PilAm Go4Health Weight Loss Program to Prevent Heart Disease

Filipino Americans are the second largest Asian population and fastest growing racial group
in the United States. They have one of the highest rates of insulin resistance (type 2
diabetes = T2DM) and central obesity (fat distributions primarily in the abdominal region).
T2DM and central obesity are two of five major risk factors for metabolic syndrome that lead
to cardiovascular disease and stroke. Key factors contributing to obesity and T2DM in
Filipinos are their physical inactivity, and a diet high in fat and soda intake. However,
there are very few research studies on improving health behaviors to reduce risks for
metabolic syndrome in Filipino Americans. To help reduce the risk of developing metabolic
syndrome in overweight/obese Filipino Americans with T2DM, the proposed project will test a
culturally appropriate health behavior intervention program to reduce weight and waist
circumference, blood glucose levels (evaluating insulin resistance) through increasing
physical activity, and lowering fat and sugar sweetened beverage intake. This intervention
uses a mobile phone health app and social networking to encourage adherence to target health
behaviors. The goals are to:

1. To assess feasibility and acceptability of the culturally appropriate PilAm Go4Health
Weight Loss Program

2. To obtain preliminary estimates of the effect of the intervention on weight, BMI, and
insulin resistance

3. To conduct post-program process evaluations too improve the intervention relevancy for
the target population.

Inclusion Criteria:

1. Self-identified as Filipino

2. Age > 18 years

3. BMI for Asians > 23 kg/m2

4. Physician diagnosed T2DM diabetes confirmed by clinical data (e.g. documentation of
fasting blood glucose >126 mg/dL or a positive oral glucose tolerance test (OGTT) >
200 mg/dl, HbA1c > 6.5%)

5. On metformin for T2DM

4) waist circumference: men > 40 inches, women > 35 inches 6) Physically inactive - most
leisure time spent without much physical activity 7) No cognitive impairment per the
Mini-Cog test 8) has a mobile smartphone (iPhone 4s or above, or android phone) 9) English
speaking. Only one member per household allowed to enroll in the study.

Exclusion Criteria:

1. Uncontrolled T2DM

2. Glucose metabolism associated disease (Cushing's syndrome, Acromegaly, and
Pheochromocytoma currently under treatment, chronic pancreatitis), 2) Thyroid disease
- sub-optimally treated

3. Known medical conditions or other physical problems needing a special exercise program
(e.g., prior myocardial infarction, history of angioplasty or angina, admission for
hospital evaluation of chest pain, use of nitroglycerin for angina, chronic
obstructive pulmonary disease, or uncontrolled hypertension)

4. Recent acute coronary syndrome or revascularization, congested heart failure

5. Currently participating in a lifestyle modification program

6. Planning a trip outside of the US during the 6-month study period

7. Known eating disorder

8. Planning a surgery in the next 7-months

9. Taking long-term antibiotics (including HIV-related agents), anti-tuberculosis agents
(except INH alone as prophylaxis), or prescription weight-loss drugs