African-Americans lose weight in 12-week, church-based program

March 10, 2009

Nearly half of overweight and obese African Americans who completed a 12-week, faith-based program lost 5 percent or more of their body weight and most kept it off for at least six months, researchers reported at the American Heart Association's 49th Annual Conference on Cardiovascular Disease Epidemiology and Prevention.

The pilot program was conducted by trained lay leaders at Gospel Water Branch Baptist Church near Augusta, Ga. Researchers were able to collect full data on 35 (nearly 88 percent) of the 40 obese men and women who completed the initial 12 weekly sessions of the Fit Body and Soul (FBS) program. The participants were average age 46 and had an average body mass index (BMI) of 36.

After 12 weeks, almost 46 percent (16/35) of participants had lost 5 percent or more of their starting weight. About 26 percent (nine) lost 7 percent or more.

The program included six monthly "booster" sessions for six months after the 12 weekly behavioral health intervention sessions. At the study's end, 11 of the 16 subjects (nearly 69 percent) with initial weight-loss success had kept the weight off through the entire nine months.

"This kind of result is remarkable in a faith-based program run by lay leaders when so many other community-based programs have failed," said Sunita Dodani, M.D., Ph.D., M.Sc., FAHA, principal investigator, director, Center for Outcome Research and Education (CORE) and associate professor, Department of Internal Medicine, School of Medicine, Kansas University Medical Center in Kansas City, Kansas.

While similar programs have concentrated on diet and lifestyle changes for weight reduction alone, the FBS program focuses on weight loss and behavioral changes to prevent future diabetes in high-risk church members and relies on lay leaders to administer the program.

The church pastor, the Rev. Robert Ramsey, chose four lay leaders who had two days of training to present the 12 health modules of Fit Body and Soul, a faith-based diabetes prevention program. The lay leaders either had a medical background, such as being a registered nurse, or had been active in the church's health ministry.

The modules were adapted from the National Institutes of Health (NIH)-sponsored Diabetes Prevention Program. The NIH recently approved a $3.7 million grant for five years to scale up the FBS study in a controlled comparison of 20 churches in the Midwest. Ten congregations will run the FBS program and 10 controls will conduct a different community-based health promotion program developed from the Centers for Disease Control Community Guide.

Attrition was fairly high in the small pilot study, so the results need confirmation in the larger, controlled investigation, Dodani said. Of the 35 people who finished the 12 weekly sessions, 21 completed the nine-month program.

Participants in the FBS who lost a modest amount of body weight by changing their diet and exercising may be less likely to develop diabetes.

Diabetes is a major risk factor for heart disease. Being overweight (BMI of 26.9) or obese (BMI of 30.9) increases the risk of diabetes.

"We developed this study because African Americans are known to be at increased risk of both diabetes and obesity and also because studies have shown that, compared to whites, African Americans are less likely to benefit from general community weight-loss programs," Dodani said.

While the feasibility study only tracked weight loss and was limited to men and women who were overweight or obese, the scaled up investigation will be open to people of normal weight who have pre-diabetic elevations in their blood sugar and people with a strong family history of diabetes, Dodani said.

Source: American Heart Association