News from The Maya Angelou Center for Health Equity Center of Excellence with the National Institute on Minority Health and Health Disparities Diabetes/Obesity News January 2013 In This Issue Countries Gobbling High-Frucose Corn Syrup Have higher Diabetes Rates, study finds Researchers from the University of Southern California and the University of Oxford say they have found an association between countries that have more high-fructose corn syrup in their food supply and those that have higher rates of diabetes. Countries with higher use of HFCS had an average prevalence of Type 2 diabetes of 8 percent, compared with 6.7 percent in countries that don't use it, according to the research published recently in the journal Global Public Health. Those differences held, the researchers said, after adjustments for body mass index, population and gross domestic product. (continued) Mexican Immigrants to the U.S. Are Not as Healthy as Previously Believed Immigrants who come to the United States from Mexico arrive with a significant amount of undiagnosed disease, tempering previous findings that immigrants are generally healthier than native-born residents, according to a new study. About half of recent Mexican immigrants who have diabetes are Diabetes/Obesity News Faculty/Staff/Affiliate News Reports/PublicationsÂ Community Impact Upcoming Events Book Corner Closing Book Corner Race, Ethnicity, and Health: A Public Health Reader (Public Health/Vulnerable Populations) A new and critical selection of hallmark articles that address health disparities in http://campaign.r20.constantcontact.com/...aMdHR9pPUNpXEjupeRKENZZt5eTPOPyYjQPbCzX_p_mDD3Ocfx1US61Kzdr91r05iA%3D%3D[1/2/2013 10:24:56 AM] News from The Maya Angelou Center for Health Equity unaware they have the disease and about one-third of those with high blood pressure are unaware of the illness, according to findings published in the December edition of the journal Health Affairs. The undiagnosed disease explains about one-third of the "healthy immigrant effect" for diabetes and one-fifth for high blood pressure. But even after undiagnosed disease is taken into account, recent immigrants are still healthier than native-born residents. (more) Black women combat obesity with candid talk, prioritizing health and motivating each other Nicole Ari Parker was motivated by frustration. For Star Jones, it was a matter of life or death. Toni Carey wanted a fresh start after a bad breakup. All three have launched individual campaigns that reflect an emerging priority for African-American women: finding creative ways to combat the obesity epidemic that threatens their longevity. African-American women have the highest obesity rate of any group of Americans. Four out of five black women have a body mass index above 25 percent, the threshold for being overweight or obese, according to the Centers for Disease Control and Prevention. By comparison, nearly two-thirds of Americans overall are in this category, the CDC said. (continued) 'Fitness Parks' Catch on in Cities No costly membership. Open 24/7. Doesn't take up any space in your home. And it's good for you. Free outdoor gyms, the latest weapon in fighting the nation's obesity epidemic, are sprouting up in city parks across the country. Clusters of traditional fitness equipment from elliptical machines to leg press and sit-up benches are being installed in city parks, often in poorer neighborhoods that may not have access to healthful options. Leading the effort is the Trust for Public Land, a non-profit land conservation group that created its Fitness Zones program about three years ago to help cities fund outdoor health playgrounds. (more) Junk Food Taxes Pay Off, Study Finds America. It effectively documents the need for equal treatment and equal health status for minorities. (read more about this book here) http://campaign.r20.constantcontact.com/...aMdHR9pPUNpXEjupeRKENZZt5eTPOPyYjQPbCzX_p_mDD3Ocfx1US61Kzdr91r05iA%3D%3D[1/2/2013 10:24:56 AM] News from The Maya Angelou Center for Health Equity Taxing soft drinks and foods high in saturated fats and providing subsidies for fruits and vegetables might encourage people to change their eating habits and possibly improve their health, according to a new study. Researchers in New Zealand analyzed 32 previous studies and concluded that there would be a 0.02 percent decline in consumption of fatty foods with each 1 percent price increase. They also determined that a 10 percent increase in the price of soft drinks would decrease consumption by between 1 percent and 24 percent. A 10 percent decrease in the price of fruits and vegetables would increase consumption by 2 percent to 8 percent, according to the findings, which were published Dec. 11 in the journal PLoS Medicine. (continued) In U.S., More Cite Obesity as Most Urgent Health Problem More Americans than in the past say obesity is the most urgent health problem facing the United States, climbing to a new high of 16%. That compares with 1% in 1999, when Gallup began asking the question on an annual basis. These results are based on Gallup's annual Health and Healthcare survey, conducted Nov. 15-18. As part of that survey, Gallup asks Americans, in an open-ended format, to name the nation's most urgent health problem. The question was first asked in 1987, with obesity receiving mentions of 3% or less prior to the annual updates that started in 1999. Americans' increasing concerns about obesity mirror the rising rates of obesity in the United States. The percentage of adults who are obese doubled from 1980 to 2008, according to the U.S. Centers for Disease Control and Prevention. And Gallup and Healthways find obesity remains high as of the third quarter of 2012, at 26.1%. (more) Obesity Drugs May Soon See More Insurance Coverage, and Boston study to Test New Medication Here's some interesting news from the obesity drug front. First off, Aetna, one of the nation's largest insurers, announced Wednesday that it was going to provide coverage for prescription obesity medications including Qsymia and Belviq. Many insurance http://campaign.r20.constantcontact.com/...aMdHR9pPUNpXEjupeRKENZZt5eTPOPyYjQPbCzX_p_mDD3Ocfx1US61Kzdr91r05iA%3D%3D[1/2/2013 10:24:56 AM] News from The Maya Angelou Center for Health Equity companies have been dragging their feet on reimbursing for the drugs -- approved by the US Food and Drug Administration this past summer -- which has led to a lag in sales. Aetna's move could pave the way for more insurance companies to follow suit, Reuters reports. And a second bit of news: Boston Medical Center researchers are looking for overweight volunteers with heart disease or diabetes to enroll in a clinical trial to test an experimental obesity medication. The drug, called Contrave, is a combination of two drugs already on the market: bupropion (an antidepressant) and naltrexone (used to help overcome drug or alcohol addiction). (more) New 'Obesity Calculator' Predicts Child's Likelihood of Being Overweight Childhood obesity has been on the rise in the United States, a trend that is putting many children at risk for a multitude of health problems - from cardiovascular disease and high blood pressure to early type 2 diabetes. For parents looking to keep their child healthy and physically fit as they grow up, a better understanding of their child's propensity towards obesity could be an essential tool in helping to keep off the pounds. But how are parents supposed to know the likelihood their child will be overweight? A new, simple formula could be the key. Available as an online calculator, an equation developed by researchers at the Imperial College London can strongly predict a baby's probability of becoming obese during childhood. (continued) Mediterranean Diet May be too Expensive for Many Results from the Italian Moli-sani study suggest that the Mediterranean diet, once so typical in this region of Europe, is now too expensive for many people. People with lower incomes were also more likely to be obese than those with higher incomes, add the researchers, perhaps due to consuming a poorer quality diet. "We sought to see whether the increasing cost of the main food http://campaign.r20.constantcontact.com/...aMdHR9pPUNpXEjupeRKENZZt5eTPOPyYjQPbCzX_p_mDD3Ocfx1US61Kzdr91r05iA%3D%3D[1/2/2013 10:24:56 AM] News from The Maya Angelou Center for Health Equity products and the progressive impoverishment of people could contribute to the obesity pandemic which has been affecting the countries of the Mediterranean area during the recent years, including Italy," explained lead author Marialaura Bonaccio (Fondazione di Ricerca e Cura "Giovanni Paolo II," Campobasso, Italy) in a press statement. (continued) Faculty/Staff/Affiliate News Dr. Ronny A. Bell Receives Award Dr. Ronny Bell, Co-Director of the Maya Angelou Center for Health Equity, received the Community Spirit Award from the American Diabetes Association (ADA) on October 22nd, 2012 at a ceremony in Washington, DC. The award was given in recognition of his work in understanding and addressing diabetes disparities with the American Indian/Alaska Native population. Dr. Bell was also a featured speaker and panelist at the ADA 5th Disparities Partnership Forum, which was held in conjunction with the ceremony. Others receiving recognition at the ceremony included: Dr. Pedro Greer, Jr.(first from left), Assistant Dean, Florida International University; Mr. David Mann (second from left), noted actor and comedian; Mr. Ben Vereen, (third from right) world-renowned actor, singer and dancer; and Dr. Kenneth Moritsugu (second from right), Vice President for Global Strategic Affairs for Johnson and Johnson's Family of Diabetes Companies and Acting Surgeon General from 2006 - 2008. Best Doctors in America Congratulations to our affiliates who have been named on the 20122013 Best Doctors in America® database. Arthur W. Blackstock Jr, M.D. Radiation Oncology Thomas D. DuBose, Jr., M.D. Nephrology http://campaign.r20.constantcontact.com/...aMdHR9pPUNpXEjupeRKENZZt5eTPOPyYjQPbCzX_p_mDD3Ocfx1US61Kzdr91r05iA%3D%3D[1/2/2013 10:24:56 AM] News from The Maya Angelou Center for Health Equity John Jeffrey Carr, M.D. Radiology Barry I. Freedman, M.D. Nephrology Amy McMichael, M.D. Dermatology Medge D. Owen, M.D. Anesthesiology John H. Stewart IV, M.D. Surgical Oncology Gretchen L. Wells, M.D., Ph.D. Cardiovascular Disease http://campaign.r20.constantcontact.com/...aMdHR9pPUNpXEjupeRKENZZt5eTPOPyYjQPbCzX_p_mDD3Ocfx1US61Kzdr91r05iA%3D%3D[1/2/2013 10:24:56 AM] News from The Maya Angelou Center for Health Equity Center Affiliate Featured in Reuters Research from Amy McMichael, MD, dermatology, about hair care practices and exercise concerns for African American women is featured in Reuters. REPORTS/PUBLICATIONS Association of an Intensive Lifestyle Intervention With Remission of Type 2 Diabetes Edward W. Gregg, PhD, Haiying Chen, PhD, Lynne E. Wagenknecht, DrPH, Jeanne M. Clark, MD, MPH, Linda M. Delahanty, MS, RD, John Bantle, MD, Henry J. Pownall, PhD, Karen C. Johnson, MD, MPH, Monika M. Safford, MD, Abbas E. Kitabchi, MD, PhD, F. Xavier Pi-Sunyer, MD, Rena R. Wing, PhD, Alain G. Bertoni, MD, MPH for the Look AHEAD Research Group Context -The frequency of remission of type 2 diabetes achievable with lifestyle intervention is unclear. Objective -To examine the association of a long-term intensive weight-loss intervention with the frequency of remission from type 2 diabetes to prediabetes or normoglycemia. Design, Setting, and Participants - Ancillary observational analysis of a 4-year randomized controlled trial (baseline visit, August 2001April 2004; last follow-up, April 2008) comparing an intensive lifestyle intervention (ILI) with a diabetes support and education control condition (DSE) among 4503 US adults with body mass index of 25 or higher and type 2 diabetes. Interventions - Participants were randomly assigned to receive the ILI, which included weekly group and individual counseling in the first 6 months followed by 3 sessions per month for the second 6 months and twice-monthly contact and regular refresher group series and campaigns in years 2 to 4 (n=2241) or the DSE, which was an offer of 3 group sessions per year on diet, physical activity, and social support (n=2262). (read entire publication here) Transferability and Fine Mapping of Type 2 Diabetes Loci in African Americans: The Candidate Gene Association Resource http://campaign.r20.constantcontact.com/...aMdHR9pPUNpXEjupeRKENZZt5eTPOPyYjQPbCzX_p_mDD3Ocfx1US61Kzdr91r05iA%3D%3D[1/2/2013 10:24:56 AM] News from The Maya Angelou Center for Health Equity Plus Study. Ng MC, Saxena R, Li J, Palmer ND, Dimitrov L, Xu J, Rasmussen-Torvik LJ, Zmuda JM, Siscovick DS, Patel SR, Crook ED, Sims M, Chen YD, Bertoni AG, Li M, Grant SF, Dupuis J, Meigs JB, Psaty BM, Pankow JS, Langefeld CD, Freedman BI, Rotter JI, Wilson JG, Bowden DW. Source Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, North Carolina Abstract Type 2 diabetes (T2D) disproportionally affects African Americans (AfA) but, to date, genetic variants identified from genome-wide association studies (GWAS) are primarily from European and Asian populations. We examined the single nucleotide polymorphism (SNP) and locus transferability of 40 reported T2D loci in six AfA GWAS consisting of 2,806 T2D case subjects with or without endstage renal disease and 4,265 control subjects from the Candidate Gene Association Resource Plus Study. Our results revealed that seven index SNPs at the TCF7L2, KLF14, KCNQ1, ADCY5, CDKAL1, JAZF1, and GCKR loci were significantly associated with T2D (P < 0.05). The strongest association was observed at TCF7L2 rs7903146 (odds ratio [OR] 1.30; P = 6.86 × 10(-8)). Locus-wide analysis demonstrated significant associations (P(emp) < 0.05) at regional best SNPs in the TCF7L2, KLF14, and HMGA2 loci as well as suggestive signals in KCNQ1 after correction for the effective number of SNPs at each locus. Of these loci, the regional best SNPs were in differential linkage disequilibrium (LD) with the index and adjacent SNPs. Our findings suggest that some loci discovered in prior reports affect T2D susceptibility in AfA with similar effect sizes. The reduced and differential LD pattern in AfA compared with European and Asian populations may facilitate fine mapping of causal variants at loci shared across populations. (read publication) 30,000 Fewer Heart Attacks and Strokes in North Carolina: A Challenge to Prioritize Prevention Alain G. Bertoni, Don Ensley, David C. Goff N C Med J. 2012;73(6):449-456 Heart disease and stroke are leading causes of death in North Carolina and are also important contributors to poor health and excess health care expenditures. The risk factors for heart disease, stroke, and other forms of cardiovascular disease are well known, and include smoking, high blood pressure, elevated serum cholesterol levels, diabetes mellitus, and obesity. These risk factors persist as a result of suboptimal assessment, treatment, and control; adverse trends in health behaviors; and environmental and societal conditions negatively affecting the pursuit of optimal cardiovascular health. If North Carolina is to do its share in making it possible for the national Million Hearts initiative to meet its goals, then 30,000 heart attacks and strokes need to be prevented in the state over the next 5 http://campaign.r20.constantcontact.com/...aMdHR9pPUNpXEjupeRKENZZt5eTPOPyYjQPbCzX_p_mDD3Ocfx1US61Kzdr91r05iA%3D%3D[1/2/2013 10:24:56 AM] News from The Maya Angelou Center for Health Equity years. Both the Million Hearts initiative and North Carolina's JustusWarren Heart Disease and Stroke Prevention Task Force Plan include specific recommendations aimed at the primary and secondary prevention of heart disease and stroke. Million Hearts focuses on the ABCS: aspirin use when appropriate, blood pressure control, cholesterol control, and smoking cessation or abstention. The task force plan also addresses physical inactivity, poor nutrition, and the control of obesity and diabetes. The commentaries published in this issue of the NCMJ address the challenge of cardiovascular disease prevention among children and adults across the state and highlight efforts to enhance prevention via public policies and legislation, community coalitions, and quality improvement in the clinical arena. (continued) Admixture Mapping of Coronary Artery Calcified Plaque in African Americans with Type 2 Diabetes Jasmin Divers, Nicholette D. Palmer, Lingyi Lu, Thomas C. Register, J. Jeffrey Carr, Pamela J. Hicks, R. Caresse Hightower, S. Carrie Smith, Jianzhao Zu, Amanda J. Cox, Keith A. Hruska, Donald W. Bowden, Cora E. Lewis, Gerardo Heiss, Michael A. Province, Ingrid B. Borecki, Kathleen F. Kerr, Y.-D. Ida Chen, Walter Palma, Jerome I. Rotter, Christina L. Wassel, Alain Bertoni, David Herrington, Lynne E. Wagenknecht, Carl D. Langefeld, Barry I. Freedman Abstract Background-The presence and severity of coronary artery calcified plaque (CAC) differs markedly between individuals of African and European descent, suggesting that admixture mapping (AM) may be informative for identifying genetic variants associated with subclinical cardiovascular disease (CVD). Methods and Results AM of CAC was performed in 1,040 unrelated African Americans with type 2 diabetes mellitus from the African American-Diabetes Heart Study (AA-DHS), Multi-Ethnic Study of Atherosclerosis (MESA), and Family Heart Study (FamHS) using the Illumina custom ancestry informative marker (AIM) panel. All cohorts obtained computed tomography scanning of the coronary arteries using identical protocols. For each AIM, the probability of inheriting 0, 1, and 2 copies of a European-derived allele was determined. Linkage analysis was performed by testing for association between each AIM using these probabilities and CAC, accounting for global ancestry, age, gender and study. Markers on 1p32.3 in the GLIS1 gene (rs6663966, LOD=3.7), 1q32.1 near CHIT1 (rs7530895, LOD=3.1), 4q21.2 near PRKG2 (rs1212373, LOD=3.0) and 11q25 in the OPCML gene (rs6590705, LOD=3.4) had statistically significant LOD scores, while markers on 8q22.2 (rs6994682, LOD=2.7), 9p21.2 (rs439314, LOD=2.7), and 13p32.1 (rs7492028, LOD=2.8) manifested suggestive evidence of linkage. These regions were uniformly characterized by higher levels of European ancestry associating with higher levels or odds of CAC. Findings were replicated in 1,350 AAs without diabetes and 2,497 diabetic http://campaign.r20.constantcontact.com/...aMdHR9pPUNpXEjupeRKENZZt5eTPOPyYjQPbCzX_p_mDD3Ocfx1US61Kzdr91r05iA%3D%3D[1/2/2013 10:24:56 AM] News from The Maya Angelou Center for Health Equity European Americans from MESA and the Diabetes Heart Study. (read publication) Community Impact Lisa D. Houston Lisa D. Houston is Founder and President of Blameless Faces Foundation, Inc. She recently resigned as VP to The Liberian Organization of the Piedmont. Lisa was born in Liberia, West Africa. Her father was a Liberian, and mother is an American. Lisa believes that she has the best of both worlds. In 1979 she came to the U.S. to attend school. In 1980, a bloody coup changed the country's leadership due to the assassination of then President William R. Tolbert Jr., and in turn, causing the Constitution to thereby be suspended. In 1989, disagreements sparked the First Liberian Civil War. By 1995, a fragile peace was eventually reached but not for long. In 1999, the Second Liberian Civil War began and lasted until 2003. Liberia's entire infrastructure were left in ruins and noted as one of Africa's bloodiest war that claimed the lives of over 300,000 people and more than 200,000 displaced. Families were degraded, elderly women, young girls & babies raped, children exploited and became warlords/killers themselves, drug users as early as eight years old; in addition, many of whom were orphaned or left homeless. - Unimaginable sufferings. (read more here) Upcoming Events 34th Annual Minority Health Conference February 22, 2013 The UNC Gillings School of Global Public Health would like to invite you to join us at the 34th Annual Minority Health Conference. This year's conference, Constructing the Foundation for Health Equity, focuses on how health equity can be achieved through systems-level change. For more information about the conference click here) Immigration Matters Forum February 28, 2013 James B. Hunt Library Centennial Campus North Carolina State Library 12:00 - 5:15pm The UNC Center for International Understanding will present Immigration Matters, a fast-paced, focused forum designed to elevate the immigration conversation. Northwest AHEC will be a http://campaign.r20.constantcontact.com/...aMdHR9pPUNpXEjupeRKENZZt5eTPOPyYjQPbCzX_p_mDD3Ocfx1US61Kzdr91r05iA%3D%3D[1/2/2013 10:24:56 AM] News from The Maya Angelou Center for Health Equity satellite site for this event. (more) 2nd Annual MACHE Bowl March 2, 2013 Biotech Place Atrium 2:00-4:00pm (reception to follow) Please join us for the 2nd annual student healthcare competition where students from several disciplines from Appalachian State University, The University of North Carolina at Greensboro, Wake Forest School of Medicine, Wake Forest University and Winston Salem State University, collaborate to solve a healthcare case in front of a live audience. Translational Science 2013: Increasing the Value of Your Research Through Team Science April 17-19, 2013 Omni Shoreham Hotel Washington, DC Translational Science 2013, sponsored by the Association for Clinical Research Training (ACRT), the American Federation for Medical Research (AFMR), and the Society for Clinical and Translational Science (SCTS), bringing together all of the disciplines involved in clinical and translational research, for the shared benefits of networking and education. Closing The Faculty and Staff of the Maya Angelou Center for Health Equity wish you and yours a warm and wonderful holiday season. We look forward to working with you in 2013. Sincerely, Dr. Ronny A. Bell Dr. Bettina M. Beech Co-Director Co-Director Health Equity Updates | Maya Angelou Center for Health Equity | Wake Forsest School of Medicine To subscribe/unsubscribe to the Health Equity Updates, please click here. Forward this email http://campaign.r20.constantcontact.com/...aMdHR9pPUNpXEjupeRKENZZt5eTPOPyYjQPbCzX_p_mDD3Ocfx1US61Kzdr91r05iA%3D%3D[1/2/2013 10:24:56 AM] News from The Maya Angelou Center for Health Equity This email was sent to [email protected] by [email protected] | Update Profile/Email Address | Instant removal with SafeUnsubscribe™ | Privacy Policy. The Maya Angelou Center for Health Equity | Maya Angelou Center for Health Equity | Medical Center Boulevard | Winston Salem | NC | 27157 http://campaign.r20.constantcontact.com/...aMdHR9pPUNpXEjupeRKENZZt5eTPOPyYjQPbCzX_p_mDD3Ocfx1US61Kzdr91r05iA%3D%3D[1/2/2013 10:24:56 AM]