Abstract
After decades of resistance, there is now a genuine consensus that disease cannot be prevented or even successfully treated unless the role of stress is addressed alongside traditionally recognized factors such as genes and the environment. Measurement of allostatic load, which is quantified by the allostatic load score (ALS), is one of the most frequently used methods to assess the physiologic response to stress. Even though there is universal agreement that in the calculation of ALS, biomarkers from three categories should be included (cardiovascular, metabolic and immune), enormous variation exists in how ALS is calculated. Specifically, there is no consensus on which biomarkers to include or the method which should be used to determine whether the value of a biomarker represents high risk. In this perspective, we outline the approach taken in 21 different NHANES studies.

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Author Michelle T. Duong, Author Brianna A. Bingham, Author Paola C. Aldana, Author Stephanie T. Chung, and Author Anne E. Sumner were supported by the intramural program of the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health. Anne E. Sumner is also supported by the intramural program of the National Institute of Minority Health and Health Disparities. Organization which sponsored the research in is the Intramural Research Program of the National Institutes of Health. The grant number/intramural study protocol is 99-DK-0002.
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Michelle T. Duong and Brianna A. Bingham contributed equally.
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Duong, M.T., Bingham, B.A., Aldana, P.C. et al. Variation in the Calculation of Allostatic Load Score: 21 Examples from NHANES. J. Racial and Ethnic Health Disparities 4, 455–461 (2017). https://doi.org/10.1007/s40615-016-0246-8
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DOI: https://doi.org/10.1007/s40615-016-0246-8