Gender-Specific Interactions Between Adiposity, Alcohol Consumption, and Biological Stress Biomarkers Among College Students in the United States

Background: Obesity is a well-documented risk factor for cardiometabolic diseases associated with insulin resistance. However, research on its relationship with alcohol intake and stress markers, such as cortisol and α-amylase, remains limited, particularly among young adults in the general population. Objective: This study investigated the relationship between adiposity measures, alcohol intake, and biological stress biomarkers among college students. Methods: Participants (n = 189) completed the NIH Diet History Questionnaire II. Body composition was measured via bioelectrical impedance analysis. Salivary α-amylase (sAA) activity and cortisol (sCort) were assessed using the Salimetrics α-amylase kinetic enzyme assay and enzyme immunoassay kits, respectively. Multivariable linear regression models were used to determine the association between alcohol consumption and adiposity on biological stress biomarkers. Results: Among students who were overweight and obese, higher alcohol consumption increased sAA activity (β = 1.52, p = 0.030), with a greater effect in females (β = 2.24, p = 0.012). Body fat percentage showed similar patterns with sAA activity (β = 2.20, p = 0.015), with no significant effect in males. There was no significant interaction between BMI or body fat and alcohol consumption on sCort levels. However, significant main effects were observed for African Americans (β = 0.22, p = 0.020) and overweight and obese status (β = −0.19, p = 0.025) on male students’ sCort levels. African Americans (β = 0.21, p = 0.026) and young male adults within the underfat category (β = 0.35, p = 0.022) also exhibited increased sCort levels. Conclusion: Sex-specific patterns in physiological responses between males and females revealed stronger associations in females for sAA activity and distinct patterns in sCort levels among African American males.