Comfort food is comforting to those most stressed: evidence of the chronic stress response network in high stress women

Predictors of Body Image Perception among African American Women

Obesity is a significant health problem in the US with African American (AA) women having one of the highest prevalence of obesity. Some AA women may equate a larger BMI with a positive body image. The purpose of this cross-sectional descriptive study was to examine the relationship between demographic variables, body image perception, coping behaviors and BMI with a non-probability sample of 191 AA women, 18-40 years old. Participants completed a demographic form and Pulver's Figure Rating Scale (PFRS). Weight and height were measure and body mass index (BMI) calculated. Significant findings show that chronological age, hypertension, cigarette smoking and BMI were positively associated with body image perception. Using regression analysis, hypertension and BMI were predictors of body image perception. The study findings indicate that chronic illness and BMI impact body image perception.

Adolescent Obesity: Diet Quality, Psychosocial Health, and Cardiometabolic Risk Factors

Obesity is a multifaceted chronic condition with several contributing causes, including biological risk factors, socioeconomic status, health literacy, and numerous environmental influences. Of particular concern are the increasing rates of obesity in children and adolescents, as rates of obesity in youth in the United States have tripled within the last three decades. Youth from historically disadvantaged backgrounds tend to have higher rates of obesity compared to other groups. Adolescents often do not meet intake recommendations for certain food groups and nutrients, which may contribute to a heightened risk of obesity. With obesity disproportionately affecting adolescents (ages 12–19 years), negative effects of excess adiposity may be particularly salient during this critical period of development. The presentation of chronic cardiometabolic disease symptoms typically observed in adults, such as hypertension, hyperglycemia, dyslipidemia, and inflammation, are becoming increasingly common in adolescents with obesity. Additionally, there is dynamic interplay between obesity and psychosocial health, as adolescents with obesity may have increased levels of stress, depressive symptoms, and reduced resilience. To reduce and prevent adolescent obesity, the implementation of theory-driven multicomponent school- and community-based interventions have been suggested. These interventions promote knowledge and self-efficacy for healthful practices that have the potential to progress to sustained behavior change.

Dietary quality differences between women with and without weight loss in nutritional treatment

BACKGROUND & AIMS

The obesity nutritional treatment is structured to weight loss and diet is considered an important indicator of treatment effectiveness. The purpose of this study is to compare the diet quality among women who lost weight to women who maintained or gained weight during the nutritional treatment.

METHODS

This is a retrospective study that included 66 obese women in nutritional treatment for weight loss, over six months, divided in tercile according to their weight loss. The diet quality was evaluated by score, which was obtained with a food frequency questionnaire.

RESULTS

The diet quality comparison was made among the group with weight loss (GL; n = 22) and the group that maintained or gained weight during the nutritional treatment (GG; n = 22) showed that both groups had improvement in their diet quality scores from pre-treatment to post-treatment. Nevertheless, the GG had higher sugar consumption than the GL in the pre-treatment (p = 0.02) and in the post-treatment (p 0.01) periods. In the post-treatment, GL increased their scores for leafy vegetables (0.013), fruit (0.004), sweets (p 0.03), and soft drinks (p 0.02). GL improved their scores for fried food (p 0.01) and sweets (p 0.008).

CONCLUSION

This indicates that in the weight loss treatment special attention should be given to the incentive to the fruit and leafy vegetables consumption and, to reduce the consumption of sweets.

Stress hormones and eating disorders

AIMS

The aim of this paper is to emphasize the role of stress processes in the aetiology of eating disorders.

METHODS

We have examined the literature for evidence that people with eating disorders might exhibit markers of stress and show signs of the "maltreated ecophenotype".

RESULTS

Early adversity is more common among people with binge eating behaviours. The secondary effects of malnutrition, which are mostly marked in anorexia nervosa, may be an added stressor that could also contribute to the stress related phenotype. People with eating disorders have anomalies in brain structure, reward and punishment sensitivity, and the balance between HPA and SMA function. These may be potential targets for treatment.

Oxytocin reduces post-stress sweet snack intake in women without attenuating salivary cortisol

Intranasal oxytocin produces anorectic effects on snack intake in men when tested in the absence of deprivation-induced hunger, but its effects on food intake in women without eating disorders have not been reported. Oxytocin may reduce food intake by reducing stress eating, since it inhibits ACTH release. The present study adopted a double-blind, repeated measures and fully concealed crossover protocol in which 38 women self-administered 24 IU of oxytocin or placebo intranasally, ate lunch, and underwent two consecutive stress tests. Snack intake was assessed 15-20 min after lunch, via a sham taste test. Salivary cortisol was measured throughout the test period every 15 min. Oxytocin significantly reduced sweet fatty snack intake independently of any effect on salivary cortisol, which declined over time at a similar rate after either drug or placebo. Ratings of sweet taste were slightly reduced by oxytocin, but only in self-reported stress eaters. These results differ from previous studies with men that found an effect of oxytocin on postprandial cortisol levels. However, previous research assayed the less active form of plasma cortisol and did not control for protein intake, which can drive elevated cortisol. The finding that oxytocin reduces snack intake in females after acute stress has important implications for appetite regulation and its treatment in obese people and in those with eating disorders.

Overweight and obesity in sexual and gender minority adolescents: A systematic review

Population data indicate that sexual and gender minority adolescents may be at increased risk for excess weight gain compared with cisgender, heterosexual youth. However, no studies, to our knowledge, have systematically reviewed the literature on weight disparities in this population nor explored risk for overweight and obesity by sexual and gender minority subgroup across studies. The current systematic review, therefore, identified 21 studies that assessed the relationship between sexual and gender minority status and weight among adolescents. Results indicated an overall greater prevalence of overweight and obesity among sexual and gender minority adolescents compared with cisgender, heterosexual youth. However, cisgender sexual minority males demonstrated lower or no added risk for overweight and obesity, whereas cisgender sexual minority females demonstrated greater risk for overweight and obesity. Findings were mixed among gender minority adolescents. This study highlights weight disparities in sexual and gender minority youth, although important subgroup differences exist. Additional research is needed to elucidate the mechanisms that may contribute to differential weight trajectories in this population and to develop tailored approaches for prevention and treatment.

Weight-based teasing is associated with gain in BMI and fat mass among children and adolescents at-risk for obesity: A longitudinal study

BACKGROUND

Youths with overweight and obesity report frequent instances of weight-based teasing. However, little is known about the prospective associations between weight-based teasing and changes in body composition among youth.

OBJECTIVE

To assess associations between weight-based teasing and changes in body mass index (BMI) and fat mass in a longitudinal study of youths with, or at-risk for, overweight and obesity.

METHODS

One hundred ten youths with, or at-risk for, overweight participated in a longitudinal observational study. The Perception of Teasing Scale was administered at baseline. Height, weight, and body composition were obtained at baseline and at follow-ups (range: 1-15 years).

RESULTS

Mean age at baseline was 11.8 years; 53% had overweight/obesity; 36% were non-Hispanic Black; 55% were female; mean follow-up from baseline: 8.5 years. Adjusting for covariates and repeated measures of BMI or fat mass, linear mixed models revealed that weight-based teasing was associated with greater gain of BMI and fat mass across the follow-up period (ps ≤ .007). Adjusting for covariates, youths reporting high weight-based teasing (two standard deviations above the mean) experienced a 33% greater gain in BMI (an additional 0.20 kg/m² ) and a 91% greater gain in fat mass (an additional 0.65 kg) per year compared with peers who reported no weight-based teasing.

CONCLUSIONS

Among youths with, and at-risk for, overweight and obesity, weight-based teasing was associated with greater weight and fat gain.

A Randomized Controlled Trial of a Mindfulness-Based Weight Loss Intervention on Cardiovascular Reactivity to Social-Evaluative Threat Among Adults with Obesity

Objective

Mindfulness-based interventions have been found to reduce psychological and physiological stress reactivity. In obesity, however, stress reactivity is complex, with studies showing both exaggerated and blunted physiological responses to stressors. A nuanced view of stress reactivity is the "challenge and threat" framework, which defines adaptive and maladaptive patterns of psychophysiological stress reactivity. We hypothesized that mindfulness training would facilitate increased challenge-related appraisals, emotions, and cardiovascular reactivity, including sympathetic nervous system activation paired with increased cardiac output (CO) and reduced total peripheral resistance (TPR) compared to a control group, which would exhibit an increased threat pattern of psychophysiological reactivity to repeated stressors.

Methods

Adults (N=194) with obesity were randomized to a 5.5-month mindfulness-based weight loss intervention or an active control condition with identical diet-exercise guidelines. Participants were assessed at baseline and 4.5 months later using the Trier Social Stress Task. Electrocardiogram, impedance cardiography, and blood pressure were acquired at rest and during the speech and verbal arithmetic tasks to assess pre-ejection period (PEP), CO, and TPR reactivity.

Results

Mindfulness participants showed significantly greater maintenance of challenge-related emotions and cardiovascular reactivity patterns (higher CO and lower TPR) from pre to post-intervention compared to control participants, but groups did not differ in PEP. Findings were independent of changes in body mass index.

Conclusions

Mindfulness training may increase the ability to maintain a positive outlook and mount adaptive cardiovascular responses to repeated stressors among persons with obesity though findings need to be replicated in other populations and using other forms of mindfulness interventions.

Household Food Insecurity is Associated with Higher Adiposity among US Schoolchildren Ages 10-15 Years: The Healthy Communities Study

BACKGROUND

Limited research exists on the relationship between food insecurity and children's adiposity and diet and how it varies by demographic characteristics in the United States.

OBJECTIVE

The aim of this study was to assess the relationship between household food insecurity and child adiposity-related outcomes, measured as BMI (kg/m2) z score (BMI-z), weight status, and waist circumference, and diet outcomes, and examined if the associations differ by age, sex, and race/ethnicity.

METHODS

Data collected in 2013-2015 from 5138 US schoolchildren ages 4-15 y from 130 communities in the cross-sectional Healthy Communities Study were analyzed. Household food insecurity was self-reported using a validated 2-item screener. Dietary intake was assessed using the 26-item National Cancer Institute's Dietary Screener Questionnaire, and dietary behaviors were assessed using a household survey. Data were analyzed using multilevel statistical models, including tests for interaction by age, sex, and race/ethnicity.

RESULTS

Children from food-insecure households had higher BMI-z (β: 0.14; 95% CI: 0.06, 0.21), waist circumference (β: 0.91 cm; 95% CI: 0.18, 1.63), odds of being overweight or obese (OR: 1.17; 95% CI: 1.02, 1.34), consumed more sugar from sugar-sweetened beverages (β: 1.44 g/d; 95% CI: 0.35, 2.54), and less frequently ate breakfast (β: -0.28 d/wk; 95% CI: -0.39, -0.17) and dinner with family (β: -0.22 d/wk; 95% CI: -0.37, -0.06) compared to children from food-secure households. When examined by age groups (4-9 and 10-15 y), significant relationships were observed only for older children. There were no significant interactions by sex or race/ethnicity.

CONCLUSIONS

Household food insecurity was associated with higher child adiposity-related outcomes and several nutrition behaviors, particularly among older children, 10-15 y old.

Palatable food reduces anxiety-like behaviors and HPA axis responses to stress in female rats in an estrous-cycle specific manner

Eating tasty foods dampens responses to stress - an idea reflected in the colloquial term 'comfort foods'. To study the neurobiological mechanisms by which palatable foods provide stress relief, we previously characterized a limited sucrose intake (LSI) paradigm in which male rats are given twice-daily access to 4 ml of 30% sucrose solution (vs. water as a control), and subsequently have reduced hypothalamic-pituitary-adrenocortical (HPA) axis responsivity and anxiety-related behaviors. Notably, women may be more prone to 'comfort feeding' than men, and this may vary across the menstrual cycle, suggesting the potential for important sex and estrous cycle differences. In support of this idea, LSI reduces HPA axis responses in female rats during the proestrus/estrus (P/E), as opposed to the diestrus 1/diestrus 2 (D1/D2) estrous cycle stage. However, the effect of LSI on anxiety-related behaviors in females remains unknown. Here we show that LSI reduced stress-related behaviors in female rats in the elevated plus-maze and restraint tests, but not in the open field test, though only during P/E. LSI also decreased the HPA axis stress response primarily during P/E, consistent with prior findings. Finally, cFos immunolabeling (a marker of neuronal activation) revealed that LSI increased post-restraint cFos in the central amygdala medial subdivision (CeM) and the bed nucleus of the stria terminalis posterior subnuclei (BSTp) exclusively during P/E. These results suggest that in female rats, palatable food reduces both behavioral and neuroendocrine stress responses in an estrous cycle-dependent manner, and the CeM and BSTp are implicated as potential mediators of these effects.

Cookie or clementine? Psychophysiological stress reactivity and recovery after eating healthy and unhealthy comfort foods

Many people eat unhealthy foods that are high in calories, fat, or sugar when feeling stressed, yet little is known about whether this unhealthy comfort eating actually comforts. Additionally, prior research has not tested whether healthy comfort eating of fruits and vegetables might also alleviate stress, or whether comfort eating during the stress anticipation phase versus immediately after a stressful event is more beneficial for stress relief. The present experiment tested whether unhealthy and healthy comfort eating reduce acute psychophysiological responses to a socially evaluative stressor. Participants (N = 150 healthy women) underwent the Trier Social Stress Test in the lab and were randomly assigned to one of five conditions according to a 2 (food type: unhealthy vs. healthy) x 2 (eating timing: during stress anticipation vs. after the stressor) + 1 (no food control) between-subjects design. Stress outcomes included mood, cognitive appraisals, rumination, salivary cortisol, heart rate variability, and pre-ejection period. Unhealthy and healthy comfort eating did not dampen reactivity or enhance recovery of psychophysiological stress compared to control, and no differences in reactivity or recovery were found by comfort food type. Findings suggest that by replacing unhealthy comfort foods with fruits and vegetables, women will not be sacrificing any stress-reducing benefits and can inherently improve the quality of their diet while avoiding potential drawbacks of unhealthy comfort eating (e.g., links with abdominal obesity).

Negative affect is associated with increased stress-eating for women with high perceived life stress

Perceived life stress (PLS) and cognitive restraint are associated with increased comfort food intake under stress and lead to weight gain and obesity, but the mechanisms by which they do so remain unclear. Stress and negative affect (NA) are associated with increased reward-driven comfort food intake as a means to 'feel better', particularly for individuals with higher PLS and cognitive restraint. Thus, we propose that PLS and cognitive restraint increase stress-eating by strengthening the relationship between stress-induced NA and comfort food intake. Upon comfort eating, individuals with higher PLS show greater reductions in the negative consequences of stress (e.g. NA). The rewarding effects of this 'emotional relief' may promote future stress-induced comfort eating, but this has yet to be examined. Thus, we investigate the pathways by which PLS or cognitive restraint increase snack intake under stress by proposing that 1) stress-induced NA is a stronger predictor of increased snack intake for women with greater PLS and cognitive restraint, and 2) greater PLS will be associated with greater reductions in NA upon snacking under stress (i.e. emotional relief). Forty-three healthy women were given snacks (chips, golden oreos, and M&Ms) to eat after a Trier Social Stress Test or rest period on separate days in counterbalanced order. Following linear regression analyses, we determined that stress-induced NA predicted more snack intake for women with higher PLS, and that higher PLS was associated with heightened emotional relief upon snacking under stress. Future studies are needed to directly assess whether greater emotional relief following stress-eating reinforces the learned association between stress-induced NA and intake, and ultimately explains greater stress-eating and obesity in women with higher PLS. This work may lead clinicians to focus on NA in the treatment of obesity-and stress-related illnesses for women with higher PLS.

Loneliness as a risk factor for metabolic syndrome: results from the HUNT study

Objective

Metabolic syndrome (MetS) includes hyperglycaemia, hypertension, central adiposity, elevated triglyceride levels and low levels of high-density lipoprotein cholesterol. All factors are identified as risk factors for cardiovascular disease and mortality. This longitudinal study examined whether loneliness, which has been shown to predict a range of negative health outcomes, increases the risk for MetS.

Methods

We used data from ‘the Nord-Trøndelag Health Study’ (HUNT) which is a large longitudinal health study based on a Mid-Norway county population (n=26 990). Self-reports, physical examinations and blood samples were analysed to evaluate the associations between loneliness and incidents of MetS after 10 years (follow-up survey conducted during 2006–2008). We also investigated the role of depression as a potential mediating factor.

Results

Individuals who reported higher levels of loneliness had a higher odds for MetS (adjusted OR 1.09 (95% CI 1.02 to 1.16); p=0.007). This effect was mediated through depression.

Conclusions

Findings suggest that loneliness may be an important factor that increases the risk for MetS. The effect of loneliness on MetS is mediated through depressive symptoms. Reducing loneliness may help prevent the incidence of MetS and related diseases.

Feeling Hurt: Revisiting the Relationship Between Social and Physical Pain

Pain overlap theory has generated decades of controversy and still receives considerable research attention. A major advance has been the revelation that social and physical pain activate similar neural regions, providing suggestive evidence of a “piggybacked” alarm system that coevolved to detect social exclusion. Recent developments, however, have brought neural evidence for pain overlap into question. We analyze these developments from a social psychological perspective and identify the need for a reformulated approach. To meet this need, we provide a framework that a priori predicts generalized overlap and specific divergence across a range of biopsychosocial domains. The framework points to a functional pattern for similarities and differences, which can be utilized to generate testable hypotheses so that the field can move forward. To demonstrate the utility and promise of the framework, we identify key hypotheses relating to attention, motivation, and responses to pain, and review research relevant to these hypotheses.

"Comfort-foods" chronic intake has different behavioral and neurobiological effects in male rats exposed or not to early-life stress

The ability of "comfort-food" (CF) diet to revert long-term effects of early-life stress (ELS) is less well known. The objective of this study was to verify if the chronic exposure to CF diet in animals submitted to ELS could relief the stress response at behavioral, neuroendocrine, and neurobiochemical levels, via differences in glucocorticoid receptors expression in brain areas involved in the stress response. From the second day of life, litters of Wistar rats and their mothers were submitted to the reduced nesting material protocol (ELS). In adult life, ELS and a control group were exposed chronically to two diet schemes: standard rat chow only or both "CF" diet, containing fat (34%) and sugar (20%) and a diet similar to the standard diet. Anxiety-like behavior, neuroendocrine response stress, leptin, GR, SOCS-3, pSTAT3, and the abdominal fat were evaluated. The anxiety-like behavior results showed that ELS group when exposed to comfort food were not different from the others groups. Chronic exposure to CF diet induced an anxiety-like behavior in the control group. Groups chronically exposed to CF diet had lower levels of corticosterone over time independent of the neonatal group. The ELS group exposed to the "CF" diet had higher levels of hippocampal GR, lower levels of hypothalamic SOCS-3 and greater accumulation of abdominal fat. Chronic CF diet consumption is able to reduce corticosterone levels independent of the neonatal history, but is associated with anxiety-like behavior in animals without previous history of trauma. Metabolic disturbances like increased adiposity and altered SOCS-3 seem to be a result of multiple insults (neonatal trauma followed by chronic CF diet). We highlight that the Control-chow and ELS-chow data were previously published, and are included in this study for comparative analysis.

'Dis-comfort eating': An investigation into the use of food as a coping strategy for the management of chronic pain

OBJECTIVES

Chronic pain and obesity are major public health concerns. Animal and human models have demonstrated that eating high-sugar nutrient-dense foods confers analgesic effects. Moreover, recent research suggests that people with chronic pain may "comfort eat" to cope with their pain. Given the harmful impact of obesity on chronic pain, it is critical to determine whether pain elicits comfort eating amongst individuals with chronic pain to ensure that this potentially maladaptive pain coping strategy is not overlooked in chronic pain treatment. Therefore, this study aimed to: determine whether chronic pain intensity predicts pain-induced comfort eating and identify mediators of this relationship; to determine whether pain-induced comfort eating predicts elevated BMI; and to establish whether BMI predicts chronic pain interference.

METHODS

This study utilised a cross-sectional online survey design and a sample of 151 adults with chronic pain.

RESULTS

Over three-quarters of this chronic pain sample reported engaging in pain-induced comfort eating. Chronic pain intensity did not significantly predict pain-induced comfort eating. However, there was a significant indirect effect of chronic pain intensity on pain-induced comfort eating through stress-but not experiential avoidance or pain catastrophising. As predicted, pain-induced comfort eating significantly predicted increased BMI, and BMI in turn significantly predicted greater chronic pain interference.

DISCUSSION

This study indicates that pain-induced comfort eating is both common and harmful amongst individuals with chronic pain, across the entire BMI spectrum. Pain-induced comfort eating and stress have emerged as promising chronic pain treatment targets. The findings are discussed and interpreted in light of extant research and theory, as well as limitations of the current study. Future research directions and clinical implications are also considered.

Maternal caregivers have confluence of altered cortisol, high reward-driven eating, and worse metabolic health

Animal models have shown that chronic stress increases cortisol, which contributes to overeating of highly palatable food, increased abdominal fat and lower cortisol reactivity. Few studies in humans have simultaneously examined these trajectories. We examined premenopausal women, either mothers of children with a diagnosis of an autism spectrum disorder (n = 92) or mothers of neurotypical children (n = 91). At baseline and 2-years, we assessed hair cortisol, metabolic health, and reward-based eating. We compared groups cross-sectionally and prospectively, accounting for BMI change. Caregivers, relative to controls, had lower cumulative hair cortisol at each time point, with no decreases over time. Caregivers also had stable levels of poor metabolic functioning and greater reward-based eating across both time points, and evidenced increased abdominal fat prospectively (all ps ≤.05), independent of change in BMI. This pattern of findings suggest that individuals under chronic stress, such as caregivers, would benefit from tailored interventions focusing on better regulation of stress and eating in tandem to prevent early onset of metabolic disease, regardless of weight status.

Comfort Eating and All-Cause Mortality in the US Health and Retirement Study

PURPOSE

Comfort eating is a prevalent behavior. Prior research shows that comfort eating is associated with reduced stress responses and increased metabolic risk across adolescence, young adulthood, and middle adulthood. The purpose of the current research was to test if comfort eating prospectively predicted all-cause mortality in older adulthood.

METHOD

The US Health and Retirement Study is an ongoing, nationally representative, longitudinal study of older adults. The final sample for the present study (N = 1445) included participants randomly selected to report how often they comfort ate. Comfort eating data were collected in 2008 and all-cause mortality data were collected in 2014. Participants also reported how often they consumed high-fat/sugar food as well as their height and weight in 2008.

RESULTS

For each 1-unit increase in comfort eating, the expected odds of all-cause mortality (n = 255 deceased) decreased by 14%, OR = 0.86, p = 0.048, 95% CI [0.74, 0.99]. This analysis statistically accounted for other predictors of mortality in the sample including age, biological sex, race, highest educational degree attained, moderate and vigorous exercise, smoking, and cumulative illness. High-fat/sugar intake did not mediate (or diminish) the association but body mass index did.

CONCLUSION

Comfort eating-irrespective of consuming high-fat/sugar food-may be associated with reduced mortality in older adults because it may promote greater body mass, and greater body mass is associated with lower risk of mortality in nationally representative samples. Interventionists might consider both beneficial and detrimental aspects of comfort eating across the lifespan.

Greater Lifetime Stress Exposure Predicts Blunted Cortisol but Heightened DHEA Responses to Acute Stress

Although prior research has examined how early adversity and chronic stress exposure relate to hypothalamic-pituitary-adrenal (HPA) axis responses to acute stress, to date, no studies have examined how stressors occurring over the entire lifespan predict such responses. To address this issue, we recruited 61 healthy young adults and measured their exposure to 55 different types of acute life events and chronic difficulties occurring over the lifespan. In addition, we characterized differences in participants' HPA axis responses to acute stress by measuring their salivary cortisol and DHEA responses to the Trier Social Stress Test for Groups. Greater cumulative stress exposure was associated with a blunted cortisol response, but a heightened DHEA response, to the acute stressor. Moreover, it was participants' exposure to these stressors (i.e., lifetime count), not their perceived severity, which predicted their cortisol and DHEA responses to acute stress. Furthermore, differential effects were observed by stress exposure domain. Notably, only adulthood and marital/partner stressors significantly predicted cortisol responses to acute stress, whereas stress was more uniformly associated with DHEA responses to the acute stressor. These results thus reveal how cumulative stress exposure is associated with HPA axis responsivity to acute stress, while highlighting the fact that different stressors may have substantially different associations with these biological outcomes.

Sex differences in stress-related alcohol use

Rates of alcohol use disorder (AUD) have increased in women by 84% over the past ten years relative to a 35% increase in men. This substantive increase in female drinking is alarming given that women experience greater alcohol-related health consequences compared to men. Stress is strongly associated with all phases of alcohol addiction, including drinking initiation, maintenance, and relapse for both women and men, but plays an especially critical role for women. The purpose of the present narrative review is to highlight what is known about sex differences in the relationship between stress and drinking. The critical role stress reactivity and negative affect play in initiating and maintaining alcohol use in women is addressed, and the available evidence for sex differences in drinking for negative reinforcement as it relates to brain stress systems is presented. This review discusses the critical structures and neurotransmitters that may underlie sex differences in stress-related alcohol use (e.g., prefrontal cortex, amygdala, norepinephrine, corticotropin releasing factor, and dynorphin), the involvement of sex and stress in alcohol-induced neurodegeneration, and the role of ovarian hormones in stress-related drinking. Finally, the potential avenues for the development of sex-appropriate pharmacological and behavioral treatments for AUD are identified. Overall, women are generally more likely to drink to regulate negative affect and stress reactivity. Sex differences in the onset and maintenance of alcohol use begin to develop during adolescence, coinciding with exposure to early life stress. These factors continue to affect alcohol use into adulthood, when reduced responsivity to stress, increased affect-related psychiatric comorbidities and alcohol-induced neurodegeneration contribute to chronic and problematic alcohol use, particularly for women. However, current research is limited regarding the examination of sex in the initiation and maintenance of alcohol use. Probing brain stress systems and associated brain regions is an important future direction for developing sex-appropriate treatments to address the role of stress in AUD.

Childhood psychosocial challenges and risk for obesity in U.S. men and women

Childhood psychosocial challenges (i.e., adversities, mental and substance use disorders, social challenges) may relate to the onset of obesity and extreme obesity. Identifying the types of psychosocial challenges most strongly associated with obesity could advance etiologic understanding and help target prevention efforts. Using a nationally representative sample of U.S. adults (N = 24,350), the present study evaluates relationships between childhood psychosocial challenges and development of obesity and extreme obesity. After mutually controlling, childhood poverty was a risk in men OR = 1.2 (1.0-1.4) and a significantly stronger one in women OR = 1.6 (1.4-1.8); maltreatment increased odds of obesity in both men and women OR = 1.3, 95% CI (1.1-1.4), and specifically increased odds of extreme obesity in women OR = 1.5 (1.3-1.9). Early childrearing (before age 18) was an independent risk factor in both men OR = 1.4 (1.0-1.9) and women OR = 1.3 (1.1-1.5); not finishing high school was the strongest childhood psychosocial challenge risk factor for extreme obesity in both men (OR = 1.6, 1.1-2.2) and women (OR = 2.0, 1.5-2.5). Psychiatric disorders (MDD, anxiety disorder, PTSD) before age 18 were not independently associated with adult obesity in men nor women, but substance use disorders (alcohol or drug) were inversely associated with adult obesity. Individuals who have experienced childhood adversities and social challenges are at increased risk for obesity. Previous findings also indicate that these individuals respond poorly to traditional weight management strategies. It is critical to identify the reasons for these elevated weight problems, and to develop interventions that are appropriately tailored to mitigate the obesity burden faced by this vulnerable population.

Chronic stress increases susceptibility to food addiction by increasing the levels of DR2 and MOR in the nucleus accumbens

Background: Stress-related obesity might be related to the suppression of the hypothalamic-pituitary- adrenocortical axis and dysregulation of the metabolic system. Chronic stress also induces the dysregulation of the reward system and increases the risk of food addiction, according to recent clinical findings. However, few studies have tested the effect of chronic stress on food addiction in animal models. Purpose: The objective of this study was to identify whether chronic stress promotes food addiction or not and explore the possible mechanisms. Method: We applied adaily 2 hrsflashing LED irradiation stress to mice fed chow or palatable food to mimic the effect of chronic stress on feeding. After 1 month of chronic stress exposure, we tested their binge eating behaviors, cravings for palatable food, responses for palatable food, and compulsive eating behaviors to evaluate the effect of chronic stress on food addiction-like behaviors. We detected changes in the levels of various genes and proteins in the nucleus accumbens (NAc), ventral tegmental area (VTA) and lateral hypothalamus using qPCR and immunofluorescence staining, respectively. Results: Behaviors results indicated chronic stress obviously increased food addiction score (FAS) in the palatable food feeding mice. Moreover, the FAS had astrong relationship with the extent of the increase in body weight. Chronic stress increased the expression of corticotropin-releasing factor receptor 1(CRFR1) was increased in the NAc shell and core but decreased in the VTA of the mice fed with palatable food. Chronic stress also increased expression of both dopamine receptor 2 (DR2) and mu-opioid receptor (MOR) in the NAc. Conclusion: Chronic stress aggravates the FAS and contributed to the development of stress-related obesity. Chronic stress drives the dysregulation of the CRF signaling pathway in the reward system and increases the expression of DR2 and MOR in the nucleus accumbens.

Perceived maternal care is associated with emotional eating in young adults

INTRODUCTION

Early life adversity, including the perception of poor quality of maternal care, is associated with long-term metabolic and psychosocial consequences. The negative quality of mother/child relationship is associated with emotional overeating in young children, which is defined by eating in response to emotional arousal states such as fear, anger or anxiety. However, it is not known if this association persists through adolescence. Therefore, we aimed at verifying if maternal care during infancy can influence emotional eating in young adults.

METHODS

Seventy-five adolescents, residents of Porto Alegre, who participated in the PROTAIA Program (anxiety disorder in childhood and adolescence program), answered the Parental Bonding Instrument (PBI - assessment of perceived maternal care), and the Dutch Eating Behavior Questionnaire (DEBQ). Regression analysis models were built to predict Emotional Eating, a domain of the DEBQ, using maternal care, gender, and anxiety as independent variables.

RESULTS

The model was statistically significant when adjusted for potential confounders (r² = 0.272; p < 0.0001). Emotional eating was significantly predicted by levels of maternal care, anxiety and gender (beta = -0.316; p = 0.006).

CONCLUSION

The results demonstrated a negative association between the quality of maternal care and emotional eating in young adults, suggesting that the early environment could be involved on the development of eating disorders or on the differential eating behavior in adolescents with emotional disorders.

A reconceptualization of the definition of binge eating for African American women: A concept analysis

AIM

The aim of this analysis is to develop a better understanding of the concept of binge-eating behavior among African American women (AAW).

BACKGROUND

Obesity is a major public health concern that is disproportionately prevalent among AAW. Among the factors that contribute to obesity development, binge eating may be of significant concern to AAW.

DESIGN

A critical analysis and synthesis of the empirical literature using Walker and Avant's model for concept analysis. The databases MEDLINE, Cumulative Index to Nursing Health Literature (CINAHL) Complete, PsycINFO, and PsycARTICLES were used. Keywords included binge eating AND African American women or Black women race or ethnicity or minority.

RESULTS

Binge eating is a behavior that exists on a continuum that involves the overconsumption of food, with or without loss of control (LOC), whereas binge eating with LOC is related to increased impairment and severity. While the main attribute of binge eating involves the consumption of a large amount of food, the LOC component of binge eating definition may not be culturally relevant criteria to include as a requirement, as it may exclude AAW in diagnostics and subsequent treatment as well as overlook the health implications of binge eating regardless of LOC endorsement.

CONCLUSION

Including LOC in defining binge-eating behavior among AAW is significant, but should not be necessitated. This concept analysis illustrates the complexities related to binge-eating behavior among AAW, enumerating the characteristics of binge eating that may be unique to certain populations. The definition for binge eating among AAW developed from this concept analysis needs to be further explored in future studies.

Palatable Food Affects HPA Axis Responsivity and Forebrain Neurocircuitry in an Estrous Cycle-specific Manner in Female Rats

Eating palatable foods can provide stress relief, but the mechanisms by which this occurs are unclear. We previously characterized a limited sucrose intake (LSI) paradigm in which twice-daily access to a small amount of 30% sucrose (vs. water as a control) reduces hypothalamic-pituitary-adrenocortical (HPA) axis responses to stress and alters neuronal activation in stress-regulatory brain regions in male rats. However, women may be more prone to 'comfort feeding' behaviors than men, and stress-related eating may vary across the menstrual cycle. This suggests that LSI effects may be sex- and estrous cycle-dependent. The present study therefore investigated the effects of LSI on HPA axis stress responsivity, as well as markers of neuronal activation/plasticity in stress- and reward-related neurocircuitry in female rats across the estrous cycle. We found that LSI reduced post-restraint stress plasma ACTH in female rats specifically during proestrus/estrus (P/E). LSI also increased basal (non-stress) FosB/deltaFosB- and pCREB-immunolabeling in the basolateral amygdala (BLA) and central amygdala specifically during P/E. Finally, Bayesian network modeling of the FosB/deltaFosB and pCREB expression data identified a neurocircuit that includes the BLA, nucleus accumbens, prefrontal cortex, and bed nucleus of the stria terminalis as likely being modified by LSI during P/E. When considered in the context of our prior results, the present findings suggest that palatable food reduces stress responses in female rats similar to males, but in an estrous cycle-dependent manner. Further, the BLA may contribute to the LSI effects in both sexes, whereas the involvement of other brain regions appears to be sex-dependent.

Pathways of Association from Stress to Obesity in Early Childhood

OBJECTIVE

The objective of this study is to critically review the literature on early life stress in relation to obesity in humans, including the multiple biological and behavioral mechanisms through which early life stress exposure (birth to the age of 5 years) may associate with obesity risk during childhood.

METHODS

A review of the literature was conducted to identify studies on associations between early childhood stress and risk for obesity and the mechanisms of association. Multiple databases (PubMed, PsycInfo, Google Scholar) were used in the search as well as a "snowball" search strategy. All study designs were included.

RESULTS

Early life stress and adverse childhood experiences are associated with obesity and overweight in adults. Evidence is less consistent in children. Studies vary in the nature of the stress examined (e.g., chronic vs. acute), sample characteristics, and study designs. Longitudinal studies are needed, as the effects of early life stress exposure may not emerge until later in the life-span. Early life stress exposure is associated with biological and behavioral pathways that may increase risk for childhood obesity.

CONCLUSIONS

There is evidence that early life stress is associated with multiple biological and behavioral pathways in children that may increase risk for later obesity. Little work has detailed the interconnections among these mechanisms across development or identified potential moderators of the association. Mapping the mechanisms connecting early life stress exposure to obesity risk in young children longitudinally should be a priority for obesity researchers. Recommendations for developmentally sensitive approaches to research that can inform obesity prevention strategies are presented.

Stress and Obesity

Many pathways connect stress and obesity, two highly prevalent problems facing society today. First, stress interferes with cognitive processes such as executive function and self-regulation. Second, stress can affect behavior by inducing overeating and consumption of foods that are high in calories, fat, or sugar; by decreasing physical activity; and by shortening sleep. Third, stress triggers physiological changes in the hypothalamic-pituitary-adrenal axis, reward processing in the brain, and possibly the gut microbiome. Finally, stress can stimulate production of biochemical hormones and peptides such as leptin, ghrelin, and neuropeptide Y. Obesity itself can be a stressful state due to the high prevalence of weight stigma. This article therefore traces the contribution of weight stigma to stress and obesogenic processes, ultimately describing a vicious cycle of stress to obesity to stigma to stress. Current obesity prevention efforts focus solely on eating and exercise; the evidence reviewed in this article points to stress as an important but currently overlooked public policy target.

Adipose and skeletal muscle thermogenesis: studies from large animals

The balance between energy intake and energy expenditure establishes and preserves a 'set-point' body weight. The latter is comprised of three major components including metabolic rate, physical activity and thermogenesis. Thermogenesis is defined as the cellular dissipation of energy via heat production. This process has been extensively characterised in brown adipose tissue (BAT), wherein uncoupling protein 1 (UCP1) creates a proton leak across the inner mitochondrial membrane, diverting protons away from ATP synthesis and resulting in heat dissipation. In beige adipocytes and skeletal muscle, thermogenesis can occur independent of UCP1. Beige adipocytes have been shown to produce heat via UCP1 as well as via both futile creatine and calcium cycling pathways. On the other hand, the UCP1 homologue UCP3 is abundant in skeletal muscle and post-prandial thermogenesis has been associated with UCP3 and the futile calcium cycling. This review will focus on the differential contributions of adipose tissue and skeletal muscle in determining total thermogenic output and energy expenditure in large mammals. Sheep and pigs do not have a circumscribed brown fat depot but rather possess white fat depots that contain brown and beige adipocytes interspersed amongst white adipose tissue. This is representative of humans, where brown, beige and white adipocytes have been identified in the neck and supraclavicular regions. This review will describe the mechanisms of thermogenesis in pigs and sheep and the relative roles of skeletal muscle and adipose tissue thermogenesis in controlling body weight in larger mammals.

Is the childhood home food environment a confounder of the association between child maltreatment exposure and adult body mass index?

Childhood maltreatment is consistently associated with adult obesity, leading to calls for tailored weight interventions for people with maltreatment histories. However, it is possible that the maltreatment-obesity association is spurious and driven by unmeasured confounding, in which case such interventions would be misplaced. The home food environment in childhood is a potential confounder, but its role in the association of maltreatment with obesity has not been examined. We used a longitudinal dataset (Project EAT) to examine the association of adult retrospective reports of maltreatment history in childhood (1+ types of maltreatment before age 18 years) with previously-collected prospective childhood reports of home food environment characteristics (availability of healthy foods, availability of sweet/salty snack food, family meal frequency, and food insufficiency). We then estimated the association between maltreatment and adult body mass index (BMI, kg/m²) with and without adjustment for these home food environment factors. After adjustment for sociodemographics, maltreatment had a 0.84 kg/m² (95% CI: 0.28, 1.41) higher BMI at age 24-39 years, compared to those with no maltreatment, after adjustment for sociodemographics, parenting style, and BMI in childhood. Additional adjustment for home food environment factors had little effect on this association (β = 0.78 kg/m²; 95% CI: 0.21,1.35), suggesting limited confounding influence of the home food environment factors. Findings provide additional robust evidence that childhood maltreatment is a risk factor for obesity that may warrant tailored interventions.

Causes of Emotional Eating and Matched Treatment of Obesity

PURPOSE OF THE REVIEW

Eating in response to negative emotions (EE) may be an explanatory factor of the weight regain of many dieters. This narrative review presents evidence on possible causes of EE and the association of EE with depression and obesity and discusses implications of these findings for the treatment of obesity.

RECENT FINDINGS

Possible causes of EE are high dietary restraint, poor interoceptive awareness, alexithymia, emotion dysregulation and a reversed hypothalamic pituitary adrenal (HPA) stress axis. EE may be the outcome of inadequate parenting or depressive feelings in interaction with genetic susceptibility. There is also robust evidence that EE is a mediator between depression and obesity. The association of EE with depression and poor emotion regulation skills suggests that the treatment of obese people with high EE should not focus on calorie-restricted diets but on emotion regulation skills. The DEBQ (Dutch Eating Behavior Questionnaire) enables such a matched treatment of obesity.

​Depressive symptoms and weight loss behaviors in U.S. adults

OBJECTIVE

We sought to determine whether depressive symptoms are associated with attempting to lose weight and engaging in weight loss behaviors in a large, diverse sample of adults representative of the U.S.

METHODS

Respondents were 23,106 adults, free of cardiovascular disease and diabetes, who participated in the 2005-2014 years of the National Health and Nutrition Examination Survey (NHANES). Depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9), and weight loss variables were obtained from a Weight History Questionnaire.

RESULTS

PHQ-9 total was not associated with attempting to lose weight in the past year (OR = 1.03, 95%CI = 1.00-1.06, p = 0.074; n = 23,106). Among respondents who attempted to lose weight (n = 9582), PHQ-9 total was associated with a lower odds of exercising (OR = 0.84, 95%CI = 0.79-0.89, p < 0.001) and a greater odds of skipping meals (OR = 1.31, 95%CI = 1.22-1.41, p < 0.001), eating diet foods/products (OR = 1.16, 95%CI = 1.08-1.24, p < 0.001), eating less food (OR = 1.09, 95%CI = 1.04-1.15, p < 0.001), taking non-prescription supplements (OR = 1.31, 95%CI = 1.23-1.41, p < 0.001), taking prescription diet pills (OR = 1.28, 95%CI = 1.10-1.49, p = 0.001), and taking laxatives/vomiting (OR = 1.55, 95%CI = 1.28-1.88, p < 0.001).

CONCLUSIONS

Although depressive symptoms were not associated with attempting to lose weight in the past year, adults who attempted to lose weight tended to employ potentially ineffective/unhealthy weight loss behaviors and avoid effective behaviors. This pattern of behaviors may be another mechanism that explains the excess risk of obesity in depressed adults and may be a modifiable target for future interventions. Given the cross-sectional nature of this study, reverse causality is a possibility. Future studies should investigate the prospective associations between depressive symptoms and weight loss behaviors.

Negative affective stress reactivity: The dampening effect of snacking

The present study sets out to further elucidate the complex relationship between daily hassles, snacking, and negative affect (NA). The aim of the present study was to examine whether or not moment-to-moment energy intake from snacks moderates the association between momentary stress and NA. And, if so, can this moderating effect be replicated by using the amount of macronutrient intake (i.e., carbohydrates, fat, and protein) as moderator on the association between momentary stress and NA? Adults (N = 269), aged 20-50 years, participated in this study. Stress, NA, and snack intake were assessed 10 times a day for 7 consecutive days in daily life with an experience sampling smartphone application. Multilevel regression analyses were performed to assess the hypothesized associations. Our study revealed a dampening effect of snacking on negative affective stress reactivity. However, this dampening effect could not be replicated by the amount of macronutrient intake from snacks. On the contrary, the amount of carbohydrates has an enhancing effect on negative affective stress reactivity. In the end, our study suggests that the critical question is which mechanisms are decisive in the dampening role of snacking on stress reactivity. A multidisciplinary approach may provide a full perspective.

Childhood Adversity and Mental Health Correlates of Obesity in a Population at Risk

The staggering prevalence of obesity and obesity-related health conditions takes exorbitant tolls on health care resources. This cross-sectional study with private evaluations of 636 adult inmates in a southern state prison was conducted with regressions comparing obese (body mass index [BMI] ≥ 30) to nonobese individuals to define obesity risk factors. Obese individuals more likely were female, were victims of childhood sexual abuse, suffered greater severity of childhood sexual abuse, attempted suicide, reported drug dependency, were non-Caucasian, and were older than nonobese. Psychopathy predicted lower BMI. Though obesity might be expected in victims of childhood physical abuse, traumatic brain injury, or other mental health conditions due to mobility or decision-making deficits, neither were significant. Adjusting for related variables, childhood sexual abuse remained significant. Females attempted suicide more frequently and suffered greater childhood sexual abuse.

Visceral adipose tissue in patients with severe mental illness

Background Severe mental illnesses (SMIs), i.e. major depression, schizophrenia and bipolar disorder, are associated with an elevated risk for the development of type-2 diabetes mellitus and cardiovascular disorders. Several factors have been associated with increased cardiometabolic morbidity and mortality in SMI, including lifestyle factors (smoking, inactivity, unhealthy diet), endocrine and immunologic alterations; however, the underlying mechanisms remain to be fully uncovered. It is now well accepted that visceral adipose tissue (VAT) promotes the development of cardiometabolic disorders, at least in part by inflammatory and metabolic functions. Methods This paper reviews studies concerning VAT, with special focus on intra-abdominal and pericardial adipose tissue, in SMI. Results In patients with SMI, several studies have been performed concerning VAT. Most of these studies reported alterations of VAT particularly in patients with major depression and schizophrenia, independent of body weight and body mass index. Some of the studies also reported an increased cardiometabolic risk. Conclusion Patients with SMI are at increased risk of developing cardiometabolic disorders, and display increased amounts of VAT. As studies so far were mainly performed on patients before the onset of cardiometabolic disorders, VAT may serve as a biomarker for patients with SMI to assess cardiometabolic risks beyond established risk scores. Further, interventions aiming at reducing VAT in SMI are highly recommended in long-term multimodal treatment plans.

Diurnal and Reactivity Measures of Cortisol in Response to Intensive Resilience and Tactical Training Among Special Forces Police

Special Forces Police are called to the most dangerous situations that require skills and equipment beyond the training available to a patrol officer. We recruited a platoon of special forces (n = 18) and examined their basal and reactivity levels of cortisol in relation to occupational duties. Moreover, we measured the impact of a multiday program of intensive resilience and tactical training in improving cortisol responses to stressful situations. Participants were significantly more likely to exhibit basal cortisol levels higher than the civilian norms across all of the 5 days of intensive training. However, anticipatory cortisol, measured directly before exposure to critical incident scenarios, was significantly lower in Day 5 than in Day 1 of the training period. This study demonstrates that measuring cortisol is an objective method of examining training effects and possible long-term occupational health outcomes.

Adult adiposity linked to relationship hostility for low-cortisol reactors

Past research on the relation between hostility in intimate relationships and adiposity has yielded mixed findings. The present study investigated whether the association between relationship hostility and adiposity is moderated by people's biological reactions to couple conflict. Cohabiting adult couples (N = 117 couples) engaged in two conflict interactions, before and after which salivary cortisol levels were measured. Results revealed an association between relationship hostility and adiposity, but this association was concentrated among people with relatively low levels of cortisol reactivity to couple conflict. Results are interpreted in light of research demonstrating that cortisol reactivity can become blunted over time in response to repeated stressors. These results provide precision to etiological models of obesity by identifying cortisol reactivity as a factor that moderates the association between relationship hostility and adiposity. (PsycINFO Database Record

A Role for Exercise in Attenuating Unhealthy Food Consumption in Response to Stress

It is well established that both acute and chronic stress can be detrimental to health and wellbeing by directly increasing the risk of several chronic diseases and related health problems. In addition, stress may contribute to ill-health indirectly via its downstream effects on individuals’ health-related behaviour, such as promoting the intake of unhealthy palatable foods high in fat and sugar content. This paper reviews (a) the research literature on stress-models; (b) recent research investigating stress-induced eating and (c) the potential physiological and psychological pathways contributing to stress-induced eating. Particular attention is given to (d) the role of physical exercise in attenuating acute stress, with exploration of potential mechanisms through which exercise may reduce unhealthy food and drink consumption subsequent to stressor exposure. Finally, exercise motivation is discussed as an important psychological influence over the capacity for physical exercise to attenuate unhealthy food and drink consumption after exposure to stressors. This paper aims to provide a better understanding of how physical exercise might alleviate stress-induced unhealthy food choices.

The impact of chronic stress on the predictors of acute stress-induced eating in women

Chronic stress is associated with palatable food intake and thus, the development of obesity. This may be due to chronic stress disrupting the regulatory effects of the hypothalamic pituitary adrenal (HPA) axis on stress-induced eating. Thus, the primary objective of the current study was to investigate how chronic stress (CS) and cortisol stress reactivity affect eating behaviors following acute stress. Exploratory analyses also sought to determine the distinct psychophysiological factors driving acute stress-induced eating in women with high versus low CS. Women with high (n = 21) and low (n = 14) perceived CS were subjected to the Trier Social Stress task and a rest period on two separate days in order to assess HPA axis and subjective psychological responses to acute stress. Following either stress or rest, participants portioned and consumed snack foods. Women displaying high cortisol reactivity to acute stress ate a smaller percentage of the food they poured than low cortisol reactors, but only in the low CS group. Additionally, stress-induced eating behaviors were associated with cortisol stress reactivity, depressive symptoms, and hunger for women with low CS, but only with a reduction in negative affect for women with high CS. Results indicated that chronic stress may disrupt HPA axis regulation of acute stress-induced consummatory behavior in favor of affective regulation. Replication in women across the weight spectrum may yield a greater understanding of how chronic stress affects the mechanisms underlying acute stress-induced eating, and inform prevention and treatment efforts for conditions related to stress and obesity.

Dietary Manipulations That Induce Ketosis Activate the HPA Axis in Male Rats and Mice: A Potential Role for Fibroblast Growth Factor-21

In response to an acute threat to homeostasis or well-being, the hypothalamic-pituitary-adrenocortical (HPA) axis is engaged. A major outcome of this HPA axis activation is the mobilization of stored energy, to fuel an appropriate behavioral and/or physiological response to the perceived threat. Importantly, the extent of HPA axis activity is thought to be modulated by an individual's nutritional environment. In this study, we report that nutritional manipulations signaling a relative depletion of dietary carbohydrates, thereby inducing nutritional ketosis, acutely and chronically activate the HPA axis. Male rats and mice maintained on a low-carbohydrate high-fat ketogenic diet (KD) exhibited canonical markers of chronic stress, including increased basal and stress-evoked plasma corticosterone, increased adrenal sensitivity to adrenocorticotropin hormone, increased stress-evoked c-Fos immunolabeling in the paraventricular nucleus of the hypothalamus, and thymic atrophy, an indicator of chronic glucocorticoid exposure. Moreover, acutely feeding medium-chain triglycerides (MCTs) to rapidly induce ketosis among chow-fed male rats and mice also acutely increased HPA axis activity. Lastly, and consistent with a growing literature that characterizes the hepatokine fibroblast growth factor-21 (FGF21) as both a marker of the ketotic state and as a key metabolic stress hormone, the HPA response to both KD and MCTs was significantly blunted among mice lacking FGF21. We conclude that dietary manipulations that induce ketosis lead to increased HPA axis tone, and that the hepatokine FGF21 may play an important role to facilitate this effect.

Cortisol Stress Reactivity to the Trier Social Stress Test in Obese Adults

OBJECTIVE

Approximately 600 million adults worldwide suffer from obesity. In addition to individual's eating behavior and lack of physical activity in the development of obesity and overweight, psychosocial stress as well as hormonal stress reactivity must also be considered as important contributing factors. In the current study we compared the cortisol stress response pathway in a psychosocial stress induction (Trier Social Stress Test; TSST) with obese individuals and normal-weight controls.

METHOD

32 obese individuals (17 females; mean age = 33.94 years, SD = 11.31 years) and 32 normal-weight controls (17 females; mean age = 29.09 years, SD = 10.46 years) underwent the TSST. The salivary cortisol responses and three appraisal questionnaires (Primary Appraisal Secondary Appraisal, Visual Analogue Scale, Trier Inventory for Chronic Stress) were measured.

RESULTS

After stress induction, there was a significant main group difference between the obese individuals and the normal-weight controls for cortisol, with lower baseline and post-stress cortisol levels in the obese individuals. Nevertheless, the obese individuals as well as the normal-weight controls showed no significant difference in the self-reported assessment of the stress condition but some significant differences in the cognitive appraisal of the TSST.

CONCLUSION

In conclusion, the induction of psychosocial stress showed differences in the cortisol patterns between the obese individuals and the normal-weight controls. Furthermore, the present data suggest that obesity leads to lower cortisol activity, which may indicate alterations in the Hypothalamic-pituitary-adrencortical (HPA) axis.

Physical activity and negative affective reactivity in daily life

OBJECTIVE

The results from experimental studies indicate that physically active individuals remain calmer and report less anxiety after the induction of a standardized stressor. The current study extends this research to real life, and examines whether daily physical activity attenuates negative affect that occurs in response to naturally occurring daily stressors.

METHOD

The current study used data from the second wave of the National Study of Daily Experiences, a sub-study of the second wave of the Midlife in the United States Study (MIDUS-II) of 2,022 individuals aged 33-84 questioned nightly for eight consecutive days about their general affect and affective responses to stressful events and their engagement in physical activity.

RESULTS

Results indicated that while negative affect is significantly elevated on days with stressful events compared to days free of events in all individuals, these effects are attenuated in those who remain physically active when compared to those who were underactive. This was also true for any day participants were physically active. Importantly, negative affect in response to any specific stressor was reduced the closer in time that the stressor occurred to the bout of exercise in underactive participants, while, in active participants, negative affect in response to any stressor remained low throughout the entire day that participants reported that they were active.

CONCLUSION

Given the significant mental and physical health implications of elevated affective reactivity observed in previous studies, the current study sheds further light on the importance of remaining physically active in times of stress. (PsycINFO Database Record