Hair practices may be barrier to physical activity for some African-American women

Dec. 17, 2012 — A study that surveyed 103 African-American women suggests that nearly 40 percent of the women reported avoiding exercise at times because of their hair, according to a report published Online First by Archives of Dermatology, a JAMA Network publication.

Regular physical activity (PA) is associated with a decreased risk for obesity, but African-American women have been among the least likely to meet some of the targeted PA goals. Sufficient physical activity has been defined as moderate-intensity aerobic PA for at least 150 minutes per week or vigorous-intensity aerobic PA for at least 75 minutes per week. Hair care and hairstyle maintenance can be costly for African-American women and because of the relative infrequency of hair washing needed to maintain many common hairstyles they may opt to avoid exercise and the associated sweating, according to the study background.

Rebecca R. Hall, M.D., of the Wake Forest School of Medicine, Winston-Salem, N.C., and colleagues surveyed African-American women about their hair care practices and PA to characterize the relationship of hairstyle maintenance with exercise. The average age of the 103 women surveyed was about 42 years.

"Hair maintenance in African-American women in this study limited their participation in PA with more than half of the women exercising less than 75 minutes/week and 26.2 percent reporting 0 minutes of exercise per week," the authors note.

Most of the women (62.1 percent) wore their hair in a relaxed (chemically straightened) style and most of the women washed their hair every one to two weeks (81.6 percent).

Hair concerns caused 35.9 percent of the women surveyed to avoid swimming and water activities, while 29.1 percent avoided aerobic and gym activities. Women with normal scalps (not dry or oily) were significantly more like to participate in aerobic/gym activities than those with scalp complaints. Women who exercised less because of hair concerns were 2.9 times less likely to exercise more than 150 minutes per week, according to study results.

"Effective strategies to promote PA in African-American women, known to disproportionately have obesity and associated sedentary diseases, must include addressing dermatologic barriers to PA with strategies that address hairstyle maintenance. The high percentage of African-American women with baseline scalp complaints suggests that dermatologists need to consider these symptoms when providing care for African-American women," the authors conclude.

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Rebecca R. Hall. Hair Care Practices as a Barrier to Physical Activity in African American WomenHair Practices and PA in African American Women. Archives of Dermatology, 2012; DOI: 10.1001/jamadermatol.2013.1946

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Maintaining weight loss as important as losing it for older women

Dec. 10, 2012 — When you're postmenopausal and overweight, losing weight is a good thing, but gaining back just a few pounds may actually be detrimental to your cardiovascular health.

New research from Wake Forest Baptist Medical Center found that gaining weight back after intentional weight loss is associated with negative long-term effects on some cardiometabolic (CM) risk factors in postmenopausal women.

In this paper, published online by the Journal of Gerontology: Medical Sciences, lead authors Daniel Beavers, Ph.D., and Kristen Beavers, Ph.D., wanted to look at how weight regain affects health risk in these women. The researchers looked specifically at CM risk factors -- a cluster of risk factors that are indicators of a person's overall risk for type 2 diabetes and cardiovascular disease. They include blood pressure, HDL and LDL cholesterol, triglycerides, fasting glucose and insulin.

"In this group of women, weight loss and maintaining that loss offers the most health benefit, but therein lies the problem," Daniel Beavers said. "For most people, weight regain after intentional weight loss is an expected occurrence, and the long-term health ramifications of weight regain in older adults are not well understood."

Specifically, the researchers looked at how CM risk factors change in the year following significant, intentional weight loss and whether these changes are affected by weight regain.

"What we found was that all CM risk factors are improved with weight loss, which is not surprising, but most regressed back to their baseline values 12 months later, especially for women who were classified as 'regainers,'" Kristen Beavers said. "For women who had regained weight in the year after their weight loss, several risk factors were actually worse than before they lost the weight."

For the study, sponsored by the National Institute on Aging, the researchers evaluated 112 obese, postmenopausal women averaging 58 years of age, through a five-month weight loss intervention and a subsequent 12 month non-intervention period. Body weight/composition and CM risk factors were analyzed before and after the weight loss intervention and at six and 12 months after the intervention. During the intervention, women lost a significant amount of weight, an average of 25 pounds, and 80 women returned for at least one followup measurement. Weight regain status was based on whether a participant regained at least four pounds during the follow-up period. Two-thirds of the women fell into this category and, on average, regained approximately 70 percent of lost weight.

Beavers said these study results highlight the need for future research to better identify barriers to long-term weight loss success and develop effective strategies to promote the maintenance of weight loss in this population. These new findings build on previously published data from Wake Forest Baptist's gerontology research group that found when postmenopausal women lose weight and gain it back, they regain it mostly in the form of fat, rather than muscle.

"Our data suggest that for postmenopausal women, even partial weight regain following intentional weight loss is associated with increased cardiometabolic risk. Conversely, maintenance of or continued weight loss is associated with sustained improvement in the cardiometabolic profile," Kristen Beavers said. "The take away message for overweight, older women is to approach weight loss as a permanent lifestyle change, with weight maintenance just as important as weight loss."

This work was supported by the NIH (R01-AG/DK20583, R01-HL093713 and F32-AG039186), Wake Forest University Claude D Pepper Older Americans Independence Center (P30- AG21332), and Wake Forest University General Clinical Research Center (M01-RR07122). Co-authors are: Barbara Nicklas, Ph.D., and Mary F. Lyles, M.D., of Wake Forest Baptist.

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The above story is reprinted from materials provided by Wake Forest Baptist Medical Center, via Newswise.

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D. P. Beavers, K. M. Beavers, M. F. Lyles, B. J. Nicklas. Cardiometabolic Risk After Weight Loss and Subsequent Weight Regain in Overweight and Obese Postmenopausal Women. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 2012; DOI: 10.1093/gerona/gls236

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Steroid injection linked with significant bone loss in postmenopausal women treated for back pain

Dec. 1, 2012 — Postmenopausal women suffered significant bone density loss in their hip after they were treated with an epidural steroid injection for back pain relief, according to a Henry Ford Hospital study

Bone density loss after six months was six times greater when compared to the typical bone density loss seen in a year in a postmenopausal woman who doesn't receive steroid injection, researchers say.

Shlomo Mandel, M.D., a Henry Ford orthopedic physician and the study's lead author, says physicians should exercise caution prescribing an epidural steroid for select patients, suggesting that multiple injections may compromise bone strength.

"The findings of our study suggest that epidural steroid injections for back pain relief should be approached cautiously in patients at risk for bone fragility," Dr. Mandel says. "Physicians who do prescribe them should consider measures that optimize bone health such as calcium and vitamin D supplements and exercise as part of their patient's treatment plan.

The study will be published in the Dec. 1 edition of Spine.

Back pain is one of the most common medical conditions in the United States, affecting 8 out of 10 people at some point during their lives. As people age, their spine ages with them, causing degenerative changes in the spine.

Patients are typically treated with anti-inflammatory drugs and physical therapy. If symptoms persist, an epidural steroid is often prescribed to alleviate pain and improve function. However, steroid use has been linked to diminished bone quality.

In the observational study, Henry Ford sought to evaluate whether steroid injections used for treating lumbar stenosis, increased the risk of bone loss in postmenopausal women. Lumbar stenosis is an abnormal narrowing of the spine canal. Twenty-eight patients, aged 65 and older and treated between 2007-2010, were evaluated for bone loss using bone density testing and serum biochemical markers prior to receiving an injection, then at three- and six-month intervals.

The bone loss data was compared to bone loss data for postmenopausal women who hadn't been treated with an epidural injection.

"Patients receiving multiple steroid injections with a history of steroid exposure may be especially susceptible to compromised bone strength," Dr. Mandel says.

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Eating fewer, larger meals may prove healthier for obese women

Dec. 6, 2012 — Media articles and nutritionists alike have perpetuated the idea that for healthy metabolisms individuals should consume small meals multiple times a day. However, new research conducted at the University of Missouri suggests all-day snacking might not be as beneficial as previously thought, especially for obese women.

"Our data suggests that, for obese women, eating fewer, bigger meals may be more advantageous metabolically compared to eating smaller, more frequent meals throughout the day," said the study's lead author, Tim Heden, a doctoral student in MU's Department of Nutrition and Exercise Physiology. "Eating larger meals less often lowered blood-fat levels. Over time, consistently eating fewer, larger meals each day could lower the women's blood-fat levels and thereby lower their risk of developing heart disease."

Heden and other MU researchers studied how meal frequency affected blood-sugar and blood-fat levels in eight obese women throughout two 12-hour periods on two separate days. All of the women consumed 1,500 calories. During the two different testing days, the participants consumed three 500-calorie liquid meals or six 250-calorie liquid meals. Throughout the 12-hour time frames, researchers tested sugar and fat levels in the women's blood every 30 minutes. Women who consumed three meals had significantly lower fat in their blood.

"The mass media and many health care practitioners often advocate eating several small meals throughout the day," Heden said. "However, when we examined the literature, we didn't find many studies examining or supporting this popular claim. This lack of research led to our study, which is one of the first to examine how meal frequency affects insulin and blood-fat levels in obese women during an entire day of eating."

More than one-third of Americans are obese, and these individuals are especially at risk for heart disease, the leading cause of death in the country, according to the Centers for Disease Control and Prevention. Heden says the research could help nutritionists and medical professionals develop strategies to improve the health of obese women.

"With multiple meals throughout the day, you have to be careful. If you start consuming several meals, there's more potential to overeat or to make unhealthy snack choices with easily accessible junk food," said Jill Kanaley, professor in the Department of Nutrition and Exercise Physiology and study co-author. "Some people are good at making efforts to eat healthy snacks; however, most people aren't, and they end up taking in too many calories. The more times you sit down to eat, the more calories you're probably going to take in."

Obese women would benefit from consuming three balanced meals a day, Heden and Kanaley agree.

The study, "Meal Frequency Differentially Alters postprandial Triacylglycerol and Insulin Concentrations in Obese Women," will be published in the journal Obesity.

The Department of Nutrition and Exercise Physiology is jointly administered by MU's College of Agriculture, Food and Natural Resources, College of Human Environmental Sciences and School of Medicine.

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Timothy D. Heden, Ying Liu, Lauren J. Sims, Adam T. Whaley-Connell, Anand Chockalingam, Kevin C. Dellsperger, Jill A. Kanaley. Meal Frequency Differentially Alters Postprandial Triacylglycerol and Insulin Concentrations in Obese Women. Obesity, 2012; DOI: 10.1038/oby.2012.171

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