Hair care and maintenance issues are primary factors that deter African-American women from exercising, a major health concern for a group that has the highest rates of overweight or obesity in the country.Research from Wake Forest Baptist Medical Center shows that about a third of African-American women cite complications of hair care as the reason they do not exercise or exercise less than they would like, according to Amy J. McMichael, M.D., the lead author of the study published online today by Archives of Dermatology, a JAMA network publication.McMichael, professor of dermatology at Wake Forest Baptist, specializes in hair and scalp diseases, ethnic and pigmented skin diseases, as well as general dermatology and skin care. She got interested in the correlation between hair care and weight issues because of the patients she was seeing on a daily basis. The U.S. Department of Health & Human Services' Office of Minority Health reports that about four out of five African-American women are overweight or obese."I treat a lot of African American women in our clinic and had noticed how many of them are overweight, and I wanted to know why," she said. "I'm treating them for dermatology related issues, but as a doctor this was even more concerning because excess weight puts these women at risk for hypertension, diabetes and other serious problems."For the study, 103 African-American women ranging in age from 21 to 60 - with a mean age of 42.3 - participated by filling out a 40-question survey that asked about physical activity, hair care and maintenance, hair and scalp concerns. Questions were specific: how much and what types of exercise they do, and the time, expense and complications of caring for their hair. All of the respondents believed it was important for them to exercise but 40 percent reported avoiding exercise at times due to hair-related issues. Half of them said they had modified their hairstyle to accommodate exerciseBecause many African American women with coarser hair use either heat straighteners or chemical products to straighten their hair - a time consuming process - they can't just easily wash their hair after exercise because of its fragility, McMichael said."Overwashing fragile hair can make it break off easily," McMichael said.McMichael and colleagues began this research several years ago and presented early findings in a 2007 poster presentation at the annual International Symposium of the L'Oréal Institute for Ethnic Hair & Skin Research."We have now identified the problem - hair care does seem to be a factor - and it is one that is not easily solvable. Somebody might say, 'Oh, just cut your hair,' but that does not make sense. We have to figure out better ways to address this issue," McMichael said.