142nd APHA Annual Meeting and Exposition

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Direct clinical measures detect significant reductions in body fat in obese adolescent African American females after intensive, culturally-relevant, nutrition and behavioral intervention

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Sunday, November 16, 2014

Nicole Pelligrino, MPH , School of Public Health, Behavioral and Community Health Sciences Department, Louisiana State University Health Sciences Center, New Orleans, LA
Cruz Velasco-Gonzalez, PhD , Department of Biostatistics, Louisiana State University Health Sciences Center School of Public Health, New Orleans, LA
Jovanny Zabaleta, PhD , Department of Pediatrics, Louisiana State University Health Sciences Center School of Medicine and Stanley S. Scott Cancer Center, New Orleans, LA
John Estrada, MD , Department of Pediatrics, Louisiana State University Health Sciences Center School of Medicine and Stanley S. Scott Cancer Center, New Orleans, LA
Robert Uddo , School of Public Health, Behavioral and Community Health Sciences Department, Louisiana State University Health Sciences Center, New Orleans, LA
Rebecca Miller, RD, MPH , School of Public Health, Behavioral and Community Health Sciences Department, Louisiana State University Health Sciences Center, New Orleans, LA
Amanda Arguello, MPH , School of Public Health, Behavioral and Community Health Sciences Department, Louisiana State University Health Sciences Center, New Orleans, LA
Alexandria Augustus, MPH , School of Public Health, Behavioral and Community Health Sciences Department, Louisiana State University Health Sciences Center, New Orleans, LA
Meghan Brown, RD, MPH , School of Public Health, Behavioral and Community Health Sciences Department, Louisiana State University Health Sciences Center, New Orleans, LA
Maura Mohler, MPH , School of Public Health, Behavioral and Community Health Sciences Department, Louisiana State University Health Sciences Center, New Orleans, LA
Yolanda Powell-Young, PhD, PCNS-BC, CPN, CNE , School of Nursing, Dillard University, New Orleans, LA
Kyle Happel, MD, FCCP , Section of Pulmonary and Critical Care Medicine, Louisiana State University Health Sciences Center School of Medicine, New Orleans
Hamid Boulares, PhD , Department of Pharmacology, Louisiana State University Health Sciences Center School of Medicine and Stanley S. Scott Cancer Center, New Orleans, LA
Tung-Sung Tseng, DrPH., M.S. , School of Public Health, Behavioral and Community Health Sciences Department, Louisiana State University Health Sciences Center, New Orleans, LA
Henry Nuss, PhD , School of Public Health, Behavioral and Community Health Sciences Department, Louisiana State University Health Sciences Center, New Orleans, LA
Richard Scribner, MD, MPH , Epidemiology, LSU School of Public Health, New Orleans, LA
Melinda Sothern, PhD, C.E.P. , School of Public Health, Behavioral and Community Health Sciences Department, Louisiana State University Health Sciences Center, New Orleans, LA
Background

Adolescent African-American females in Louisiana post high obesity prevalence. Body mass index (BMI), is commonly employed in nutrition and behavioral interventions to estimate body composition, despite its inability to discern excess fat versus lean muscle mass. This study aims to demonstrate that significant reductions in adiposity may only be possible with intensive, culturally-relevant interventions, and detected by sensitive, direct clinical measures, like those obtained by dual-energy x-ray absorptiometry (DXA).

Methods

Obese (BMI >95th percentile) African-American female participants (n=13; 13-19 years) were enrolled into a clinic-based 10-week nutrition and behavioral intervention, and prescribed a hypocaloric, non-ketogenic, high protein-modified fast supplemented with daily multi-vitamins, calcium plus vitamin D, and potassium. Lessons were instructed by Master of Public Health (MPH)-level staff (registered dietician (RD) and health educator). Fat mass, lean muscle mass and bone mineral content (BMC) were measured at pre-and-post-intervention directly by DXA; BMI(kg/m2)_for-gender-age-z-score was estimated based on the Centers for Disease Control (CDC) 2010 growth charts; waist circumference (cm) was measured using standard procedures.

Results

Significantly decreased fat mass (ȳ=-2469.8, se=671.88, p=0.0015) and increased BMC (ȳ=110.2, se=0.0134, p=0.0134) were observed from pre-to-post-intervention. Total weight was also reduced significantly (ȳ=-2.2, se=1.0, p=0.0425). No significant differences were detected in lean muscle mass, BMI_z-score, height, or waist circumference.

Conclusions

DXA detected significant fat loss and improved BMC, post-intervention. However, BMI_z-score and waist circumference revealed no significant changes. When replicating intensive, culturally-relevant, clinic-based nutrition and behavioral interventions in community settings, it may be important to avoid BMI_z-score to detect treatment effect in obese adolescent African-American females.

Learning Areas:

Implementation of health education strategies, interventions and programs
Public health or related research
Social and behavioral sciences

Learning Objectives:
Compare changes in body composition utilizing direct versus indirect measures before and after an intensive, culturally-relevant, clinic-based nutrition and behavioral intervention targeting obese adolescent African-American females in New Orleans, Louisiana.

Keyword(s): Obesity, Minority Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an MPH, CHES, well-versed in academic and community-level adolescent public health education. I supervise implementation of an NIH-funded translational research intervention study (the focus of my abstract) examining obesity disparities in adolescent African-American females. I manage the team involved in participant screening, monitoring and intervention facilitation; and liaise between participants, intervention staff and research scientists. I also facilitate evidence-based adolescent health interventions for the Central Louisiana Area Health Education Center and Planned Parenthood.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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