Supplement for Kentucky BIRCWH Program: Training the Next Generation of Women's Health Scholars: Postdoctoral Scholar Dr. Kang

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In the patient-family caregiver dyad, the focus is necessarily on the patient’s health yet this patient-centered focus discounts the physical and mental health caregiver. Relative to men, women are disproportionately represented in informal caregivers’ roles and handle the most difficult and stressful caregiving tasks. Women caregivers are at increased risk of developing of cardiovascular disease (CVD) due to the stress of patient care and limited time for self-care such as diet, exercise, and stress management. Depression is a major risk factor for CVD; caregiver responsibilities can increase stress and risk of depression or anxiety. Because caregivers often share the same environment as their patient, caregivers with chronic illness have substantially higher risk for developing depression than non-caregivers. Here we hypothesize that persistent psychological stress in caregivers can result in a monotonous diet and decreased diet quality and thereby increase CVD risk or progression. Data from a completed, prospective, randomized controlled trial of both female and male caregivers (n=300) will be used to test the following hypotheses during the BIRCWH Post-Doctoral training. To date, no investigation of the association between depressive symptoms and diet quality, including dysbiosis, on risk of CVD or its progression in female or male caregivers. To address this gap, we pose the following: Aim 1. Determine associations between caregiving stress, depressive symptoms, diet quality dysbiosis, and CVD risk factors among caregivers and explore genders differences (e.g. male and female). Aim 2. Explore whether and how diet quality, dysbiosis and depressive symptoms serially mediate the association between caregiving stress and CVD risk factors among female caregivers. We will test the hypothesis that caregiving stress would result in poor diet quality, dysbiosis, which in turn increases levels of depressive symptoms which could in turn increase CVD risk, measured by lipid panel. Impact: Expected outcomes of the proposed studies include delineation of novel mechanisms by which caregiver stress may change diet quality and lead to changes in microbiota, to increase in depressive symptoms, and ultimately increased CVD risk or progression. This study has high translational impact with potential interventional advances in reducing risk of CVD for male and female caregivers. This mediational research may inform future development of dietary interventions and improvement of microbiota compositions in female caregivers by identifying the mechanisms of actions needed for effective intervention development. Training: This Administrative Supplement will provide training for Dr. Kang through the existing UK BIRCWH career development and mentorship program.
Effective start/end date8/1/227/31/27


  • National Institute on Drug Abuse


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