Venita K. Wolfe

Personal, social, and environmental correlates of physical activity in Native American women

BACKGROUND Rates of physical activity among Native American women are low, and few studies have assessed the factors associated with physical activity in this population. The purpose of this study was to determine the relationship among physical activity and various personal, social environmental, and physical environmental factors in Native American women. METHODS As part of the multisite study of the Womens Cardiovascular Health Network Project, 350 Native American women from the Southwest completed a face-to-face interview. Participants ranged in age from 20 to 50 years. Logistic regression analyses were conducted using physical activity as the dependent variable. RESULTS Participants represented a variety of tribal groups, with most being Navajo or Pueblo. More than one half (55.1%) met moderate or vigorous physical activity recommendations, with 32.0% being insufficiently active, and 12.9% being inactive. Personal factors related to being more active included not having a marital partner, self-reporting excellent or very good health, and having very high physical activity self-efficacy. In terms of social environmental factors, women were more likely to meet physical activity recommendations if they knew people who exercised, if they saw people exercising in their neighborhood, and if they attended religious services. Physical environmental factors that were examined were not associated with meeting physical activity recommendations. CONCLUSIONS Social environmental factors were significantly associated with physical activity in Native American women. The results emphasize the importance of support from family, friends, communities, and leaders in increasing physical activity among this group of women.

Reducing Diabetes Risk in American Indian Women

BACKGROUND American Indians experience high rates of type 2 diabetes. The impact of low-intensity interventions on diabetes risk among young American Indian women is unknown. DESIGN Randomized controlled trial. SETTING/PARTICIPANTS Community-based; participants were 200 young urban American Indian women who were block-randomized on fasting blood glucose (FBG) into intervention and control groups. Inclusion criteria included self-reported identity, aged 18-40 years, not pregnant, willingness to stay in urban area for 2 years, and not having type 2 diabetes. Measures were taken at baseline, 6, 12, and 18 months. Data were gathered in 2002-2006 and analyzed in 2006-2007. INTERVENTION Five discussion group sessions (one meeting per month for 5 months) were held focusing on healthful eating, physical activity, goal-setting, and social support. MAIN OUTCOME MEASURES Primary outcomes included dietary fat and vegetable consumption and self-reported physical activity. Secondary outcomes included cardiorespiratory fitness, insulin sensitivity, blood pressure, lipid profiles, percent body fat, BMI, intake of fruit, total sugar and sweetened beverages, FBG, and television viewing. RESULTS Mean vegetable and fruit intake increased significantly more in the intervention group than in the control group over time (group by visit interaction, p=0.02 and p=0.002, respectively). Both groups had significant increases in percent body fat and decreases in waist circumference, insulin sensitivity, blood cholesterol, LDL, television viewing, and total intakes of energy, saturated fat, sugar, and sweetened beverages. CONCLUSIONS A culturally influenced, low-intensity lifestyle intervention can improve self-reported intakes of vegetables and fruit over 18 months in young, urban American Indian women.

Associations Between Body Mass Index, Cardiorespiratory Fitness, Metabolic Syndrome, and Impaired Fasting Glucose in Young, Urban Native American Women

BACKGROUND To investigate the baseline associations between body composition, cardiorespiratory fitness, physical activity, family history of type 2 diabetes, metabolic syndrome and impaired fasting glucose (IFG) among 200 asymptomatic urban Native American women aged 18-40 years participating in a diabetes prevention intervention. METHODS Participants without diabetes who self-identified as Native American were recruited from the general urban community into a randomized controlled trial. Inclusion criteria included not being pregnant and willingness to stay in the urban area for 2 years. From June 2002 to June 2004, baseline measures were taken and included fasting serum glucose, insulin, and lipids, body mass index (BMI), waist circumference, percent body fat, submaximal predicted cardiorespiratory fitness, and self-reported leisure physical activity and family history of type 2 diabetes. RESULTS Most participants were overweight or obese (mean BMI = 29.4 +/- 6.3 kg/m(2); mean percent body fat = 41.2% +/- 6.2%). Fifty-five (27.5%) had metabolic syndrome and 42 (21%) had IFG. Stepwise logistic regression indicated that BMI (odd ratio [OR] = 1.24; p < 0.001) and a family history of type 2 diabetes (OR = 4.96; p = 0.008) were significantly associated with metabolic syndrome. BMI (OR = 1.13; p = 0.003) was strongly positively associated with IFG. After adjusting for BMI, age (OR = 1.08; p = 0.021) was positively, and high-density lipoprotein cholesterol (HDL-C; OR = 0.93; p = 0.008) and cardiorespiratory fitness (OR = 0.36; p = 0.046) were inversely significantly associated with IFG. CONCLUSIONS BMI, cardiorespiratory fitness, and physical activity levels are important variables to modify when attempting to reduce the prevalence of metabolic syndrome and IFG among young, asymptomatic Native American women. This information can be used to design effective diabetes prevention interventions.