Race may affect weight and fitness level

December 13, 2004

Race may play an important role in determining a person's obesity and fitness levels, shows a new study in the December issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians (ACCP). The study found that African-American patients had a higher level of obesity and a lower exercise capacity compared to Caucasian patients, with the most pronounced difference found between African-American and Caucasian males.

"There is a popular belief among the lay public and by many clinicians that African-Americans are more fit than Caucasian patients. However, our findings suggest this is not the case," said Carl J. Lavie, MD, Ochsner Clinic Foundation, New Orleans, LA. "Despite being older, Caucasian patients in our study had significantly higher exercise capacities and lower obesity levels than African-Americans, suggesting that some races may be more susceptible to increases in weight and decreases in fitness levels."

Researchers from the Ochsner Heart and Vascular Institute at the Ochsner Clinic Foundation compared obesity status and exercise capacity among African-American and Caucasian men and women in order to determine if race was an independent predictor of fitness. Dr. Lavie and colleagues studied 4,428 Caucasian and 641 African-American patients, ages 52 to 74, who were referred for an exercise stress test for the detection of coronary artery disease (CAD). Exercise capacity was determined using a standard treadmill test, and obesity status was determined by body mass index (BMI). Results showed that within the entire cohort, African-Americans had a 7 percent lower exercise capacity compared to Caucasians. In regard to gender, African-American men were, on average, 3 years younger, had a higher baseline BMI, a higher prevalence of obesity and severe obesity, and an exercise capacity that was 7 percent lower than their Caucasian counterparts. Compared to Caucasian women, African-American women were, on average, 4 years younger, had considerably higher BMIs, and a significantly higher prevalence of obesity and severe obesity. African-American women also had a slightly lower exercise capacity than Caucasian women, although the difference was not significant. Overall, Caucasian race, younger age, male gender, and lower BMI were all independent predictors of higher exercise capacity. The prevalence and severity of CAD were similar in both races.

"Our society is known for high-calorie, high-fat, and high-sugar diets, lack of exercise, and sky-rocketing prevalence of obesity and diabetes, all of which have been associated with an increased risk in cardiovascular disease," said Dr. Lavie. "With CAD being a significant health threat among African-Americans, a greater effort is needed to direct health and exercise programs toward this population."

"Obesity and physical inactivity have become major health concerns in the United States, being linked to cardiovascular disease, respiratory and sleep disorders, diabetes, and many other medical conditions," said Paul A. Kvale, MD, FCCP, President of the American College of Chest Physicians. "Although African-American patients may be particularly at risk for obesity and lower exercise capacity, it is important for physicians to encourage all patients to maintain a healthy weight and lifestyle in order to avoid serious health complications in the future."
CHEST is a peer-reviewed journal published by the ACCP. It is available online each month at www.chestjournal.org. ACCP represents 16,000 members who provide clinical respiratory, sleep, critical care, and cardiothoracic patient care in the United States and throughout the world. The ACCP's mission is to promote the prevention and treatment of diseases of the chest through leadership, education, research, and communication. For more information about the ACCP, please visit the ACCP Web site at www.chestnet.org.

American College of Chest Physicians

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