification of race-ethnicity on PA and T2D. Methods PubMed and Embase databases were systematically searched through June 2016. Study assessment for inclusion was conducted in three phases: 1) title review (N = 13,022), 2) abstract review (N = 2,200), and 3) full text review (N = 265). A total of 27 studies met the inclusion criteria and were used in the analysis. Relative risks (RRs) and 95% confidence intervals (CIs) were extracted and analyzed using the Comprehensive Meta-Analysis software. All analyses used a random-effects model. Results A significant protective summary RR, comparing the most active group to the least active PA group, was found for non-Hispanic White (RR 0.71, 95% CI 0.60-0.85), Asians (RR 0.76, 95% CI 0.67-0.85), Hispanics (RR 0.75, 95% CI 0.64-0.89), and American Indians (RR 0.73, 95% CI 0.60-0.88). The summary effect for non-Hispanic Blacks (RR 0.91, 95% CI 0.76-1.08) was non-significant. Conclusions The results of this study indicate that PA (comparing most to least active groups) provides significant protection from T2D with the exception of non-Hispanic Blacks. The results also indicate a need for race-ethnicity specific reporting of RRs in prospective cohort studies that incorporate multi-ethnic samples.

Objective: Little is known about high-intensity interval training (HIIT) in African-American (AA) women. The purpose of this pilot study was to evaluate the effects of HIIT and steady-state (SS) exercise on cardiometabolic risk factors in young AA women.Design: A 16-week exercise intervention was conducted 3x/week. Twenty-seven AA women were randomized to SS (n = 11; 32 continuous minutes of treadmill walking at 60–70% of maximum heart rate (HRmax)), or HIIT (n = 16; 32 min of treadmill HIIT alternating 3 min at 60–70% of HRmax with 1 min at 80–90% of HRmax). Two-way repeated measures ANOVA with intention-to-treat analysis was used to identify changes between groups. Significance was accepted at P ≤ 0.05.Results: Of the 27 women who entered the study (age: 30.5 ± 6.8 years; BMI: 35.1 ± 5.1 kg/m2; 5274 ± 1646 baseline steps/day), 14 completed the intervention. HIIT significantly decreased waist circumference (107.0 ± 11.3 to 105.1 ± 11.9 cm) compared to SS, which showed no change. There was a signi...

Hunter, GR, Neumeier, WH, Chandler-Laney, PC, Carter, SJ, Borges, JH, Hornbuckle, LM, Plaisance, EP, and Fisher, G. Ratings of perceived exertion during walking predicts endurance independent of physiological effort in older women. J Strength Cond Res 34(5): 1340-1344, 2020-This study aimed to determine whether ratings of perceived exertion (RPE) and physiological effort at different exercise intensities relate to exercise endurance. Ninety-eight sedentary women (older than 60 years) completed 3 submaximal locomotion tasks: (a) stair climbing, (b) flat walking at 2 mph, and (c) grade walking at 2 mph. Maximal treadmill endurance was measured at least 3 days before the submaximal tests. Oxygen uptake was measured during all tests, and RPE were collected for the submaximal tasks. Ratings of perceived exertion during moderate-intensity exercise (walking on the flat at 43% V[Combining Dot Above]O2max, partial R = -0.35, p0.01), but not higher intensity exercise (grade walk at 59% V[Combining Dot Above]O2max, p = 0.49, and stair climbing at 67% V[Combining Dot Above]O2max, p = 0.17), were related to endurance even after adjusting for aerobic capacity and physiological effort (composite of maximal heart rate, ventilation, and respiratory exchange ratio). However, physiological effort was significantly related to endurance for the higher intensity exercise (both grade walk and stair climbing partial R-0.24, p0.02). Similar to previous findings that subjective ratings of fatigue at rest were related to RPE during low/moderate-intensity exercise, but not higher intensity exercise, these data further support Ekkekakis's dual-mode hypothesis that cognitive factors influence RPE during low/moderate-intensity exercise. A practical application is that the coach and personal trainer should know that physiological effort seems to play a greater role in influencing endurance than RPE as intensity of exercise increases.

This study investigated factors influencing regular group indoor cycling (GIC) participation in a sample of Black (71%) and White (29%) adults. Seventeen regular GIC participants (≥1 day/week for ≥3 consecutive months) completed surveys that examined motivations for GIC participation. Treatment Self-Regulation Questionnaire (TSRQ), Preference for and Tolerance of Intensity of Exercise Questionnaire (PRETIE-Q), and open-ended survey questions were used. TSRQ showed autonomous motivation was significantly higher than controlled ( p

Purpose: The study�s purpose was to evaluate the effects of walking (W) and walking plus resistance training (WRT) on cardiovascular disease risk factors in inactive middle-aged (49.0 ± 5.5 yr) African-American women (body mass index = 34.7 ± 6.4 kg·m-2). Methods: Body composition, blood pressure, HDL cholesterol, triglycerides, glycosylated hemoglobin (HbA1c), C-reactive protein, and fibrinogen were measured before and after a 12-wk exercise intervention. Subjects were randomly assigned to one of two training groups. The W group (n = 25) was instructed to increase daily pedometer-measured walking to =10,000 steps per day, whereas the WRT group (n = 19) was given the same walking prescription plus supervised resistance training 2 d·wk-1. A two-way repeated-measures ANOVA with an intention-to-treat analysis was performed to examine changes between groups. Significance was accepted at P = 0.05. Results: Both groups significantly (P < 0.001) increased walking (W = 5453 ± 2119 to 6845 ± 2279 steps per day, WRT = 4823 ± 1758 to 6859 ± 2012 steps per day). WRT significantly (P < 0.001) increased both upper (100 ± 15 to 113 ± 18 kg) and lower (102 ± 20 to 116 ± 25 kg) body strength compared with W. WRT significantly decreased waist circumference (94.8 ± 12.3 to 92.9 ± 12.0 cm, P = 0.021) and total fat mass (42.6 ± 11.1 to 41.8 ± 10.8 kg, P = 0.036) compared with W. WRT also significantly decreased pre- to postintervention body fat (45.8% ± 6.2% to 45.3% ± 6.2%, P = 0.018), HbA1c (5.9% ± 1.2% to 5.6% ± 1.0%, P = 0.028), and mean glucose calculated from HbA1c (122 ± 39 to 114 ± 32 mg·dL-1, P = 0.028), whereas W showed no changes. Blood pressure, HDL cholesterol, triglycerides, and C-reactive protein were not affected by either intervention. Conclusions: Although both interventions increased steps per day, WRT was more effective in improving several body composition measures and glucose control in 12 wk. WRT may be an important addition to a lifestyle intervention aiming to facilitate reductions in cardiovascular disease risk factors in overweight and obese African-American women

Objective: The Learning and Developing Individual Exercise Skills (L.A.D.I.E.S.) for a Better Life study compared a faith-integrated (FI) and a secular (SEC) intervention for increasing physical activity with a self-guided (SG) control group among African American women. Design/Setting/Participants: L.A.D.I.E.S. was a cluster randomized, controlled trial. Churches (n=31) were randomized and women within each church (n=12 – 15) received the same intervention. Interventions: FI and SEC participants received 24 group-based sessions, delivered over 10 months. SG participants received printed materials to review independently for 10 months. Participants were followed for 12-months post-intervention to assess long-term intervention impact. Main Outcome Measures: Data on participant characteristics, physical activity, and intervention-related constructs were collected at baseline, 10 months, and 22 months. Results: Intervention session attendance was greater for FI compared with SEC participants (15.7 + 5.7 vs 12.4 + 7.3 sessions, respectively, PConclusions: The FI intervention is a feasible strategy for short- and long-term increases in physical activity among African American women. Additional dissemination and evaluation of the strategy could be useful for reducing chronic disease in this high-risk population. Ethn Dis.2017;27(4):411- 420; doi:10.18865/ed.27.4.411.

This chapter reviews the incidence of abdominal fat and visceral adipose tissue (VAT) in African-American (AA) adults and children, and examines their relationship to cardiometabolic disease. Racial differences in the amount of abdominal fat and VAT stores have been reported in multiple investigations. Despite a greater prevalence of obesity in AAs, studies have consistently shown lower amounts of metabolically harmful VAT in AAs compared to other races or ethnicities. Since AAs have been shown to have less VAT compared to other races/ethnicities, even when matched for body mass index, it may be expected that cardiovascular and metabolic disease risk would also be lower in AAs. However, there is evidence that this speculation does not hold true. This chapter also provides evidence that AAs have lower VAT thresholds at which cardiometabolic disease risk increases compared to other races, as well as data showing racial differences in hormonal variations related to VAT.

Introduction Randomized trials have demonstrated the effectiveness of the Dietary Approaches to Stop Hypertension (DASH) program for lowering blood pressure; however, program participation has been limited in some populations. The objective of this pilot study was to test the feasibility of using a culturally modified version of DASH among African Americans in an underresourced community. Methods This randomized controlled pilot study recruited African Americans in 2 North Carolina neighborhoods who had high blood pressure and used fewer than 3 antihypertension medications. We offered 2 individual and 9 group DASH sessions to intervention participants and 1 individual session and printed DASH educational materials to control participants. We collected data at baseline (March 2010) and 12 weeks (June 2010). Results Of 152 potential participants, 25 were randomly assigned to either the intervention (n = 14) or the control (n = 11) group; 22 were women, and 21 were educated beyond high school. At baseline, mean blood pressure was 130/78 mm Hg; 19 participants used antihypertension medications, and mean body mass index was 35.9 kg/m2. Intervention participants attended 7 of 9 group sessions on average. After 12 weeks, we observed significant increases in fruit and vegetable consumption and increases in participants’ confidence in their ability to reduce salt and fat consumption and eat healthier snacks in intervention compared with control participants. We found no significant decreases in blood pressure. Conclusion Implementation of a culturally modified, community-based DASH intervention was feasible in our small sample of African Americans, which included people being treated for high blood pressure. Future studies should evaluate the long-term effect of this program in a larger sample.

This study examined the effects of a 12-month walking intervention in overweight/obese, low socioeconomic women. Forty-six women (48.2 ± 8.0 years) entered the study. Outcomes included weight, waist and hip circumferences, body mass index (BMI), blood pressure, glycosylated hemoglobin, blood lipids, fibrinogen, and high-sensitivity C-reactive protein (hsCRP). Both intention-to-treat analyses in all participants and group analyses in study completers only (3K group = increased steps/day by ≥3,000; No Δ group = did not increase steps/day by ≥ 3,000) were conducted. Group × time ANOVA was used. In study completers, 3K significantly increased steps/day (6,903 ± 3,328 to 12,323 ± 5,736) compared to No Δ (4,926 ± 3,374 to 5,174 ± 3,095) from baseline to 12 months. There was a significant time effect for weight ( P = 0.030), BMI ( P = 0.029), and hsCRP ( P = 0.044). Low socioeconomic women who adhere to a long-term, pedometer-based walking intervention significantly increased steps/day and may improve body weight, BMI, and hsCRP. This could help reduce health disparities in this population over time.

To determine the association between total body fat and abdominal region fat derived from dual-energy x-ray absorptiometry (DXA) scans and cardiovascular disease (CVD) risk factors in middle- to older-aged African American (AA) women. We also compared tape-measured waist and hip circumference and their ratio (WHR) with DXA measurements in the context of CVD risk factor predictability.Participants included 59 overweight or obese African American women (age, 48.7 ± 5.6 years). Anthropometries, including waist and hip circumferences, were measured, and DXA scans were used to derive fat mass from the total body and abdominal region. Blood analyses included glucose, total cholesterol, triglycerides, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, total cholesterol/HDL and LDL/HDL ratios, C-reactive protein (CRP), and fibrinogen. Multiple linear regression models were used to investigate the association among DXA-derived fat mass measures, waist circumference, WHR, and cardiovascular risk factors.Among DXA-derived fat mass measures, DXA-derived abdominal fat mass showed the best prediction for glucose and triglycerides, although waist circumference and DXA-derived abdominal fat mass had equivalent capacity for predicting the total cholesterol/HDL ratio. Furthermore, waist circumference showed the best prediction for LDL/HDL ratio and CRP.Both DXA-derived abdominal fat mass and waist circumference had comparable capacity for predicting blood lipid profiles and CRP. Therefore, if waist circumference is measured correctly, it could be used as the simplest means of predicting CVD risk factors in overweight/obese AA women when DXA is not available.

Stretching before anaerobic events has resulted in declines in performance; however, the immediate effects of stretching on endurance performance have not been investigated. This study investigated the effects of static stretching on energy cost and endurance performance in trained male runners. Ten trained male distance runners aged 25 +/- 7 years with an average VO2max of 63.8 +/- 2.8 ml/kg/min were recruited. Participants reported to the laboratory on 3 separate days. On day 1, anthropometrics and VO2max were measured. On days 2 and 3, participants performed a 60-minute treadmill run randomly under stretching or nonstretching conditions separated by at least 1 week. Stretching consisted of 16 minutes of static stretching using 5 exercises for the major lower body muscle groups, whereas nonstretching consisted of 16 minutes of quiet sitting. The run consisted of a 30-minute 65% VO2max preload followed by a 30-minute performance run where participants ran as far as possible without viewing distance or speed. Total calories expended were determined for the 30-minute preload run, whereas performance was measured as distance covered in the performance run. Performance was significantly greater in the nonstretching (6.0 +/- 1.1 km) vs. the stretching (5.8 +/- 1.0 km) condition (p < 0.05), with significantly greater energy expenditure during the stretching compared with the nonstretching condition (425 +/- 50 vs. 405 +/- 50 kcals). Our findings suggest that stretching before an endurance event may lower endurance performance and increase the energy cost of running.