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；它的流行率在 过去三十年，与一系列短期和长期的医疗和社会心理问题有关。 青春期是肥胖发生和持续的关键时期，与肥胖的变化相关 饮食、体力活动和健身、脂肪分布和胰岛素敏感性。有种族和性别差异 肥胖患病率和负担的差异。非裔美国人 (AA) 女性的患病率最高 肥胖，冠心病、代谢综合征的聚集性危险因素是AA的2倍 男性。肥胖患病率和负担存在种族和性别差异的原因尚不清楚 明白了。由于经济和社会原因，AA 比非西班牙裔白人 (NHW) 承受更高的压力 不平等，压力对能量密集型饮食和肥胖的影响在女性中更为突出。更好的 了解压力与肥胖之间的联系机制，特别是在青少年时期，肥胖发生率很高 肥胖、压力体验增加以及对压力的更强的行为和生理反应出现， 将为减少 AA 女性肥胖和相关医疗状况的新临床指南做出贡献。 生理应激系统影响肥胖并通过下丘脑调节其适应性功能 垂体-肾上腺 (HPA) 轴。长期应激诱导的糖皮质激素分泌会促进糖皮质激素的消耗 能量密集型饮食（EI）和腹部脂肪沉积直接或间接通过其对代谢的影响 荷尔蒙。压力还会减少体力活动并改变能量平衡。拟议的研究将审查 100 AA 和 100 中压力和 HPA 轴对 EI 和体力活动相关能量消耗的影响 NHW 青春期女性。对 EI 的影响将在两个背景下进行评估：自然环境和 在包含标准化心理社会压力源的受控条件下。压力将在 自然环境作为多个领域（即个人、家庭和社会）以及 HPA 的多个指标 将获得代表昼夜变化、12-15 周内的状态以及对压力的反应的轴。肥胖- 相关参数将通过人体测量、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、能量平衡和肥胖相关参数之间的关联将是 AA 和 NHW 样本之间以及内部的比较。结合起来，它们将提高我们对 肥胖的种族和个体差异的社会因素和生物行为机制，并促进 根据个体化原则，在种族群体内部和跨种族群体中开发有效的治疗方法 药品。据我们所知，客观测量的饮食摄入量和能量消耗存在种族差异 尚未对青少年或青少年对压力的反应或其潜在的生理机制进行评估 成年人。这是我们努力开发更好的循证转化性肥胖的重要知识差距 预防和体重控制干预措施作为传统干预措施对少数民族青年无效。