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

项目总结 食品不安全在美国非常普遍，11.1%的家庭受到影响。这一高流行率意义重大 因为粮食不安全与代谢后果有关，如肥胖、代谢综合征(METS)、 以及糖尿病等慢性疾病。缓解粮食不安全带来的健康负担的一个解决方案是 那些因其糟糕的结果而面临最大风险的人。因此，这个项目的总体目标是使用一个多学科的， 识别这类个人的多方法方法。这个项目的中心假设是那些有食物的人 不安全感和高水平的应激激素皮质醇对负面行为和健康的风险最大 粮食不安全的后果。这一假设是基于文献和初步数据显示的(A) 食物不安全可能给许多人带来压力；(B)皮质醇是高脂肪、高钠、高糖的原因驱动因素，以及- 碳水化合物(“超适口性”)食物摄入量和(B)皮质醇与代谢结果差有关 就像糖尿病和大都会。此外，该项目的初步数据显示，皮质醇调节这种关系 在实验中操纵的压力状态和超美味食物的消费之间。两种模式 皮质醇水平可能预示着更高的风险：(1)长期皮质醇水平高和/或(2)皮质醇水平高 对瞬间剧烈压力源的反应能力。本项目通过追求以下具体目标来审查这两个问题： 目的1.确定慢性高皮质醇水平对食物不安全之间的关系的调节作用 和(A)超级美味的食物摄入量和(B)蛋氨酸--最近从研究小组的NHLBI增长中收集的数据 而健康研究(N=624；R01 HD073568)将测试以下假设：那些慢性皮质醇水平较高的人 头发指数将显示食物不安全与超适口食物摄入量之间的更强关系 分别是大都会。目的2.确定实验操作的高皮质醇反应性的调节作用 在实验室中，食物不安全与客观测量的可口食物摄入量之间的关系 采用受试者内设计的范例，400名有粮食不安全的人将接触到黄金标准 实验室应激源，以测量皮质醇的反应性与无应激期的比较。经过检验的假设将是 那些对压力有更高皮质醇反应性的人(与对照组相比)会摄入更多超美味的食物， 客观地衡量。在一个探索性的目标中，该项目将检查感知到的压力的潜在作用 和心理社会韧性因素。通过成功实现这些目标并展示出强大的 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美味食品的理由。随着对粮食不安全的筛查变得越来越重要 在临床环境中很常见，用于压力筛查和管理的额外资源可能是 散播的。发现在粮食不安全的情况下增强韧性的因素将使未来的工作测试成为可能 他们被视为干预目标。因此，这一项目最终可以减少粮食不安全的后果。 并改善国家的健康。

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.