Ethnic Influences on Stress, Energy Balance and Obesity in Adolescents

种族对青少年压力、能量平衡和肥胖的影响

• 批准号: 10355414
• 负责人: UMA RAO
• 金额: $ 123.24万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-02-24 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10355414
• 关键词: Abbreviations; Accelerometer; Accounting; Acute; Adolescence; Adolescent; Adolescent obesity; Adrenal Glands; Adult; Affect; African American; Anthropometry; Behavioral; Biological; Biological Markers; Blood; Body Composition; Body mass index; Caucasians; Cause of Death; Cholesterol; Chronic; Client; Clinical; Consumption; Controlled Environment; Coronary heart disease; Deposition; Development; Diet; Diurnal Rhythm; Dual-Energy X-Ray Absorptiometry; Eating; Economic Burden; Economics; Energy Metabolism; Environment; Etiology; Family; Fasting; Fatty acid glycerol esters; Female; Female Adolescents; Food; Glucocorticoids; Guidelines; Hair; Health; Hormones; Hour; Hydrocortisone; Hypothalamic structure; Individual; Individual Differences; Insulin Resistance; Intake; Intervention; Interview; Isoprostanes; Knowledge; Leptin; Life; Link; Maintenance; Measures; Mediating; Medical; Metabolic hormone; Metabolic syndrome; Methodology; Methods; Mexican Americans; Minority; Morbidity - disease rate; National Health and Nutrition Examination Survey; Not Hispanic or Latino; Obesity; Overweight; Palate; Patient Self-Report; Physical Fitness; Physical activity; Physiological; Pituitary Gland; Policies; Poverty; Pre-Post Tests; Prevalence; Prevention; Process; Protocols documentation; Public Health; Race; Randomized; Reporting; Research; Risk Factors; Role; Saliva; Salivary; Sampling; Science; Socioeconomic Status; Solid; Standardization; Stress; Stressful Event; System; Testing; Text; Trier Social Stress Test; Triglycerides; Variant; Visceral fat; Visit; Weight maintenance regimen; Woman; Youth; abdominal fat; acute stress; adiponectin; biobehavior; cardiometabolism; cost; critical period; design; diet and exercise; effective therapy; energy balance; evidence base; experience; girls; good diet; hypothalamic-pituitary-adrenal axis; improved; indexing; individualized medicine; insulin sensitivity; male; minority children; mortality; obesity prevention; obesity treatment; programs; psychologic; psychosocial; psychosocial stressors; racial difference; racial disparity; response; saliva sample; sex; social; social factors; social inequality; stressor; sugar

Obesity is one of the most serious public health problems in the US; its prevalence has tripled in the last three decades and is associated with a range of short- and long-term medical and psychosocial problems. Adolescence is a critical period for the development and persistence of obesity, and is associated with changes in diet, physical activity and fitness, fat distribution and insulin sensitivity. There are racial and sex-specific disparities in the prevalence and burden of obesity. African-American (AA) females have the highest rates of obesity, and the clustered risk factors for coronary heart disease and metabolic syndrome are twice that of AA males. The reasons for racial and sex-specific disparities in the prevalence and burden of obesity are not well understood. AA experience higher stress levels than Non-Hispanic Whites (NHW) due to economic and social inequalities, and the effect of stress on energy-dense diet and adiposity is more prominent in females. A better understanding of the mechanisms that link stress to obesity, particularly during adolescence when high rates of obesity, increased stressful experiences and stronger behavioral and physiological responses to stress emerge, will contribute to new clinical guidelines for reducing obesity and associated medical conditions in AA females. The Physiological stress system affects obesity and mediates its adaptive functions via hypothalamic- pituitary-adrenal (HPA) axis. Prolonged stress-induced glucocorticoid secretion promotes the consumption of energy-dense diet (EI) and abdominal fat deposition both directly and indirectly through its effects on metabolic hormones. Stress also reduces physical activity and alters energy balance. The proposed study will examine the effects of stress and HPA axis on EI and physical activity-related energy expenditure in 100 AA and 100 NHW adolescent females. The effects on EI will be assessed in two contexts, the natural environment and under controlled conditions incorporating a standardized psychosocial stressor. Stress will be assessed in the natural environment as multiple domains (i.e., individual, family and social), and several indices of the HPA axis will be obtained to represent diurnal variation, its status over 12-15 weeks and reactivity to stress. Obesity- related parameters will be measured through anthropometry, fat distribution and cardio-metabolic biomarkers. Associations among stress, HPA activity/function, energy balance and obesity-related parameters will be compared between and within AA and NHW samples. In combination they will improve our understanding of the social factors and biobehavioral mechanisms of both racial and individual differences in obesity and facilitate the development of effective treatments within and across racial groups according to the principles of individualized medicine. To our knowledge, racial differences in objectively-measured diet intake and energy expenditure in response to stress, or their underlying physiological mechanisms, have not been assessed in adolescents or adults. This is an important knowledge gap in our efforts to develop better evidence-based translational obesity prevention and weight-control interventions as the traditional interventions are not effective with minority youth.

肥胖症是美国最严重的公共卫生问题之一；在美国，肥胖症的患病率增加了两倍 在过去的三十年里，它与一系列短期和长期的医疗和心理社会问题有关。 青春期是肥胖发展和持续的关键时期，并与变化有关 在饮食、体力活动和健身、脂肪分布和胰岛素敏感性方面。有针对种族和性别的 肥胖症患病率和负担的差异。非裔美国人(AA)女性患病率最高 肥胖，冠心病和代谢综合征的聚集危险因素是AA的两倍 男性。导致肥胖症患病率和负担存在种族和性别差异的原因并不充分。 明白了。由于经济和社会原因，AA比非西班牙裔白人(NHW)经历更高的压力水平 不平等，压力对高能量饮食和肥胖的影响在女性中更加突出。更好的 了解压力与肥胖的联系机制，特别是在青春期，当 肥胖，更多的压力经历和对压力的更强的行为和生理反应， 将有助于制定新的临床指南，以减少再障女性的肥胖和相关医疗条件。 生理应激系统影响肥胖，并通过下丘脑调节其适应功能。 垂体-肾上腺(HPA)轴。长期应激诱导的糖皮质激素分泌促进了对 高能量饮食(EI)和腹部脂肪沉积直接或间接通过其对代谢的影响 荷尔蒙。压力还会减少体力活动，改变能量平衡。拟议的研究将审查 应激和HPA轴对100AA和100AA的EI和体力活动相关能量消耗的影响 青春期女性。对EI的影响将在两个背景下进行评估，自然环境和 在受控条件下，结合了标准化的心理社会应激源。压力评估将在 自然环境为多个领域(即个人、家庭和社会)，以及HPA的几个指数 将获得代表日变化的轴，它在12-15周内的状态以及对压力的反应。肥胖- 相关参数将通过人体测量、脂肪分布和心脏代谢生物标志物进行测量。 压力、HPA活动/功能、能量平衡和肥胖相关参数之间的关联将是 AA和NHW样品之间和内部的比较。它们结合在一起将提高我们对 社会因素和生物行为机制在肥胖的种族和个体差异中的作用 根据个别化原则在种族群体内部和跨种族群体发展有效的治疗方法 医药。据我们所知，在客观测量的饮食摄入量和能量消耗方面存在种族差异 对压力的反应，或其潜在的生理机制，还没有在青少年或 成年人。这是我们努力开发更好的基于证据的转化性肥胖的一个重要的知识鸿沟 作为传统干预措施的预防和体重控制措施对少数族裔青年无效。