Stress Measured by Allostatic Load Score Varies by Reason for Immigration: The Africans in America Study.
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ABSTRACT:
SUBMITTER: Utumatwishima JN
PROVIDER: S-EPMC5656551 | biostudies-literature | 2018 Apr
REPOSITORIES: biostudies-literature
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Stress Measured by Allostatic Load Score Varies by Reason for Immigration: The Africans in America Study.
Utumatwishima Jean N JN Baker Rafeal L RL Bingham Brianna A BA Chung Stephanie T ST Berrigan David D Sumner Anne E AE
Journal of racial and ethnic health disparities 20170425 2
<h4>Objective</h4>Reason for immigration as a biological stress has not been studied in Africans. Our goal was to determine in African immigrants, if biological stress measured by allostatic load score (ALS) varies by reason for immigration.<h4>Methods</h4>Using an ALS which had been previously developed with the National Health and Nutrition Examination Survey (NHANES) data to assess stress due to racism and nativity, ALS was calculated in 85 African immigrants (67% male, age 42 ± 10 years). Fo ...[more]
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Project description:Stress leads to physiologic dysfunction and cardiometabolic disease. Allostatic load score (ALS) measures stress-induced cardiovascular, metabolic, and inflammatory biomarkers. We estimated the odds of high ALS by reason for and age at immigration, duration of American residence, number of children, and socioeconomic status in 193 African immigrants (male: 65%, age 41 ± 10 y (mean ± Standard Deviation (SD)), range 22-65 y). ALS was calculated with High-ALS defined as ALS ≥ 3.0 and Low-ALS defined as ALS < 3.0. Oral glucose tolerance tests (OGTT) were performed, the cardiovascular disease (CVD) risk estimated, and TNF-α, an inflammatory cytokine, measured. Logistic regression was used to estimate odds of High-ALS. In the High- and Low-ALS groups, ALS were 4.0 ± 1.2 vs. 1.3 ± 0.7, diabetes prevalence: 14% vs. 4%, CVD risk: 23% vs. 8%, TNF-α levels: 15 ± 9 vs. 11 ± 6 pg/mL, respectively (all p ≤ 0.01). Immigrants were more likely to be in the High-ALS group if their reason for immigration was work or asylum/refugee (OR 2.18, p = 0.013), their age at immigration was ≥30 y (OR 3.28, p < 0.001), their duration of residence in United States was ≥10 y (OR 3.16, p = 0.001), or their number of children was ≥3 (OR 2.67, p = 0.019). Education, income, health insurance, marital status, and gender did not affect High-ALS odds. Factors adversely influencing allostatic load and cardiometabolic health in African immigrants were age at and reason for immigration, duration of residence in America, and number of children.
| S-EPMC7345091 | biostudies-literature
Project description:IntroductionAllostatic load score (ALS) summarizes the physiological effect of stress on cardiovascular, metabolic and immune systems. As immigration is stressful, ALS could be affected.ObjectiveAssociations between age of immigration, reason for immigration, and unhealthy assimilation behavior and ALS were determined in 238 African immigrants to the United States (age 40 ± 10, mean ± SD, range 21-64 years).MethodsALS was calculated using 10 variables from three domains; cardiovascular (SBP, DBP, cholesterol, triglyceride, homocysteine), metabolic [BMI, A1C, albumin, estimated glomerular filtration rate (eGFR)], and immunological [high-sensitivity C-reactive protein (hsCRP)]. Variables were divided into sex-specific quartiles with high-risk defined by the highest quartile for each variable except for albumin and eGFR, which used the lowest quartile. One point was assigned if the variable was in the high-risk range and 0 if not. Unhealthy assimilation behavior was defined by a higher prevalence of smoking, alcohol consumption, or sedentary activity in immigrants who lived in the US for ≥10 years compare to <10 years.ResultsSixteen percent of the immigrants arrived in the US as children (age < 18 years); 84% arrived as adults (age ≥ 18 years). Compared to adulthood immigrants, childhood immigrants were younger (30 ± 7 vs. 42 ± 9, P < 0.01) but had lived in the US longer (20 ± 8 vs. 12 ± 9 years, P < 0.01). Age-adjusted ALS was similar in childhood and adulthood immigrants (2.78 ± 1.83 vs. 2.73 ± 1.69, P = 0.87). For adulthood immigrants, multiple regression analysis (adj R2 = 0.20) revealed older age at immigration and more years in the US were associated with higher ALS (both P < 0.05); whereas, current age, education, income, and gender had no significant influence (all P ≥ 0.4). The prevalence of smoking, alcohol intake, and physical activity did not differ in adulthood immigrants living in the US for ≥10 years vs. <10 years (all P ≥ 0.2). Reason for immigration was available for 77 participants. The reasons included: family reunification, lottery, marriage, work, education, and asylum. Compared to all other reasons combined, immigration for family reunification was associated with the lowest ALS (1.94 ± 1.51 vs. 3.03 ± 1.86, P = 0.03).ConclusionAfrican immigrants do not appear to respond to the stress of immigration by developing unhealthy assimilation behaviors. However, older age at immigration and increased duration of stay in the US are associated with higher ALS; whereas, family reunification is associated with lower ALS.Clinical trialsgov identifierNCT00001853.
| S-EPMC5122568 | biostudies-literature
Project description:IntroductionDespite the understanding of allostatic load (AL) as a consequence of ongoing adaptation to stress, studies of the stress-AL association generally focus on a narrow conceptualization of stress and have thus far overlooked potential confounding by personality. The present study examined the cross-sectional association of objective and subjective stress with AL, controlling for Big Five personality traits.MethodsParticipants comprised 5,512 members of the Copenhagen Aging and Midlife Biobank aged 49-63 years (69% men). AL was measured as a summary index of 14 biomarkers of the inflammatory, cardiovascular, and metabolic system. Objective stress was assessed as self-reported major life events in adult life. Subjective stress was assessed as perceived stress within the past four weeks.ResultsBoth stress measures were positively associated with AL, with a slightly stronger association for objective stress. Adjusting for personality traits did not significantly change these associations.ConclusionsThe results suggest measures of objective and subjective stress to have independent predictive validity in the context of personality. Further, it is discussed how different operationalizations of stress and AL may account for some of the differences in observed stress-AL associations.
| S-EPMC6749483 | biostudies-literature
Project description:AimsAlcohol use is associated with both positive and negative effects on individual cardiovascular risk factors, depending upon which risk factor is assessed. The present analysis uses a summative multisystem index of biologic risk, known as allostatic load (AL), to evaluate whether the overall balance of alcohol-associated positive and negative cardiovascular risk factors may be favorable or unfavorable.MethodsThis analysis included 1255 adults from the Midlife in the United States (MIDUS) biomarker substudy. Participants, average age 54.5 (±11) years, were divided into 6 alcohol-use categories based on self-reported drinking habits. Current non-drinkers were classified as lifelong abstainers and former light drinkers, former moderate drinkers, or former heavy drinkers. Current alcohol users were classified as light, moderate, or heavy drinkers. A total AL score was calculated using 24 biomarkers grouped into 7 physiologic systems including cardiovascular, inflammation, glucose metabolism, lipid metabolism, sympathetic and parasympathetic nervous systems, and the hypothalamic-pituitary-adrenal axis. Mixed-effects regression models were fit to determine the relationship between alcohol use categories and AL with controls for covariates that may influence the relationship between alcohol use and AL.Results468 (37.6%) individuals were current non-drinkers while 776 (62.4%) were current drinkers. In adjusted mixed-effects regression models, all 3 groups of current drinkers had significantly lower average AL scores than the lifelong abstainer/former light drinker group (light: -0.23, 95% CI -0.40, -0.07, p < 0.01; moderate: -0.20, 95% CI -0.38, -0.02, p < 0.05; heavy: -0.30, 95% CI -0.57, -0.04, p < 0.05), while the average AL scores of former moderate and former heavy drinkers did not differ from the lifelong abstainer/former light drinker group.ConclusionsCurrent alcohol use is associated cross-sectionally with a favorable multisystem physiologic score known to be associated with better long-term health outcomes, providing evidence in support of long-term health benefits related to alcohol consumption.
| S-EPMC6768542 | biostudies-literature
Project description:ObjectivesThe prevalence of cardiometabolic disease has risen in Africa and parallels the obesity epidemic. To assess cardiometabolic risk, body composition measurements by dual-energy X-ray absorptiometry (DXA) are ideal. In communities with limited resources, alternative measures may be useful but have not been compared extensively in black Africans. Therefore, the aim of this study was to identify alternative methods of body composition assessment, such as body adiposity index (BAI) and bioelectrical impedance analysis (BIA), for use in African-born blacks.MethodsThis was a cross-sectional study with African-born blacks. BAI and five BIA predictive equations (using variations of height, weight, age, sex, and impedance) were compared with DXA to estimate percent fat. Participants were 266 African-born blacks (39 ± 10 y, body mass index 28 ± 4 kg/m2, and 68% men) living in metropolitan Washington DC. Equivalence (90% confidence interval, -3 to 3), concordance, and Bland-Altman analyses (bias <2%, R2 closest to zero) compared BAI or BIA predictive equations to DXA as the criterion method.ResultsDXA percent fat was 27.2% ± 5.5% and 40.3% ± 6.9% in men and women, respectively. BAI underestimated percent fat in men (bias: 1.88 ± 4.71, R2 = 0.25, P < 0.001) and women (bias: 6.47 ± 4.94, R2 = 0.08, P = 0.01). Of the five BIA predictive equations, the equation reported by Sun et al. had the best agreement with DXA percent fat for men (bias: -0.91 ± 3.67, R2 = 0.02, P = 0.05) and women (bias: -0.92 ± 4.02, R2 = 0.003, P = 0.58). Percent fat from the Sun et al. equation best agreed with DXA percent fat.ConclusionBIA with the Sun et al. predictive equation was the best alternative to DXA for body fat assessment in African-born blacks.
| S-EPMC7230013 | biostudies-literature
Project description:OBJECTIVES:Studies investigating health effects of work and family stress usually consider these factors in isolation. The present study investigated prospective interactive effects of job strain and informal caregiving on allostatic load (AL), a multisystem indicator of physiological dysregulation. METHODS:Participants were 7007 British civil servants from the Whitehall II cohort study. Phase 3 (1991-1994) served as the baseline, and Phases 5 (1997-1999) and 7 (2002-2004) served as follow-ups. Job strain (high job demands combined with low control) and caregiving (providing care to aged or disabled relatives) were assessed at baseline. AL index (possible range, 0-9) was assessed at baseline and both follow-ups based on nine cardiovascular, metabolic, and immune biomarkers. Linear mixed-effect models were used to examine the association of job strain and caregiving with AL. RESULTS:High caregiving burden (above the sample median weekly hours of providing care) predicted higher AL levels, with the effect strongest in those also reporting job strain (b = 0.36, 95% confidence interval = 0.01-0.71); however, the interaction between job strain and caregiving was not significant (p = .56). Regardless of job strain, participants with low caregiving burden (below sample median) had lower subsequent AL levels than did non-caregivers (b = -0.22, 95% confidence interval = -0.06--0.37). CONCLUSIONS:The study provides some evidence for adverse effects of stress at work combined with family demands on physiological functioning. However, providing care to others may also have health protective effects if it does not involve excessive time commitment.
| S-EPMC4471110 | biostudies-literature
Project description:Resilience to psychological stress is defined as adaption to challenging life experiences and not the absence of adverse life events. Determinants of resilience include personality traits, genetic/epigenetic modifications of genes involved in the stress response, cognitive and behavioral flexibility, secure attachment with a caregiver, social and community support systems, nutrition and exercise, and alignment of circadian rhythm to the natural light/dark cycle. Therefore, resilience is a dynamic and flexible process that continually evolves by the intersection of different domains in human's life; biological, social, and psychological. The objective of this minireview is to summarize the existing knowledge about the multitude factors and molecular alterations that result from resilience to stress response. Given the multiple contributing factors in building resilience, we set out a goal to identify which factors were most supportive of a causal role by the current literature. We focused on resilience-related molecular alterations resulting from mind-body homeostasis in connection with psychosocial and environmental factors. We conclude that there is no one causal factor that differentiates a resilient person from a vulnerable one. Instead, building resilience requires an intricate network of positive experiences and a healthy lifestyle that contribute to a balanced mind-body connection. Therefore, a holistic approach must be adopted in future research on stress response to address the multiple elements that promote resilience and prevent illnesses and psychopathology related to stress allostatic load.
| S-EPMC10251360 | biostudies-literature
Project description:Allostatic load is a commonly used metric of health risk based on the hypothesis that recurrent exposure to environmental demands (e.g., stress) engenders a progressive dysregulation of multiple physiological systems. Prominent indicators of response to environmental challenges, such as stress-related hormones, sympatho-vagal balance, or inflammatory cytokines, comprise primary allostatic mediators. Secondary mediators reflect ensuing biological alterations that accumulate over time and confer risk for clinical disease but overlap substantially with a second metric of health risk, the metabolic syndrome. Whether allostatic load mediators covary and thus warrant treatment as a unitary construct remains to be established and, in particular, the relation of allostatic load parameters to the metabolic syndrome requires elucidation. Here, we employ confirmatory factor analysis to test: 1) whether a single common factor underlies variation in physiological systems associated with allostatic load; and 2) whether allostatic load parameters continue to load on a single common factor if a second factor representing the metabolic syndrome is also modeled. Participants were 645 adults from Allegheny County, PA (30-54 years old, 82% non-Hispanic white, 52% female) who were free of confounding medications. Model fitting supported a single, second-order factor underlying variance in the allostatic load components available in this study (metabolic, inflammatory and vagal measures). Further, this common factor reflecting covariation among allostatic load components persisted when a latent factor representing metabolic syndrome facets was conjointly modeled. Overall, this study provides novel evidence that the modeled allostatic load components do share common variance as hypothesized. Moreover, the common variance suggests the existence of statistical coherence above and beyond that attributable to the metabolic syndrome.
| S-EPMC3480389 | biostudies-literature
Project description:The stress pathway posits that those in disadvantaged circumstances are exposed to a higher degree of stressful experiences over time resulting in an accumulated biological burden which subsequently relates to poorer health. Trajectories of disadvantage, in the form of neighbourhood deprivation and structural social capital, are evaluated in their relation to allostatic load representing the cumulative “wear and tear” of chronic stress. This paper uses data from the British Household Panel Survey and Understanding Society in a latent class growth analysis. We identify groups of exposure trajectories over time using these classes to predict allostatic load at the final wave. The results show that persistent exposure to higher deprivation is related to worse allostatic load. High structural social capital over time relates to lower allostatic load, in line with a stress buffering effect, though this relationship is not robust to controlling for individual sociodemographic characteristics. By demonstrating a gradient in allostatic load by histories of deprivation, this analysis supports a biological embedding of disadvantage through chronic exposure to stressful environments as an explanation for social health inequalities.
| S-EPMC8308019 | biostudies-literature
Project description:Background Prevention of hearing loss via addressing potentially modifiable risk factors may offer means of reducing the global burden of hearing loss. Prior studies reported associations between individual markers of inflammation and risk of hearing impairment. Allostatic load is an index of cumulative physiological stressors, including inflammation, to multiple biological systems. Our aims were to investigate associations between allostatic load and both audiometric and self-reported hearing impairment and examine whether associations are stronger over time due to prolonged high allostatic load. Methods Data were taken from the English Longitudinal Study of Ageing (ELSA), a nationally representative study of people aged 50+ living in England over 3 time points between 2008 and 2014. Allostatic load score was comprised of thirteen different measures available at baseline and 4 years post-baseline (high-density lipoprotein/total cholesterol, triglyceride, fibrinogen, haemoglobin A1c, C-reactive protein, insulin-like growth factor 1 (IGF-1), systolic and diastolic blood pressure, mean arterial pressure, resting pulse rate, peak expiratory flow, BMI and waist circumference), measured using clinical cut-off points for normal biomarker parameters. Hearing acuity was measured with a simple handheld tone-producing device at follow-up 7 years post-baseline, while self-reported hearing impairment was measured at time point. Results We included samples of 4373 and 4430 for the cross-sectional and longitudinal analysis, respectively. In the cross-sectional model high allostatic load was associated both self-reported (OR = 1.08, 95% CI 1.0,1.1; p < 0.01) and objective hearing loss (OR = 1.10, 95% CI 1.1,1.2; p < 0.001) adjusting for age and sex. Cross-sectional associations between allostatic load and hearing were not significant after further adjustment for covariates (qualification, physical activity and smoking). In longitudinal modelling, high allostatic load was associated with both audiometric (Z score OR = 1.11, 95% CI 1.1,1.2; p < 0.001) and self-reported hearing impairment (OR = 1.08, 95% CI 1.0,1.1; p < 0.001) adjusting for age and sex. Allostatic load was no longer associated with self-reported hearing loss but the association with audiometric hearing impairment (OR = 1.08, 95% CI 1.03,1.13; p < 0.001) remained following additional adjustment for baseline self-reported hearing, education, physical activity, and smoking. Conclusions Prolonged high allostatic load was associated with risk of hearing impairment. Reducing allostatic load via healthy lifestyle changes including non-smoking, healthy diet and exercise may offer an opportunity to reduce the risk of hearing impairment in later life. Highlights • Allostatic load captures cumulative physiological stress which has consequence for subsequent hearing function.• Prolonged high allostatic load was associated with risk of objectively measured hearing impairment.• This association is shown in nationally representative longitudinal ageing study.
| S-EPMC9429496 | biostudies-literature