Obesity in African Americans : A Product of Sedentary Lifestyle

1. OBESITY IN AFRICAN AMERICANS : A PRODUCT OF SEDENTARY
LIFE STYLE
 MARYAM QADRI
Walden University Student

2. Key Learning Points
 1.Why obesity is risk factor ?
 2.Why do African Americans have increased obesity rate ?
 3.What health consequences can result in African Americans due to obesity?
 4.What strategies can be adapted to change behavior of African Americans
towards obesity?
5.What is the role of public health experts in reducing obesity rate in
African Americans ?

3. Health Consequences due to Obesity
 Obesity due to sedentary life style can result in following health consequences
among African Americans :
 1.Cardiovascular disease due to high C-reactive protein (CRP)
resulting in myocardial infarction.(Ravussin, E., 2002).
2.Fasting glucose and insulin levels are higher in obese African Americans
compared to Caucasian, resulting in diabetes mellitus. (Palaniappan, L., P.,
2002).
3.Hypertension rate is higher due to obesity in African Americans then,
Caucasians. (Wang, W., 2004).

4. Pathophysiology of Cardiovascular Disease in African Americans due to
Obesity
 1.A strong inverse association between aerobic fitness and body fat has
been reported among African Americans. (Willig, A., L., 2011).
2.The study showed that 57% of African Americans fell in within low
fitness group and have multiple risk factors for cardiovascular disease.
(Zeno, S., A., 2010).
3. Due to low fitness, they have tendency to gain weight and prone to have
cardiovascular complications.

5. Pathophysiology of Cardiovascular Disease in African Americans due to
Obesity
 4.Abdominal obesity is likely a stronger cardiovascular risk factor then,
body mass index (BMI).The BMI more then 25 kg/m2 is categorized as,
overweight and BMI more then, 30 kg/m2 is classified as, an obese.
Abdominal obesity is measured with the help of waist circumference.
(Gurundy, S., M., 2005).
 5.However, studies showed that waist circumference is not an appropriate
marker of abdominal obesity in African Americans.(Carroll, J., F., 2008).

6. Pathophysiology of Cardiovascular Disease in African Americans due to
Obesity
 6.The lipoprotein lipase is an enzyme that clears triglyceride rich lipid
particles from blood.This is significantly found to be higher in African
Americans then, Caucasians.This may limit the release of free fatty acids
from peripheral adipose tissue into the circulation resulting in normal
triglycerides in African Americans. (Yu, S., S., 2012).
 7.Genome-wide association studies are ongoing to find genetic link that may
affect lipid levels.(Barber, M., J., 2010).

7. Pathophysiology of Type II Diabetes Mellitus in African Americans due to
Obesity
1.In African Americans, fasting blood sugar and insulin levels are reported
to be elevated in both normal weight and obese individuals. (Palaniappan,
L., P., 2002).
 2.African American women have high prevalence of insulin resistance due
to high glucocorticoid sensitivity. (Ellis, A., C., 2012).
 3.Cortisol is a key physiologic modulator in maintaining energy
balance.The glucocorticoid receptors can be under or overexpressed
leading to resistance or sensitivity. (Silverman, M., N., 2012).

8. Pathophysiology of Type II Diabetes Mellitus in African Americans due to
Obesity
 4.Hyperinsulinemia induced by stress or steroids reflect prediabetic state
and therefore, can be reduced to prevent epidemic of obesity, insulin
resistance and type II diabetes mellitus in African Americans. (Frazier, B.,
2010).
 5.The studies on prepubertal children showed 20% lower insulin sensitivity
and higher insulin secretion despite of having normal BMI. (Arslanian, S.,
A., 2002).

9. Pathophysiology of Type II Diabetes Mellitus in African Americans due to
Obesity
 6.Initially, high levels of cortisol in African Americans can increase
adiposity, and increased visceral fat.Later, chronic stress may result in
low cortisol levels due to adrenal exhaustion or increased sensitivity to
glucocorticoids. (Paquali, R., 2012).

10. Data on outcomes of Morbidity
 1.The studies reported that 47.8% of African Americans are obese.
 2.These include 37.1% of men and 56.6% of women.
 3.The collected data showed 20.5% of African American girls obese and
19.9% of African American boys obese.
 4.More then, eight percent of African American children ages two to nine
were severly obese as, compared to Whites. (Stateofobesity.org, 2014).

11. Data on Outcomes of Mortality
 1.African Americans reported to have twice as, high rates of deaths due to
cardiovascular disease and stroke as, compared to Whites. (U.S.
Department of Health and Human Services Office of Minority Health,
2014).
 80% of obese African Americans are reported to have type II diabetes
mellitus. (U.S. Department of Health and Human Services Office of
Minority Health, 2014).

12. Prevention Strategies
 1.Promotion of physical fitness can reduce obesity in African American
population.
 2.Brisk walking or jogging 400 meters can reduce mortality due to obesity
by 10%.
 3.Provision of safe environment and reduction of crime rates can motivate
African Americans to be physically active.(Stateofobesity.org, 2014).

13. Prevention Strategies
 4.Public and private investments in community can prevent obesity in
African Americans.
 5.Community members can engage in culturally sensitive communications and
culture.
 6.Development of walking paths, parks and recreational areas to motivate
African Americans for physical activity.

14. Prevention Strategies
 7.Grocery stores with healthy food can be opened in low socio-economical
areas by small business owners to promote healthy food.
 8.Food advertisements regarding fast food and beverages to be limited.
 9.Educational campaigns regarding health consequences of obesity to be
carried out in African American communities.
10.Public health experts can join community members for frequent
discussions on healthy lifestyle and how to maintain body weight with
an exercise and food.

15. Take Home Message
 Obesity is health risk factor due to lack of physical activity.
 African Americans have low socio-economical status. They lack walking
paths, safe areas, parks leading to lack of physical activity and
causing obesity.
 Obesity can cause cardiovascular diseases, diabetes mellitus, hypertension
and stroke in African Americans.
 Exercise through motivation can prevent obesity in African American
community.

16. References
 Arslanian, S., A., Saad, R., Lewy, V., Danadian, K., & Janosky,J.
(2002).Hyperinsulinemia in African-American children : Decreased Insulin
Clearance and Increased Insulin Secretion and its Relationship to Insulin
Sensitivity.Diabetes.51(10) : 3014-3019.
doi: https://doi.org/10.2337/diabetes.51.10.3014
Abraham, P., A., Kazman, J., B., Zeno, S., A., & Deuster, P., A.
(2012).Obesity and African Americans: Physiologic and Behavioral
Pathways.Hindawi.doi: http://dx.doi.org/10.1155/2013/314295.

17. References
Barber, M., J., Mangravite, L., M., Hyde, C., L., Chasman, D., I., Smith, J.,
D., McCarty, C., A., Li, X., Wilke, R., A., Rieder, M., J., Williams, P., T.,
Ridker, P., M., Chatterjee, A., Rotter, J., I., Nickerson, D., A., Stephens, M.,
& Krauss, R., M.(2010).Genome-Wide Association of Lipid-Lowering
Response to Statins in Combined Study Populations.PLOS ONE.5(3):
E9763. doi: 10.1371/journal.pone.0009763
 Carroll, J., F., Chiapa, A., L., Rodriquez, M., Phelps, D., R., Cardarelli, K., M.,
Vishwanatha, J., K., Bae, S., Cardarelli, R.(2008).Visceral Fat, Waist
Circumference, and BMI: Impact of Race/Ethnicity.Obesity Journal.(Vol.16,
no.3. pp.600-607).doi: 10.1038/oby.2007.92.

18. References
 Ellis, A., C., Alvarez, A., Granger, W., M., Ovalle, F., & Gower, B., A.
(2012).Ethnic Differences in Glucose Disposal, Hepatic Insulin Sensitivity,
and Endogeneous Glucose Production among African American and
European American Women.Metabolism.(Vol.61, no.5, pp.634-640).
doi: https://doi.org/10.1016/j.metabol.2011.09.011
Grundy, S., M., Cleeman, J., I., Daniels, S., R., Donato, K., A., Eckel, R.,
H., Franklin, B., A., Gordon, D., J., Krauss, R., M., Savage, P., J., Smith,
S., C., Spertus, J., A., & Costa, F.(2005). Diagnosis and Management of the
Metabolic Syndrome.American Heart Association Journals.(pp.
2735-2752).doi: https://doi.org/10.1161/CIRCULATIONAHA.105.169404

19. References
Islam, A., Poth, C., M., Smith, Z., P., & Deuster, P., A.(2012).
Glucocorticoid Receptor Density Correlates with Health Risk Factors and
Insulin Resistance in Caucasian and African American
Subjects.Experimental and Clinical Endocrinology & Diabetes.(Vol.120,
no.8, pp.477-481).doi: 10.1055/s-0032-1321809
Miller, W., C.(2009).Excercise: The Vaccine and Antidote for
Obesity.Essential of Public Health Biology : A Guide for the Study of
Pathophysiology. (pp.165-175).Massachusetts:MA, Jones & Bartlett
Learning.

20. References
 Obesity Prevention in Black Communities. Racial and Ethnic Disparities in
Obesity.(2014).The State of Obesity. Retrieved from http://
stateofobesity.org/disparities/blacks/#footnote-26
 Palaniappan, L., P., Carnethon, M., R., & Fortmann, S.
(2002).Heterogeneity in the Relationship between Ethnicity, BMI, and
Fasting Insulin.Diabetes Care.(Vol.25, no.8, pp.1351-1357).
doi: https://doi.org/10.2337/diacare.25.8.1351

21. References
Pasquali, R.(2012).The Hypothalamic –Pituitary-Adrenal Axis and Sex
hormones in Chronic Stress and Obesity: Pathophysiological and Clinical
Aspects.Annals of the New York Academy of Sciences.(Vol.1264, no.1, pp.
20-35).doi: 10.1111/j.1749-6632.2012.06569.x
Ravussin, E., Smith, S., R.(2002).Increased Fat Intake, Impaired Fat
Oxidation, and Failure of Fat cell Proliferation result in Ectopic Fat
Storage, Insulin Resistance, and type 2 Diabetes Mellitus.Annals of
the New York Academy of Sciences.(Vol.967, pp.363-378).
doi: 10.1111/j.1749-6632.2002.tb04292.x

22. References
 Silverman, M., N., & Sternberg, E., M.(2012).Glucocorticoid Regulation
of Inflammation and its Functional Correlates : from HPAAxis to
Glucocorticoid Receptor Dysfunction. Annals of the New York Academy of
Sciences.(Vol.126, pp.55-63).doi: 10.1111/j.1749-6632.2012.06633.x
U.S. Department of Health and Human Services Office of Minority Health.
(2014).Obesity and African Americans. Retrieved from https://
minorityhealth.hhs.gov/Default.aspx

23. References
 Willig, A., L., Hunter, G., R., Casazza, K., Heimburger, D., C., Beasley, T.,
M., & Fernandez, J., R.(2011).Body Fat and Racial Genetic Admixture are
Associated with Aerobic Fitness Levels in a Multiethnic Pediatric
Population.Obesity Journal.(Vol.19, no.11, pp.2222-2227).
doi: 10.1038/oby.2011.109
Yu, S., S., Catillo, D., C., Courville, A., B., & Sumner, A., E.(2012).The
Triglyceride Paradox in People of African Descent. Metabolic Syndrome
and Related Disorders.(Vol.10, no. 2, pp. 77-82).
doi: https://doi.org/10.1089/met2011.0108

24. References
Zeno, S., A., Kim-Doner, S., J., Deuster, P., A., Davis, J., L., Remaley, A.,
T., & Poth, M.(2010).Cardiovascular Fitness and Risk Factors of Healthy
African Americans and Caucasians.Journal of the National Medical
Association. (Vol.102, no.1, pp. 28-35).
doi:https://doi.org/10.1016/S0027-9684(15)30472-7.

25. Transcript of Narration
Slide # 1: Hi class.My name is Maryam Qadri.My topic of presentation is about
obesity in African Americans due to sedentary lifestyle. Sedentary
lifestyle is defined as, a lifestyle without any physical activity and low
physical fitness.The title of my topic presentation is obesity in
African Americans : A Product of Sedentary lifestyle.
Slide # 2 :Key Features. What are the important key features of obesity?. Why
it is considered health risk factor?.Why it is common in African
Americans and what is the main causative factor?.What health
consequences can result due to obesity?.What strategies can be
adapted to reduce obesity?.What is the role of public health experts
in reducing obesity.

26. Transcript of Narration
Slide # 03 :Health consequences due to obesity. Obesity due to sedentary
lifestyle can result in following health consequences among
African Americans. Cardiovascular disease is found in obese
African Americans and studies showed that inflammatory marker
CRP or C-reactive Protein is directly linked to myocardial
infarction in obese African Americans. Fasting glucose and insulin
levels are found to be high in obese African Americans as,
compared to Caucasians. This results in diabetes mellitus.
Hypertension is another health consequence due to obesity in
African Americans found to be in higher rates then, in Caucasians.

27. Transcript of Narration
 Slide # 4 : Pathophysiology of Cardiovascular Disease in African
Americans due to Obesity A strong inverse association between
aerobic fitness and body fat has been reported among African
Americans. The study showed that 57% of African Americans
fell in within low fitness group and have multiple risk factors for
cardiovascular disease.Due to low fitness, African Americans
have tendency to gain weight and therefore, develop
cardiovascular complications.

28. Transcript of Narration
Slide# 5 : Abdominal obesity is likely a stronger cardiovascular risk factor
then, body mass index (BMI).The BMI more then, 25kg/m2 is
categorized as, an overweight and BMI more then, 30kg/m2 is
classified as, an obese. Abdominal obesity is measured with the help
of waist circumference .However, studies showed that waist
circumference is not an appropriate marker of abdominal obesity in
African Americans.

29. Transcript of Narration
 Slide # 6 : The lipoprotein lipase is an enzyme that clears triglyceride rich
lipid particles from blood. This is significantly found to be
higher in African Americans then, Caucasians. This may limit
the release of free fatty acids from peripheral adipose tissue into
the circulation resulting in normal triglycerides in African
Americans. Genome-wide association studies are ongoing to
find genetic link that may affect lipid levels.

30. Transcript of Narration
 Slide # 7 :Pathophysiology of Type II diabetes mellitus in African
Americans due to obesity. In African Americans, fasting blood
sugar and insulin levels are reported to be elevated in both normal
weight and obese individuals. African American women have
high prevalence of insulin resistance due to high glucocorticoid
sensitivity. Cortisol is a key physiologic modulator in maintaining
energy balance.The glucocorticoid receptors can be under or
overexpressed leading to resistance or sensitivity.

31. Transcript of Narration
 Slide # 8 : Hyperinsulinemia induced by stress or steroids reflect
prediabetic state and therefore, can be reduced to prevent
epidemic of obesity, insulin resistance and type II diabetes
mellitus in African Americans. The studies on prepubertal
children showed 20% lower insulin sensitivity and higher
insulin secretion despite of having normal BMI.

32. Transcript of Narration
 Slide # 9 :Initially, high levels of cortisol in African Americans can
increased adiposity, and increased visceral fat. Later, chronic
stress may result in low cortisol levels due to adrenal exhaustion
or increased sensitivity to glucocorticoids.
 Slide # 10 : Data on outcomes of morbidity. The studies reported that
47.8% of African Americans are obese.These include
37.1% of men and 56.6% of women. The collected data
showed 20.5% of African American girls obese and
19.9% of African American boys obese.More then, eight
percent of African American children ages two to nine
were severly obese as, compared to Whites.

33. Transcript of Narration
 Slide # 11 : Data on outcomes of mortality. According to U.S. Department
of Health and Human Services Office of Minority Health,
African Americans reported to have twice as, high rates of
deaths due to cardiovascular disease and stroke as, compared to
Whites. 80% of obese African Americans are reported to have
type II diabetes mellitus.
Slide # 12 : Prevention strategies. .Promotion of physical fitness can
reduce obesity in African American population. Brisk walking
or jogging 400 meters can reduce mortality due to obesity by
10%.Provision of safe environment and reduction of crime
rates can motivate African Americans to be physically active.

34. Transcript of Narration
 Slide # 13 :Public and private investments in community can prevent
obesity in African Americans. Community members can engage
in culturally sensitive communications and culture. Development
of walking paths, parks and recreational areas to motivate
African Americans for physical activity.
Slide # 14 : Grocery stores with healthy food can be opened in low socio-economical
areas by small business owners to promote healthy food. Food
advertisements regarding fast food and beverages to be limited.
Educational campaigns regarding health consequences of obesity to be
carried out in African American communities. Public health experts can
join community members for frequent discussions on healthy lifestyle
and how to maintain body weight with an exercise and food.

35. Transcript of Narration
 Slide # 15 :Take home message. Obesity is health risk factor due to lack of
physical activity. African Americans have low socio-
economical status. They lack walking paths, safe areas,
parks leading to lack of physical activity and causing
obesity. Obesity can cause cardiovascular diseases, diabetes
mellitus, hypertension and stroke in African Americans.
Exercise through motivation and provision of safe environment
can prevent obesity in African American community.