Behavioral medicine surveys consistently find that obesity is a treatment-resistant disease that continues to be a significant health problem and that the incidence of obesity is much higher in Blacks relative to Whites in general, and even higher in Black women relative to White women. In fact, a recent NIH Program Announcement (PA-91-99), """"""""Obesity in adults has not declined in the past three decades"""""""" and """"""""Obesity is particularly prevalent in minority populations, especially among minority women."""""""" Obesity is an independent risk factor for cardiovascular disease, stroke, and hypertension. Obesity is a complex phenomenon involving behavioral, lifestyle, and complex biobehavioral mechanisms. To the best of our knowledge, there are no prospective studies that have simultaneously evaluated a systematic set of psychosocial variables with energy balance (dietary intake, physical activity, resting metabolic rate) determinants that may account for the increased risk for obesity in African-American versus Euro-American women. As such, we propose the following Specific Aims: (1) To recruit 460 (230 Black, 230 White) normal-weight (n = 230) and obese (n = 230) women and to relate psychosocial and energy balance (dietary intake, physical activity, metabolic rate) baseline measures to levels of body fat as measured by DEXA (dual electron X-ray absorptiometry); and (2) to evaluate prospectively the role of these variables to adiposity changes in both White and Black women over a 24-month period.
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