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C-Reactive Protein Levels in African Americans

A Diet and Lifestyle Randomized Community Trial
  • James R. Hébert
    Correspondence
    Address correspondence to: James R. Hébert, ScD, Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Suite 241, Columbia SC 29208
    Affiliations
    Cancer Prevention and Control Program (Hébert, Wirth, L. Davis, B. Davis, Harmon, Hurley, Drayton, Shivappa, Adams, Brandt, Armstead, Steck), Arnold School of Public Health, University of South Carolina, Columbia, South Carolina

    Department of Epidemiology and Biostatistics (Hébert, Wirth, Shivappa, Adams, Steck, Blair), Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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  • Michael Wirth
    Affiliations
    Cancer Prevention and Control Program (Hébert, Wirth, L. Davis, B. Davis, Harmon, Hurley, Drayton, Shivappa, Adams, Brandt, Armstead, Steck), Arnold School of Public Health, University of South Carolina, Columbia, South Carolina

    Department of Epidemiology and Biostatistics (Hébert, Wirth, Shivappa, Adams, Steck, Blair), Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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  • Lisa Davis
    Affiliations
    Cancer Prevention and Control Program (Hébert, Wirth, L. Davis, B. Davis, Harmon, Hurley, Drayton, Shivappa, Adams, Brandt, Armstead, Steck), Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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  • Briana Davis
    Affiliations
    Cancer Prevention and Control Program (Hébert, Wirth, L. Davis, B. Davis, Harmon, Hurley, Drayton, Shivappa, Adams, Brandt, Armstead, Steck), Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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  • Brook E. Harmon
    Affiliations
    Cancer Prevention and Control Program (Hébert, Wirth, L. Davis, B. Davis, Harmon, Hurley, Drayton, Shivappa, Adams, Brandt, Armstead, Steck), Arnold School of Public Health, University of South Carolina, Columbia, South Carolina

    University of Hawaii Cancer Center (Harmon), Honolulu, Hawaii
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  • Thomas G. Hurley
    Affiliations
    Cancer Prevention and Control Program (Hébert, Wirth, L. Davis, B. Davis, Harmon, Hurley, Drayton, Shivappa, Adams, Brandt, Armstead, Steck), Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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  • Ruby Drayton
    Affiliations
    Cancer Prevention and Control Program (Hébert, Wirth, L. Davis, B. Davis, Harmon, Hurley, Drayton, Shivappa, Adams, Brandt, Armstead, Steck), Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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  • E. Angela Murphy
    Affiliations
    Department of Pathology, Microbiology (Murphy), College of Arts and Sciences, University of South Carolina, Columbia, South Carolina
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  • Nitin Shivappa
    Affiliations
    Cancer Prevention and Control Program (Hébert, Wirth, L. Davis, B. Davis, Harmon, Hurley, Drayton, Shivappa, Adams, Brandt, Armstead, Steck), Arnold School of Public Health, University of South Carolina, Columbia, South Carolina

    Department of Epidemiology and Biostatistics (Hébert, Wirth, Shivappa, Adams, Steck, Blair), Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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  • Sara Wilcox
    Affiliations
    Department of Exercise Science (Wilcox, Blair), Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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  • Swann A. Adams
    Affiliations
    Cancer Prevention and Control Program (Hébert, Wirth, L. Davis, B. Davis, Harmon, Hurley, Drayton, Shivappa, Adams, Brandt, Armstead, Steck), Arnold School of Public Health, University of South Carolina, Columbia, South Carolina

    Department of Epidemiology and Biostatistics (Hébert, Wirth, Shivappa, Adams, Steck, Blair), Arnold School of Public Health, University of South Carolina, Columbia, South Carolina

    Department of Immunology, School of Medicine, the School of Nursing (Adams), College of Arts and Sciences, University of South Carolina, Columbia, South Carolina
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  • Heather M. Brandt
    Affiliations
    Cancer Prevention and Control Program (Hébert, Wirth, L. Davis, B. Davis, Harmon, Hurley, Drayton, Shivappa, Adams, Brandt, Armstead, Steck), Arnold School of Public Health, University of South Carolina, Columbia, South Carolina

    Department of Health Promotion, Education, and Behavior (Brandt, Blake), Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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  • Christine E. Blake
    Affiliations
    Department of Health Promotion, Education, and Behavior (Brandt, Blake), Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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  • Cheryl A. Armstead
    Affiliations
    Cancer Prevention and Control Program (Hébert, Wirth, L. Davis, B. Davis, Harmon, Hurley, Drayton, Shivappa, Adams, Brandt, Armstead, Steck), Arnold School of Public Health, University of South Carolina, Columbia, South Carolina

    Department of Psychology (Armstead), College of Arts and Sciences, University of South Carolina, Columbia, South Carolina
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  • Susan E. Steck
    Affiliations
    Cancer Prevention and Control Program (Hébert, Wirth, L. Davis, B. Davis, Harmon, Hurley, Drayton, Shivappa, Adams, Brandt, Armstead, Steck), Arnold School of Public Health, University of South Carolina, Columbia, South Carolina

    Department of Epidemiology and Biostatistics (Hébert, Wirth, Shivappa, Adams, Steck, Blair), Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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  • Steven N. Blair
    Affiliations
    Department of Epidemiology and Biostatistics (Hébert, Wirth, Shivappa, Adams, Steck, Blair), Arnold School of Public Health, University of South Carolina, Columbia, South Carolina

    Department of Exercise Science (Wilcox, Blair), Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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      Background

      Chronic inflammation is linked to poor lifestyle behaviors and a variety of chronic diseases that are prevalent among African Americans, especially in the southeastern U.S.

      Purpose

      The goal of the study was to test the effect of a community-based diet, physical activity, and stress reduction intervention conducted in 2009–2012 on reducing serum C-reactive protein (CRP) in overweight and obese African-American adults.

      Methods

      An RCT intervention was designed jointly by members of African-American churches and academic researchers. In late 2012, regression (i.e., mixed) models were fit that included both intention-to-treat and post hoc analyses conducted to identify important predictors of intervention success. Outcomes were assessed at 3 months and 1 year.

      Results

      At baseline, the 159 individuals who were recruited in 13 churches and had evaluable outcome data were, on average, obese (BMI=33.1 [±7.1]) and had a mean CRP level of 3.7 (±3.9) mg/L. Reductions were observed in waist-to-hip ratio at 3 months (2%, p=0.03) and 1 year (5%, p<0.01). In female participants attending ≥60% of intervention classes, there was a significant decrease in CRP at 3 months of 0.8 mg/L (p=0.05), but no change after 1 year. No differences were noted in BMI or interleukin-6.

      Conclusions

      In overweight/obese, but otherwise “healthy,” African-American church members with very high baseline CRP levels, this intervention produced significant reductions in CRP at 3 and 12 months, and in waist-to-hip ratio, which is an important anthropometric predictor of overall risk of inflammation and downstream health effects.

      Trial registration

      This study is registered at www.clinicaltrials.gov NCT01760902.
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