Dual burden of infectious and chronic disease in low-resource U.S. communities: examining relationships between infection, adiposity, and inflammation.

BACKGROUND: Rising global obesity rates are linked with inflammation and associated morbidities. These negative outcomes are generally more common in low-resource communities within high-income countries; however, it is unclear how frequent infectious disease exposures in these settings may influence the relationship between adiposity and inflammation. AIM: We test associations between adiposity measures and distinct forms of inflammation among adults (n = 80) living in low-resource U.S. communities experiencing high levels of obesity and pathogen exposure. SUBJECTS AND METHODS: Adiposity measures included BMI and percent body fat. Inflammation measures included systemic inflammation (C-reactive protein [CRP]) and localised intestinal inflammation (faecal calprotectin [FC]). The relationship between a condition characterised by elevated inflammation (Helicobacter pylori infection) and adiposity was also considered. RESULTS: Adiposity was not significantly related to FC concentration. However, both adiposity measures were positively related with odds of CRP elevation and H. pylori infection was associated with significantly lower adiposity measures (all p < 0.05). CONCLUSION: For this disadvantaged U.S. sample, the association between adiposity and inflammation varies by the systemic/localised nature of inflammation and the likely underlying cause of inflammation. Defining these associations will improve understanding of how rising obesity rates shape long-term health inequities, with implications for more effective intervention design.

Toddler hair cortisol levels are associated with maternal prenatal depression.

OBJECTIVES: Cortisol is an important metabolic hormone that regulates multiple physiologic systems. Cortisol metabolism is sensitive to early life environments, including that experienced prenatally. Limited research has evaluated factors that predict variation in maternal and offspring toddler hair cortisol, which is important since hair cortisol represents different dynamics of hypothalamic pituitary adrenal (HPA)-axis function than more common salivary or serum measures. METHODS: To address this gap, we longitudinally evaluated whether maternal depression measured in pregnancy and 1 month postnatal was associated with maternal and offspring hair cortisol levels approximately 15 months after birth (n = 46 mothers, 40 toddlers; mean 15.6 months postnatal, SD = 2.9 months). RESULTS: Mean depression symptoms were highest during the prenatal period. Prenatal, but not postnatal, maternal depression was associated with offspring hair cortisol levels (B = 0.095, p = .01). Maternal hair cortisol was not associated with depression measured at either time point. CONCLUSIONS: These findings indicate that offspring hair cortisol more than a year after birth is associated with maternal prenatal depression, consistent with previous research in salivary cortisol, suggesting that long-term offspring stress physiology may be influenced by conditions experienced in utero. These findings highlight the potential for hair cortisol-a minimally invasive and easy-to-collect measure- to index toddler HPA-axis dynamics.