Stress-Induced Suppression of Food Intake in Overweight and Obese Adolescents

Community Violence Exposure and Stress Reactivity in African American and Non-Latino White Adolescents With Overweight/Obesity

Adolescents who experience community violence are exposed to toxic stressors at a critical period of growth and development. The purpose of this study was to examine the relationship between community violence exposure and stress reactivity in African American and non-Latino white adolescents with overweight/obesity. Fifty-one adolescents (47% female, 55% African American; aged 14-19) participated in this study. Community violence was assessed using the Survey of Children's Exposure to Community Violence. Stress reactivity was assessed via salivary cortisol and alpha-amylase area under the curve (AUC) during a Trier Social Stress Test (TSST). Race was a significant predictor of alpha-amylase reactivity (β = 10740±3665, p = 0.0006), with a higher alpha-amylase AUC observed in African American compared to non-Latino white adolescents. There was also a significant difference in the relationship between community violence exposure and alpha-amylase AUC by race (β = -3561±1226, p = 0.007). At similar increases in violence exposure, African Americans demonstrated a significant decline in alpha-amylase AUC while non-Latino whites demonstrated a significant increase in alpha-amylase AUC. Neither race nor violence exposure were significant predictors of cortisol AUC and there were no significant differences in the relationship between community violence exposure and cortisol AUC by race (all p's > .05). These preliminary findings suggest exposure to community violence may act to exacerbate autonomic dysregulation in African American adolescents with overweight/obesity. Longitudinal studies are needed to confirm the mechanisms by which community violence exposure differentially impacts stress responses by race.

A High-Sugar Diet Consumption, Metabolism and Health Impacts with a Focus on the Development of Substance Use Disorder: A Narrative Review

Carbohydrates are important macronutrients in human and rodent diet patterns that play a key role in crucial metabolic pathways and provide the necessary energy for proper body functioning. Sugar homeostasis and intake require complex hormonal and nervous control to proper body energy balance. Added sugar in processed food results in metabolic, cardiovascular, and nervous disorders. Epidemiological reports have shown enhanced consumption of sweet products in children and adults, especially in reproductive age and in pregnant women, which can lead to the susceptibility of offspring’s health to diseases in early life or in adulthood and proneness to mental disorders. In this review, we discuss the impacts of high-sugar diet (HSD) or sugar intake during the perinatal and/or postnatal periods on neural and behavioural disturbances as well as on the development of substance use disorder (SUD). Since several emotional behavioural disturbances are recognized as predictors of SUD, we also present how HSD enhances impulsive behaviour, stress, anxiety and depression. Apart from the influence of HSD on these mood disturbances, added sugar can render food addiction. Both food and addictive substances change the sensitivity of the brain rewarding neurotransmission signalling. The results of the collected studies could be important in assessing sugar intake, especially via maternal dietary patterns, from the clinical perspective of SUD prevention or pre-existing emotional disorders. Methodology: This narrative review focuses on the roles of a high-sugar diet (HSD) and added sugar in foods and on the impacts of glucose and fructose on the development of substance use disorder (SUD) and on the behavioural predictors of drugs abuse. The literature was reviewed by two authors independently according to the topic of the review. We searched the PubMed and Scopus databases and Multidisciplinary Digital Publishing Institute open access scientific journals using the following keyword search strategy depending on the theme of the chapter: “high-sugar diet” OR “high-carbohydrate diet” OR “sugar” OR “glucose” OR “fructose” OR “added sugar” AND keywords. We excluded inaccessible or pay-walled articles, abstracts, conference papers, editorials, letters, commentary, and short notes. Reviews, experimental studies, and epidemiological data, published since 1990s, were searched and collected depending on the chapter structure. After the search, all duplicates are thrown out and full texts were read, and findings were rescreened. After the selection process, appropriate papers were included to present in this review.

Racial/ethnic differences in dietary intake among a diverse sample of adolescents: An experimental study

BACKGROUND

African-American (AA) and Hispanic/Latina (HL) females have higher obesity prevalence than do non-Hispanic Whites (NHW); this may be due to AA and HL consuming more energy-dense foods in response to stressors.

OBJECTIVES

This study examined racial/ethnic differences in dietary intake under controlled conditions (relaxation and stress) in a diverse sample of adolescent females.

METHODS

Participants included 120 adolescent females (30% AA, 37% HL and 33% NHW) who participated in a laboratory food intake study. Using a randomized cross-over design, ad libitum food consumption was measured following control/relaxation and social-evaluative stress conditions. Food intake was indexed as consumed calories, added sugars and solid fats.

RESULTS

The effect of laboratory conditions on food intake varied by race/ethnicity, such that AA consumed more energy following relaxation than following stress. For NHW and HL, food intake did not differ between conditions.

CONCLUSIONS

To the best of our knowledge, these findings are the first to directly observe racial/ethnic differences in food intake in response to acute stress, which may contribute to obesity-related health disparities.

Acute Daily Stress, Daily Food Consumption, and the Moderating Effect of Disordered Eating among Adolescents with Overweight/Obesity

Objective: The purpose of this study was to examine the associations between acute daily stress dimensions (frequency, sum) and food intake in adolescents with overweight/obesity, and to explore the potential moderating effect of disordered eating behaviors on these associations. Methods: One hundred eighty-two adolescents with overweight/obesity (65% females; 68.7% non-white; 16.2 ± 1.8 years of age) were included in this analysis. Acute daily stress was measured using the Daily Stress Inventory, and daily caloric intake was measured using a food frequency questionnaire. Disordered eating behavior was assessed using the Eating Attitudes Test (EAT-26). Results: Acute daily stress frequency (B = 0.013 ± 0.003; p < 0.001) and acute daily stress sum (B = 0.003 ± 0.001; p < 0.001) were associated with greater daily caloric intake. Disordered eating behavior moderated the association between acute daily stress frequency and caloric intake (p_interaction = 0.039), with greater daily caloric intake among those with higher levels of disordered eating. Disordered eating behavior did not significantly moderate the association between acute daily stress sum and daily caloric intake (p_interaction = 0.053). Conclusions: These findings suggest that greater exposure to acute daily stressors may increase daily food intake in adolescents with overweight/obesity, with greater susceptibility among those engaging in high levels of disordered eating. Longitudinal research is warranted to elucidate the long-term effect of acute daily stressors and disordered eating on food intake among adolescents with overweight/obesity. The Health and Culture Project is registered at www.clinicaltrials.gov (No. NCT02938663).

Stress coping strategies and stress reactivity in adolescents with overweight/obesity

This study explored the associations between the frequency and effectiveness of habitual stress coping strategies on physiological and psychological stress responses to an acute laboratory stressor in adolescents with overweight/obesity (51 adolescents; 47% female; ages 14-19 years). Coping strategies were assessed using the Schoolager's Coping Strategies Inventory. Acute physiological stress responses were measured as salivary cortisol and α-amylase output during the Trier Social Stress Test and during a control condition. Acute psychological stress was measured using a Likert-type scale, and systolic blood pressure (SBP) and heart rate were measured at baseline. Results revealed that higher coping effectiveness was associated with lower log-based α-amylase during the stress (β = -0.025, p = 0.018) and control (β = -0.030, p = 0.005) conditions, but not with cortisol across either condition (all ps > 0.05). SBP moderated the association between coping effectiveness and α-amylase during the stress condition, with higher coping effectiveness associated with lower α-amylase only among individuals with lower SBP (β = 0.002, p = 0.027). Coping frequency was not associated with cortisol responses, neither was habitual stress coping strategies associated with psychological stress (all ps > 0.05). These findings provide preliminary evidence that effective use of stress coping strategies may provide a dampening effect on sympathetic activity in an at-risk adolescent population.