All ETDs from UAB

Advisory Committee Chair

Douglas R Moellering

Advisory Committee Members

Elizabeth R Baker

Brenda Bertrand

Yenni E Cedillo

Andrew D Fruge

Suzanne E Judd

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Health Professions


Concerning trends for obesity, diabetes, heart attacks, and obesity-related cancers, or cardiometabolic disease (CMD), are developing within the emerging and young adult/adulthood (EYA) population. Evidence supports the concept that chronic stress leads to physiologic dysregulation, reduced mental health, chronic diseases, and reduced longevity; however, these are not inevitable outcomes, and resilience or vulnerability is determined by interacting environmental and biobehavioral factors. Although CMD manifests clinically in older adulthood, disease pathophysiology begins earlier, and thus, EYA is a critical time for observation and intervention. Growing evidence indicates inflammation is a major risk factor in CMD development and may be exacerbated by psychosocial stress and dietary patterns characterized by an imbalanced intake of pro- and anti-inflammatory food components. Emerging young adults in the 21st century live in an environment undergoing substantial socioeconomic, technological, political, and cultural transformations, which have diversified and exacerbated the experience of daily psychosocial stress. A prominent psychosocial stressor in the U.S. today is discrimination based on one’s race, age, sex, iv national origin, or way of speaking. Identifying associations between discrimination and physiological markers is vital to understanding discrimination’s potential role in CMD risk among EYA women of Birmingham, AL. Additionally, new indices that link diet with physiologic risk, namely inflammation, are emerging. Observing the influence of inflammatory properties of the diet with cardiometabolic health markers in EYA will provide a further understanding of dietary mechanisms for intervention and disease prevention. Last, the gut microbiome has been hypothesized as a new pathway in which social and biobehavioral factors interact to affect health. The gut microbiome is posited to be crucial to maintaining physiological homeostasis and has been associated with various diseases and risk factors. In EYA, CMD risk may involve the interactions of psychosocial stress and inflammatory properties of the diet with the gut microbiome. The overall objective of this dissertation is to investigate the influence of psychosocial stressors and inflammatory properties of the diet with cardiometabolic risk and parameters of the gut microbiota in a cross-sectional study cohort (N=62) of metabolically healthy African American and European American women ages 19-45. We hypothesize that measures of psychosocial stress and inflammatory properties of the diet will be associated with increased cardiometabolic risk, increased abundance of pathogenic gut microbiota, and decreased gut microbiota diversity. We also hypothesize that inflammatory properties of the diet will mediate the associations found between psychosocial stress, pathogenic gut microbiota genera, and gut microbiota diversity.