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

摘要： 粮食不安全，或在质量和数量上都缺乏足够的食物来维持积极健康的生活，是一种 美国面临着紧迫的健康问题，超过18%的成年人食物不安全。粮食不安全是一种风险 导致多种慢性病的因素，包括肥胖。重要的是，食物不安全和肥胖都比 与其他群体相比，在非裔美国人(AA)女性中流行。此外，粮食不安全被认为是一种 “周期性现象”，指粮食充足(即足够的食物)和粮食短缺(即 足够吃的食物)。需要更多的研究来更好地理解为什么食物不安全与肥胖有关， 包括承认粮食不安全的间歇性是一种压力源，并查明潜在的 机械装置。为此，我们将研究心理和生理参数在 食物不安全与肥胖之间的联系，在一个健康状况不同的人群中也是如此，AA女性。 这项探索性/发展性研究的目的是调查粮食不安全的间歇性，如 纵向上通过体重和心理和生理参数的反应而产生的压力源。我们会 招募30名食物不安全和30名食物安全的AA肥胖妇女(年龄18-65岁)到 1)远程测量超过22周的每日体重和2)心理和生理参数 在22周开始和结束时进行临床评估。此外，我们将评估粮食不安全的情况。 每周都要有压力。所有参与者将被提供拼车作为往返的交通选择 所有的诊所就诊。我们假设，食物缺乏保障的肥胖AA女性会表现出体型增加。 体重和心理和生理终点的变化，而食物确保再生障碍性贫血女性 肥胖不会。我们还将研究心理和生理变化之间的联系。 参数和体重的变化。 心理问卷将评估压力、执行功能、决策和动机；以及 影响和非稳态进食。生理指标包括皮质醇、脱氢表雄酮-S、C-反应 蛋白质、甲状腺激素、葡萄糖、糖化血红蛋白、胰岛素和不平衡负荷。我们相信这将是第一个研究 检查饮食不安全的再障妇女体重和心理生理因素的变化 食物不安全时期的肥胖问题。这项研究的发现将提供一系列新的数据， 将转化为资金充足的后续赠款。这项研究也有重大的公共卫生影响，通过 处理粮食不安全的周期性问题，以确定可针对的基本机制 缓解FI和肥胖症之间的不利关系，缩小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.