Marital Discord, Fast Food, Obesity, and Inflammation

描述(申请人提供)：饮食显然会影响炎症；美国人口总能量的三分之一来自于通常富含饱和脂肪的快餐，最近有证据表明，高饱和脂肪饮食后炎症加剧，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、快餐类型的膳食含有大量简单碳水化合物和甘油三酯时，这些膳食可能还会刺激IL-6和CRP的激增，同时增强氧化应激和交感神经过度活动。此外，对高脂肪饮食的促炎反应会因肥胖，特别是内脏肥胖而被夸大，而高脂肪饮食会将肥胖症特有的高炎症水平进一步推高，并持续更长时间。抑郁和心理社会压力也可以直接促进促炎细胞因子的产生，而动荡的婚姻是两者的丰富来源；婚姻不和谐极大地增加了抑郁的风险，婚姻不和谐也有显著的生理影响，这与炎症相关疾病(包括心血管疾病和代谢综合征)较差的临床结果有关。一系列控制良好的实验室研究提供了重要的机制数据；婚姻冲突期间的负面或敌对行为(婚姻不和的标志)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。利用行为学、营养学和免疫学研究，这项双盲随机交叉试验将评估快餐型饮食与健康饮食(中等脂肪水平)对痛苦和非痛苦夫妇的炎症和情绪变化的影响。夫妻们将被要求在两餐后讨论并解决分歧，以最大限度地突出婚姻苦恼对与餐饮相关的炎症反应的突出程度和影响；对这些互动进行行为编码将提供有关敌对婚姻行为的数据。我们的主要目的是描述快餐型膳食与健康膳食相比对痛苦和非痛苦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标是评估性别和消极或敌对的婚姻行为对基线的抑郁症状和炎症反应的相对贡献，以及在饮食挑战之后。这一建议为肥胖、饮食和婚姻不和相互作用促进炎症的生物行为途径提供了一个新的视角。促炎细胞因子水平的升高与癌症风险、抑郁症、心血管疾病、骨质疏松症、关节炎、II型糖尿病以及虚弱和功能下降有关，强调了广泛的临床相关性。 公共卫生相关性：该项目旨在为转化研究奠定基础，以增强我们对肥胖、饮食和婚姻不和相互作用促进炎症的生物行为途径的理解。快餐型膳食促进餐后代谢障碍的证据相对较新，仍处于初步阶段，但餐后炎症作为慢性炎症驱动因素的可能性显然很重要。促炎细胞因子水平的升高与癌症风险、抑郁症、心血管疾病、骨质疏松症、关节炎、II型糖尿病以及虚弱和功能下降有关，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.