Purpose-To examine the relationship between two sedentary behaviors (riding in car and watching television) and cardiovascular disease (CVD) mortality in men in the Aerobics Center Longitudinal Study.Methods-Participants were 7,744 men (20-89 yr) initially free of CVD who returned a mailback survey during 1982. Time spent watching TV and riding in a car were reported. Mortality data were ascertained through the National Death Index till Dec 31, 2003. Cox regression analysis quantified the association between sedentary behaviors (hr/wk watching television, hr/wk riding in car, total hr/wk in these two behaviors) and CVD mortality rates.Results-377 CVD deaths occurred during 21 years of follow-up. After age-adjustment, time riding in a car and combined time spent in these two sedentary behaviors were positively (p trend <.001) associated with CVD death. Men who reported >10 hrs/wk riding in a car or >23 hr/wk of combined sedentary behavior had 82% and 64% greater risk of dying from CVD than those who reported <4 hr/wk or <11 hr/wk, respectively. The pattern of the association did not materially change after multivariate adjustment. Regardless of the amount of sedentary activity reported by these men, being older, normal weight, normotensive, and physically active was associated with a reduced risk of CVD death.Conclusion-In men, riding in a car and combined time spent in these two sedentary behaviors were significant CVD mortality predictors. Additionally, high levels of physical activity were related to notably lower rates of CVD death even in the presence of high levels of sedentary behavior. Health promotion efforts targeting physically inactive men should emphasize both reducing sedentary activity and increasing regular physical activity for optimal cardiovascular health.

Background Faith-based interventions hold promise for promoting health in ethnic minority populations. To date, however, few of these interventions have used a community-based participatory research (CBPR) approach, have targeted both physical activity and healthy eating, and have focused on structural changes in the church. Purpose To report the results of a group randomized CBPR intervention targeting physical activity and healthy eating in African-American churches. Design Group RCT. Data were collected from 2007 to 2011. Statistical analyses were conducted in 2012. Setting/participants Seventy-four African Methodist Episcopal (AME) churches in South Carolina and 1257 members within them participated in the study. Intervention Churches were randomized to an immediate (intervention) or delayed (control) 15-month intervention that targeted organizational and environmental changes consistent with the structural ecologic model. A CBPR approach guided intervention development. Intervention churches attended a full-day committee training and a full-day cook training. They also received a stipend and 15 months of mailings and technical assistance calls to support intervention implementation. Main outcome measures Primary outcomes were self-reported moderate-to-vigorous-intensity physical activity (MVPA), self-reported fruit and vegetable consumption, and measured blood pressure. Secondary outcomes were self-reported fat- and fiber-related behaviors. Measurements were taken at baseline and 15 months. Intent-to-treat repeated measures ANOVA tested group X time interactions, controlling for church clustering, wave, and size, and participant age, gender, and education. Post hoc ANCOVAs were conducted with measurement completers. Results There was a significant effect favoring the intervention group in self-reported leisure-time MVPA (d=0.18, p=0.02), but no effect for other outcomes. ANCOVA analyses showed an intervention effect for self-reported leisure-time MVPA (d=0.17, p=0.03) and self-reported fruit and vegetable consumption (d=0.17, p=0.03). Trainings were evaluated very positively (training evaluation item means of 4.2–4.8 on a 5-point scale). Conclusions This faith-based structural intervention using a CBPR framework showed small but significant increases in self-reported leisure-time MVPA. This program has potential for broad-based dissemination and reach. Trial registration This study is registered at www.clinicaltrials.gov NCT00379925.

IntroductionObesity is associated with hypertension and diabetes, which are independent risk factors for cardiovascular disease (CVD); 53% of African American women are obese. Of the approximately 44% of African American women who are hypertensive, more than 87% are overweight or obese. Additionally, more than twice as many African American women (13.1%) as white women (6.1%) have been diagnosed with type 2 diabetes. Obesity is usually measured using body mass index (BMI). However, abdominal adiposity may be more predictive of CVD risk than BMI. This study investigates the independent association of waist circumference with hypertension and diabetes in African American women.MethodsAs part of the Faith, Activity, and Nutrition (FAN) program, we recruited 843 African American women (mean age 53.8 y [SD, 14.1 y]) from African Methodist Episcopal churches. If a participant reported she had hypertension or had measured systolic blood pressure at or higher than 140 mm Hg or measured diastolic blood pressure at or higher than 90 mm Hg, she was classified as having hypertension. To assess increased health risks associated with waist circumference, we used the World Health Organization’s standards to categorize waist circumference as normal risk (waist circumference <80 cm), increased risk (waist circumference 80–88 cm), or substantially increased risk (waist circumference >88 cm). We used logistic regression models to test predictors of hypertension and diabetes.ResultsOf 843 study participants, 205 had diabetes and 545 were hypertensive. Women with a waist circumference of 88 cm or more were at increased risk for hypertension (odds ratio [OR] = 7.17, P < .002) and diabetes (OR = 6.99, P < .001). Associations remained after controlling for all variables (hypertension OR = 5.53, P < .001; diabetes, OR = 5.38, P < .001).ConclusionAfter controlling for all variables, waist circumference was independently associated with a 5-fold risk in hypertension and diabetes in African American women.

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