Purpose and Hypothesis

Sample Characteristics (N=165)

Results

Implications

Discussion

Acknowledgment

BIOPSYCHOSOCIAL PREDICTORS OF OBESITY IN BIOPSYCHOSOCIAL PREDICTORS OF OBESITY IN AFRICAN AMERICANSAFRICAN AMERICANS

Joneis Thomas, PhD1, Denee T. Mwendwa, PhD1, Serge Madhere, PhD1, Clive O. Callender, MD2, Debra L. Morehead, BA1, Mana Ali, BA1, Alfonso Campbell Jr., PhD1

Howard University1 and Howard University Hospital2

Washington, DC 20059

Background

Design and Methodology

Obesity in the U.S. has reached epidemic proportions.

Two-thirds of American adults are overweight and almost one-third are obese.

Disparities exist across racial/ethnic groups, with African Americans, particularly women, being disproportionately impacted by obesity.

Studies have examined biological (e.g., CRP) and psychological (e.g., anxiety, stress, depression, anger/hostility) correlates of obesity.

However, scant research exists on how these factors influence obesity in African Americans, as well as, risk factors that are unique to African Americans (e.g., coping with racism).

Purpose: The purpose of this research was to establish a risk factor model for the development of obesity in African Americans and include variables such as coping with racism and anger/hostility, which have not been given extensive attention in the literature.

Hypothesis: We hypothesized that C-reactive protein, anger/hostility, anxiety, depression, perceived stress, and coping with perceived racism would be significant predictors of body mass index.

Participants: African Americans (N=165), males (n=82) and females (n=83), 18 to 73 years of age, residing in Washington, DC, Maryland, or Virginia, were the participants in this study.

Setting: Howard University Hospital’s General Clinical Research Center (GCRC) located in Washington, DC was the study site.

Tests and Measures: Informed consent was obtained. Participants completed self-report measures of anxiety, depression, anger/hostility, coping with perceived racism, and perceived stress. Participants also underwent a medical examination, which included measurements of body mass index (BMI) and C-reactive protein (CRP). ELISA assay procedures were conducted for serum CRP. Weight and height measurements were used to calculate BMI.

Anxiety, depression, and anger/hostility were measured using the NEO Personality Inventory-Revised (NEO-PI-R; Costa & McCrae, 1992). Perceived stress was measured using the Perceived Stress Scale (Cohen et al., 1983). Coping with perceived racism was measured using the Perceived Racism Scale (McNeilly et al., 1986).

This research is part of a larger study entitled “Stress and Psychoneuroimmulogical Factors in Renal Health and Disease” that is funded by The National Center on Minority Health and Health Disparities under grant #1P20MD000512-04, “A Research Center to Reduce Ethnic Disparities in ESRD.”

This study offers insight into the biopsychosocial correlates of obesity in African Americans.

Log normalized CRP, depression, anger/hostility, and coping with perceived racism were positively correlated with BMI.

In a hierarchical multiple regression analysis, log normalized CRP, anger/hostility, and coping with perceived racism emerged as significant predictors of BMI after controlling for age, income, and gender. This model accounted for 52.1% of the variance in BMI.

While depression and anxiety were correlated with BMI, they were not significant predictors of BMI in this sample of African Americans. This unexpected finding may be attributable to how depression and anxiety were measured.

Our study contributes to the literature by showing that both coping with perceived racism and anger/hostility play a role in obesity in African-Americans.

The process by which coping with racism influences obesity in African Americans needs to be further explored.

Mood states need to be considered when conducting research with and providing services to African Americans at risk for obesity.

Health promotion and the prevention and treatment of obesity need to be targeted to the specific experiences of African Americans.

1 2 3 4 5 6 7

1. Anxiety ----

2. Depression .414 ----

3. Anger/hostility .284 .514 ----

4. Coping with Perceived Racism -.023 .034 -.122 ----

5. Perceived Stress .352 .489 .354 -.004 ----

6. CRP -.018 .115 .087 .023 .057 ----

7. BMI -.059 .133 .219 .190 .122 .643 ----

Bivariate Analyses

Variable β Sig.

CRP .600 .000

Coping with Perceived Racism .198 .001

Anger/hostility .211 .002

Regression Analysis

Outcome Variable: BMI

Age (yrs.) 45.18 + 12.02Men n=82 (49.7%) Women n=83 (50.3%)Coping with Perceived Racism 8.60 + 4.93Anxiety 50 + 5Depression 50 + 5Anger/hostility 50 + 5Perceived Stress 15.72 + 7.07 C-reactive protein (log normalized) 0.47 + 1.23Body Mass Index (kg/m²) 30.98 + 8.72____________________________Values are expressed as mean + SD or number (%).

Note: significant correlations are highlighted