Effects of Episodic Food Insecurity on Psychological and Physiological Responses in African American Women with Obesity

摘要： 粮食不安全，或缺乏足够的食物，无论是质量和数量，以积极和健康的生活，是一个 在美国，超过18%的成年人面临粮食不安全的紧迫健康问题。粮食不安全是一种风险 包括肥胖在内的多种慢性疾病的因素。重要的是，粮食不安全和肥胖都比 与其他群体相比，非裔美国人（AA）妇女的患病率较高。此外，粮食不安全被认为是 “周期现象”与食物充足的事件（即，食物不足（也就是，不 有足够的食物吃）。需要更多的研究来更好地理解为什么粮食不安全与肥胖有关， 包括承认粮食不安全作为一个压力源的偶发性， 机制等为此，我们将研究心理和生理参数的潜在作用， 食物不安全与肥胖的联系，并在健康状况不同的人群中，AA妇女中进行。 这项探索性/发展性研究的目的是调查粮食不安全的偶发性， 通过体重和心理和生理参数纵向反应的应激源。我们将 招募30名食物不安全和30名食物安全的AA女性（年龄18-65岁），肥胖（BMI 30-50 kg/m2）， 测量1）22周内的每日体重，以及2）通过 在22周开始和结束时进行临床评估。此外，我们还将评估粮食不安全事件， 每周都有压力所有参与者都将获得乘车共享作为往返于 所有诊所访问。我们假设，食物不安全的AA妇女肥胖将表现出增加身体 体重和心理和生理终点的变化，而食物安全AA妇女， 肥胖则不会。我们还将研究心理和生理变化之间的联系， 参数和体重变化。 心理问卷将评估压力;执行功能，决策和动机;以及 影响和非稳态饮食。生理测量将包括皮质醇、DHEA-S、c反应 蛋白质、甲状腺激素、葡萄糖、HbA 1c、胰岛素和非稳态负荷。我们相信这将是第一个研究， 研究食物不安全的AA妇女的体重变化以及心理和生理因素， 在粮食不安全时期的肥胖问题。这项研究的结果将提供一系列新的数据， 转化为有力的后续赠款。这项研究还具有重要的公共卫生意义， 解决粮食不安全的周期性问题，以确定可针对的基本机制， 减轻FI和肥胖之间的不利关系，减少少数群体的健康差距。

Abstract: Food insecurity, or the lack of sufficient food in both quality and quantity for an active and healthy life, is a pressing health issue in the United States with over 18% of adults being food insecure. Food insecurity is a risk factor for multiple chronic diseases, including obesity. Importantly, both food insecurity and obesity are more prevalent in African American (AA) women compared to other groups. Further, food insecurity is considered a `cyclic phenomenon' with episodes of food adequacy (i.e., enough food to eat) and food shortage (i.e., not enough food to eat). More research is needed to better understand why food insecurity is linked to obesity, including acknowledging the episodic nature of food insecurity as a stressor and identifying underlying mechanisms. To this end, we will examine the potential role of psychological and physiological parameters in the food insecurity-obesity linkage and do so in a health disparate population, AA women. The objective of this exploratory/developmental study is to investigate the episodic nature of food insecurity as a stressor via responses in body weight and psychological and physiological parameters longitudinally. We will enroll 30 food insecure and 30 food secure AA women (age 18-65 y) with obesity (BMI 30-50 kg/m2) to measure 1) daily body weight remotely over 22 weeks and 2) psychological and physiological parameters via clinic assessments at the beginning and end of 22 weeks. Further, we will assess episodes of food insecurity and stress on a weekly basis. All participants will be offered ride-sharing as a transportation option to and from all clinic visits. We hypothesize that food insecure AA women with obesity will demonstrate increased body weight and changes in psychological and physiological endpoints, whereas food secure AA women with obesity will not. We will also examine associations between changes in psychological and physiological parameters and changes in body weight. Psychological questionnaires will assess stress; executive function, decision-making, and motivation; and affect and non-homeostatic eating. Physiological measurements will include cortisol, DHEA-S, c-reactive protein, thyroid hormones, glucose, HbA1c, insulin, and allostatic load. We believe this will be the first study to examine changes in body weight and psychological and physiological factors in food insecure AA women with obesity during episodes of food insecurity. Findings from this study will provide a range of novel data that will be translated into well-powered follow-up grants. This study also has significant public health implications by addressing the cyclic nature of food insecurity to identify underlying mechanisms that can be targeted to mitigate the adverse relationship between FI and obesity and reduce health disparities in minority populations.