Food Insecurity, Poor Diet, and Metabolic Syndrome: Cortisol’s Amplifying Role

项目摘要 食品不安全在美国非常普遍，影响11.1%的家庭。这一高流行率意义重大 因为食物不安全与代谢后果如肥胖、代谢综合征（MetS） 和慢性疾病如糖尿病。减轻粮食不安全造成的健康负担的一个解决办法是， 那些最有可能导致其不良结果的人。因此，该项目的总体目标是利用多学科， 多方法方法来识别这些人。这个项目的核心假设是那些有食物的人 不安全感和高水平的压力荷尔蒙皮质醇是最危险的负面行为和健康 粮食不安全的后果。这一假设是基于文献和初步数据，表明（a） 食物不安全对许多人来说可能是压力;（B）皮质醇是高脂肪，高钠，高糖的因果驱动力， 碳水化合物（“超美味”）食物消耗和（B）皮质醇与不良代谢结果相关 比如糖尿病和代谢综合征此外，该项目的初步数据表明皮质醇调节这种关系 实验操纵的压力状态和食用超美味食物之间的关系。的两种模式 皮质醇水平可能预示着更高的风险：（1）长期高水平的皮质醇和/或（2）高皮质醇 对急性应激源的反应。本项目通过追求以下具体目标来审查这两个方面： AIM 1.确定慢性高皮质醇水平对食物不安全之间关联的调节作用 和（a）超美味的食物摄入量和（B）MetS-最近从研究小组的NHLBI增长中收集的数据 和健康研究（N = 624; R 01 HD 073568）将检验以下假设： 头发中的指数将表明粮食不安全与食物摄入量过咸之间存在更强的关系， MetS，分别。AIM 2.确定实验操作的高皮质醇反应性的调节作用 食物不安全和客观测量的超美味食物摄入之间的关系-在实验室 采用受试者内设计的范例，400名粮食不安全的人将暴露于金标准 实验室应激源来测量皮质醇反应性相比，无压力会话。检验的假设将是 那些对压力有更高皮质醇反应的人（与对照组相比）会摄入更多的超美味食物， 客观衡量。在探索性目标中，该项目将研究感知压力的潜在作用 和心理社会弹性因素。通过成功地实现这些目标， 不健康饮食的生物行为驱动因素，联邦食品计划（每5年更新一次）将有更强的 优先考虑营养食品而不是超美味食品的理由。随着食品不安全筛查成为 在临床环境中很常见，用于压力筛查和管理的额外资源可以 传播。发现在粮食不安全的情况下赋予复原力的因素，将有助于今后的工作测试 作为干预目标。因此，这一项目最终可以减轻粮食不安全的后果 改善国民健康状况。

PROJECT SUMMARY Food insecurity is highly prevalent in the U.S., affecting 11.1% of households. This high prevalence is significant because food insecurity is associated with metabolic consequences such as obesity, metabolic syndrome (MetS), and chronic diseases such as diabetes. One solution for relieving the health burden of food insecurity is to target those most at risk for its poor outcomes. Therefore, the overarching goal of this project is to use a multidisciplinary, multimethod approach to identify such individuals. The central hypothesis of this project is that those with food insecurity and high levels of the stress hormone cortisol are most at risk for the negative behavioral and health consequences of food insecurity. This hypothesis is based on literature and preliminary data showing that (a) food insecurity can be stressful for many; (b) cortisol is a causal driver of high-fat, -sodium, -sugar, and - carbohydrate (“hyperpalatable”) food consumption and (b) cortisol is associated with poor metabolic outcomes like diabetes and MetS. Further, preliminary data for this project show that cortisol modulates the relationship between experimentally manipulated stressful states and consumption of hyperpalatable foods. Two patterns of cortisol levels can potentially index higher risk: (1) chronically high levels of cortisol and/or (2) high cortisol reactivity to acute in-the-moment stressors. This project examines both by pursuing the following specific aims: AIM 1. Determine the modulating effect of chronic high cortisol levels on associations between food insecurity and (a) hyperpalatable food intake and (b) MetS—Recently collected data from the study team’s NHLBI Growth and Health Study (N = 624; R01 HD073568 ) will test the hypothesis that those with higher chronic cortisol levels indexed in hair will show a stronger relationship between food insecurity with hyperpalatable food intake and MetS, respectively. AIM 2. Determine the modulating effect of experimentally manipulated high cortisol reactivity on the association between food insecurity and objectively measured hyperpalatable food intake—In a laboratory paradigm using within-subjects design, 400 individuals with food insecurity will be exposed to a gold-standard laboratory stressor to measure cortisol reactivity compared to a no-stress session. The hypothesis tested will be that those with greater cortisol reactivity to stress (vs. control) will engage in greater hyperpalatable food intake, measured objectively. In an EXPLORATORY AIM, the project will examine potential roles of perceived stress and psychosocial resilience factors. By successfully achieving these aims and demonstrating the strong biobehavioral drivers of unhealthy diet, federal food programs (updated every 5 years) will have stronger rationale to prioritize nutritious foods over hyperpalatable ones. With screening for food insecurity becoming commonplace in clinical settings, additional resources for stress screening and management could be disseminated. Discovering factors that confer resilience in the face of food insecurity will allow future work testing them as intervention targets. This project, therefore, could ultimately reduce the consequences of food insecurity and improve the nation’s health.