C-reactive protein levels in African Americans: a diet and lifestyle randomized community trial.
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.


OBJECTIVE
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.


BACKGROUND
This study is registered at www.clinicaltrials.gov NCT01760902.
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. Electronic address: jhebert@sc.edu.
James R
JR
Hébert
Michael
M
Wirth
Lisa
L
Davis
Briana
B
Davis
Brook E
BE
Harmon
Thomas G
TG
Hurley
Ruby
R
Drayton
E
E
Angela Murphy
Nitin
N
Shivappa
Sara
S
Wilcox
Swann A
SA
Adams
Heather M
HM
Brandt
Christine E
CE
Blake
Cheryl A
CA
Armstead
Susan E
SE
Steck
Steven N
SN
Blair
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis*; D004032:Diet / Q000208:ethnology*; D005260:Female; D015438:Health Behavior / Q000208:ethnology; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008019:Life Style / Q000208:ethnology*; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000208:ethnology; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000208:ethnology
D002097:C-Reactive Protein