(P22-040-23) Effects of Episodic Food Insecurity on Psychological and Physiological RESPONSES in African American Women with Obesity: Protocol for a Longitudinal, Observational Study

Objectives: Food insecurity is a risk factor for multiple chronic diseases, including obesity. Importantly, both food insecurity and obesity are more prevalent in African American women compared to other groups. Further, food insecurity is considered a ‘cyclic phenomenon’ with episodes of food adequacy (i.e., enough food to eat) and food shortage (i.e., not enough food to eat). The objective of this study is to longitudinally investigate the episodic nature of food insecurity as a stressor via responses in body weight and psychological and physiological parameters in two cohorts of African American women with obesity.

Methods: We are currently enrolling 30 food insecure and 30 food secure, assessed using a modified version of the 6-Item Food Security Scale, African American women (age 18-65 y) with obesity (BMI 30-50 kg/m²) and reported income ≤ 250% of the federal poverty level to measure 1) daily body weight remotely over 22 weeks and 2) psychological and physiological parameters via clinic assessments at the beginning and end of 22 weeks. Further, we are assessing episodes of food insecurity, stress, hedonic eating, and appetite on a weekly basis. We hypothesize that food insecure African American women with obesity will demonstrate increased body weight and changes in psychological and physiological endpoints, whereas food secure African American women with obesity will not. We are also examining associations between changes in psychological and physiological parameters and changes in body weight.

Results: We are utilizing a range of psychological questionnaires to assess stress; executive function, decision-making, and motivation; and affect and non-homeostatic eating. We are also collecting a range of physiological measurements, including cortisol, DHEA-S, c-reactive protein, thyroid hormones, glucose, HbA1c, insulin, and allostatic load.

Conclusions: We believe this is the first study to examine changes in body weight and psychological and physiological factors in African American women with obesity during episodes of food insecurity.

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.