metabolic variables were studied in 8 black and. 10 white age- and weight-matched obese women undergoing a 6-mo weight-reducing regimen. Fat pat- terning.
Visceral adipose women1’ Joan
M
Conway,
Susan
ABSTRACT studied
tissue
Z Yanovski,
Fat distribution
8 black
in
women
undergoing
terning
was
and
a 6-mo
determined
by
Nib
and
10 white
weight-matched
weight-reducing
regimen.
using
anthropometry
total,
subcutaneous,
ipose
(VAT)
at the
L2-L3
spine,
women
had
the
during,
smaller
L2-L3
ences
before,
(P
depots 0.004)
=
persisted
after
an
was
similar
23%
VAT
than
white
less
(P
glycerides
lower 0.006)
=
density-lipoprotein study
bolic
risk
1995;61
L4-L5
(P
that
factors
sites.
(P
0.007).
=
Black
(P < 0.001). exist
for obesity-related
illness.
who
in
posity,
computed
body
tomography,
sition
than
do white
children
this meta-
Am J Clin
Nutr
regional
adi-
ethnicity
particularly
hypertension,
tance
(1-4).
The
performed
in
studies
have
dominal
are
Black 50%
are
kg/m2] of black
of severe
complications VAT depot, Differences
Am
J Clin
comes
from
the
effect by
race
on
of
obesity
composition for in
is an increased
1995;61:765-71.
these
little
with metabolic
observed surrogates,
in
Printed
more
deposits
trends
fatness,
these
in
fat
socioecodistribution, in
black,
differences
central
of VAT
as might
patterns
of obesity
and
are
therefore
more
associated with and Pi-Sunyer
obese black women (as defined had less insulin resistance, less serum They
of total than white
in their
I
medical
From
vice,
triglycerides concluded
by glu-
than did upperthat upper-body
body fatness, is less detrimental women. Actual VAT was not
study.
the US Department
Beltsville
Human
Laboratory, of Diabetes,
[body
mass
index
ical
whether the to the greater
excess preva-
to the size of the to obesity. and
white
(12).
The
between
fat-free American
Radiology, 2
mass Society
The
800
Center,
Institute
and
Institutes
used
Agricultural
Research
and the National Digestive
National
Optifast
of Agriculture,
Nutrition
Kidney was
Research
Ser-
Human
Per-
and
of Mental
Diseases,
of Health,
in the study
Diet
Health,
National
Department
Bethesda,
of Clin-
MD.
a gift of Sandoz
Nutrition
Corp
(Minneapolis). 3
of obesity-related
© 1995
ethnic of
differ-
evident in the into adulthood.
patterns
The
of fat depo-
factors. exceeding
composition
in USA.
are
metabolic aberrations of VAT. However, Dowling
obesity, independent for black women
Institute
of the
be-
in body-fat
intolerance, and lower obese white women.
formance
black
density
large
and
decades
this
in childhood,
fat distribution
the
or how
704),
Apparently,
differences
(19) found that upper-body waist-hip ratios) actually
measured
that
recently =
women, as measured by anthropometnic that they may be more likely than white
to demonstrate larger depots
cose body
(n
VAT-deposition
variables.
to have
The
independent
women,
black suggest
likely
four
body
white
women
pattern
children adolescence
reported
about
more
between
(18).
were
is known
mellitus
risk
almost
further
patterns
are also
obese
to an increased
noted
abwomen,
obesity-related they
severely
difference
whites
Nutr
been
white
diabetes
However,
studies
between in
of
resis-
numerous
association
(1 1). It is not known women is secondary
in body have
and
be
insulin
aberrations
affected
obesity,
documented
blacks
to
and
at a similar degree of obesity, or to some other factors unrelated
populations best
an
adipose tissue and mortality,
Although
a prevalence
(10).
women 32
(5-8).
non-insulin-dependent
disease
white
lence
on have
particularly as
evidence
shown
data
such
the
metabolic
who
cardiovascular (BMI)> morbidity
of
populations
and
limited
conditions
than
bulk
consistently
women, (9),
hyperlipidemia,
white
obesity
there
that increased visceral with greater morbidity
central
thickness was
(17).
mass
and Conupper-body
This
begins
a more
nomic status, and age. Despite these apparent
likely these
Introduction
study
ences between black and white preschool period and through (18)
black
patterns
skeletal
Zillikens greater
50).
of
CARDLA
have
women
It is well established (VAT) is associated
in the
children
Mueller
denser
skinfold
(n
population
black
and
composition,
a large
cause
deposition
and
subscapular whites
of fat-deposition
affect Obesity,
increased with
are described
compared
WORDS
an
Differ-
:765-71.
KEY
on
as compared
centrality
from
VAT
44)
of a heavier
mass (12-15). In 1990, that black women have
at both
women
Data
in
because
based
confirmed
(P 0.031) and tnhigher plasma high-
differences
in blacks denser muscle (16) suggested
the
weight loss. Although groups, black women had
women
and way (n
Black
women
(FFM)
adof
fast.
0.054)
-
plasma glucose with significantly
racial
levels
S Hubbard
obesity
visceral
L4-L5
white
pat-
17.2-kg
in both
concentrations
suggest
Fat computed
a modified
than
average
ratio
after
of VAT and
waist-hip
had significantly
and
and
were obese
and
and
Van
in black and white
Mention
guarantee imply 4
of a trade or warranty
approval Address
Building
or proprietary US
to the exclusion reprint
308,
mark by the
requests
Room
101,
of other to IM
10300
product
Department
products
Conway,
Baltimore
does
of Agriculture that
may
not
constitute and
does
a not
be suitable.
USDA/ARS/BHNRC/DHPL, Avenue,
Beltsville,
MD
20705-
2350. Received
June
Accepted
for
for Clinical
21,
1994.
publication
Nutrition
October
7, 1994.
765
Downloaded from www.ajcn.org by guest on July 13, 2011
lumbar
and
variables
and
to quantitate areas
A Avila,
metabolic
age-
tomography tissue
differences
766
CONWAY The
present
study
was
conducted
to determine
whether
white women, and variables in obese
age-
during,
and
weight-matched
women
very-low-energy-diet
before,
and
after
AL
kJ/d
dif-
ferences exist in VAT between black and how these differences might affect metabolic
El
(800
period gradually a
program.
wk
kcal/d)
consumed
(refeeding) increased
they
were
in
lasted their
five
consuming
a balanced
5024-6276 kJ/d (1200-1500 living during all periods
and
Subjects
dietary exercise
Twenty
obese
women,
weight-loss
parents Similarly, One
and
woman
were
born
to have
was
in
VAT
white
All
grandparents all black women
black
den
9 black
study.
born
measured
woman
was
white
in the West States.
by
unable
participated
women
Indies
Two
computed
in
had
and
white
were
CT
5 of
the
last
Body
week
to
abdominal
made
degree
of
abdomen
activity,
but
required
to
determined
and only recruited
MD,
No
selections
by
body
overweight,
or physical
have a BMI weight loss. loss treatment
> 30 (kg/m2), because of the The subjects were participating study, designed to evaluate
type,
subjects
were
maximal
(thigh) (24). level of the
amount of expected in a 6-mo weightthe effects of binge
region was
height
was
Body isotope
composition dilution
and
tions
to calculate
with
measured
and
without
variables,
binge-eating
the
data
are
disorder
not
between
for
presented
any
of the
by binge-eating
status. Subjects were in general a diagnosis of hypertension subjects taking medication wk
before
beginning
good health. In particular, none or dyslipidemia at study entry. discontinued these medications
the
study.
No
subject
had
overt
had All 2
diabetes,
in
no
method
to report.
Detroit)
was
for
by
one white woman Program guidelines
time
point
during
abdominal dcx (CI)
and mid-thigh was calculated
risk,
low-density-lipoprotein
at
one
time
approved ical the
point
by the
Research US
and
during
the
National
and
the
Center in Bethesda, Research Center periods.
during (1200
which kcal/d).
metabolic
women
The
first
subjects Initial
measures
protocol
Clin-
Committee
of
Research
consent
was
Waist
was
Ser-
obtained
A CT was
NIH/NIMH
MD, and in Beltsville, period
the USDA/ARS MD. There
(baseline)
assessed
800;
Corp,
and
the
supine spine
for
this
period.
volunteers were diet (VLED)
Minneapolis)
containing
at the L2-L3
of 1 wk,
subcutaneous
kJ/d and During
provided (Optifast 3349
To
with
a stadiometer.
underwater impedance
weighing, analysis
between
lack
from
the
(% BF)
the
equa-
density
selected
by
hy-
as
the
BLA
from
equations
BIA of
two
methods. between
of validated body
we
fat
with the the total TAT
the body A density
but
excluded
calculated
(RJL,
Gray
et al
circumferences, as follows (27): [square
9800;
tissue in each
lumbar software
(SAT) with made
pixels ranging of attenuation nonfatty
soft
the
conicity
in-
Milwaukee)
was
placed
view of the transaxial
were
levels.
The
package each the
in the
lower lumbar sections were images currently
image VAT,
the area and the
calculated.
cross-sectional
was traced mask was
the
Electric, subject
the L4-L5
using
(wt/ht)]
General
a lateral scout One-centimeter and
and
root
Each
by
measurements, the from the minimal
CT scanner used. For adipose tissue (TAT),
adipose
that included all units. This range (fat)
was
circumference was calculated
by the HIGHLIGHT
measure
ery of cursor.
hip
(model
analyzed
available (cm2) of
to consume 5024 and anthropometnic during
were
(WHR)
all measurements.
position and was performed.
Human three
were
consisted
NIH
fat
using
X 0. 109
scanner
used
obtained at the
period the liquid-formula
Nutrition
high-
Intramural
Agriculture
were instructed CT scanning were
study Studies
informed
had
concentrations
of Health Human
the 12 wk of the second with a very-low-energy Sandoz
The
of Agriculture’s
vice (USDA/ARS) and written from all subjects. The research was conducted
dietary
white
study.
Institutes
Subpanel
Department
Clinical Nutrition
two
(LDL)-cholesterol
and
body
calculated
Program
study,
0. 1 cm
was kg and
(25), developed in a population of obese women. Zillikens and Conway (26) demonstrated that prediction equations developed from BIA data in white populations are applicable in a black
black and Education
the
0.01
women,
Percent
Education
one
to the nearest
difference
body black
and (WTR)
hypertension,
at
the minimal Weight
the
ratio
mild
nearest
therefore analyses.
estimated by and bioelectric
(15),
abdominal ratio
for
(ht),
(hip), mid-thigh
women
minimal waist-thigh
met the National Cholesterol (23) for high cholesterol at one
and
fat by any of the in bone density
population. The waist-hip
(22)
balance
percent
weighing
buttocks,
and
significant
as assessed by fasting blood glucose. During the 6-mo course of study two white women met National High Blood Pressure guidelines
during
height
hip
in percent body known differences
white
drostatic
the
(wt),
(waist),
statistical
to the
was
weight
women, all
was (2H2O),
black
subjects
were
and
period.
abdomen of
in several
measured
(21).
found
included
on an electronic
of women of the
were
aerobic during
we also measured the abdomen at the the umbilicus was displaced from the
used
There
differences
during
measures (baseline)
dietary
minimal
Although umbilicus,
(BIA).
significant
food
patterning
circumference
groups Because
no
program
subsequent
at the
eating on weight loss and were therefore selected by presence or absence of binge-eating disorder (20). Four black women and five white women met criteria for binge-eating disorder Because
own
of
free-
image,
the
peniph-
a region of interest (ROI) of the resulting body ROl
from values tissues,
-150 to -50 Hounsfield included adipose tissue air,
and
bone.
The
total
Downloaded from www.ajcn.org by guest on July 13, 2011
Bethesda,
were
were
their
were
All subjects were assessed study and health status and
Experimental
of the
measures
circumferences
their data are presented. by advertisement in the
measurements, Subjects
too obese completed
period.
andfat
Anthropometnic
One
secondary
the
woman was 18 women
VLED
of each
third
diet
subjects
monitored. A low-intensity was initiated by the subjects
initiation
composition
to fit into all three
and one black The remaining
the
at the
The
unable
(CT).
scanning
week obtained
the remain-
subjects tomography
to tolerate
claustrophobia the CT scanner.
area.
1 1 white,
the
and were born in the United States. had black parents and grandparents.
United
the
and
of
were (walking)
The
consumed
Methods
the
meals.
energy-deficient
kcal/d).
the baseline and refeeding periods. weekly by a physician during the compliance program
equal
12 wk, during which the women energy intake, so that by the final 6
RACIAL TABLE
DIFFERENCES
of demographic
data
at study Black
entry’
All
women
White
Education
(y)
14.3
± 2.0
34.8
±
165.3
±
(y) (cm)
Weight
(kg)
109.5
Hip
(cm) (cm)
Weight
loss
Percent
body
2
and
1.7
38.6
± 6.3
demographic
± 6.0 ± 8.1
0.84
± 0.1
1 10.9
± 14.0
parisons
were
133.0
± 16.9
period
and race)
± 5.9
17.1
± 15.0
groups.
52.8 ± 6.9
51.5
± 5.4
differences
between
races
were
were
t tests
were
characteristics
± 10.5
significant
SDs
performed
made
by using
Significance
mean
± SD
as a determination
black
and
test means
white
for of
women,
% BF, waist, hip, and age. of VAT, SAT, and TAT calculated. All other com-
a three
set at P
where
(SAS
as the measure
computed
by two
of variance
was
except
PC-SAS
that included Bartlett’s used to compare the
between
analysis
with
calculated
including: wt, ht, WHR, WTR, BMI, Pearson product-moment correlations with anthropometric surrogates were
± 24.4
38.2
Unpaired variances
± 8.6
17.4
no
tendency
of variability. equality of
128.8 fat (%) were
±
102.9
Means
factorial
(ANOVA) 0.05.
=
(dietary
for unbalanced
Data
are presented
as
indicated.
by
t test.
Entry
P
