Does stress induce salt intake?

Association of psychological stress with wives' hypertension across over 10 million Chinese married female population aged 20-49 years

BACKGROUND

Psychological stress has been reported to be a potential risk factor for hypertension among females, but it remains unclear whether spousal chronic stress levels alter the risk of hypertension among women. We examined the associations between stress within the family and hypertension among married women.

METHODS

Reproductive-aged women who were planning for pregnancy and their husbands were recruited from the National Free Pre-pregnancy Checkup Projects (NFPCP) across 31 provinces in China in 2016 and 2017. Perceived stress of wives or husbands was measured with a 5-point Likert-type scale, and assessed from three domains: work/life-related stress, economic stress, and overall stress. Multivariable-adjusted logistic regression models were used to assess the associations between stress status and the prevalence of hypertension.

RESULTS

Of 10,027,644 couples, 261,098 (2.60%) women had hypertension. The results showed that higher stress levels among themselves or their husbands were associated with a higher prevalence of hypertension in women ( Pfor trend <0.001). Compared with non-stressed participants, female participants with the highest stress themselves were at a greater risk of hypertension, with adjusted odds ratio (OR) of 1.31 (95% confidence interval [CI]: 1.25-1.37); and compared with participants whose husbands had no stress, those whose husbands had the highest stress level were at a higher risk of hypertension with adjusted OR of 1.24 (95% CI: 1.20-1.29). Moreover, compared with non-stressed status for both couples, only-wife-stressed, only-husband-stressed, and both-stressed couples were found to be significantly associated with increased risks of wives' hypertension, with adjusted ORs of 1.28 (95% CI: 1.25-1.31), 1.19 (95% CI: 1.17-1.21), and 1.28 (95% CI: 1.26-1.31), respectively.

CONCLUSION

Moderate to severe stress in both spouses might be associated with female hypertension prevalence, which highlights the importance of paying attention to the psychological stresses of couples within the family.

Mental Health Conditions, Including Depression and Stress, Are Associated with Increased Odds of Gastric Cancer-Insights into the Role of Diet: A Case-Control Study

Several risk factors, including nutritional/lifestyle ones, play a role in gastric cancer etiology. Further interactions with mental health have also been emphasized. We hypothesized that individuals with mental disorders would exhibit compromised nutrient intake, increasing their risk of gastric cancer. The state of mental health was evaluated in 82 patients with gastric cancer and 95 healthy controls using the 21-item Depression-Anxiety-Stress Scale. The participants' dietary intakes were evaluated by a 168-item food frequency questionnaire. Based on fully adjusted logistic regressions, there was a significant association between depression (OR = 1.938, CI 95%: 1.009-3.723) and stress (OR = 2.630, CI 95%: 1.014-6.819) with increased odds of gastric cancer. According to fully adjusted multinomial regressions, vitamins A and B6, beta-carotene, and black tea decreased the odds of depression, based on comparing the control group with cases of depression, while sugar and salt increased its odds. The highest significant association was found for salt intake and anxiety in cases with present anxiety (OR = 4.899, 95% CI: 2.218-10.819), and the highest significant protective effect was found for vitamin B6 and depression in cases with present depression (OR = 0.132, 95% CI: 0.055-0.320). However, considering causal relationships and clarifying the underlying mechanisms is imperative and requires further investigation. Advising healthy dietary patterns, e.g., a Mediterranean diet rich in vitamins, minerals, and phytochemicals such as vitamin A, B6, beta-carotene, and fiber, is expected to reduce the odds of gastric cancer, possibly related to lower levels of anxiety and depression.

Relationship between nocturia and hypertension: findings from the NHANES 2005-2016

Objectives

The objective of this study was to explore the association between nocturia and hypertension in a large, nationally representative adult sample.

Methods

We used data from 2005 to 2016 National Health and Nutritional Examination Surveys (NHANES). A total of 29,505 participants aged 20 years old or older were included. A participant was considered to have nocturia if he or she had two or more voiding episodes at night. Multivariable logistic regression models were used to explore the association between nocturia and hypertension.

Results

Participants with nocturia were associated with a higher risk of hypertension (OR, 1.36; 95% CI, 1.28-1.45). Interaction tests revealed no significant effect of sex, age, race, or body mass index on the association of nocturia with hypertension. As the severity of nocturia increases, the risk of hypertension increases (P for trend <0.0001). In addition, nocturia was also related to different grades of hypertension (II vs. I: OR, 1.34, 95% CI, 1.16-1.55; III vs. I: OR, 1.67, 95% CI, 1.32-2.13).

Conclusion

In this cross-sectional study, our results suggest that nocturia is associated with an increased risk for hypertension.

Food Selection Under Stress Among Undergraduate Students in Riyadh, Saudi Arabia

Background

University students might experience numerous sources of stress in their daily lives. Previous research has found that stress affects food selection patterns, but the effect might vary by country and sex. No previous study conducted in Saudi Arabia has assessed the association between stress and dietary habits among university students. Thus, this study aimed to examine the association between perceived stress and food selection patterns among undergraduate students by sex at King Saud University (KSU).

Methods

A cross-sectional study of 400 students attending the College of Applied Medical Sciences in Riyadh, Saudi Arabia, was conducted. The self-administered questionnaire that was used consisted of three sections: sociodemographic, food frequency questionnaire, and Cohen's Perceived Stress Scale.

Results

Approximately (59.0%) of the participants reported suffering from some level of stress, with more females (64.5%) experiencing stress than males (54.0%). The univariate analysis showed that under stress, more females (68.0%) reported eating more than usual than males (49.0%), while the percentage of respondents that reported eating less than usual was higher for females (23.0%) than that for males (31.0%). The McNemar test indicated that under stress, there was an increased preference for salty flavors, which was not associated with sex. Significantly more females (82.0%) than males (64.5%) reported preferring sweets under stress. More males reported preferring bitter and savory flavors than females. Under stress, females preferred homemade food, while males preferred takeout foods. More females (68.0%) reported losing control and overeating than males (49.0%). A logistic regression showed that for female students, perceived stress was associated with frequent consumption of sweets, cake/cookies, snacks and beverages and less frequent consumption of fruits and vegetables. For males, the consumption of fast food and meat was significantly positively associated with perceived stress.

Conclusion

Perceived stress led to unhealthy changes in eating patterns in both sexes, as evidenced by reports of an increased preference for sweets, snacks and cake/cookies among females and an increased preference for fast food and meat among males. These results may be potentially important targets for interventions for stress-related food consumption.

High salt intake enhances swim stress-induced PVN vasopressin cell activation and active stress coping

PURPOSE

Stress contributes to many psychiatric disorders; however, responsivity to stressors can vary depending on previous or current stress exposure. Relatively innocuous heterotypic (differing in type) stressors can summate to result in exaggerated neuronal and behavioral responses. Here we investigated the ability of prior high dietary sodium chloride (salt) intake, a dehydrating osmotic stressor, to enhance neuronal and behavioral responses of mice to an acute psychogenic swim stress (SS). Further, we evaluated the contribution of the osmo-regulatory stress-related neuropeptide arginine vasopressin (VP) in the hypothalamic paraventricular nucleus (PVN), one of only a few brain regions that synthesize VP. The purpose of this study was to determine the impact of high dietary salt intake on responsivity to heterotypic stress and the potential contribution of VPergic-mediated neuronal activity on high salt-induced stress modulation, thereby providing insight into how dietary (homeostatic) and environmental (psychogenic) stressors might interact to facilitate psychiatric disorder vulnerability.

APPROACH

Salt loading (SL) with 4% saline for 7 days was used to dehydrate and osmotically stress mice prior to exposure to an acute SS. Fluid intake and hematological measurements were taken to quantify osmotic dehydration, and serum corticosterone levels were measured to index stress axis activation. Immunohistochemistry (IHC) was used to stain for the immediate early gene product c-Fos to quantify effects of SL on SS-induced activation of neurons in the PVN and extended amygdala - brain regions that are synaptically connected and implicated in responding to osmotic stress and in modulation of SS behavior, respectively. Lastly, the role of VPergic PVN neurons and VP type 1 receptor (V1R) activity in the amygdala in mediating effects of SL on SS behavior was evaluated by quantifying c-Fos activation of VPergic PVN neurons and, in functional experiments, by nano-injecting the V1R selective antagonist dGly[Phaa1,d-tyr(et), Lys, Arg]-VP bilaterally into the amygdala prior to the SS.

FINDINGS

SL increased serum osmolality (P < 0.01), which positively correlated with time spent mobile during, and time spent grooming after a SS (P < 0.01, P < 0.01), and SL increased serum corticosterone levels (P < 0.01). SL alone increased c-Fos immunoreactivity among PVN neurons (P = .02), including VP positive neurons (P < 0.01). SL increased SS-induced c-Fos activation of PVN neurons as well (P < 0.01). In addition, SL and SS each increased the total number of PVN neurons that were immunoreactive for VP (P < 0.01). An enhancing effect of SL and SS was observed on c-Fos positive cell counts in the central (P = .02) and basolateral (P < 0.01) nuclei of the amygdala and bilateral nano-injections of V1R antagonist into the amygdala reduced time spent mobile both in salt loaded and control mice during SS (P < 0.05, P < 0.05).

SUMMARY

Taken together, these data indicate that neuronal and behavioral responsivity to an acute psychogenic stressor is potentiated by prior exposure to high salt intake. This synergistic effect was associated with activation of PVN VP neurons and depended, in part, on activity of V1 receptors in the amygdala. Findings provide novel insight into neural mechanisms whereby prior exposure to a homeostatic stressor such as osmotic dehydration by excessive salt intake increases responsivity to a perceived stress. These experiments show that high dietary salt can influence stress responsivity and raise the possibility that excessive salt intake could be a contributing factor in the development of stress-related psychiatric disorders.

Interaction of stress and dietary NaCl intake in hypertension: renal neural mechanisms

A synthesizing concept of the development of primary hypertension is that it arises from an interaction of genetic and environmental factors. Of the environmental factors, dietary NaCl intake and mental stress are among the most thoroughly investigated. This review will focus on the interaction between genetic predisposition and the environmental influences of dietary NaCl intake and mental stress in the development of primary hypertension.

Neighborhood food environment role in modifying psychosocial stress-diet relationships

Exposure to highly palatable foods may increase eating in response to stress, but this behavioral response has not been examined in relation to the neighborhood food environment. This study examined whether the neighborhood food environment modified relationships between psychosocial stress and dietary behaviors. Probability-sample survey (n=460) and in-person food environment audit data were used. Dietary behaviors were measured using 17 snack food items and a single eating-out-of-home item. Chronic stress was derived from five subscales; major life events was a count of nine items. The neighborhood food environment was measured as availability of large grocery stores, small grocery stores, and convenience stores, as well as proportion of restaurants that were fast food. Two-level hierarchical regression models were estimated. Snack food intake was positively associated with convenience store availability and negatively associated with large grocery store availability. The measures of chronic stress and major life events were generally not associated with either dietary behavior overall, although Latinos were less likely to eat out at high levels of major life events than African Americans. Stress-neighborhood food environment interactions were not statistically significant. Important questions remain regarding the role of the neighborhood food environment in the stress-diet relationship that warrant further investigation.

Emergency department patients self-report higher patient inertia, hopelessness, and harmful lifestyle choices than community counterparts

Patient inertia is defined as an individual's failure to take responsibility for proactive lifestyle change and health conditions including hypertension. Generalized and hypertension-specific patient inertia factors were compared in 110 patients (48% women; 52% African American) from a Forsyth County, NC, emergency department (ED) and 104 community members (79% women; 70% African American) using the patient inertia-facilitated survey Patient Inertia-36. Statistically, more ED than community participants added salt to food at the table and consumed fast foods 5 to 7 days a week. ED patients agreed less often with health literacy questions about salt and BP. Hypertension associated Patient inertia questions asked of 45 ED and 40 community participants with a personal history of hypertension revealed a statistically higher sense of hopelessness surrounding blood pressure management in ED participants. Past BP control experiences of family members had statistically greater impact on community participants regarding their own BP control. Using a logistic regression model, advancing age and being surveyed in the ED were correlated with hopelessness towards BP control. ED patients make unhealthier diet choices and possess heightened generalized and hypertension-specific patient inertia including hopelessness towards controlling their BP that increases with age. These factors may contribute to this population's poor BP control, particularly self-efficacy barriers.