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.

肥胖是美国最严重的公共卫生问题之一。它的患病率在 最近三十年，与一系列短期和长期的医疗和社会心理问题有关。 青春期是肥胖发展和持久性的关键时期，与变化有关 在饮食，体育锻炼和健身，脂肪分布和胰岛素敏感性中。有种族和性别特定的 肥胖症患病率和负担的差异。非裔美国人（AA）女性的率最高 肥胖和冠状动脉疾病和代谢综合征的聚类危险因素是AA的两倍 男性。肥胖症患病率和负担的种族和性别差异的原因不好 理解。由于经济和社会，AA的压力水平高于非西班牙裔白人（NHW） 在女性中，不平等以及压力对能量浓密饮食和肥胖的影响更为突出。更好 了解将压力与肥胖联系起来的机制，特别是在青春期 肥胖，增加压力的经历以及对压力出现的更强的行为和生理反应， 将有助于新的AA女性肥胖和相关医疗状况的新临床指南。 生理压力系统会影响肥胖症，并通过下丘脑 - 垂体 - 肾上腺（HPA）轴。长时间压力诱导的糖皮质激素分泌促进了 能量密度饮食（EI）和腹部脂肪沉积通过其对代谢的影响直接和间接地沉积 激素。压力还可以减少体育活动并改变能量平衡。拟议的研究将检查 压力和HPA轴对100 AA和100​​的EI与体育活动相关的能量消耗的影响 NHW青春期女性。对EI的影响将在两种情况下进行自然环境和 在融合标准化社会心理压力源的受控条件下。压力将在 自然环境是多个领域（即个人，家庭和社会），以及HPA的几个索引 将获得轴代表昼夜变化，其状态在12-15周内以及对压力的反应性。肥胖- 相关参数将通过人体测量法，脂肪分布和心脏代谢生物标志物进行测量。 压力，HPA活性/功能，能量平衡和与肥胖相关的参数之间的关联是 在AA和NHW样品之间进行比较。结合在一起，他们将提高我们对 种族和个体差异的社会因素和生物行为机制，并促进 根据个性化的原则，开发种族内部和跨种族的有效治疗 药品。据我们所知，客观测量的饮食摄入和能量消耗的种族差异 在青少年或 成年人。这是我们努力发展更好的循证转化肥胖的重要知识差距 作为传统干预措施，预防和权重控制干预措施与少数族裔青年无效。