200223 Allostatic load is associated with chronic conditions in Puerto Rican older adults

Monday, November 9, 2009: 10:50 AM

Josiemer Mattei, PhD, MPH , Department of Nutrition, Harvard School of Public Health, Boston, MA
Serkalem Demissie, PhD , Department of Biostatistics, School of Public Health, Boston University, Boston, MA
Luis Falcon, PhD , Northeastern University, Boston, MA
Jose Ordovas, PhD , Nutrition and Genomics Laboratory, Tufts University, Boston, MA
Katherine L. Tucker, PhD , Department of Health Sciences, Northeastern University, Boston, MA
Puerto Ricans in the United States present multiple disparities for disease. Allostatic load (AL), or physiological dysregulation in response to stressors, has been proposed as a mechanism for health disparities, but has not been studied in Puerto Ricans. The aim of this study was to determine the association of AL to chronic disease in Puerto Ricans, and to assess potential mechanisms for its primary and secondary mediators. Data was obtained from questionnaires and biological samples collected from participants of the Boston Puerto Rican Health Study (n=1116, ages 45-75 years). A definition for AL was constructed using clinically-defined cutoffs and medication use for 10 physiological parameters in different body systems. Parameters were further categorized by primary or secondary mediators. Logistic regression models were run to determine association of AL and disease status, controlling for age, sex, smoking, alcohol use, physical activity, perceived stress, total fat intake and energy intake. 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. Primary mediators of AL were not associated with any condition, while secondary mediators were associated with all conditions except cancer. The strength of associations of AL with diabetes, CVD and arthritis paralleled those of the secondary mediators, but were weaker for abdominal obesity and hypertension. In conclusion, Puerto Ricans experienced physiological dysregulation that was associated with increased odds of chronic conditions. These results have prospective implications for interventions and research in Puerto Ricans and other ethnic groups.

Learning Objectives:
1.) Define allostatic load as a summary measure of physiological dysregulation using a novel classification 2.) Identify allostatic load as a potential mechanism for health disparities and a composite marker of stress that contributes to disease 3.) Describe the role of dysregulated physiological parameters due to stress on prevalence of chronic diseases in a minority group

Keywords: Chronic Diseases, Health Disparities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I designed the project, conducted the analysis and discussed the results. I conduct research on the proposed topic as part of my current endeavors.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Chronic Disease Epidemiology
See more of: Epidemiology