Longitudinal Changes in Allostatic Load during a Randomized Church-based, Lifestyle Intervention in African American Women

Abstract

Introduction: African American (AA) women have disproportionately higher risk of cardiovascular disease than White women, which may be explained by the uniquely higher allostatic load (AL) found in AA women. No studies have tested the effect of lifestyle interventions on AL in AA women. Our objectives were to assess the change in allostatic load following a lifestyle intervention and explore the roles of life­style behaviors and socioeconomic factors on allostatic load change.Methods: Participants were non-diabetic (mean age and SD: 48.8±11.2 y) AA women (n=221) enrolled in a church-based, cluster randomized trial testing a standard diabetes prevention program (DPP) and a faith-enhanced DPP with 4-months of follow-up. We assessed the relation­ships of changes in diet, physical activity, neighborhood disadvantage, individual socioeconomic factors, and other lifestyle variables to changes in AL at 4-months using a multilevel multinomial logistic regression model.Results: Average AL decreased (-.13±.99, P=.02) from baseline to 4-months. After adjusting for other variables, a high school education or less (OR:.1, CI:.02–.49) and alcohol use (OR: .31, CI: .09-.99) contrib­uted to increased AL. Living in a disadvan­taged neighborhood was responsible for increased AL, though it was not statistically significant. There were no statistically sig­nificant associations between AL and other health behavior changes.Conclusions: Lower education levels may dampen the benefits of lifestyle interventions in reducing AL. Although a significant reduction in AL was found after participation in a lifestyle intervention, more research is needed to determine how lifestyle behaviors and socioeconomic factors influence AL in AA women.Ethn Dis. 2019;29(2):297-308; doi:10.18865/ ed.29.2.297

Allostatic Load and Its Impact on Health: A Systematic Review

“…In some studies, allostatic load was negatively associ ated with years of education [61,73,79,[90][91][92]. However, two investigations [93,94], examining the mediating role of ethnicity in the relationship between allostatic load and educational attainment, found the highest levels of allo static load among minorities with a college degree or more.…”

“…Physical activity was found to be associated with lower allostatic load [227][228][229], whereas poor sleep quality [230][231][232][233], unhealthy diet and overweight [52,218,228,[234][235][236][237][238][239], alcohol consumption [52,92,228,229,240] and smoking habits [241] were associated with high allo static load levels.…”