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Clinical Studies and Practice

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

International Journal of Obesity volume 38, pages 1147–1152 (2014)Cite this article

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Abstract

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<0.04), resulting in a lower energy deficit (333±210 vs 485±264 kcal per day).

Conclusion:

Adherence to the behavioral intervention was similar in AA and Caucasian women. However, neglecting to account for the lower energy requirements in AA women when calculating the energy prescription resulted in a lower level of calorie restriction and, hence, less body weight loss. Therefore, to achieve similar weight loss in AA women, the prescribed caloric restriction cannot be based on weight alone, but must be lower than in Caucasians, to account for lower energy requirements.

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Acknowledgements

This study was funded by the Commonwealth of Pennsylvania Department of Health.

Author information

Author notes

  1. J B Lowery

    Present address: 3Current address: Department of Medicine, Morehouse College of Medicine, Atlanta, GA, USA.,

  2. K C Hames

    Present address: 4Current address: Department of Medicine, Mayo Clinic, Rochester, MN, USA.,

  3. D E Kelley

    Present address: 5Current address: Merck Sharp & Dohme Corporation, Rahway, NJ, USA.,

  4. B H Goodpaster

    Present address: 6Current address: Florida Hospital EUR Sanford, Burnham Medical Research Institute, Orlando, FL, USA.,

Authors and Affiliations

  1. Division of Endocrinology and Metabolism, Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA,

    J P DeLany, J B Lowery, K C Hames, D E Kelley & B H Goodpaster

  2. Department of Health and Physical Activity, Physical Activity and Weight Management Research Center, University of Pittsburgh, Pittsburgh, PA, USA

    J M Jakicic & K C Hames

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  1. J P DeLany
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Correspondence to J P DeLany.

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Competing interests

JMJ is at the Scientific Advisory Board for ILSI North America. The remaining authors declare no conflict of interest.

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DeLany, J., Jakicic, J., Lowery, J. et al. African American women exhibit similar adherence to intervention but lose less weight due to lower energy requirements. Int J Obes 38, 1147–1152 (2014). https://doi.org/10.1038/ijo.2013.240

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