Obesity in Black American Women Essay

Culture, Biology and Lifestyle Cause Forty Nine Percent of Black American Women to be Obese Abstract. Obesity is a major factor in health today. Certain ethnic groups and genders suffer from obesity more than others. Around 49% of all Black American women are classified obese today. There are many reasons for this. But the three the Black American women are susceptible to are culture, lifestyle and biology. Forty nine percent of Black American women are obese. This is an over representation compared to 38% of Latina women and 33% of non-Hispanic white women. (Phelan, Johnson, Wesley). Many factors determine a person’s weight and health status. Economics, lifestyle, diet, culture, biology and society all affect a person’s body size and composition. Culture, biology and lifestyle have the largest impact on why Black American women are obese. Health, economic and societal implications of obesity are overwhelming and affect every person in this country. The medical community defines obesity as having a Body Mass Index (BMI) of 30 or greater. BMI is simply a comparison of weight to height. The actual formula is weight in kilograms divided by height in meters squared. A BMI of greater than 25 but less than 30 is considered overweight and a BMI of greater than 40 is considered morbidly obese. BMI is a comparison of weight to height, not fat to height. BMI is a useful tool for most of the population, but does not work well for heavily muscled people, such as body builders. Fat is damaging to health. Muscle is not. The general population knows that obesity causes diabetes and heart problems. But obesity is much more severe than that. Obesity causes health problems that many find eye opening. Obesity causes hardening of the arteries, increased cholesterol and cardiac failure. In addition to damaging the heart and arteries obesity causes cancer. Twenty percent of all cancer related deaths in women are attributed to obesity (Dixon). Fifty percent of all Type II diabetes patients are obese. (Dixon). Obesity is associated with increased risk of metabolic syndrome and fatty liver disease (Kogiso, Moriyoshi and Nagahara). Obesity causes many more not so well known, but still very concerning health issues. Thirty one percent of all arthritis patients are obese. (Dixon). Sixty three percent of women who suffer from osteoarthritis are obese (Dixon). Obese women show a 37% increased risk of depression (Stunkard). Obesity can cause infertility and pregnancy complications (Phelan, Edelman). It even can reduce the effectiveness of birth control. Obese people are three times more apt to suffer from sleep apnea (Visscher, Seidell). And for the real shocker, 300,000 deaths per year in the United States alone are attributed to obesity! Obesity is only second to smoking in preventable deaths per year in the US. (Visscher, Seidell). The reasons nearly half of all Black women in the US are obese are complex and many. We can point our finger at economics, lifestyle, society, biology, diet, culture. Culture, lifestyle and biology are the primary reasons 49% of Black women in the US are obese. Studies have shown that culture can have a profound effect on body size. Several studies have found that the Black American population has a preference for larger body size (Johnson). Portia Johnson, in her article, Scholarly Perspectives on Obesity in Black American Women, references a 2002 study that shows that African American men prefer African American women with a larger body size. The same author also cites a 2006 study that shows that African American women â€Å"describe a model of health that speaks to the Black women’s cultural belief that a larger body size is ideal† (Johnson). African women also have a preference for larger bodies. A 2006 study on ethnic Zulus, Zulu migrants to London, and Anglo Londoners show a preference for larger body size by the Zulu migrants and the ethnic Zulus (Brewis 88). Each participant in were shown gray scale images of women of known BMI. The participants were asked to choose which image represented the most healthy and attractive body. The Anglo Londoners chose a BMI size of 20, the ethnic Zulus chose BMI 26 and the migrant Zulus chose a BMI of 24. Dr. James Kirby and colleagues made the interesting discovery that simply living in a community with 25% or more non-Hispanic blacks increases ones propensity of being overweight (Kirby et al). Similarly Dr. Kirby discovered that living in a community of 25% or more Asians decreases a person’s propensity of being overweight (Kirby et al). Kirby surmises this is due to the availability of healthy food, parks, sidewalks and recreation facilities in each community. Kirby found that a predominance of black Americans live in communities with fewer recreational facilities, gyms, parks and fewer choices of healthy food than other ethnicities. The same study also found more fast food restaurants and convenience food stores in predominately black and Hispanic American communities. Perhaps the most convincing evidence is in the words of African American women. In her article ‘Voices from the Inside: African American Women’s Perspectives on Healthy Lifestyles’ Jill Rowe interviewed African American women on healthy lifestyles and food choices. One woman explains eating in African American culture as: It’s almost like every person in my family has something they cook real good and I don’t want to hurt anybody’s feelings. When you go to your mama’s house, I’ve always gone to the refrigerator. That’s how African Americans show their love. From the birthday parties, to when you have company. My family, when we’re happy we eat. When we’re sad, we eat. We eat when we’re married, we eat when we’re born, we eat when we die. It’s always, who’s bringing the fried chicken and pound cake. (Rowe) Culture can significantly affect a person’s weight. But we should also be aware that biology can affect weight too. Researchers have found that Black American women have a lower Resting Metabolic Rate (RMR). RMR is the rate at which energy (calories) are metabolized to keep organs functioning at rest. Black American women have a lower RMR than white or Hispanic women. This means they burn fewer calories throughout the day and function more efficiently than white Americans making it harder to lose weight (Johnson). A 1996 study found that the Resting Energy Expenditure (REE) of black American women was lower than for Caucasian American women. The researchers measured the REE of each participant and found that the Black women had a REE of 1790 calories per day at rest, while the Caucasian women had an REE of 1949 calories per day at rest. Simply put this means that Caucasian women burn, on average, 250 more calories per day at rest than Black American women do. This makes it harder for black women to lose weight (Johnson). Researchers have also discovered that Black Americans have an over expression of fatty acid transport protein. This means that more fat is delivered to fat storage cells making it easier for Black Americans to store fat than white Americans (Barakat). Researchers have measured and found more upper body fat in Black Women compared to white women. A larger below the skin level (subcutaneous) fat level was found in Black Women as compared to white American women (Conway). Diet and exercise are part of a persons’ lifestyle and both have a significant impact on weight and health. Several studies have proven that Black Americans eat more sweetened foods as compared to European Americans. Portia Johnson and colleagues cite a 2000 study on preference for sweet food amongst African Americans and European Americans. The study offered taste tests to each ethnic group and compared how each group responded to sweets. The researchers discovered that Black Americans ate more of the sweetened foods offered at various intervals during a taste test (Johnson). They conclude that African Americans could be using a sweetened food to compensate for greater perceived stress causing greater weight gain and obesity. Angelia Paschal and colleagues examined the results of a study on self-reported diet and exercise habits of African American men and women. They found that 55-75% of the women in their study rarely exercise. They also found that 76% of all participants did not eat the minimum daily requirements for fruit and less than half met the minimum requirements for vegetables. Not surprisingly this study reports that 62% of participants were diagnosed with hypertension and 14% were diagnosed with elevated blood sugar levels and/or diabetes (Paschal et al). A study that compared fitness of Latina American women to Black American women found similar results. â€Å"More than one-half of the women reported engaging in no regular physical activity. However, the substantial variability in the number of minutes exercised per week points to the need to investigate methods to enhance the duration of physical activity. † (Sanchez-Johnsen et al). Genesis, a church based health and fitness program aimed at Black Americans, found that many of the participants did not correlate obesity with poor health. The participants in Genesis completed a self-reported survey where only 16% indicated they were obese, but when clinically measured 87% were found to be overweight or obese. This indicates that participants failed to connect excess weight with medical risk, possibly due to cultural conditioning, personal denial or not associating body weight with health risk (Cowart et al). It is not all gloom and doom for women of color in the US. Culture, biology and lifestyle are all things that can be changed or at least worked with to lose weight and gain fitness. There are several programs in this country aimed at overall fitness for Black American women. The Genesis program has worked with black Americans through churches and found this combination very successful. Genesis provided health and diet education, exercise prescriptions and a motivation partner. Some of their successes include a 71% less soda consumption, fried meat consumption was reduced from 91% to 55%. The percent of respondents reporting no exercise at all went from 45% at the start of the program to 27% on the post pilot survey (Cowart et al). Just as diet, lifestyle and culture can be changed so can biology. Resting Metabolic Rate (RMR) can be raised by obtaining a leaner body mass as muscle is more active than fat. Withers and colleagues have proved this with a study conducted on 49-70 year old women. Their study has found that aerobic training in older women increases RMR. They compared active women to non-active women and found that the active women had a significantly higher RMR. Having a body composition of more lean mass to fat mass greatly has â€Å"implications for increased independence and improved quality of life. † (Withers et al). Black American women have special challenges and considerations in weight loss and fitness. They face a culture that encourages eating and appreciates large body size, a more efficient metabolic system that uses fewer calories at rest, a propensity for their bodies to store fat, and a lifestyle that makes diet and exercise difficult. Yet knowing these challenges is half the battle. With knowledge, the support of the community and their family, and commitment they can overcome these challenges and reach a goal of lifetime fitness and health. Works Cited Barakat, HA. â€Å"Obesity; Overexpression of Fatty Acid Transport Proteins May Contribute to Obesity in Black Women. † Science Letter. 7 Feb 2006. 1218. Web. 18 Feb 2013. Brewis, Alexandra. Obesity Cultural and Biocultural Perspectives. New Brunswick. Rutgers University Press. (2011). Print. Conway, Joan. â€Å"Ethnicity and Energy Stores†. The American Journal of Clinical Nutrition. 62. 5. Nov 1995. Web. 18 Feb 2013. Cowart, Luvenia. et al. â€Å"Designing and Pilot-Testing a Church-Based Community Program to Reduce Obesity among African Americans. † ABNF Journal. 21. 1. (2010). 4-10. Web. 18 Feb 2013. Dixon, John. â€Å"The Effect of Obesity on Health Outcomes. † Molecular and Cellular Endocrinology. Vol. 316. Issue 2. 25 Mar 10. 104-108. Endocrine Aspects of Obesity. Web. 18 Feb 2013. Edelman, Allison. â€Å"Special Feature: Do We Have a Problem? Obesity and Contraception. † OB GYN Clinical Alert. Dec 2011. n. pag. Web. 18 Feb 2013. Johnson, Portia; Yvonne Wesley. â€Å"Scholarly Perspectives on Obesity among Black Women. † ABNF Journal. 23. 3. (2012). 46-50. Web. 18 Feb 2013. Kirby, James, et. al. â€Å"Race, Place, and Obesity: The Complex Relationships among Community Racial/Ethnic Composition, Individual Race/Ethnicity, and Obesity in the United States. † American Journal of Public Health. 102. 8. Aug 2012. 1572-1578. Web. 18 Feb 2013. Kogiso, Tomomi. et al. â€Å"Clinical Significance with Fatty Liver Associated with Metabolic Syndrome. † Hepatology Research. Vol. 37. Issue 9. Sep 2007. 711-721. Web. 18 Feb 2013. Paschal, Angelia. et al. â€Å"Baseline Assessment of the Heath Status and Health Behaviors of African American Participating in the Activities for Life Program: A Community Based Health Intervention Program. † Journal of Community Health. 29. 4. Aug 2004. 305-318. Web. 18 Feb 2013. Phelan, Sharon. â€Å"Obesity in the American Population: Calories, Cost and Culture. † American Journal of Obstetrics and Gynecology. Volume 203, Issue 6, Dec 2010. 522–524. Web. 18 Feb 2013. Rowe, Jill. â€Å"Voices From the Inside: African American Women’s Perspectives on Healthy Lifestyles. † Health Education and Behavior. Vol. 37. Dec 2010. 789-800. Web. 18 Feb 2013. Sanchez-Johnsen, Lisa. et al. â€Å"Ethnic Differences in Correlates of Obesity between Latin-American and Black Women. † Obesity Research. 12. 4. Apr 2004. 652-660. Web. 18 Feb 2013. Stunkard, Albert. â€Å"Depression and Obesity. † Biological Psychology. Vol. 54 Issue 3. 1 Aug 2003. 330-337. Web. 18 Feb 2013. Visscher, Tommy, Jacob Seidell. â€Å"The Public Health Impact of Obesity. † Annual Review of Public Health. (2001). 355-375. Web. 18 Feb 2013. Withers, RT. et al. â€Å"Energy Metabolism in Sedentary and Active 49- to 70-yr-old Women. † Journal of Applied Physiology. Vol. 84. Apr 1998. 1333-1340. Web. 18 Feb 2013. Bibliography Brewis, Alexandra. Obesity Cultural and Biocultural Perspectives. New Brunswick. Rutgers University Press. (2011). Print. Brewis’ book is a must read for anyone studying, researching or working in health, weight management or fitness. The author takes a look at obesity from an anthropologist’s standpoint. Where did obesity originate? How does if effect certain races/genders more than others? These are some of the questions answered. The author has lived in different cultures and worked with different ethnicities obtaining answers to some of the mysteries surrounding weight gain. She has uncovered reasons why obesity is prevalent in the United States and other countries. And discusses why some ethnicities are more vulnerable to weight gain after migrating to the United States or other developed nations. The author has studied the culture of the Pima Indians of both the US and Mexico and explains why obesity affects the US Pimas more than the Mexican Pimas. Brewis also explains why some ethnicities find larger body weigh acceptable and why some ethnicities have larger males than females and why they find this perfectly normal. Biagioli, Brian. Advanced Concepts of Personal Training. National Council on Strength and Fitness. (2007). Print. This book was by a medical doctor. This manual is applicable to anyone interested in learning more about physical fitness, nutrition, physiology, body composition and exercise mechanics. It is the National Council on Strength and Fitness’ guide for all their certified personal trainer candidates. The manual contains 540 pages with many illustrations explaining obesity, Resting Metabolic Rate (RMR), Body Mass Index (BMI) and physiology. This manual includes chapters on special populations such as women, children and special needs individuals. HBO The Weight of the Nation. HBO Documentary Films; Centers for Disease Control and Prevention; National Institute of Health. Et al. Various actors/directors. (2007). DVD. This is a four part documentary on obesity in America. Each part is approximately one hour long. The parts consist of consequences, choices, children in crisis and challenges. The films explore why the United States is facing an obesity crisis, and what we can do about it now. Various health experts narrate the films. Interviews are conducted with a host of citizens dealing with obesity right now. They tell in their own words the challenges they face. There is significant commentary and interview on ethnicities, females, citizens living in inner cities and the issues surrounding obesity and weight gain. The Skinny on Obesity. Perf. Robert Lustig et al. UCTV Prime. 12 Apr. 2012. Web Video. This video series plays on UCSF Prime TV online. Dr. Robert Lustig is endocrine expert at the UCSF Children’s Hospital. This is a seven part series that tackles the basics of the obesity epidemic such as sugar, hormones, fast food, childhood obesity, and endocrine system. Each part is about 15 minutes long. Only a basic understanding of health and physiology is needed to fully understand concepts presented. Platkin, Charles. The Automatic Diet. New York. Penguin. 2005. Print. This book discusses how to slowly improve your diet over time with small changes. Dr. Platkin holds a master of public health and is one of the nation’s leading public health advocates. He writes The Diet Detective, a syndicated article that appears in hundreds of newspapers throughout the country. His book takes the reader through small steps of diet and lifestyle changes that together create a whole new diet makeover making healthful eating simple and thus ‘automatic’.