No population in the United States has a higher obesity rate than African American women, with four out of five defined as overweight or obese, according to a 2012 study by the Centers for Disease Control and Prevention.
Their weight issues are also contributing factors in other maladies that typically plague black women more than other groups, such as diabetes, breast cancer and glaucoma.
But Julie Palmer is trying to do something about the problem.
A senior epidemiologist at Boston University’s Slone Epidemiology Center and a School of Public Health professor of epidemiology, Palmer is a coordinator of the Black Women’s Health Study (BWHS), which has been tracking the health of 59,000 African American women since 1995.
Her team has explored the root causes of their obesity and suggested realistic ways African-American women can alter their lifestyles to lose weight.
“Our study is really trying to make a difference,” Palmer tells BU Today. “It is pure research, but it is research with a heart. We want it to lead to changes in individual behaviors, changes in medical practitioners’ recommendations, and changes at the highest policy levels that will help all of us have better health.”
The initial BWHS calculated the women’s body mass index (BMI) and then every two years asked them about their weight and their consumption of soda and fast food, as well as their level of physical activity.
The Black Women’s Health Study found that women who consumed large amounts of soda and other sugar-sweetened beverages were more likely to be overweight or obese.
In 1995, the average age of participants was 38, and 30 percent were obese. Now, it’s more like 40 percent. Palmer finds that increase alarming, but it still doesn’t approach the national figure of 54 percent for all African-American women. This may be because most women in the study have a college degree (61 percent) and aren’t as likely to be obese as are less educated women, according to the CDC.
The BWHS team combed through survey responses about diet and exercise to learn why the women struggled to maintain a healthy weight.
“We found that even controlling for other things they ate, drinking a regular amount of sugar-sweetened sodas increased weight gain and increased the risk of obesity,” Palmer says.
And when the women were asked how often they ate out and what type of fast food they chose – burgers, pizza, Mexican, Chinese, fried chicken, or fried fish – those who frequently chose the first option had the most consequences.
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“We found that eating burgers from fast food or other restaurants definitely increased risk for obesity,” she says. “This was after controlling for soft drinks and after controlling for total fat. There’s something about red meat; we don’t know exactly what it is. And then there’s something about eating that type of meal and everything that goes with it. It was clearly worse than eating the fried fish, fried chicken, or the pizza.”
Palmer published their findings in biannual newsletters sent to study participants, with the recommendation that they substitute diet soda or water for regular soda and order pizza or Mexican, which has more nutrients and fewer calories than burgers.
“We’re trying to identify things that people can actually do,” she says. “Because you can’t just say, ‘Lose weight,’ or, ‘Don’t eat so much.’ That’s really hard to do.”
The issue has taken prominence as one company recently began a website, Black Health Matters, to provide information about health and well-being to African-American women from a service-oriented perspective while providing solutions in a positive tone.
Palmer encourages survey participants to choose take-out food such as pizza or Mexican instead of burgers, which have more calories and fewer nutrients.
When it came to exercise, women who vigorously worked out three or more hours a week had a much lower risk of becoming obese, Palmer says.
“That’s something people can do more easily,” she says. “They can build that into their day.”
Childbearing also proved a factor in weight gain. In a 2003 paper published in Nature, Palmer and her colleagues reported that African-American women who have children young, are overweight at the time of pregnancy, or gain an excess amount of weight during pregnancy have a higher prevalence of obesity compared to white women.
Palmer also found that participants who live in disadvantaged neighborhoods – where grocery stores are scarce, parks and sidewalks aren’t maintained, or crime is rampant – often gained weight or were obese.
Palmer says that people everywhere need to be taught healthy eating habits, but especially children. Cities must clean up parks and quash violence to encourage physical activity. And urban planners should design more walker-friendly neighborhoods.
“We need to fund more small-scale or local-level efforts to help people make these changes in their lives,” she says.