Ethnic Comparison of Weight Loss in the Trial of Nonpharmacologic Interventions in the Elderly

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Abstract
Objective:To compare weight loss in blacks and whites in the Trial of Nonpharmacologic Interventions in the Elderly (TONE).Research Methods and Procedures:TONE enrolled 421 overweight white and 164 overweight black adults, 60 to 79 years old, with blood pressure well‐controlled on a single, antihypertensive drug. Drug therapy withdrawal was attempted 3 months after randomization to counseling for weight loss, sodium reduction, both weight loss and sodium reduction, or to usual care, with follow‐up for 15 to 36 months after enrollment. Statistical procedures included repeated measures analysis of covariance and logistic and proportional hazards regression.Results:In the weight‐loss condition, net weight change (in kilograms) was −2.7 in blacks and −5.9 in whites (p< 0.001; ethnic difference,p= 0.0002) at 6 months and −2.0 (p< 0.05) in blacks and −4.9 (p< 0.001) in whites at the end of follow‐up (ethnic difference,p= 0.007). In weight/sodium, net weight change was −2.1 (p< 0.01) in blacks and −2.8 (p< 0.001) in whites at 6 months, and −1.9 in blacks and −1.7 in whites at the end of follow‐up (p< 0.05; ethnic difference,p> 0.5). Exploratory analyses suggested a more favorable pattern of weight change in blacks than in whites from 6 months onward. There was no ethnic difference in blood pressure outcomes.Discussion:Whites lost more weight than blacks without, but not with, a concurrent focus on sodium reduction.