All ETDs from UAB

Advisory Committee Chair

Jose R Fernandez

Advisory Committee Members

Elizabeth Baker

Mark Beasley

Brenda M Bertrand

Andrea L Cherrington

Document Type

Dissertation

Date of Award

2019

Degree Name by School

Doctor of Philosophy (PhD) School of Health Professions

Abstract

Obesity has increased during the last two decades in the United States (U.S.) and is considered a major risk factor for chronic diseases within the Hispanic community. The burden of obesity in Hispanics is associated with higher rates of morbidity and mortality and an increase in healthcare costs. Hispanics’ challenges after migration extend to subsequent generations, putting the population at risk for disease development. Specifically, migration can lead to the adoption of health behaviors, beliefs, values, and language of the host country, a process known as acculturation, which has been associated with changes in health behaviors. Among the Hispanic population, some health behaviors correlate with improvements in physical health; however, the adoption of unhealthy behaviors has been associated with an increase in chronic diseases. In some communities, factors such as an obesogenic environment, stress exposure, low socioeconomic status, cultural barriers, and physical activity can exacerbate obesity development among immigrants recently exposed (or acculturated) to this new environment. Exposure to a new environment appears to increase allostatic load (ALoad), which is a measure of biological “wear and tear” on the body from cumulative exposure to environmental, interpersonal, and societal stressors. However, the link between ALoad scores and measures of acculturation on the prevalence of obesity in Hispanics is not well understood. Therefore, to expand our understanding of acculturation, stress, and obesity, the focus of this dissertation was to evaluate the ALoad as a risk factor for obesity among Hispanics while 1) examining ALoad differences by place of birth, 2) exploring the relationship of ALoad and obesity among adults, and 3) investigating ALoad differences by race/ethnicity and its relationship to obesity in children. We observed that U.S.-born Hispanics showed higher ALoad compared to foreign-born Hispanics, and that length of residence in the U.S. and age upon arrival were associated with higher ALoad scores. When we measured the influence of ALoad on obesity, we found that higher ALoad scores increased the risk for obesity among Hispanic adults and children. In conclusion, ALoad may serve as a predictor of obesity, but future investigation to determine directional cause and effect between these relationships is required.

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