'From a public health perspective, prevention is as important as treatment. Still, what I observed was a large gap in prevention approaches to address obesity in Black women'
Loneke Blackman Carr, an assistant professor in the Department of Nutritional Sciences in the College of Agriculture, Health and Natural Resources, has received funds from the National Heart, Lung, and Blood Institute to study the effects of a weight-gain prevention program on Black women's health.
The project aims to more holistically address Black women's lived experiences and support healthier choices that promote weight stability.
"Receiving funding for this work says something encouraging: that we still value rigorous, innovative science that can meet real human needs. It is significant to uplift science for obesity prevention, in the community that has weathered the weight of so much. I am hopeful that this work will contribute to solutions to address obesity that may impact communities well beyond the bounds of this project," says Blackman Carr.
She is collaborating with Kim Gans, a principal investigator at the UConn Institute for Collaboration on Health, Intervention and Policy (InCHIP) and professor in the Department of Human Development and Family Sciences in the College of Liberal Arts and Sciences; Amy Gorin, professor of Psychological Sciences and Senior Vice Provost for Health Sciences and Interdisciplinary Initiatives; and Keisha Bently-Edwards, associate professor of medicine at Duke University's Division of General Internal Medicine.
Black women often face higher levels of stress, which can make it harder to maintain healthy behaviors and develop self-regulation skills. This can contribute to poor diet, physical inactivity, and delayed self-care, potentially leading to weight gain.
The study will leverage acceptance-based strategies and mindfulness-based stress reduction, which teach individuals how to honor their values and intentions to achieve more healthful outcomes. While mindfulness-based stress reduction has been found to improve heart health in Black women, it has not been widely applied to weight gain prevention.
During the trial, participants will learn problem solving and goal setting skills to promote healthy eating and exercise even when faced with unsupportive emotions, thoughts, and environments. They will also meet with a dietitian monthly and receive social support and feedback on their progress.
Overweight and obesity impact about 82% of Black women. Higher body mass indexes (BMI) can increase the risk of chronic disease like heart disease or type 2 diabetes. For Black women, the risk of weight-associated disease increases when BMI is 35 kg/m2 or higher, suggesting maintaining body weight could decrease chronic disease risk.
"Losing weight is hard. Anyone who has been on that journey will tell you of the ups and downs along the way. Preventing weight gain can be a strategy to avoid the onset of weight-associated diseases. It is also a culturally relevant approach for Black women whose beauty standards value curvy frames. A 'maintain, don't gain' orientation resonates well among those whose goal is not thinness," says Blackman Carr.
The project aims to fill a critical gap in weight management research by testing a weight gain prevention intervention for Black women and tailoring it to address the health burden of chronic stress.
"From a public health perspective, prevention is as important as treatment. Still, what I observed was a large gap in prevention approaches to address obesity in Black women," says Blackman Carr.
Current evidence indicates that preventing weight gain could reduce heart disease risk and improve heart health. However, most work in this area has not explored the effects of weight gain prevention or implication of stress for Black women. Most studies in this area have been conducted among mostly young, white women whose body weights ranged from normal to overweight.
Moreover, there is very little research exploring the effects of weight gain prevention interventions for Black women. Nor does the existing research evaluate how stress impacts intervention efficacy.
The Shape Program from Duke University researchers is the only study that specifically evaluated weight gain prevention strategies in Black women. The program was an 18-month randomized controlled trial of a weight gain prevention intervention consisting of building self-regulatory skills for Black women with overweight between the ages of 25 and 44 years.
Although innovative, the trial did not include participants with normal body weight - a common target for weight gain prevention treatment. It also did not investigate the effects of mindfulness-based stress reduction or acceptance-based treatment strategies.
For her study, Blackman Carr will recruit Black women between the ages of 18 to 44 years of age whose body mass indexes range from normal to class 1 obesity - a more inclusive range.
She believes that results from this project could demonstrate how stress-reduction and acceptance-based treatments could help individuals maintain body weight, improve health, and lower heart disease risk during stress.
Blackman Carr studies racial disparities in obesity and related diseases, and the cultural and social contexts that influence diet and physical activity behaviors. Her recent work has focused on Black men and women and controlling hypertension through adherence to a Dietary Approaches to Stop Hypertension (DASH).
The project intentionally weaves community-engaged methods. A community advisory board will guide development and implementation of the study intervention. The board includes representatives from Black Girls Run!, a national health organization, Brown Skin Women, a textured hair stylist, and others who reflect the women participating in the study.
"My goal is that what we collectively produce will be highly relevant, meaningful, and effective for the women we aim to serve in this work and beyond," says Blackman Carr.
