UMass Worcester PRC Publications


Changes in Glycemic Load Are Positively Associated with Small Changes in Primary Stress Markers of Allostatic Load in Puerto Rican Women

UMMS Affiliation

Department of Population and Quantitative Health Sciences, Division of Preventive and Behavioral Medicine; Department of Medicine, Division of Cardiovascular Medicine; Department of Population and Quantitative Health Sciences, Division of Biostatistics and Health Services Research; UMass Worcester Prevention Research Center

Publication Date


Document Type



Community Health | Community Health and Preventive Medicine | Dietetics and Clinical Nutrition | Endocrinology, Diabetes, and Metabolism | Nutritional Epidemiology | Preventive Medicine | Psychiatry and Psychology


BACKGROUND: Puerto Ricans experience a high prevalence of type 2 diabetes. Dietary glycemic load (GL) and allostatic load (AL) have been linked with diabetes. AL, the wear and tear on the body from chronic stress, starts with secretion of primary stress markers from activation of the hypothalamic-pituitary-adrenal (HPA) axis, sympathetic nervous system (SNS), and immune system. GL can act as a physiological stressor, contributing to the primary AL response.

OBJECTIVE: We examined the relation between GL and a composite score of primary stress markers of AL in Puerto Rican adults.

METHODS: Data were from the Boston Puerto Rican Health Study, a cohort study of Puerto Ricans, aged 45-75 y, including 262 men and 697 women with complete data at baseline and 2-y follow-up. GL was calculated from dietary intake obtained with an FFQ. Sex-specific composite primary AL scores included markers of the HPA axis (cortisol and dehydroepiandrosterone sulfate), SNS (epinephrine and norepinephrine), and immune system (C-reactive protein). Linear regression models were stratified by sex and adjusted for covariates.

RESULTS: Mean +/- SD baseline GL score was 155 +/- 28 for men and 135 +/- 34 for women. Mean primary stress AL score was 1.25 +/- 1.14 for men and 1.25 +/- 1.06 for women. GL was not associated with AL score in men. In women, increasing GL from baseline to 2 y was significantly associated with increasing AL, after adjusting for sociodemographics, physical activity, smoking, BMI, menopause, and baseline AL score (beta = 0.03; P = 0.049). Results became marginally significant after further adjustment for chronic diseases (P = 0.06) and intake of fats (P values: saturated fats = 0.08; trans fats = 0.06; unsaturated fats = 0.07), but the magnitude of the association remained unchanged.

CONCLUSIONS: Increasing GL over 2 y was positively associated with increasing composite score of primary markers of AL in Puerto Rican women. More studies are needed to confirm our findings.


allostatic load, diabetes, glycemic load, Puerto Rican, women

DOI of Published Version



J Nutr. 2019 Oct 26. pii: 5607413. doi: 10.1093/jn/nxz260. Link to article on publisher's site

Journal/Book/Conference Title

The Journal of nutrition

Related Resources

Link to Article in PubMed

PubMed ID