Cancer Control Research5R21CA158868-02
Kiecolt-Glaser, Janice K.
MARITAL DISCORD, FAST FOOD, OBESITY, AND INFLAMMATION
DESCRIPTION (provided by applicant): Diet clearly impacts inflammation; about one-third of the total energy intake in the US population comes from fast food consumption that is typically high in saturated fat, and recent demonstrations of enhanced inflammation following meals high in saturated fats have sparked interest in the possibility that postprandial inflammation acts as a driver for chronic inflammatory responses; when high-fat, fast-food-type meals flood the body with simple carbohydrates and triglycerides, the meals may also provoke spikes in IL-6 and CRP while enhancing oxidative stress and sympathetic hyperactivity. Furthermore, proinflammatory responses to high-fat meals are exaggerated by obesity, particularly visceral adiposity, and high-fat meals push obesity's characteristic elevated inflammation levels even higher and sustain them longer. Depression and psychosocial stress can also directly promote proinflammatory cytokine production, and a turbulent marriage is a rich source for both; marital discord greatly enhances risk for depression, and marital discord also has notable physiological repercussions as documented by its association with poorer clinical outcomes for inflammation-related conditions including cardiovascular disease and metabolic syndrome. A series of well-controlled laboratory studies have provided important mechanistic data; negative or hostile behavior during marital conflict (a hallmark of marital discord) substantially augments adverse endocrine and immune changes, including enhanced production of proinflammatory cytokines. Drawing on behavioral, nutritional, and immunological research, this double-blind, randomized crossover trial will assess changes in inflammation and mood following a fast-food-type meal compared to a healthier meal (moderate level of fats) in distressed and nondistressed couples. Couples will be asked to discuss and resolve a disagreement following both meals to maximize the salience and impact of marital distress on meal- related inflammatory responses; behavioral coding of these interactions will provide data on hostile marital behaviors. Our primary aim is to characterize the impact of a fast-food-type meal compared to a healthier meal on postprandial inflammatory responses in distressed and nondistressed couples, and to appraise the relative impact of central adiposity as a predictor of inflammatory responses. Our secondary, exploratory aim is to assess the relative contributions of gender and negative or hostile marital behaviors to depressive symptoms and inflammatory responses at baseline, as well as following the meal challenge. This proposal provides a new perspective on the biobehavioral pathways through which obesity, diet, and marital discord interact to promote inflammation. Elevated levels of proinflammatory cytokines are associated with cancer risk, depression, cardiovascular disease, osteoporosis, arthritis, Type II diabetes, and frailty and functional decline, underscoring the broad clinical relevance. PUBLIC HEALTH RELEVANCE: This project seeks to lay the foundation for translational research that would enhance our understanding of the biobehavioral pathways through which obesity, diet, and marital discord interact to promote inflammation. The evidence that fast food-type meals promote postprandial dysmetabolism is relatively recent and still preliminary, but the possibility that postprandial inflammation acts as a driver for chronic inflammation is clearly important. Elevated levels of proinflammatory cytokines are associated with cancer risk, depression, cardiovascular disease, osteoporosis, arthritis, Type II diabetes, and frailty and functional decline, underscoring the broad clinical relevance.