(P02-075-25) Change in Allostatic Load Across 22 Weeks in African American Women With Obesity: Differences by Food Security Status

Objectives: Food insecurity can include episodes of food adequacy (i.e., enough food to eat) and food shortage (i.e., not enough food to eat), which can increase stress. Stress is a central component in the pathway from food insecurity to chronic disease. This study examined allostatic load (AL), as a physiological biomarker of stress, differences between a food secure (FS) cohort and food insecure (FI) cohort of African American women with obesity.

Methods: African American women (age 18-65 y) with obesity (BMI 30-50 kg/m²) were enrolled into a ~22 week observational, cohort study. Food security status at baseline was assessed using a modified version of the 6-Item Food Security Scale and 30 FI and 30 FS participants were enrolled. AL was measured via an AL total score, which included cardiovascular (systolic and diastolic blood pressure, high-density lipoprotein, pulse, and total cholesterol), metabolic (albumin, waist to hip ratio, HbA1c), and immune (c-reactive protein) biomarkers. AL was assessed at the beginning (Week 1) and end (~Week 22) of the study. Linear mixed-effects models were used to evaluate differences between cohorts, accounting for repeated measurements. Models included FI vs. FS, week, an interaction term between FI vs. FS and week, and age.

Results: Among participants, mean AL total score was 3.32 (SE=0.14) at Week 1 and 3.25 (SE=0.16) at ~Week 22 (p=0.442). AL was 3.52 (SE=0.18) and 3.12 (SE=0.17) in the FI and FS cohorts, respectively, at Week 1 (p=0.092). Following 22 weeks, the FI cohort demonstrated a mean AL of 3.52 (SE=0.22) with no significant change (0±0.13; p=1) from Week 1, while the FS cohort demonstrated a slight decrease in AL, 2.98 (SE=0.21), but no significant change (-0.15±0.13; p=0.278) from Week 1. At the end of the study the mean difference in AL between the cohorts, -0.54 (SE=0.28; p=0.061), was not significantly different.

Conclusions: African American women with obesity and food insecurity demonstrated greater physiological stress at the beginning and end of a 22-week observational study compared to African American women with obesity and food security. However, these differences were not significant.

Funding Sources: National Institutes of Health, including National Institute on Minority Health and Health Disparities, National Institute of General Medical Sciences, and National Institute of Diabetes and Digestive and Kidney Diseases.