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Coping Strategies Influence Cardiometabolic Risk Factors in Chronic Psychological Stress: A Post Hoc Analysis of A Randomized Pilot Study.
Armborst, D, Bitterlich, N, Alteheld, B, Rösler, D, Metzner, C, Siener, R
Nutrients. 2021;14(1)
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Chronic psychological stress is increasingly recognized as a significant contributor to mental and physiological disorders in modern societies. The individual response to chronic stressors and resulting disorders depends on numerous factors. The aim of this study was to investigate the cardiometabolic risk profile in participants with ‘high’ and ‘very high’ chronic stress loads and the impact of positive and negative coping factors used. This study is a post hoc analysis of a randomised pilot study. For this analysis, baseline data were available for 62 chronic psychologically stressed participants, of whom 61 participants (43 women and 18 men) were included in the intention-to-treat (ITT) population. Results indicate that: - perceiving high chronic stress is significantly associated with the criteria of the metabolic syndrome. - on the contrary, a very high perceived chronic stress load seemed to be rather associated with mental health risk than with cardiometabolic risk. - inflammation and oxidative stress markers significantly correlated with cardiometabolic risk parameters. - stress load can be coped with in diverse ways and that the coping strategy is crucial for cardiometabolic risk. Authors conclude that long-term studies are necessary to examine further adaptations to chronic stress and to evaluate individual stress-management strategies.
Abstract
Chronic psychological stress can result in physiological and mental health risks via the activation of the hypothalamic-pituitary-adrenal (HPA) axis, sympathoadrenal activity and emotion-focused coping strategies. The impact of different stress loads on cardiometabolic risk is poorly understood. This post hoc analysis of a randomized pilot study was conducted on 61 participants (18-65 years of age) with perceived chronic stress. The Perceived Stress Questionnaire (PSQ30), Psychological Neurological Questionnaire (PNF), anthropometric, clinical and blood parameters were assessed. Subjects were assigned to 'high stress' (HS; PSQ30 score: 0.573 ± 0.057) and 'very high stress' (VHS; PSQ30 score: 0.771 ± 0.069) groups based on the PSQ30. Morning salivary cortisol and CRP were elevated in both groups. Visceral adiposity, elevated blood pressure and metabolic syndrome were significantly more frequent in the HS group vs. the VHS group. The fatty liver index (FLI) was higher (p = 0.045), while the PNF score was lower (p < 0.001) in the HS group. The HS group was comprised of more smokers (p = 0.016). Energy intake and physical activity levels were similar in both groups. Thus, high chronic stress was related to visceral adiposity, FLI, elevated blood pressure and metabolic syndrome in the HS group, while very high chronic stress was associated with psychological-neurological symptoms and a lower cardiometabolic risk in the VHS group, probably due to different coping strategies.
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Mindfulness Is Associated with the Metabolic Syndrome among Individuals with a Depressive Symptomatology.
Guyot, E, Baudry, J, Hercberg, S, Galan, P, Kesse-Guyot, E, Péneau, S
Nutrients. 2018;10(2)
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Metabolic syndrome is a combination of risk factors including obesity, type 2 diabetes, high blood pressure and a poor lipid profile. Dispositional mindfulness is a psychological trait that is defined as a non-judgemental awareness of the present moment. While mindfulness has been shown to produce beneficial effects on physical and mental health, no study has examined the associated between mindfulness and the metabolic syndrome risk factors. The aim of this cross-sectional web-based study was to explore the relationship between mindfulness and metabolic syndrome in modifying depressive symptomology across 17,490 individuals. Participants attended a clinical exam and completed the Five Facets Mindfulness Questionnaire to assess dispositional mindfulness. Depressive symptomology was measured through self-administered online questionnaires at the beginning of the study and each year of follow-up. This study found that individuals with higher levels of overall mindfulness were less likely to present with metabolic syndrome, but only among individuals showing depressive symptomology. Based on these results, the authors conclude it is important to encourage mindfulness practices in patients at risk of metabolic syndrome, particularly among those with depressive symptomology. More longitudinal studies are required to better understand mindfulness-based interventions in the clinical setting.
Abstract
The Metabolic Syndrome (MetS) is a major public health burden. Dispositional mindfulness has recently been associated with eating disorders, being overweight, and could therefore be associated with the MetS. We aimed to examine in a cross-sectional design the relationship between mindfulness, the MetS, and its risk factors in a large sample of the adult general population and the influence of depressive symptomatology on this association. Adults participating in the NutriNet-Santé study who had completed the Five Facets Mindfulness Questionnaire and attended a clinical and biological examination were available for inclusion. Multivariable logistic regression models adjusted for socio-demographic and lifestyle factors were performed. A total of 17,490 individuals were included. Among individuals with a depressive symptomatology, those with higher mindfulness were less likely to have a MetS (OR: 0.73, 95% CI: 0.57-0.93), a high waist circumference, a low HDL-cholesterol level and an elevated fasting blood glucose level (all p <0.05). In those without depressive symptomatology, individuals with higher mindfulness were less likely to have a high waist circumference (p <0.01). In conclusion, higher mindfulness was associated with lower odds of developing a MetS only among individuals with a depressive symptomatology.
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A decline in inflammation is associated with less depressive symptoms after a dietary intervention in metabolic syndrome patients: a longitudinal study.
Perez-Cornago, A, de la Iglesia, R, Lopez-Legarrea, P, Abete, I, Navas-Carretero, S, Lacunza, CI, Lahortiga, F, Martinez-Gonzalez, MA, Martinez, JA, Zulet, MA
Nutrition journal. 2014;13:36
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Metabolic syndrome (defined as a cluster of cardiovascular risk factors including central obesity, glucose intolerance, hypertension and lipid disorders) is rising rapidly worldwide. Certain features of metabolic syndrome including adiposity, glucose intolerance and lipid disorders have also been linked to depression, another burden on healthcare worldwide. The exact pathways linking these diseases are unclear but appear to be bidirectional and dependent on biological and behaviour factors. This study hypothesises that hypo caloric treatment may have a positive impact on both metabolic syndrome and depression, and explores the possible mechanisms for this effect. The sample included 60 subjects with a BMI of at least 36.1 and aged over 50 years. These were a subsample of the RESMENA-S study which involved a 6 month weight loss intervention (either RESMANA-S or a control both with the same energy restrictions). This study found a reduction in depressive symptoms, alongside a reduction in CRP and leptin following the diet. Previous research has found a relationship between weight loss and reduced depression, but this study specifically found the decrease in CRP and leptin with a reduction of depression. The precise mechanism between CRP and depression remains unclear but the authors suggest that inflammation may be responsible. Theoretically, the association between leptin and depression may be related to its metabolic properties and neurobiological activity (it may relate to mood and cognition).
Abstract
BACKGROUND Metabolic syndrome (MetS) and depression have become two prevalent diseases worldwide, whose interaction needs further investigation. Dietary treatment for weight loss in patients with MetS may improve depressive manifestations, however, the precise interactive pathways remain uncertain. Therefore, the aim of this study was to examine the effects of a hypocaloric diet designed to reduce MetS features on self-perceived depression and the possible underlying factors. METHODS Sixty subjects (Age: 50 ± 1 y; BMI: 36.1 ± 0.6 kg/m(2)) with MetS were selected from the RESMENA study (control and intervention) after they completed the 6-months hypocaloric treatment and rated for depressive symptoms using the Beck Depression Inventory (BDI). Anthropometric and biochemical measurements including leptin, C-reactive protein (CRP) and insulin levels were evaluated. RESULTS Depressive symptoms decreased during the weight loss intervention, with no differences between both dietary groups (control group -4.2 ± 0.8 vs RESMENA group -3.2 ± 0.6, P = 0.490). The number of criteria of the MetS was higher among subjects with more somatic-related depressive symptoms at baseline (B = 1.032, P-trend = 0.017). After six months of dietary treatment, body weight decreased in all subjects (-8.7%; confidence interval (95% CI) = 7.0-9.7) and also self-perceived depression (-37.9%; 95% CI = 2.7-4.9), as well as circulating leptin (-20.1%; 95% CI = 1.8-6.8), CRP (-42.8%; 95% CI = 0.6-3.0) and insulin (-37.7%; 95% CI = 4.1-7.2) concentrations. The decrease in BDI was significantly associated with declines in body fat mass (B = 0.34, 95% CI = 0.11-0.56) and also with the decrease in leptin (B = 0.16, 95% CI = 0.04-0.28) and CRP (B = 0.24, 95% CI = 0.01-0.46) concentrations. CONCLUSIONS The decrease in depressive manifestations after a weight loss intervention was related with adiposity, CRP and leptin in subjects with MetS. TRIAL REGISTRATION ClinicalTrials.gov: NCT01087086.