JMIR Publications

ABSTRACT

Background:

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).

Objective:

The objective of this study is to investigate the episodic nature of food insecurity as a stressor via responses in body weight and psychological and physiological parameters longitudinally.

Methods:

We have enrolled 30 food insecure and 30 food secure African American women (age 18-65 y) with obesity (BMI 30-50 kg/m2) 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 and performing a mediation analysis on the psychological parameters assessed at the study mid-point. Psychological questionnaires assess stress; executive function, decision-making, and motivation; and affect and non-homeostatic eating. Physiological measurements include cortisol, DHEA-S, c-reactive protein, thyroid hormones, glucose, HbA1c, insulin, and allostatic load.

Results:

This study has completed participant recruitment (n=60).

Conclusions:

We believe this is the first study to examine changes in body weight and psychological and physiological factors in food insecure African American women with obesity. Clinical Trial: ClinicalTrials.gov identifier: NCT05076487; Date of registration: 30 September 2021.