Marital Discord, Fast Food, Obesity, and Inflammation

描述（由申请人提供）：饮食明显影响炎症；美国人大约三分之一的总能量摄入来自饱和脂肪含量高的快餐，最近有证据表明，在摄入饱和脂肪含量高的食物后，炎症会加剧，这引发了人们对餐后炎症可能是慢性炎症反应的驱动因素的兴趣；当高脂肪、快餐类的食物充斥着简单的碳水化合物和甘油三酯时，这些食物也可能引起IL-6和CRP的飙升，同时增加氧化应激和交感神经亢进。此外，对高脂肪食物的促炎反应被肥胖夸大了，尤其是内脏脂肪，高脂肪食物会使肥胖的特征炎症水平升高，并持续更长时间。抑郁和心理压力也可以直接促进促炎细胞因子的产生，而动荡的婚姻是这两者的丰富来源；婚姻不和谐大大增加了患抑郁症的风险，而且婚姻不和谐也有显著的生理影响，因为它与炎症相关疾病（包括心血管疾病和代谢综合征）的临床结果较差有关。一系列控制良好的实验室研究提供了重要的机理数据；婚姻冲突期间的消极或敌对行为（婚姻不和谐的标志）大大增加了不利的内分泌和免疫变化，包括促炎细胞因子的产生增加。在行为学、营养学和免疫学研究的基础上，这项双盲、随机交叉试验将评估焦虑和非焦虑夫妇在吃快餐和吃健康餐（脂肪含量适中）后炎症和情绪的变化。夫妇将被要求在两次用餐后讨论和解决分歧，以最大限度地提高婚姻困扰对用餐相关炎症反应的显著性和影响；这些相互作用的行为编码将提供敌对婚姻行为的数据。我们的主要目的是描述与健康饮食相比，快餐类型的饮食对焦虑和非焦虑夫妇餐后炎症反应的影响，并评估中心性肥胖作为炎症反应预测因子的相对影响。我们的第二个探索性目的是评估性别和消极或敌对的婚姻行为对基线时抑郁症状和炎症反应的相对贡献，以及在进餐挑战之后。这一建议为肥胖、饮食和婚姻不和谐相互作用促进炎症的生物行为途径提供了新的视角。促炎细胞因子水平升高与癌症风险、抑郁、心血管疾病、骨质疏松、关节炎、II型糖尿病、虚弱和功能衰退有关，强调了广泛的临床相关性。

DESCRIPTION (provided by applicant): Diet clearly impacts inflammation; about one-third of the total energy intake in the US population comes from fast food consumption that is typically high in saturated fat, and recent demonstrations of enhanced inflammation following meals high in saturated fats have sparked interest in the possibility that postprandial inflammation acts as a driver for chronic inflammatory responses; when high-fat, fast-food-type meals flood the body with simple carbohydrates and triglycerides, the meals may also provoke spikes in IL-6 and CRP while enhancing oxidative stress and sympathetic hyperactivity. Furthermore, proinflammatory responses to high-fat meals are exaggerated by obesity, particularly visceral adiposity, and high-fat meals push obesity's characteristic elevated inflammation levels even higher and sustain them longer. Depression and psychosocial stress can also directly promote proinflammatory cytokine production, and a turbulent marriage is a rich source for both; marital discord greatly enhances risk for depression, and marital discord also has notable physiological repercussions as documented by its association with poorer clinical outcomes for inflammation-related conditions including cardiovascular disease and metabolic syndrome. A series of well-controlled laboratory studies have provided important mechanistic data; negative or hostile behavior during marital conflict (a hallmark of marital discord) substantially augments adverse endocrine and immune changes, including enhanced production of proinflammatory cytokines. Drawing on behavioral, nutritional, and immunological research, this double-blind, randomized crossover trial will assess changes in inflammation and mood following a fast-food-type meal compared to a healthier meal (moderate level of fats) in distressed and nondistressed couples. Couples will be asked to discuss and resolve a disagreement following both meals to maximize the salience and impact of marital distress on meal- related inflammatory responses; behavioral coding of these interactions will provide data on hostile marital behaviors. Our primary aim is to characterize the impact of a fast-food-type meal compared to a healthier meal on postprandial inflammatory responses in distressed and nondistressed couples, and to appraise the relative impact of central adiposity as a predictor of inflammatory responses. Our secondary, exploratory aim is to assess the relative contributions of gender and negative or hostile marital behaviors to depressive symptoms and inflammatory responses at baseline, as well as following the meal challenge. This proposal provides a new perspective on the biobehavioral pathways through which obesity, diet, and marital discord interact to promote inflammation. Elevated levels of proinflammatory cytokines are associated with cancer risk, depression, cardiovascular disease, osteoporosis, arthritis, Type II diabetes, and frailty and functional decline, underscoring the broad clinical relevance. PUBLIC HEALTH RELEVANCE: This project seeks to lay the foundation for translational research that would enhance our understanding of the biobehavioral pathways through which obesity, diet, and marital discord interact to promote inflammation. The evidence that fast food-type meals promote postprandial dysmetabolism is relatively recent and still preliminary, but the possibility that postprandial inflammation acts as a driver for chronic inflammation is clearly important. Elevated levels of proinflammatory cytokines are associated with cancer risk, depression, cardiovascular disease, osteoporosis, arthritis, Type II diabetes, and frailty and functional decline, underscoring the broad clinical relevance.