Abstract P234: Social Coherence and Religious/Spiritual Coping Skills Modify Associations Between Weight-Related Discrimination and Risk of Multi-System Physiological Dysregulation Among US Adults

Abstract

Background: Weight discrimination is associated with higher multi-system physiological dysregulation, referred to as allostatic load (AL), which increases cardiovascular risk. While reducing weight discrimination is critical for reducing its negative consequences, it is unclear whether individual-level factors can attenuate associations between weight discrimination and AL. This study examined whether religious and spiritual coping practices as well as beliefs about societal complexity modified the effect of weight discrimination on AL among adults aged 25-75y over 10-years. Hypothesis: Individual-level factors may attenuate associations between weight discrimination and AL. Methods: Participants from the national Midlife Development in the US (MIDUS) Biomarker Substudy with self-reported information on weight discrimination, individual-level factors, and perceptions about social coherence were analyzed (n=953). Social coherence (i.e. degree to which the world makes sense) and religious/spiritual coping (i.e. seeking religious/spiritual support for comfort and guidance) were assessed via 4 self-reported Likert items at baseline, with higher scores indicative of higher coherence and coping. Self-reported perceived discrimination across 9 scenarios at baseline and 10-years follow-up were summed and averaged to compute long-term discrimination. The proportion of 24 dysregulated biomarkers within 7 systems was summed to compute AL (range 0-7). Interactions between social coherence and religious/spiritual coping were tested using a threshold of p<0.05. Median splits for social coherence, religious/spiritual coping, and weight discrimination were computed and AL ≥3 was deemed high. Estimated relative risks (RR) were obtained from multivariable models adjusted for age, household income, sex and baseline BMI. Results: Obesity was present in 41% of the sample, 8% reported weight discrimination, and 19% had high AL. Both social coherence (p=0.048) and religious/spiritual coping (p=0.03) modified associations between weight discrimination and AL. In stratified analyses, participants with high social coherence experienced triple the risk of high AL (RR:3.11; 95% CI: 1.82,5.30) while weight discrimination was not associated with AL among individuals with low social coherence (RR:1.35, 95% CI: 0.71,2.61). Conversely, high religious/spiritual coping attenuated associations between weight discrimination and AL (RR: 0.98, 95% CI: 0.27,3.55), while low religious/spiritual coping was associated with AL (RR: 2.46, 95%CI: 1.61, 3.77). Conclusions: Some individual-level factors may modify associations between weight discrimination and high AL. Mindfulness and tools that adjust internalization of societal messages about weight status have the potential to produce beneficial metabolic effects that could improve cardiovascular outcomes.