Perceived Weight Discrimination and 10-Year Risk of Allostatic Load Among US Adults Childhood cumulative risk and later allostatic load: mediating role of substance use. Allostatic load is associated with chronic conditions in the Boston Puerto Rican Health Study. Social relationships and their biological correlates: Coronary Artery Risk Development in Young Adults (CARDIA) study Contingency management reduces injection-related HIV risk behaviors in heroin and cocaine using outpatients. Application of the high-risk strategy to control dental caries. Allostatic load biomarkers and asthma in adolescents. Improving health behaviours of Latina mothers of youths and adults with intellectual and developmental disabilities.
Background Discrimination promotes multisystem physiological dysregulation termed allostatic load , which predicts morbidity and mortality . It remains unclear whether weight-related discrimination influences allostatic load . Purpose The aim of this study was to prospect ively examine 10-year associations between weight discrimination , allostatic load , and its components among adults 25–75 years in the Midlife Development in the US Biomarker Sub study . Methods Participants with information on weight discrimination were analyzed ( n=986 ) . At both timepoints , participants self-reported the frequency of perceived weight discrimination across nine scenarios as “ never/rarely ” ( scored as 0 ) , “ sometimes ” ( 1 ) , or “ often ” ( 2 ) . The two scores were averaged and then dichotomized as “ experienced ” versus “ not experienced ” discrimination . High allostatic load was defined as having ≥3 out of 7 dysregulated systems ( cardiovascular , sympathetic/parasympathetic nervous systems , hypothalamic pituitary axis , inflammatory , lipid/metabolic , and glucose metabolism ) , which collectively included 24 biomarkers . Relative risks ( RR ) were estimated from multivariate models adjusted for sociodemographic and health characteristics , other forms of discrimination , and BMI . Results Over 41 % of the sample had obesity , and 6 % reported weight discrimination at follow-up . In multivariable-adjusted analyses , individuals who experienced ( versus did not experience ) weight discrimination had twice the risk of high allostatic load ( RR , 2.07 ; 95 % CI , 1.21 ; 3.55 for baseline discrimination ; 2.16 , 95 % CI , 1.39 ; 3.36 for long-term discrimination ) . Weight discrimination was associated with lipid/metabolic dysregulation ( 1.56 ; 95 % CI 1.02 , 2.40 ) , glucose metabolism ( 1.99 ; 95 % CI 1.34 , 2.95 ) , and inflammation ( 1.76 ; 95 % CI 1.22 , 2.54 ) , but no other systems . Conclusions Perceived weight discrimination doubles the 10-year risk of high allostatic load . Eliminating weight stigma may reduce physiological dysregulation , improving obesity-related morbidity and mortality OBJECTIVE The present study investigated the long-term impact of exposure to  poverty-related stressors during childhood on allostatic load , an index of physiological dysregulation , and the potential mediating role of substance use . METHOD Participants ( n = 162 ) were rural children from New York State , followed for 8 years ( between the ages 9 and 17 ) .  Poverty- related stress was computed using the cumulative risk approach , assessing stressors across 9 domains , including environmental , psychosocial , and demographic factors . Allostatic load captured a range of physiological responses , including cardiovascular , hypothalamic pituitary adrenal axis , sympathetic adrenal medullary system , and metabolic activity . Smoking and alcohol/drug use were tested as mediators of the hypothesized childhood risk-adolescent allostatic load relationship . RESULTS Cumulative risk exposure at age 9 predicted increases in allostatic load 8 years later . Smoking , but not alcohol and drug use , was a significant mediator of the prospect i ve , longitudinal relationship between childhood cumulative risk and adolescent allostatic load . CONCLUSIONS The present paper contributes to the underst and ing of the role of early life stress in health across the life span and of the mechanisms by which adverse childhood environments impact health as children emerge into early adulthood . This knowledge will have implication s for early intervention efforts Puerto Ricans living in the United States mainl and present multiple disparities in prevalence of chronic diseases , relative to other racial and ethnic groups . Allostatic load ( AL ) , or the cumulative wear and tear of physiological responses to stressors such as major life events , social and environmental burden , has been proposed as a possible mechanism for the inequalities observed in minority groups , but has not been studied in Puerto Ricans . The aim of this study was to determine the association of AL to six chronic diseases ( abdominal obesity , hypertension , diabetes , and self-reported cardiovascular disease ( CVD ) , arthritis and cancer ) in Puerto Ricans , and to contrast AL to metabolic syndrome ( MetS ) . Participants of the Boston Puerto Rican Health Study ( n=1116 , ages 45 - 75 years ) underwent a  home-based interview  , where question naires were completed and biological sample s collected . A summary definition of AL was constructed using clinical ly-defined cutoffs and medication use for 10 physiological parameters in different body systems . Logistic regression models were run to determine associations between AL score and disease status , controlling for age , sex , smoking , alcohol use , physical activity , total fat intake and energy intake . Parallel models were also run with MetS score replacing AL . We found that increasing categories of AL score were significantly associated with abdominal obesity , hypertension , diabetes and self-reported cardiovascular disease ( CVD ) and arthritis , but not with self-reported cancer . The strength of associations of AL with all conditions , except diabetes and cancer , was similar to or larger than those of MetS score . In conclusion , Puerto Rican older adults experienced physiological dysregulation that was associated with increased odds of chronic conditions . AL was more strongly associated with most conditions , compared to MetS , suggesting that this cumulative measure may be a better predictor of disease . These results have prospect i ve research implication s for Puerto Ricans and other ethnic groups OBJECTIVE Analyses test the hypothesis that aspects of social relationships ( quantity of ties , social support and social strain ) are associated with differences in levels of biological risk across multiple major physiological regulatory systems and consequently overall multi-systems risk ( i.e. , allostatic load [ AL ] ) . METHODS Data are from the Coronary Artery Risk Development in Young Adults ( CARDIA ) study --a bi-ethnic , prospect i ve , multi-center epidemiological study , initiated in 1985 - 1986 to track the development of cardiovascular risk in young adulthood ( N=5115 ) . At the year 15 follow-up when participants were between 32 and 45 years of age , additional social and biological data were collected ; biological data used to assess AL were collected at the Oakl and , CA and Chicago , IL sites ( N=844 ) . RESULTS Social strains were most strongly and positively related to overall AL ( Cohen 's d=.79 for highest vs. lowest quartile ) , and to each of its component biological subsystems , independent of social ties and support as well as sociodemographics and health behaviors . Social ties and emotional support were also negatively related to AL ( Cohen 's d=.33 and d=.44 for lowest vs. highest quartiles of ties and support , respectively ) though controls for social strains reduced these associations to non- significance . Social support and social strain were more strongly related to overall AL than to any of its component subscales while social ties were less strongly related to AL and to its component subscales . There was no evidence that effects differed by sex , age or ethnicity . CONCLUSIONS Findings focus attention on the particularly strong relationship between social strains and profiles of biological risk and support the cumulative impact of social factors on biological risks , showing larger effects for cumulative AL than for any of the individual biological systems Intravenous drug use is a major vector of HIV transmission . We assessed whether contingency management ( CM ) , in which participants earn reinforcers for drug abstinence , reduces HIV risk behaviors in methadone-maintained opiate- and cocaine-using out patients . Participants ( n=116 ) were r and omly assigned to  prize-based CM or to receipt of prize draws noncontingently on a schedule yoked to the CM group . Both groups received methadone and individual counseling throughout treatment . The HIV-Risk Taking Behaviour Scale was administered in written question naire form at 2-week intervals ( HRBS ; [ Darke , S. , Hall , W. , Heather , N. , Ward , J. , & Wodak , A. ( 1991 ) . The reliability and validity of a scale to measure HIV risk-taking behaviour among intravenous drug users . AIDS , 5 , 181 - 185 ] ) . A mediation analysis was conducted to determine whether abstinence from opiates and cocaine mediated the effect of CM on HRBS scores . Changes in HRBS scores over time differed significantly by treatment ( F(9,334)=2.4 , p<0.05 ) , with HRBS scores decreasing over time in the CM group to a greater extent than in the noncontingent control group . Participants in the CM group had significantly lower rates of simultaneous cocaine/opiate-positive urine specimens than those in the noncontingent control group during CM treatment ( F(1,111)=6.8 , p=0.01 ) . The relationship between treatment condition and HRBS scores was mediated by abstinence . CM targeted toward cocaine and heroin use produces significant reductions in injection-related drug-taking behaviors associated with heightened risk for getting or transmitting HIV OBJECTIVE The aim of this prospect i ve study was to determine whether a child population with low overall caries frequency benefits when prevention is targeted to high-risk individuals . METHODS Data from clinical examinations and salivary tests were used to assess caries risk in 12-year-olds ( n=1465 ) . Children who were regarded as being at high risk of developing caries were r and omized into two groups . Half ( HRI group ) were offered intensive prevention ( counseling , F-varnish applications , F-lozenges , sealants , chlorhexidine ) , and the other half ( HRB group ) were provided the same basic prevention given to low-risk children ( counseling , one F-varnish application/year ) . A r and om sample of the low-risk children ( LRB ) was followed up for the same 3-year period as the high-risk children . The number of children completing the study was 216 in the LRB group , 199 in the HRI group and 174 in the HRB group . RESULTS The mean ( SD ) 3-year DMFS increment was 2.0 ( 2.4 ) , 4.4 ( 4.7 ) and 5.1 ( 5.0 ) in the LRB , HRI and HRB groups , respectively . Comparison between the LRB and HRB groups revealed that risk assessment was fairly successful in terms of mean DMFS increment . However , 63 % of the children in the LRB group developed at least one new lesion ( max . 12 ) . CONCLUSIONS The negligible difference between the HRI and HRB groups implies that intensifying prevention produced practically no additional benefit . By offering all children only basic prevention , virtually the same preventive effect could have been obtained with substantially less effort and lower costs RATIONALE Allostatic load ( AL ) , a novel measure of the physiologically dysregulated response of the body to stress , represents a biomarker of chronic stress exposure . OBJECTIVES To determine whether preadolescent children with high AL are more susceptible to asthma as adolescents . METHODS This was a prospect i ve evaluation of children recruited at 7 to 10 years of age in the nested case-control arm of the Study of Asthma , Genes and Environment and followed until 11 to 14 years of age .  AL was measured using eight biomarkers : fasting glucose , total cholesterol , high-density lipoprotein cholesterol , dehydroepi and rosterone sulfate , cortisol , systolic and diastolic blood pressure , and waist-to-hip ratio . AL , created from the sum of biomarkers in a high-risk quartile , was related to prevalence and incidence of asthma using logistic regression . MEASUREMENTS AND MAIN RESULTS Among 352 participants followed until 11 to 14 years of age , prevalent asthma was four times more likely in boys with high ( > 3 ) versus low ( ≤2 ) AL after adjusting for current asthma/atopy , age , ethnicity , parental history of asthma , and overweight status . Similar results were observed in the analysis of new-onset asthma in boys ( adjusted odds ratio , 4.35 ; 95 % confidence interval , 1.19 - 15.9 ) . In girls , there were no associations between AL and asthma . In the analysis of a subset of biomarkers , combinations of total cholesterol , glucose , and cortisol were associated with similar or greater risk of asthma prevalence or onset in boys . CONCLUSIONS AL and its biomarkers are associated with an increased likelihood of asthma in adolescent boys . The observed association between AL and asthma may be attributable to a combined subset of AL biomarkers BACKGROUND Latina mothers who care for children with intellectual and developmental disabilities ( IDD ) over the lifespan struggle to take care of their own health needs in the context of their caregiving experience . Services are typically aim ed at the persons with IDD and not their family caregivers . Yet , attending to family caregiver needs may contribute to better long-term care of persons with IDD who remain at home . To address this unmet need , we developed a culturally sensitive health education intervention for Latina mothers who care for youth and adults with IDD . The aim of the intervention is to improve maternal health-related self-efficacy and health behaviours , and to reduce stress . METHOD A r and omised control design was employed to determine preliminary efficacy of the intervention . Paired sample t-tests were conducted to examine within-group changes from baseline to 3-month post-test . Repeated- measures analysis of covariance was used to examine the group-by-time interaction effects . RESULTS Intervention participants showed greater increases between pre- and post-test in health-related self-efficacy ; self-care , nutrition and overall health behaviours . Both groups reported decreases in depressive symptoms and caregiver burden . CONCLUSIONS While additional research is needed to determine long-term effects and to replicate findings , our results suggest that this culturally sensitive health intervention is a promising way to increase health behaviours which may lead to overall good health for Latina mothers who care for children with IDD across the lifespan
Lifestyle coping behaviours therefore have a significant contribution to AL .
This study is among the first to explore multiple domains of HRB in relation to AL .
Health risk behaviours ( HRB ) across the lifespan have been associated with higher cumulative physiological burden as measured by allostatic load ( AL ) .
This study examines the contribution of HRB and their effects on multisystem biological risk associated with morbidity and early mortality .