A major objective of this project is to characterize a population-based bi-racial cohort to further elucidate psychosocial and cultural differences influencing behavioral risk factors and metabolic and physiologic abnormalities associated with obesity and the metabolic syndrome (MetS). While compelling evidence indicates that genetic and other biological factors predispose to obesity, hypertension and insulin-resistance/diabetes, these common disorders likely reflect a complex interplay between biological factors and the psychosocial and cultural environment. It is postulated that ethnic differences in this environmental context and/or the influence of the environment on lifestyle options/choices plays a significant role in ethnic disparities in obesity and the MetS. Indeed, a large body of evidence indicates that perceived psychosocial stress stimulates the release of corticosteroids and other neurohumoral factors that may predispose to abdominal obesity, insulin-resistance and increased blood pressure. Accordingly, we hypothesize that ethnic differences in perceived stress contribute to the observed disparities in obesity and obesity-related CVD risk factors. Moreover we postulate that the unique experience of racial discrimination by African-Americans (AA) predisposes to ethnic differences in the susceptibility to obesity and its associated constellation of metabolic abnormalities. The large biracial cohort to be established by the proposed project will provide a unique opportunity to examine the association between psychosocial factors, cultural context, obesity and the MetS. We propose a novel multi-disciplinary approach to examine ethnic disparities in CVD risk that will combine the study of novel biomarkers of CVD risk in conjunction with analysis of the social-psychological-spiritual context as determinants of the metabolic syndrome phenotype. The proposed project will establish a unique population-based bi-racial cohort to pursue the following specific aims:
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