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HOP Faculty Receives NIH Grant to Study Effects of Stress, Social Status and Discrimination on Metabolic Syndrome in African Americans

Michelle Cardel, Ph.D., R.D., an assistant professor in the Department of Health Outcomes & Policy, received a $224,023 diversity supplement from the National Heart, Lung and Blood Institute to explore how stress, perceived social status and discrimination affect the development and severity of metabolic syndrome (MetS) in African American adults.

About one in three Americans develops MetS, a cluster of risk factors including excess body fat, high blood pressure, high blood sugar and high triglycerides, that increases the odds of developing heart disease and Type 2 diabetes.

“Given that African Americans have disproportionately high rates of heart disease and Type 2 diabetes, it is important to study the development and severity of metabolic syndrome, which often precedes these diseases,” said Cardel, whose research focus includes nutrition, obesity, psychosocial factors contributing to obesity and health disparities. Cardel is also a faculty member at UF’s Institute for Child Health Policy and chair-elect of the American Society of Nutrition’s Obesity Research Interest Section.

Cardel’s diversity funding award is part of a 5-year, $1.9 million parent grant from the National Heart, Lung, and Blood Institute to evaluate cardiovascular risks related to MetS among participants of the Jackson Heart Study, the largest longitudinal study of heart disease in African Americans ever undertaken. Matthew Gurka, Ph.D., a biostatistician in the Department of Health Outcomes & Policy at UF, is principal investigator of the parent grant.  Mark DeBoer, M.D., a pediatric endocrinologist in the Department of Pediatrics at the University of Virginia in Charlottesville, is co-principal investigator.  Gurka and DeBoer have developed a tool designed specifically to assess the severity of MetS among African Americans. (To learn more, see the metabolic syndrome severity calculator.)

Cardel said that Gurka and DeBoer have already published several high-impact papers in peer-reviewed journals demonstrating that MetS severity is an important predictor of future cardiovascular disease and Type 2 diabetes. (Read more here.)

“What has not been explored in the scientific literature or addressed in the parent grant are the roles of psychosocial stressors, perceived social status and discrimination on the development and severity of MetS in African Americans,” she said.  The NHLBI diversity supplement is part of the National Institutes of Health’s 2016 Strategic Vision, whose research priorities include finding ways to manage cardio-metabolic risk to improve health outcomes in underserved populations.

Since 2000, researchers with the Jackson Heart Study have been collecting data from 5,302 African American women and men ages 35 to 84 living in Jackson, Mississippi to help understand why African Americans have higher rates of cardiovascular disease (CVD) and higher rates of premature deaths from CVD than non-Hispanic white Americans do.

Jackson Heart Study participants agreed to undergo extensive physical exams and laboratory work that included height, weight, waist circumference, blood pressure, blood cholesterol and blood sugar levels, along with an electrocardiogram, echocardiogram, carotid ultrasound and other biological measures.   Researchers also administered a battery of psychometric evaluations, questionnaires and interviews to assess a broad set of social, ethnoracial, psychological and sociocultural variables, including social status and racial discrimination.

With the NHLBI diversity funding, Cardel will use data gathered from psychometric measures of psychosocial stress, discrimination and subjective social status (in which respondents are asked to indicate a sense of their place in the social ladder) from Jackson Heart Study participants to investigate whether these factors act as stressors that negatively alter health-related behaviors, such as eating and physical activity.

“Ultimately, poverty and limited education appear to be the driving factors for poor health outcomes in vulnerable populations, rather than race or ethnicity alone,” Cardel said. “By identifying and helping to overcome barriers unique to low social status populations, such as food insecurity, lack of insurance, and lack of access to healthy food and physical activity options, health care professionals can help these patients assess and address many of these issues, which ultimately could improve their long-term health outcomes.”