The role of stress responses on engagement in dietary and physical activity behaviors among Latino adults living with prediabetes

ABSTRACT

Objectives

Latinos are at a high risk of developing type 2 diabetes (T2D). Prediabetes is a major risk factor for T2D; however, progression to T2D can be slowed with engagement in healthy behaviors. Stress can hinder engagement with health behaviors. Qualitative methods were used to understand how Latinos with prediabetes attempted to modify their diet and physical activity behaviors to slow T2D progression and how stress affected their engagement in these behaviors.

Design

Semi-structured interviews were conducted with 20 Latinos with prediabetes in North Carolina. Participants were asked questions about types of stress they experienced and how stress affected their health. We generated codes on stress and stress responses and used content analysis to organize codes between and within participants.

Results

Behaviors changed after prediabetes diagnosis. Few participants reported changing their physical activity, however, all participants attempted to change their eating patterns by changing food types consumed and reducing portion sizes. The stress participants experienced impacted their ability to self-regulate their diet. They reported overeating or appetite suppression during stressful periods. Stress also affected cognitive responses by compromising healthy decision-making and instigating negative emotional reactions. Overall, stress complicated participants’ ability to properly engage in recommended behaviors by negatively impacting participants’ behavioral self-regulation and cognitive processes.

Conclusions

Stress affects behavioral and cognitive progresses that adversely alters primarily dietary behaviors. Tailored plans acknowledging the impact of stress and providing coping and supportive help for dealing with stress may enhance engagement in healthy behaviors for Latinos with prediabetes.

KEYWORDS:

• Stress response
• prediabetes
• Latino
• Hispanic
• qualitative analysis
• discrimination

Acknowledgements

We would like to thank Ms Claudia Rojas, Dr Daniel Reuland, and Dr Marco Alemán for their assistance in this project. We also could not have completed this project without the participants who offered their time and knowledge on living with prediabetes.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Clinical and Translation Science Award (CTSA) [grant number UL1TR002489]; a National Service Research Award Traineeship from the Agency for Healthcare Research and Quality sponsored by the Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill [grant number 5T32 HS000032]; the UNC Institute of the Study of the Americans Mellon Dissertation Fellowship in Latin American/Caribbean Research; and the National Institute of Diabetes and Digestive and Kidney Diseases (K01DK107791).