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A Gender- and Culturally-Sensitive Weight Loss Intervention to Reduce Incidence of Non-Alcoholic Fatty Liver Disease in Hispanic Males

In the U.S., Hispanic males have the highest rate of overweight and obesity when compared to males of other racial/ethnic groups. Obesity contributes to the risk for certain cancers in Hispanics. For example, obesity is associated with non-alcoholic fatty liver disease (NAFLD), which is 1.4 and 1.9 times more common in Hispanics than in Non-Hispanic Whites (NHW) and African Americans, respectively. While not all individuals with NAFLD develop liver complications, nearly 30% will develop nonalcoholic steatohepatitis (NASH) and be at risk for hepatocellular carcinoma, the most common form of liver cancer in adults. Consequently, Hispanic males have the highest rates of liver cancer incidence in the U.S., twice those of NHW men. Weight loss is considered the first line of prevention for NAFLD progression. Yet, current research is lacking to inform best practices to engage Hispanic males in weight loss and/or to promote a successful weight loss trajectory. Without this information, the health disparities associated with obesity related cancer will continue to increase. Using existing practice guidelines and evidence from our qualitative assessments in overweight/obese Hispanic males, we will test a novel intervention approach to address this knowledge gap. We propose to 1) assess the feasibility, acceptability and preliminary efficacy of a gender- and culturally-sensitive weight loss intervention in 20 overweight/obese Hispanic males ages 18-64 over 24 weeks; and 2) examine pathologic changes in the liver (NAFLD, NASH, fibrosis, or cirrhosis) in 20 overweight/obese Hispanic males ages 18-64 over 24 weeks using a non-invasive Magnetic Resonance Imaging (MRI) of the liver. This project will be the first gender and culturally-sensitive weight loss intervention of which we are aware to explicitly target Hispanic males with an emphasis on reducing body weight. In addition, the intervention will provide highly impactful formative research on the effects of a weight loss lifestyle intervention on liver histology. Given the Hispanic population is the fastest growing in the U.S., efforts to identify strategies to promote weight control among Hispanic males has potential to significantly impact obesity-related cancer health disparities.

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David O. Garcia
Melanie Bell

The University of Arizona