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Manzanares N, Monseny R, Ortega L, Montalvo I, Franch J, Gutiérrez-Zotes A, Reynolds RM, Walker BR, Vilella E, Labad J. Unhealthy lifestyle in early psychoses: the role of life stress and the hypothalamic-pituitary-adrenal axis. Psychoneuroendocrinology 2014; 39:1-10. [PMID: 24274999 DOI: 10.1016/j.psyneuen.2013.09.023] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Revised: 08/31/2013] [Accepted: 09/24/2013] [Indexed: 10/26/2022]
Abstract
An unhealthy lifestyle is thought to contribute to the metabolic syndrome in subjects with psychoses. In the present study we aimed to study whether life stress or cortisol measures may influence dietary patterns in subjects with early stages of psychoses. We studied 81 subjects with early psychoses (65 subjects with a psychotic disorder [PD] and <5 years of illness; 16 subjects at risk for psychosis [high-risk, HR]) and a control group of 25 healthy subjects (HS). Dietary habits were examined by a dietician, who registered food intake (24h recall). Physical activity was assessed by validated questionnaire. Life stress was assessed with Holmes-Rahe Social Readjustment Scale. Fasting morning salivary and plasma cortisol levels were determined. We found that PD and HR reported an unhealthier lifestyle with more smoking, reduced physical activity and poorer dietary habits. HR reported increased intake of calories and saturated fatty acids and reduced protein consumption, when compared to HS. Life stress was a predictor of these adverse behaviours, although we found opposite associations in HR and PD. Life stress was associated with increased intake of refined sugar in PD and decreased intake in HR and HS. Salivary cortisol was related to increased intake of saturated fat only in HR subjects, but cortisol levels in plasma or saliva were not associated with other dietary habits or obesity measures (BMI, waist circumference). Our study suggests that unhealthy diet in early psychoses is influenced by stress, but our data do not support this effect being mediated by hypercortisolism. Future preventive interventions in psychosis may target dietary habits, particularly for those who are at risk for psychosis.
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Affiliation(s)
- Núria Manzanares
- Early Psychosis Program and Research Department, HPU Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Rosa Monseny
- Early Psychosis Program and Research Department, HPU Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Laura Ortega
- Early Psychosis Program and Research Department, HPU Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Itziar Montalvo
- Early Psychosis Program and Research Department, HPU Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Joan Franch
- Early Psychosis Program and Research Department, HPU Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Alfonso Gutiérrez-Zotes
- Early Psychosis Program and Research Department, HPU Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Rebecca M Reynolds
- Endocrinology Unit, University/BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Brian R Walker
- Endocrinology Unit, University/BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Elisabet Vilella
- Early Psychosis Program and Research Department, HPU Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Javier Labad
- Early Psychosis Program and Research Department, HPU Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain.
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Association between perceived racism and physiological stress indices in Native Hawaiians. J Behav Med 2011; 35:27-37. [PMID: 21360284 DOI: 10.1007/s10865-011-9330-z] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2010] [Accepted: 02/09/2011] [Indexed: 01/26/2023]
Abstract
The association between racism and the physical health of native U.S. populations has yet to be examined despite their high risk for stress-related disorders and a history of discrimination toward them. We examined the correlation between perceived racism and the two physiological stress indices of cortisol level and blood pressure in 146 adult Native Hawaiians. Attributed and felt racism were assessed with a 10-item shortened version of the Oppression Questionnaire. Height, weight, blood pressure, and salivary cortisol samples (AM and PM) were collected and analyzed along with information on Hawaiian ancestry, BMI, age, sex, marital status, education level, general psychological stress, and ethnic identity. The results indicated that Native Hawaiians reporting more attributed racism had significantly (P < .05) lower average cortisol levels than those reporting less attributed racism, after adjusting for socio-demographic, biological, and psychosocial confounders. Native Hawaiians reporting more felt racism had a significantly higher systolic blood pressure than those reporting less, but this association was not significant after adjusting for the aforementioned confounders. Racism appears to be a chronic stressor that can "get under the skin" of Native Hawaiians by affecting their physical health and risk for stress-related diseases, possibly, through mechanisms of cortisol dysregulation.
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Grossniklaus DA, Gary RA, Higgins MK, Dunbar SB. Biobehavioral and psychological differences between overweight adults with and without waist circumference risk. Res Nurs Health 2010; 33:539-51. [PMID: 21053387 PMCID: PMC3707927 DOI: 10.1002/nur.20411] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2010] [Indexed: 11/11/2022]
Abstract
Waist circumference (WC) has emerged as an independent predictor of cardiometabolic disease. The purpose of this study was to examine differences between overweight adults with and without WC risk in four domains: demographic, clinical and biological, psychological, and behavioral. The sample (N = 87) was primarily sedentary, middle-aged, women, and African-Americans. The majority of participants had WC risk, those with WC risk were older, were women, and had higher body mass index, higher morning salivary cortisol levels, and more depressive symptoms than those without WC risk. Caloric and macronutrient intake did not differ between those with and without WC risk. Our findings could lead to the development of targeted interventions to prevent and/or reduce abdominal obesity, thereby reducing cardiometabolic risk.
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Affiliation(s)
- Daurice A Grossniklaus
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Northeast, Atlanta, GA 30322, USA.
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