Race and sex differences in HDL peroxide content among American adults with and without type 2 diabetes.

BACKGROUND: High-density lipoprotein (HDL) plays a critical role in protection against atherosclerosic and cardiovascular disease (ASCVD). In addition to contributing to clearing excess vascular cholesterol, HDL particles exhibit antioxidative functions, helping to attenuate adverse effects of oxidized low-density lipoproteins. However, these beneficial properties can be undermined by oxidative stress, inflammation, and unhealthy lifestyles and diet, as well as influenced by race and sex. Thus, when assessing cardiovascular risk, it is important to consider multifactorial aspects of HDL, including antioxidant activity rather than just total amount and type of HDL-cholesterol (HDL-C) particles. Because prior research showed HDL peroxide content (HDLperox) can be inversely associated with normal anti-oxidant HDL activity, elevated HDLperox may serve as a bioindicator of HDL dysfunction. METHODS: In this study, data from a large national cohort of Americans was utilized to determine the impact of sex, race, and diabetes status on HDLperox in middle-aged and older adults. A previously developed cell-free fluorometric method was utilized to quantify HDLperox in serum depleted of apo-B containing lipoproteins. RESULTS: In keeping with predictions, white men and diabetics exhibited HDLperox in the atypical upper range, suggestive of less functional HDL. White men had higher HDLperox levels than African American males (13.46 ± 6.10 vs. 10.88 ± 5.81, p < .001). There was also a significant main effect of type 2 diabetes (F(1,1901) = 14.9, p < .0001). Overall, African Americans evinced lower HDLperox levels, despite more obesity (10.3 ± 4.7 vs.11.81 ± 5.66 for Whites) suggesting that other aspects of lipid metabolism and psychosocial factors account for the higher prevalence of ASCVD in African Americans. CONCLUSION: This research helps to provide a more comprehensive understanding of HDL function in a racially and metabolically diverse adult population. HDLperox content was significantly different in adults with type 2 diabetes, and distinctive in nondiabetic White males, and suggests other processes account for the higher prevalence of ASCVD among African Americans.

Association between serum sphingolipids and eudaimonic well-being in white U.S. adults.

Emerging research has linked psychological well-being with many physiological markers as well as morbidity and mortality. In this analysis, the relationship between components of eudaimonic well-being and serum sphingolipids levels was investigated using data from a large national survey of middle-aged American adults (Midlife in the United States). Health behaviors (i.e., diet, exercise, and sleep) were also examined as potential mediators of these relationships. Serum levels of total ceramides-the main molecular class of sphingolipids previously associated with several disease conditions-were inversely linked with environmental mastery. In addition, significant correlations were found between specific ceramide, dihydroceramide, and hexosylceramides species with environmental mastery, purpose in life, and self-acceptance. Using hierarchical regression and mediation analyses, health behaviors appeared to mediate these associations. However, the link between ceramides and environmental mastery was partially independent of health behaviors, suggesting the role of additional mediating factors. These findings point to sphingolipid metabolism as a novel pathway of health benefits associated with psychological well-being. In particular, having a sense of environmental mastery may promote restorative behaviors and benefit health via improved blood sphingolipid profiles.

Cultural and life style practices associated with low inflammatory physiology in Japanese adults.

Japan is an exceptionally healthy East Asian country with extended longevity. In addition, the typical levels of several proinflammatory proteins, including both C-reactive protein (CRP) and interleukin-6 (IL-6), are often reported to be low when compared to American and European populations. This analysis determined if blood levels of CRP and IL-6 were associated with 4 cultural practices reflective of Japanese behavior and customs -- drinking tea, eating seafood, consuming vegetables, and partaking in relaxing baths regularly - among 382 adults living in Tokyo. Regression models controlled for demographic factors, adiposity (BMI), physical exercise, smoking, alcohol use, and chronic illness (e.g., diabetes). Consuming a Japanese diet was associated with significantly lower CRP and IL-6 levels. More frequent bathing was associated with lower IL-6, but not specifically predictive of low CRP. This study has confirmed prior evidence for low inflammatory activity in Japanese adults and its association with several behavioral practices common in Japan.

Age-Related Trends in the Prevalence of Type 2 Diabetes among Japanese and White and Black American Adults.

Aim: To compare the prevalence of poor glycemic control in probability samples of Japanese and American adults, and to determine the association with their somatic phenotypes. Material and Methods: Blood samples and anthropometric measures were obtained from 382 Japanese, 32-79 years of age, randomly selected to reflect the 23 wards of Tokyo. HA1c values were compared to 1215 Americans, 35-86 years of age, from a national study across the 48 continental states, along with an over-sampling of African-Americans from one city (www.midus.wisc.edu). Body Mass Index (BMI) and Waist-hip ratio (WHR) were also assessed. Results: Many Japanese now have high HA1c approaching Caucasian-American levels, although elevated HA1c (>6.5%, 48 mmol/mol) is not nearly as prevalent as among African-Americans. Significant age-related trends were evident in both countries, with poor glycemic control occurring at younger ages in males and rarely found until old age in Japanese women. Japanese had higher HA1c levels at BMIs of 23-25, in contrast to Americans with Type 2 diabetes who more typically had a BMI over 30. Central adiposity predicted HA1c levels better than BMI, a relationship also apparent at a smaller WHR in Japan. Conclusion: The prevalence of high HA1c in Tokyo almost rivals white Americans, but those statistics are dwarfed by the 37% of Afr-Amer adults identified with Type 2 diabetes. Elevated HA1c was more common in men, reflecting central adiposity, but poor glycemic control was also widespread among overweight Afr-Amer women. Type 2 diabetes was higher among older Japanese, when more women succumb. Overall, the findings highlight the societal and clinical challenges posed by demographic trends in both countries.

Scientific imperatives vis-à-vis growing inequality in America.

A landmark article published in the American Psychologist (Adler et al., 1994) encouraged psychologists to engage in research on socioeconomic inequality and health. Numerous contributions followed to fill in psychosocial and behavioral pathways. Specifically, we review advances on health inequalities research from a large public-use study (Midlife in the United States [MIDUS]). The Great Recession of 2007 to 2009 and its lingering effects are then reviewed to underscore widening inequality in access to education, employment, and income. Two MIDUS national samples of same-aged adults recruited 2 decades apart are then compared to assess historical changes in socioeconomic, physical health, and well-being profiles from the 1990s to postrecession. Despite historical gains in educational attainment over time, we show that indicators of socioeconomic status, health, and well-being are more compromised in the postrecession sample relative to the 1990s sample. Building on these preliminary findings, we elaborate opportunities for further inquiry by the scientific community to examine whether widening socioeconomic inequalities exacerbated by the Great Recession translate to widening health inequalities. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Culture and social hierarchy: Self- and other-oriented correlates of socioeconomic status across cultures.

Current theorizing on socioeconomic status (SES) focuses on the availability of resources and the freedom they afford as a key determinant of the association between high SES and stronger orientation toward the self and, by implication, weaker orientation toward others. However, this work relies nearly exclusively on data from Western countries where self-orientation is strongly sanctioned. In the present work, we predicted and found that especially in East Asian countries, where other-orientation is strongly sanctioned, high SES is associated with stronger other-orientation as well as with self-orientation. We first examined both psychological attributes (Study 1, N = 2,832) and socialization values (Study 2a, N = 4,675) in Japan and the United States. In line with the existent evidence, SES was associated with greater self-oriented psychological attributes and socialization values in both the U.S. and Japan. Importantly, however, higher SES was associated with greater other orientation in Japan, whereas this association was weaker or even reversed in the United States. Study 2b (N = 85,296) indicated that the positive association between SES and self-orientation is found, overall, across 60 nations. Further, Study 2b showed that the positive association between SES and other-orientation in Japan can be generalized to other Confucian cultures, whereas the negative association between SES and other-orientation in the U.S. can be generalized to other Frontier cultures. Implications of the current findings for modernization and globalization are discussed. (PsycINFO Database Record

Behavioral Adjustment Moderates the Link Between Neuroticism and Biological Health Risk: A U.S.-Japan Comparison Study.

Neuroticism, a broad personality trait linked to negative emotions, is consistently linked to ill health when self-report is used to assess health. However, when health risk is assessed with biomarkers, the evidence is inconsistent. Here, we tested the hypothesis that the association between neuroticism and biological health risk is moderated by behavioral adjustment, a propensity to flexibly adjust behaviors to environmental contingencies. Using a U.S.-Japan cross-cultural survey, we found that neuroticism was linked to lower biological health risk for those who are high, but not low, in behavioral adjustment. Importantly, Japanese were higher in behavioral adjustment than European Americans, and as predicted by this cultural difference, neuroticism was linked to lower biological health risk for Japanese but not for European Americans. Finally, consistent with prior evidence, neuroticism was associated with worse self-reported health regardless of behavioral adjustment or culture. Discussion focused on the significance of identifying sociocultural correlates of biological health.

Culture and Healthy Eating: The Role of Independence and Interdependence in the United States and Japan.

Healthy eating is important for physical health. Using large probability samples of middle-aged adults in the United States and Japan, we show that fitting with the culturally normative way of being predicts healthy eating. In the United States, a culture that prioritizes and emphasizes independence, being independent predicts eating a healthy diet (an index of fish, protein, fruit, vegetables, reverse-coded sugared beverages, and reverse-coded high fat meat consumption; Study 1) and not using nonmeat food as a way to cope with stress (Study 2a). In Japan, a culture that prioritizes and emphasizes interdependence, being interdependent predicts eating a healthy diet (Studies 1 and 2b). Furthermore, reflecting the types of agency that are prevalent in each context, these relationships are mediated by autonomy in the United States and positive relations with others in Japan. These findings highlight the importance of understanding cultural differences in shaping healthy behavior and have implications for designing health-promoting interventions.

Culture, inequality, and health: evidence from the MIDUS and MIDJA comparison.

This article seeks to forge scientific connections between three overarching themes (culture, inequality, health). Although the influence of cultural context on human experience has gained notable research prominence, it has rarely embraced another large arena of science focused on the influence social hierarchies have on how well and how long people live. That literature is increasingly focused psychosocial factors, working interactively with biological and brain-based mechanisms, to account for why those with low socioeconomic standing have poorer health. Our central question is whether and how these processes might vary by cultural context. We draw on emerging findings from two parallel studies, Midlife in the U.S. and Midlife in Japan, to illustrate the cultural specificity evident in how psychosocial and neurobiological factors are linked with each other as well as how position in social hierarchies matters for psychological experience and biology. We conclude with suggestions for future multidisciplinary research seeking to understand how social hierarchies matter for people's health, albeit in ways that may possibly differ across cultural contexts.

Expression of anger and ill health in two cultures: an examination of inflammation and cardiovascular risk.

Expression of anger is associated with biological health risk (BHR) in Western cultures. However, recent evidence documenting culturally divergent functions of the expression of anger suggests that its link with BHR may be moderated by culture. To test this prediction, we examined large probability samples of both Japanese and Americans using multiple measures of BHR, including pro-inflammatory markers (interleukin-6 and C-reactive protein) and indices of cardiovascular malfunction (systolic blood pressure and ratio of total to HDL cholesterol). We found that the link between greater expression of anger and increased BHR was robust for Americans. As predicted, however, this association was diametrically reversed for Japanese, among whom greater expression of anger predicted reduced BHR. These patterns were unique to the expressive facet of anger and remained after we controlled for age, gender, health status, health behaviors, social status, and reported experience of negative emotions. Implications for sociocultural modulation of bio-physiological responses are discussed.

Subjective and Objective Hierarchies and Their Relations to Psychological Well-Being: A U.S/Japan Comparison.

Hierarchy can be conceptualized as objective social status (e.g., education level) or subjective social status (i.e., one's own judgment of one's status). Both forms predict well-being. This is the first investigation of the relative strength of these hierarchy-well-being relationships in the U.S. and Japan, cultural contexts with different normative ideas about how social status is understood and conferred. In probability samples of Japanese (N=1027) and U.S. (N=1805) adults, subjective social status more strongly predicted life satisfaction, positive affect, sense of purpose, and self acceptance in the U.S. than in Japan. In contrast, objective social status more strongly predicted life satisfaction, positive relations with others, and self acceptance in Japan than in the U.S. These differences reflect divergent cultural models of self. The emphasis on independence characteristic of the U.S. affords credence to one's own judgment (subjective status) and the interdependence characteristic of Japan to what others can observe (objective status).

The Overlap of Dietary Supplement and Pharmaceutical Use in the MIDUS National Study.

Introduction. In the United States, dietary supplement (DS) use is common, often takes place outside of the purview of health care providers, and may involve DS in combination with pharmaceuticals. This situation has led to concerns about interactions between DS and pharmaceuticals, as well as the risks from polypharmacy and polysupplement use. Methods. We used data from the Midlife in the US study (MIDUS 2 Survey) to examine DS and prescription pharmaceutical use in 3876 study participants in order to determine the demographics of high-users (5 or more) of DS and pharmaceuticals and the presence of DS-pharmaceutical co-use. Results. Over 69% of study participants regularly used DS, 49.6% regularly used both DS and pharmaceuticals, and 6.3% and 8.7% were high-users of pharmaceuticals and DS, respectively. High-users of DS, pharmaceuticals, and either were more likely than the whole cohort to be female and of lower income. Conclusions. These findings corroborate those of other national studies with respect to the demographics of DS users but add new information about people at risk of DS-pharmaceutical interactions, not an insignificant proportion of the population examined by this dataset.

Social status and anger expression: the cultural moderation hypothesis.

Individuals with lower social status have been reported to express more anger, but this evidence comes mostly from Western cultures. Here, we used representative samples of American and Japanese adults and tested the hypothesis that the association between social status and anger expression depends on whether anger serves primarily to vent frustration, as in the United States, or to display authority, as in Japan. Consistent with the assumption that lower social standing is associated with greater frustration stemming from life adversities and blocked goals, Americans with lower social status expressed more anger, with the relationship mediated by the extent of frustration. In contrast, consistent with the assumption that higher social standing affords a privilege to display anger, Japanese with higher social status expressed more anger, with the relationship mediated by decision-making authority. As expected, anger expression was predicted by subjective social status among Americans and by objective social status among Japanese. Implications for the dynamic construction of anger and anger expression are discussed.

Negative emotions predict elevated interleukin-6 in the United States but not in Japan.

Previous studies conducted in Western cultures have shown that negative emotions predict higher levels of pro-inflammatory biomarkers, specifically interleukin-6 (IL-6). This link between negative emotions and IL-6 may be specific to Western cultures where negative emotions are perceived to be problematic and thus may not extend to Eastern cultures where negative emotions are seen as acceptable and normal. Using samples of 1044 American and 382 Japanese middle-aged and older adults, we investigated whether the relationship between negative emotions and IL-6 varies by cultural context. Negative emotions predicted higher IL-6 among American adults, whereas no association was evident among Japanese adults. Furthermore, the interaction between culture and negative emotions remained even after controlling for demographic variables, psychological factors (positive emotions, neuroticism, extraversion), health behaviors (smoking status, alcohol consumption), and health status (chronic conditions, BMI). These findings highlight the role of cultural context in shaping how negative emotions affect inflammatory physiology and underscore the importance of cultural ideas and practices relevant to negative emotions for understanding of the interplay between psychology, physiology, and health.

Race differences in age-trends of autonomic nervous system functioning.

OBJECTIVE: The objective of this study was to consider race differences in age-trends of autonomic nervous system functioning, using a national data set with a broad age range. METHODS: Measures of baseline heart rate variability (HRV) and HRV reactivity were derived from electrocardiograph (ECG) recordings taken at rest and during cognitive stress tasks. Age-trends in HRV and HRV reactivity were compared among 204 African Americans and 833 Whites ages 34 to 83 years (M = 53.7, SD = 11.4), before and after controlling for socioeconomic status (SES). RESULTS: For HRV-reactivity, age-trends were steeper among African Americans and lower SES participants than Whites and higher SES participants. For baseline HRV, age-trends varied by SES but not race. DISCUSSION: Results relating to HRV-reactivity (but not baseline HRV) were consistent with hypotheses suggesting that African Americans are exposed to higher levels of stress and experience accelerated declines in health across the life span. The relevance of the findings to research on social stress and health disparities is discussed.

Clarifying the links between social support and health: culture, stress, and neuroticism matter.

Although it is commonly assumed that social support positively predicts health, the empirical evidence has been inconsistent. We argue that three moderating factors must be considered: (1) support-approving norms (cultural context); (2) support-requiring situations (stressful events); and (3) support-accepting personal style (low neuroticism). Our large-scale cross-cultural survey of Japanese and US adults found significant associations between perceived support and health. The association was more strongly evident among Japanese (from a support-approving cultural context) who reported high life stress (in a support-requiring situation). Moreover, the link between support and health was especially pronounced if these Japanese were low in neuroticism.

Population differences in proinflammatory biology: Japanese have healthier profiles than Americans.

The pleiotropic cytokine, interleukin-6 (IL-6), has emerged as a key factor in the biology of aging and the physiology of inflammation. Yet much of what we know about the normal functioning of IL-6 has been generated primarily from research on European populations and Americans of European descent. Our analyses compared IL-6 levels in 382 middle-aged and older Japanese to the values found in 1209 Caucasian- and African-Americans from the Midlife in the United States survey (MIDUS). Across the life span from 30 to 80 years of age, mean IL-6 levels were strikingly lower in Japanese individuals. Significantly lower levels of C-reactive protein (CRP) and fibrinogen (FBG) provided confirmatory evidence for a population difference in proinflammatory activity. Because IL-6 release has been associated with obesity, differences in body mass index (BMI) were taken into consideration. Japanese had the lowest, and African-Americans had the highest overall BMIs, but significant group differences in IL-6 persisted even after BMI was included as a covariate in the analyses. Additional support for distinct variation in IL-6 biology was generated when systemic levels of the soluble receptor for IL-6 (sIL-6r) were evaluated. Serum sIL-6r was higher in Japanese than Americans, but was most notably low in African-Americans. Our cytokine data concur with national differences in the prevalence of age-related illnesses linked to inflammatory physiology, including cardiovascular disease. The findings also highlight the importance of broadening the diversity of people included in population studies of health and aging, especially given the relative paucity of information for some Asian countries and on individuals of Asian heritage living in the US.

Psychosocial predictors of changing sleep patterns in aging women: a multiple pathway approach.

The authors of this investigation sought to examine changes in the sleep quality of older women over time and to determine whether dimensions of psychological well-being, health (subjective health and number of illnesses), and psychological distress (depression and anxiety) predict these changes. A secondary analysis was conducted with a longitudinal sample of aging women (Kwan, Love, Ryff, & Essex, 2003). Of 518 community-dwelling older women in the parent study, 115 women (baseline M age = 67 years, SD = 7.18) with data at baseline, 8 years, and 10 years were used for this investigation. Participants completed self-administered questionnaires and participated in in-home interviews and observations. Growth curve modeling was used to examine the overall linear trajectories of sleep quality. Growth mixture modeling was used to examine whether there were different patterns of change in sleep quality over time and to examine baseline predictors of each pattern. Sleep quality declined over time but not for all women. Two distinctly different sleep patterns emerged: good but declining sleep quality and disrupted sleep quality. Higher psychological well-being (positive relations with others, environmental mastery, personal growth, purpose in life, and self-acceptance), fewer illnesses, and lower depression scores at baseline predicted reduced odds for membership in the disrupted sleep group. Future research is needed to examine whether interventions focused on maintaining or enhancing psychological well-being could minimize later life declines in sleep quality.

Socioeconomic status predicts objective and subjective sleep quality in aging women.

OBJECTIVE: To test the hypothesis that socioeconomic status (SES) would be associated with sleep quality measured objectively, even after controlling for related covariates (health status, psychosocial characteristics). Epidemiological studies linking SES and sleep quality have traditionally relied on self-reported assessments of sleep. METHODS: Ninety-four women, 61 to 90 years of age, participated in this study. SES was determined by pretax household income and years of education. Objective and subjective assessments of sleep quality were obtained using the NightCap sleep system and the Pittsburgh Sleep Quality Index (PSQI), respectively. Health status was determined by subjective health ratings and objective measures of recent and chronic illnesses. Depressive symptoms and neuroticism were quantified using the Center for Epidemiological Studies Depression Scale and the Neuroticism subscale of the NEO Personality Inventory, respectively. RESULTS: Household income significantly predicted sleep latency and sleep efficiency even after adjusting for demographic factors, health status, and psychosocial characteristics. Income also predicted PSQI scores, although this association was significantly attenuated by inclusion of neuroticism in multivariate analyses. Education predicted both sleep latency and sleep efficiency, but the latter association was partially reduced after health status and psychosocial measures were included in analyses. Education predicted PSQI sleep efficiency component scores, but not global scores. CONCLUSIONS: These results suggest that SES is robustly linked to both subjective and objective sleep quality, and that health status and psychosocial characteristics partially explain these associations.