Perceived Weight Discrimination Amplifies the Link Between Central Adiposity and Nondiabetic Glycemic Control (HbA1c)

Overview

Journal Ann Behav Med

Publisher Oxford University Press

Specialty Social Sciences

Date 2010 Dec 8

PMID 21136227

Citations 37

Authors

Vera K Tsenkova

Deborah Carr

Dale A Schoeller

Carol D Ryff

Affiliations

Soon will be listed here.

Abstract

Background: While the preclinical development of type 2 diabetes is partly explained by obesity and central adiposity, psychosocial research has shown that chronic stressors such as discrimination have health consequences as well.

Purpose: We investigated the extent to which the well-established effects of obesity and central adiposity on nondiabetic glycemic control (indexed by HbA(1c)) were moderated by a targeted psychosocial stressor linked to weight: perceived weight discrimination.

Methods: The data came from the nondiabetic subsample (n = 938) of the Midlife in the United States (MIDUS II) survey.

Results: Body mass index (BMI), waist-to-hip ratio, and waist circumference were linked to significantly higher HbA(1c) (p < 0.001). Multivariate-adjusted models showed that weight discrimination exacerbated the effects of waist-to-hip ratio on HbA(1c) ( p < 0.05), such that people who had higher waist-to-hip ratios and reported weight discrimination had the highest HbA(1c) levels.

Conclusion: Understanding how biological and psychosocial factors interact at nondiabetic levels to increase vulnerability could have important implications for public health and education strategies. Effective strategies may include targeting sources of discrimination rather than solely targeting the health behaviors and practices of overweight and obese persons.

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References

Norberg M, Stenlund H, Lindahl B, Andersson C, Eriksson J, Weinehall L . Work stress and low emotional support is associated with increased risk of future type 2 diabetes in women. Diabetes Res Clin Pract. 2006; 76(3):368-77. DOI: 10.1016/j.diabres.2006.09.002. View

Glasgow R, Wagner E, Kaplan R, Vinicor F, Smith L, Norman J . If diabetes is a public health problem, why not treat it as one? A population-based approach to chronic illness. Ann Behav Med. 1999; 21(2):159-70. DOI: 10.1007/BF02908297. View

Gerstein H . Glycosylated hemoglobin: finally ready for prime time as a cardiovascular risk factor. Ann Intern Med. 2004; 141(6):475-6. DOI: 10.7326/0003-4819-141-6-200409210-00014. View

Amy N, Aalborg A, Lyons P, Keranen L . Barriers to routine gynecological cancer screening for White and African-American obese women. Int J Obes (Lond). 2005; 30(1):147-55. DOI: 10.1038/sj.ijo.0803105. View

Pereira M, Kartashov A, Ebbeling C, Van Horn L, Slattery M, Jacobs Jr D . Fast-food habits, weight gain, and insulin resistance (the CARDIA study): 15-year prospective analysis. Lancet. 2005; 365(9453):36-42. DOI: 10.1016/S0140-6736(04)17663-0. View

Pearlin L, Schieman S, Fazio E, Meersman S . Stress, health, and the life course: some conceptual perspectives. J Health Soc Behav. 2005; 46(2):205-19. DOI: 10.1177/002214650504600206. View

Bray G, Jablonski K, Fujimoto W, Barrett-Connor E, Haffner S, Hanson R . Relation of central adiposity and body mass index to the development of diabetes in the Diabetes Prevention Program. Am J Clin Nutr. 2008; 87(5):1212-8. PMC: 2517222. DOI: 10.1093/ajcn/87.5.1212. View

Netterstrom B, Danborg L, OLESEN H . Glycated hemoglobin as a measure of physiological stress. Behav Med. 1988; 14(1):13-6. DOI: 10.1080/08964289.1988.9935118. View

Andreyeva T, Puhl R, Brownell K . Changes in perceived weight discrimination among Americans, 1995-1996 through 2004-2006. Obesity (Silver Spring). 2008; 16(5):1129-34. DOI: 10.1038/oby.2008.35. View

10.

Ivy J . Role of exercise training in the prevention and treatment of insulin resistance and non-insulin-dependent diabetes mellitus. Sports Med. 1997; 24(5):321-36. DOI: 10.2165/00007256-199724050-00004. View

11.

Black P . The inflammatory consequences of psychologic stress: relationship to insulin resistance, obesity, atherosclerosis and diabetes mellitus, type II. Med Hypotheses. 2006; 67(4):879-91. DOI: 10.1016/j.mehy.2006.04.008. View

12.

Boltri J, Okosun I, Davis-Smith M, Vogel R . Hemoglobin A1c levels in diagnosed and undiagnosed black, Hispanic, and white persons with diabetes: results from NHANES 1999-2000. Ethn Dis. 2005; 15(4):562-7. View

13.

Surwit R, Feinglos M, Livingston E, Kuhn C, McCubbin J . Behavioral manipulation of the diabetic phenotype in ob/ob mice. Diabetes. 1984; 33(7):616-8. DOI: 10.2337/diab.33.7.616. View

14.

Muntner P, Wildman R, Reynolds K, DeSalvo K, Chen J, Fonseca V . Relationship between HbA1c level and peripheral arterial disease. Diabetes Care. 2005; 28(8):1981-7. DOI: 10.2337/diacare.28.8.1981. View

15.

Kessler R, Mickelson K, Williams D . The prevalence, distribution, and mental health correlates of perceived discrimination in the United States. J Health Soc Behav. 1999; 40(3):208-30. View

16.

Zander R, Lang W, Wolf H . Alkaline haematin D-575, a new tool for the determination of haemoglobin as an alternative to the cyanhaemiglobin method. I. Description of the method. Clin Chim Acta. 1984; 136(1):83-93. DOI: 10.1016/0009-8981(84)90250-x. View

17.

Puhl R, Brownell K . Confronting and coping with weight stigma: an investigation of overweight and obese adults. Obesity (Silver Spring). 2006; 14(10):1802-15. DOI: 10.1038/oby.2006.208. View

18.

Mokdad A, Ford E, Bowman B, Dietz W, Vinicor F, Bales V . Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA. 2002; 289(1):76-9. DOI: 10.1001/jama.289.1.76. View

19.

Schwartz M, Chambliss H, Brownell K, Blair S, Billington C . Weight bias among health professionals specializing in obesity. Obes Res. 2003; 11(9):1033-9. DOI: 10.1038/oby.2003.142. View

20.

Pascoe E, Richman L . Perceived discrimination and health: a meta-analytic review. Psychol Bull. 2009; 135(4):531-54. PMC: 2747726. DOI: 10.1037/a0016059. View