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Kim KB, Shin YA. Males with Obesity and Overweight. J Obes Metab Syndr 2020; 29:18-25. [PMID: 32146733 PMCID: PMC7117999 DOI: 10.7570/jomes20008] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 01/27/2020] [Accepted: 02/13/2020] [Indexed: 01/09/2023] Open
Abstract
Global average data suggest that the prevalence of obese and overweight males is much higher than that of females in some regions. The gender gap in obese and overweight individuals has deepened in many countries, and the gap is more prominent in overweight than in obesity. In particular, the prevalence of male obesity has continuously increased in the Republic of Korea over the past two decades, whereas the increase in female obesity has slowed and may even have plateaued. The cutoff point for obesity in Korea is a body mass index of ≥25 kg/m2, which is equivalent to the international classification of being overweight. Researching obesity in males is not as prevalent as studying obesity in females. Previous studies have rarely considered obesity type (android vs. gynoid), hormones (testosterone, androgen, etc.), awareness of body shape, or special resources such as exercise interventions to improve male weight issues. Adaptations to exercise interventions show individual variability as well as differences between men and women. Therefore, integrated approaches to research should be adopted, including evaluation of socio-demographic and physiological characteristics, to ensure that such interventions are not simply a symptomatic treatment but are actually treating the root cause of the obesity.
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Affiliation(s)
- Kyoung-Bae Kim
- Department of Physical Education, Korea Military Academy, Seoul, Korea
| | - Yun-A Shin
- Department of Prescription and Rehabilitation of Exercise, College of Sport Science, Dankook University, Cheonan, Korea
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Stress Response and Appetite Regulation in Overweight and Normal-Weight Young Men: Preliminary Data. PSYCHOLOGICAL STUDIES 2019. [DOI: 10.1007/s12646-019-00479-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Chen Z, Guo Y, Feng T. Neuroanatomical correlates of time perspective: A voxel-based morphometry study. Behav Brain Res 2018; 339:255-260. [DOI: 10.1016/j.bbr.2017.11.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 09/28/2017] [Accepted: 11/03/2017] [Indexed: 11/28/2022]
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Guo Y, Chen Z, Feng T. The effect of future time perspective on delay discounting is mediated by the gray matter volume of vmPFC. Neuropsychologia 2017. [PMID: 28645750 DOI: 10.1016/j.neuropsychologia.2017.06.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Although several previous studies have shown that individuals' attitude towards time could affect their intertemporal preference, little is known about the neural basis of the relation between time perspective (TP) and delay discounting. In the present study, we quantified the gray matter (GM) cortical volume using voxel-based morphometry (VBM) methods to investigate the effect of TP on delay discounting (DD) across two independent samples. For group 1 (102 healthy college students; 46 male; 20.40 ± 1.87 years), behavioral results showed that only Future TP was a significant predictor of DD, and higher scores on Future TP were related to lower discounting rates. Whole-brain analysis revealed that steeper discounting correlated with greater GM volume in the ventromedial prefrontal cortex (vmPFC) and ventral part of posterior cingulate cortex (vPCC). Also, GM volume of a cluster in the vmPFC was correlated with Future TP. Interestingly, there was an overlapping region in vmPFC that was correlated with both DD and Future TP. Region-of-interest analysis further indicated that the overlapping region of vmPFC played a partially mediating role in the relation between Future TP and DD in the other independent dataset (Group 2, 36 healthy college students; 14 male; 20.18±1.80 years). Taken together, our results provide a new perspective from neural basis for explaining the relation between DD and future TP.
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Affiliation(s)
- Yiqun Guo
- Research center of Psychology and Social development, Faculty of Psychology, Southwest University, Chongqing, China
| | - Zhiyi Chen
- Research center of Psychology and Social development, Faculty of Psychology, Southwest University, Chongqing, China
| | - Tingyong Feng
- Research center of Psychology and Social development, Faculty of Psychology, Southwest University, Chongqing, China; Key Laboratory of Cognition and Personality, Ministry of Education, China.
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Bouret S, Levin BE, Ozanne SE. Gene-environment interactions controlling energy and glucose homeostasis and the developmental origins of obesity. Physiol Rev 2015; 95:47-82. [PMID: 25540138 PMCID: PMC4281588 DOI: 10.1152/physrev.00007.2014] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Obesity and type 2 diabetes mellitus (T2DM) often occur together and affect a growing number of individuals in both the developed and developing worlds. Both are associated with a number of other serious illnesses that lead to increased rates of mortality. There is likely a polygenic mode of inheritance underlying both disorders, but it has become increasingly clear that the pre- and postnatal environments play critical roles in pushing predisposed individuals over the edge into a disease state. This review focuses on the many genetic and environmental variables that interact to cause predisposed individuals to become obese and diabetic. The brain and its interactions with the external and internal environment are a major focus given the prominent role these interactions play in the regulation of energy and glucose homeostasis in health and disease.
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Affiliation(s)
- Sebastien Bouret
- The Saban Research Institute, Neuroscience Program, Childrens Hospital Los Angeles, University of Southern California, Los Angeles, California; Inserm U837, Jean-Pierre Aubert Research Center, University Lille 2, Lille, France; Neurology Service, Veterans Administration Medical Center, East Orange, New Jersey; Department of Neurology and Neurosciences, Rutgers, New Jersey Medical School, Newark, New Jersey; and University of Cambridge Institute of Metabolic Science and MRC Metabolic Diseases Unit, Cambridge, United Kingdom
| | - Barry E Levin
- The Saban Research Institute, Neuroscience Program, Childrens Hospital Los Angeles, University of Southern California, Los Angeles, California; Inserm U837, Jean-Pierre Aubert Research Center, University Lille 2, Lille, France; Neurology Service, Veterans Administration Medical Center, East Orange, New Jersey; Department of Neurology and Neurosciences, Rutgers, New Jersey Medical School, Newark, New Jersey; and University of Cambridge Institute of Metabolic Science and MRC Metabolic Diseases Unit, Cambridge, United Kingdom
| | - Susan E Ozanne
- The Saban Research Institute, Neuroscience Program, Childrens Hospital Los Angeles, University of Southern California, Los Angeles, California; Inserm U837, Jean-Pierre Aubert Research Center, University Lille 2, Lille, France; Neurology Service, Veterans Administration Medical Center, East Orange, New Jersey; Department of Neurology and Neurosciences, Rutgers, New Jersey Medical School, Newark, New Jersey; and University of Cambridge Institute of Metabolic Science and MRC Metabolic Diseases Unit, Cambridge, United Kingdom
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Vaccarino V, Kondwani KA, Kelley ME, Murrah NV, Boyd L, Ahmed Y, Meng YX, Gibbons GH, Hooper WC, De Staercke C, Quyyumi AA. Effect of meditation on endothelial function in Black Americans with metabolic syndrome: a randomized trial. Psychosom Med 2013; 75:591-9. [PMID: 23788695 PMCID: PMC3774317 DOI: 10.1097/psy.0b013e31829ac4f4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVES Psychological stress may play a role in metabolic syndrome. A consequence of metabolic syndrome is endothelial dysfunction, which is also influenced by psychological stress. We sought to compare the effect of consciously resting meditation (CRM), a sound based meditation, with a control intervention of health education (HE) on endothelial function in the setting of metabolic syndrome. METHODS Sixty-eight black Americans with metabolic syndrome risk factors (age, 30-65 years) were randomized to either CRM (n = 33) or HE (n = 35); interventions were matched for frequency and duration of sessions and lasted 12 months. Endothelial function was assessed by brachial artery flow-mediated dilation at baseline and at 6 and 12 months. Arterial elasticity, metabolic risk factors, and psychosocial and behavioral variables were secondary end points. RESULTS Although flow-mediated dilation improved in the CRM group for 12 months, this increase was not significantly higher than that in the HE group (p = .51 for the interaction between group and time). Non-endothelium-dependent dilation and arterial elasticity did not change in either group. Most metabolic syndrome risk factors showed beneficial trends in the CRM group only. A risk factor score counting the number of metabolic syndrome components decreased in the CRM group only (p = .049 for the interaction between treatment group and time). CONCLUSIONS Among black Americans with metabolic syndrome risk factors, CRM, did not improve endothelial function significantly more than a control intervention of HE. CRM resulted in favorable trends in metabolic syndrome risk factors, which were examined as secondary outcomes.
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Affiliation(s)
- Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
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Abstract
Adrenal steroidogenesis is under the control of the hypothalamic-pituitary-adrenal (HPA) axis. Furthermore, metabolic factors including insulin and obesity-related signals may play a role in the regulation of both enzymes involved in the steroidogenetic pathways, as well as in the regulation of the HPA axis. In women with the polycystic ovary syndrome (PCOS), cortisol production rate is probably normal, although adrenal androgens can be overproduced in a subset of affected women. Cortisol metabolism and regeneration from inactive glucocorticoids can also be disrupted in PCOS, thereby contributing to determining an adrenal hyperandrogenic state. Finally, overactivity of the HPA axis may be related to the high prevalence of psychopathological and eating disorders in women with PCOS, implying a maladaptive allostatic load in the adaptive mechanisms to chronic stress exposure.
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Affiliation(s)
- Renato Pasquali
- b Division of Endocrinology, Department of Clinical Medicine, University Alma Mater Studiorum, St. Orsola-Malpighi Hospital, Via Massarenti 9, 40138, Bologna, Italy.
| | - Alessandra Gambineri
- a Division of Endocrinology, Department of Clinical Medicine, University Alma Mater Studiorum, St. Orsola-Malpighi Hospital, Via Massarenti 9, 40138, Bologna, Italy
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Pasquali R. The hypothalamic-pituitary-adrenal axis and sex hormones in chronic stress and obesity: pathophysiological and clinical aspects. Ann N Y Acad Sci 2012; 1264:20-35. [PMID: 22612409 PMCID: PMC3464358 DOI: 10.1111/j.1749-6632.2012.06569.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Obesity, particularly the abdominal phenotype, has been ascribed to an individual maladaptation to chronic environmental stress exposure mediated by a dysregulation of related neuroendocrine axes. Alterations in the control and action of the hypothalamic-pituitary-adrenal axis play a major role in this context, with the participation of the sympathetic nervous system. The ability to adapt to chronic stress may differ according to sex, with specific pathophysiological events leading to the development of stress-related chronic diseases. This seems to be influenced by the regulatory effects of sex hormones, particularly androgens. Stress may also disrupt the control of feeding, with some differences according to sex. Finally, the amount of experimental data in both animals and humans may help to shed more light on specific phenotypes of obesity, strictly related to the chronic exposure to stress. This challenge may potentially imply a different pathophysiological perspective and, possibly, a specific treatment.
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Affiliation(s)
- Renato Pasquali
- Division of Endocrinology, Department of Clinical Medicine, S. Orsola-Malpighi Hospital, University Alma Mater Studiorum of Bologna, Bologna, Italy.
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Daubenmier J, Kristeller J, Hecht FM, Maninger N, Kuwata M, Jhaveri K, Lustig RH, Kemeny M, Karan L, Epel E. Mindfulness Intervention for Stress Eating to Reduce Cortisol and Abdominal Fat among Overweight and Obese Women: An Exploratory Randomized Controlled Study. J Obes 2011; 2011:651936. [PMID: 21977314 PMCID: PMC3184496 DOI: 10.1155/2011/651936] [Citation(s) in RCA: 175] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2011] [Accepted: 06/01/2011] [Indexed: 11/18/2022] Open
Abstract
Psychological distress and elevated cortisol secretion promote abdominal fat, a feature of the Metabolic Syndrome. Effects of stress reduction interventions on abdominal fat are unknown. Forty-seven overweight/obese women (mean BMI = 31.2) were randomly assigned to a 4-month intervention or waitlist group to explore effects of a mindfulness program for stress eating. We assessed mindfulness, psychological distress, eating behavior, weight, cortisol awakening response (CAR), and abdominal fat (by dual-energy X-ray absorptiometry) pre- and posttreatment. Treatment participants improved in mindfulness, anxiety, and external-based eating compared to control participants. Groups did not differ on average CAR, weight, or abdominal fat over time. However, obese treatment participants showed significant reductions in CAR and maintained body weight, while obese control participants had stable CAR and gained weight. Improvements in mindfulness, chronic stress, and CAR were associated with reductions in abdominal fat. This proof of concept study suggests that mindfulness training shows promise for improving eating patterns and the CAR, which may reduce abdominal fat over time.
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Affiliation(s)
- Jennifer Daubenmier
- Osher Center for Integrative Medicine, Department of Medicine, University of California, San Francisco, CA 94115, USA
- *Jennifer Daubenmier: and
| | - Jean Kristeller
- Department of Psychology, Indiana State University, Terre Haute, IN 47809, USA
| | - Frederick M. Hecht
- Osher Center for Integrative Medicine, Department of Medicine, University of California, San Francisco, CA 94115, USA
| | - Nicole Maninger
- California National Primate Research Center, University of California, Davis, CA 95616, USA
| | - Margaret Kuwata
- Osher Center for Integrative Medicine, Department of Medicine, University of California, San Francisco, CA 94115, USA
| | - Kinnari Jhaveri
- Osher Center for Integrative Medicine, Department of Medicine, University of California, San Francisco, CA 94115, USA
| | - Robert H. Lustig
- Department of Pediatrics, University of California, San Francisco, CA 94143, USA
| | - Margaret Kemeny
- Department of Psychiatry, University of California, San Francisco, CA 94143, USA
| | - Lori Karan
- Department of Medicine, University of California, San Francisco, CA 94143, USA
| | - Elissa Epel
- Department of Psychiatry, University of California, San Francisco, CA 94143, USA
- *Elissa Epel:
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George SA, Khan S, Briggs H, Abelson JL. CRH-stimulated cortisol release and food intake in healthy, non-obese adults. Psychoneuroendocrinology 2010; 35:607-12. [PMID: 19828258 PMCID: PMC2843773 DOI: 10.1016/j.psyneuen.2009.09.017] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2009] [Revised: 09/08/2009] [Accepted: 09/17/2009] [Indexed: 11/28/2022]
Abstract
BACKGROUND There is considerable anecdotal and some scientific evidence that stress triggers eating behavior, but underlying physiological mechanisms remain uncertain. The hypothalamic-pituitary-adrenal (HPA) axis is a key mediator of physiological stress responses and may play a role in the link between stress and food intake. Cortisol responses to laboratory stressors predict consumption but it is unclear whether such responses mark a vulnerability to stress-related eating or whether cortisol directly stimulates eating in humans. METHODS We infused healthy adults with corticotropin-releasing hormone (CRH) at a dose that is subjectively undetectable but elicits a robust endogenous cortisol response, and measured subsequent intake of snack foods, allowing analysis of HPA reactivity effects on food intake without the complex psychological effects of a stress paradigm. RESULTS CRH elevated cortisol levels relative to placebo but did not impact subjective anxious distress. Subjects ate more following CRH than following placebo and peak cortisol response to CRH was strongly related to both caloric intake and total consumption. CONCLUSIONS These data show that HPA axis reactivity to pharmacological stimulation predicts subsequent food intake and suggest that cortisol itself may directly stimulate food consumption in humans. Understanding the physiological mechanisms that underlie stress-related eating may prove useful in efforts to attack the public health crises created by obesity.
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Affiliation(s)
| | | | | | - James L. Abelson
- Corresponding author: James L. Abelson, M.D., Ph.D., 4250 Plymouth Rd (Box 5765), Ann Arbor, MI 48109-2700, tel: 734-764-5348; fax: 734-936-7868,
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11
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Wirtz PH, Ehlert U, Emini L, Suter T. Higher body mass index (BMI) is associated with reduced glucocorticoid inhibition of inflammatory cytokine production following acute psychosocial stress in men. Psychoneuroendocrinology 2008; 33:1102-10. [PMID: 18644679 DOI: 10.1016/j.psyneuen.2008.05.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2008] [Revised: 04/21/2008] [Accepted: 05/23/2008] [Indexed: 12/23/2022]
Abstract
BACKGROUND Body mass index (BMI) and mental stress seem to exert part of their cardiovascular risk by eliciting inflammation. However, the adverse effects of stress on inflammatory activity with BMI are not fully understood. We investigated whether higher BMI is associated with reduced glucocorticoid inhibition of inflammatory cytokine production following stress in men while controlling for age and blood pressure. We measured glucocorticoid inhibition of lipopolysaccharide (LPS)-stimulated release of the proinflammatory cytokine tumor necrosis factor (TNF)-alpha. METHODS Forty-two men (age range 21-65 years; BMI range 21-34 kg/m(2)) underwent the Trier Social Stress Test (combination of mock job interview and mental arithmetic task). Whole blood samples were taken immediately before and after stress, and during recovery up to 60 min post-stress. Glucocorticoid sensitivity of LPS-stimulated TNF-alpha expression was assessed in vitro with and without coincubating increasing doses of dexamethasone. Moreover, salivary cortisol was measured during the experiment and on a normal day for assessment of baseline circadian cortisol. RESULTS Higher BMI was associated with lower glucocorticoid sensitivity of monocyte TNF-alpha production after stress (main effect of BMI: p<0.001) and with more pronounced decreases of glucocorticoid sensitivity following stress (interaction of stress-by-BMI: p=0.002). Neither LPS-stimulated TNF-alpha release nor baseline glucocorticoid sensitivity were associated with BMI. Similarly, BMI was not associated with salivary cortisol, either in reaction to stress or in circadian cortisol secretion. CONCLUSIONS Our data suggest that with increasing BMI, glucocorticoids are less able to inhibit TNF-alpha production following stress. This might suggest a new mechanism linking BMI with elevated risk for adverse cardiovascular outcomes following stress.
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Affiliation(s)
- Petra H Wirtz
- Department of Clinical Psychology and Psychotherapy, University of Zurich, Switzerland.
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Purslow LR, Young EH, Wareham NJ, Forouhi N, Brunner EJ, Luben RN, Welch AA, Khaw KT, Bingham SA, Sandhu MS. Socioeconomic position and risk of short-term weight gain: prospective study of 14,619 middle-aged men and women. BMC Public Health 2008; 8:112. [PMID: 18400100 PMCID: PMC2323377 DOI: 10.1186/1471-2458-8-112] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2007] [Accepted: 04/09/2008] [Indexed: 12/02/2022] Open
Abstract
Background The association between socioeconomic position in middle age and risk of subsequent, short-term weight gain is unknown. We therefore assessed this association in a prospective population based cohort study in Norfolk, UK. Methods We analysed data on 14,619 middle-aged men and women (aged between 40–75 at baseline) with repeated objective measures of weight and height at baseline (1993–1997) and follow up (1998–2000). Results During follow up 5,064 people gained more than 2.5 kg. Compared with the highest social class, individuals in the lowest social class had around a 30% greater risk of gaining more than 2.5 kg (OR 1.29; 95% CI 1.11–1.51; p for trend = 0.002). This association remained statistically significant following adjustment for sex, age, baseline BMI, smoking, and follow up time (OR 1.25; CI 1.07–1.46; p for trend <0.001). We also found no material difference between unadjusted models and those including all confounders and potential mediators. Conclusion Individuals of low socioeconomic position are at greatest risk of gaining weight during middle age, which is not explained by classical correlates of socioeconomic position and risk factors for obesity.
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Affiliation(s)
- Lisa R Purslow
- MRC Epidemiology Unit, Institute of Metabolic Science, Cambridge, UK.
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Ross NA, Tremblay S, Khan S, Crouse D, Tremblay M, Berthelot JM. Body mass index in urban Canada: neighborhood and metropolitan area effects. Am J Public Health 2007; 97:500-8. [PMID: 17267734 PMCID: PMC1805015 DOI: 10.2105/ajph.2004.060954] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2005] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We investigated the influence of neighborhood and metropolitan area characteristics on body mass index (BMI) in urban Canada in 2001. METHODS We conducted a multilevel analysis with data collected from a cross-sectional survey of men and women nested in neighborhoods and metropolitan areas in urban Canada during 2001. RESULTS After we controlled for individual sociodemographic characteristics and behaviors, the average BMIs of residents of neighborhoods in which a large proportion of individuals had less than a high school education were higher than those BMIs of residents in neighborhoods with small proportions of such individuals (P< .01). Living in a neighborhood with a high proportion of recent immigrants was associated with lower BMI for men (P<.01), but not for women. Neighborhood dwelling density was not associated with BMI for either gender. Metropolitan sprawl was associated with higher BMI for men (P=.02), but the effect was not significant for women (P= .09). CONCLUSIONS BMI is strongly patterned by an individual's social position in urban Canada. A neighborhood's social condition has an incremental influence on the average BMI of its residents. However, BMI is not influenced by dwelling density. Metropolitan sprawl is associated with higher BMI for Canadian men, which supports recent evidence of this same association among American men. Individuals and their environments collectively influence BMI in urban Canada.
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Affiliation(s)
- Nancy A Ross
- Department of Geography, McGill University, Montreal, Quebec, Canada.
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Legendre A, Harris RBS. Exaggerated response to mild stress in rats fed high-fat diet. Am J Physiol Regul Integr Comp Physiol 2006; 291:R1288-1294. [PMID: 16793938 DOI: 10.1152/ajpregu.00234.2006] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
It has been suggested that high-fat (HF) diet exaggerates the stress-induced release of glucocorticoids due to activation of the hypothalamic-pituitary-adrenal (HPA) axis. In an initial experiment, in which rats were fed HF diet for 4 days, we found that HF-fed controls stopped gaining weight, indicating that they were hyperresponsive to the mild stress of tail bleeding but responded the same as low-fat (LF)-fed rats to the more severe stress of restraint. A second experiment confirmed these results when rats fed a HF diet for 4 days showed an exaggerated corticosterone release in response to an intraperitoneal injection of saline and movement to a novel cage, compared with LF-fed rats. Experiment 3 tested the same parameters as experiment 2 but interchanged the diets. This allowed us to differentiate between the effects of the dietary fat and the novelty of the diet. Additionally, this experiment determined whether hyperresponsiveness to mild stress in HF-fed rats was sustained during a prolonged exposure to diet. The results confirmed that a HF diet, not novelty, exaggerated the endocrine stress response after 9 days on the diet but that the effect was no longer present after 23 days on the diet. The hyperresponsiveness of the HPA axis in HF-fed rats is similar to that observed in animals that have been exposed to a significant chronic or acute stress, suggesting that the HF diet may initially be perceived as a stressor.
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Affiliation(s)
- Ariadne Legendre
- Dept. of Foods and Nutrition, Dawson Hall, Univ. of Georgia, Athens, GA 30602, USA.
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Pasquali R, Vicennati V, Cacciari M, Pagotto U. The Hypothalamic-Pituitary-Adrenal Axis Activity in Obesity and the Metabolic Syndrome. Ann N Y Acad Sci 2006; 1083:111-28. [PMID: 17148736 DOI: 10.1196/annals.1367.009] [Citation(s) in RCA: 225] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
A hypothetical role of glucocorticoids in human obesity has been suggested since the abdominal obesity phenotype and syndromes of endogenous or exogenous hypercortisolism share several clinical, metabolic, and cardiovascular similarities. An emerging body of evidence indicates that both neuroendocrine dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis as well as peripheral alterations of cortisol metabolism may play a role in the pathophysiology of abdominal obesity. Major alterations of the HPA axis in vivo may be identified in different ways. They include evaluation of hormone concentrations: (a) in basal conditions, in blood, urine, or saliva samples; (b) during dynamic studies following stimulation with different neuropeptides or psychological stress challenges, or suppression with inhibiting agents of the HPA axis at different levels; and (c) after mixed meals or meals containing different nutrient compositions. In addition, alteration of peripheral cortisol metabolism can be detected by direct measurement of cortisol metabolites in urine, although this is a matter of more complex investigation. Alterations of the HPA axis in abdominal obesity are associated with insulin resistance, which suggests a direct responsibility of these hormonal alterations in the susceptibility of affected patients to develop both metabolic and cardiovascular diseases. According to available data, no single marker probably has the power to detect subtle alterations of the HPA axis in conditions, such as the abdominal obesity and the metabolic syndrome. On the contrary, they indicate the need for multiple parameters. At present, evaluation of urinary free cortisol, particularly during the night-time, and salivary-free cortisol appear to be promising for these purposes, whereas dynamic tests should be reserved for specific clinical settings, involving well-characterized patients.
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Affiliation(s)
- Renato Pasquali
- Division of Endocrinology, Department of Internal Medicine, Centre for Applied Biomedical Research (C.R.B.A.), S. Orsola-Malpighi Hospital, University of Bologna, 40138 Bologna, Italy.
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Vicennati V, Ceroni L, Genghini S, Patton L, Pagotto U, Pasquali R. Sex difference in the relationship between the hypothalamic-pituitary-adrenal axis and sex hormones in obesity. Obesity (Silver Spring) 2006; 14:235-43. [PMID: 16571848 DOI: 10.1038/oby.2006.30] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE This study was carried out to investigate the role of sex in the regulation of the hypothalamic-pituitary-adrenal (HPA) axis and its relationship with testosterone levels in male and female obesity. RESEARCH METHODS AND PROCEDURES Twenty-two obese men (OB-M) and 29 obese women (OB-W) participated in the study. Two groups of normal weight men (NW-M) and women (NW-W), respectively, served as controls. In basal conditions, blood concentrations of major androgens, sex hormone-binding protein, and gonadotropins were assessed, and the free androgen index (testosterone x100/sex hormone-binding globulin) was calculated. All subjects underwent a combined corticotropin-releasing hormone plus arginine-vasopressin stimulation test. RESULTS OB-M and NW-M had higher basal adrenal cortical tropic hormone (ACTH) and cortisol levels than their female counterparts. In addition, ACTH, but not cortisol basal, levels were significantly higher in obese than in normal weight controls in both sexes. OB-W had a higher response than OB-M to the combined corticotropin-releasing hormone plus arginine-vasopressin test of both ACTH and cortisol [expressed as incremental percentage of area under the curve (AUC%)]. The same finding was present between NW-W and NW-M. Basal luteinizing hormone levels were negatively correlated to ACTH(AUC%) in both OB-W and OB-M. In the OB-W, however, a positive correlation was found between cortisol(AUC%) and testosterone (r = 0.48; p = 0.002), whereas a tendency toward a negative correlation was present in OB-M. DISCUSSION In conclusion, we have shown a significant positive relationship between the activity of the HPA axis and testosterone in obese women, which suggests a partial responsibility of increased HPA axis activity in determining testosterone levels. In addition, it clearly seems that, as reported in normal weight subjects, a sex difference in the HPA axis activity still persists even in the presence of obesity.
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Affiliation(s)
- Valentina Vicennati
- Division of Endocrinology, S. Orsola-Malpighi Hospital, University Alma Mater Studiorum, Bologna, Italy
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Abstract
OBJECTIVE To assess the relationship between adiposity and cardiovascular stress reactivity and recovery in middle-aged men and women, and investigate the influence of impaired poststress cardiovascular recovery on changes in body mass index (BMI) and waist-hip ratio over 3 y. PARTICIPANTS In total, 225 healthy men and women aged 47-59 y were recruited from the British civil service. METHODS Laboratory mental stress testing was carried out, with blood pressure (BP), cardiac output and total peripheral resistance being measured at baseline, during moderately challenging tasks, and during recovery 40-45 min poststress. Weight, height, waist and hip circumference were assessed at the time of mental stress testing and 3 y later. RESULTS Behavioural tasks elicited increases in BP sustained by a combination of cardiac activation and raised peripheral resistance. BMI and waist/hip ratio were associated cross-sectionally with impaired poststress recovery of systolic pressure, diastolic pressure and cardiac index independently of age, gender, socioeconomic status, smoking, alcohol consumption and baseline cardiovascular activity. Increases in waist-hip ratio over 3 y were predicted both by impaired poststress recovery of systolic pressure and cardiac index in men, independently of baseline adiposity and other covariates. No associations between subjective stress and BMI or waist-hip ratio were observed. CONCLUSIONS Disturbances of cardiovascular responsivity to psychological stress, manifest through impaired poststress recovery, were associated cross-sectionally with BMI, and longitudinally with central adiposity in men. Stress-related cardiovascular dysregulation may contribute to obesity risk.
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Affiliation(s)
- A Steptoe
- Department of Epidemiology and Public Health, University College London, UK.
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Wang M. The role of glucocorticoid action in the pathophysiology of the Metabolic Syndrome. Nutr Metab (Lond) 2005; 2:3. [PMID: 15689240 PMCID: PMC548667 DOI: 10.1186/1743-7075-2-3] [Citation(s) in RCA: 185] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2004] [Accepted: 02/02/2005] [Indexed: 12/11/2022] Open
Abstract
Glucocorticoids are stress hormones that modulate a large number of physiological actions involved in metabolic, inflammatory, cardiovascular and behavioral processes. The molecular mechanisms and the physiological effects of glucocorticoids have been extensively studied. However, the involvement of glucocorticoid action in the etiology of the Metabolic Syndrome has not been well appreciated. Recently, accumulating clinical evidence and animal genetics studies have attracted growing interest in the role of glucocorticoid action in obesity and insulin resistance. This review will discuss the metabolic effects in the context of glucocorticoid metabolism and establish the association of glucocorticoid action with the features of the Metabolic Syndrome, especially obesity and insulin resistance. Special discussions will be focused on corticosteroid-binding globulin and 11beta-hydroxysteroid dehydrogenase type 1, two proteins that mediate glucocorticoid action and have been implicated in the Metabolic Syndrome. Due to the complexities of the glucocorticoid biology and the Metabolic Syndrome and limited space, this review is only intended to provide a general link between the two areas with broad rather than in-depth discussions of clinical, pharmacological and genetic findings.
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Affiliation(s)
- Minghan Wang
- Department of Metabolic Disorders, Amgen Inc,, Thousand Oaks, CA, USA.
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Gluck ME, Geliebter A, Hung J, Yahav E. Cortisol, hunger, and desire to binge eat following a cold stress test in obese women with binge eating disorder. Psychosom Med 2004; 66:876-81. [PMID: 15564352 DOI: 10.1097/01.psy.0000143637.63508.47] [Citation(s) in RCA: 143] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Increased basal cortisol levels have been found in bulimia nervosa. After stress, increased cortisol levels have been associated with increased food intake in healthy women. Therefore, we assessed cortisol, hunger, and desire to binge eat after a cold pressor test (CPT) among women with binge eating disorder (BED). METHODS Twenty-two obese (body mass index [BMI] = 36.7 +/- 6.5 SD) females (11 non-BED, 11 BED) completed the Zung depression scale and underwent the CPT, hand submerged in ice water for 2 minutes. Over 60 minutes, periodic ratings of hunger and desire to binge eat were obtained, just before blood draws for cortisol, as well as insulin. On a separate day, participants had a 1-mg oral dexamethasone suppression test (DST). RESULTS The BED group had higher depression scores than the non-BED (p = .04), but depression was not a significant covariate for the cortisol response or to DST. After controlling for contraceptive use (n = 3), the BED group had higher basal cortisol than the non-BED group (p = .03), but cortisol did not differ after DST (p = .40). The BED group had nearly significant greater cortisol AUC after the CPT (p = .057) after controlling for insulin AUC and contraceptive use (p = .057). The BED group also had greater AUC for hunger (p = .03) and desire to binge eat (p = .02) after the CPT. CONCLUSION These findings support our hypothesis of a hyperactive HPA-axis in BED, which may contribute to greater hunger and binge eating.
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Affiliation(s)
- Marci E Gluck
- New York Obesity Research Center, Department of Medicine, St. Luke's/Roosevelt Hospital Center, New York, NY 10025, USA.
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20
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Hershberger AM, McCammon MR, Garry JP, Mahar MT, Hickner RC. Responses of lipolysis and salivary cortisol to food intake and physical activity in lean and obese children. J Clin Endocrinol Metab 2004; 89:4701-7. [PMID: 15356083 DOI: 10.1210/jc.2003-031144] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
This investigation was conducted to determine whether there were differences in lipolytic responses to feeding and physical activity between lean (LN) and obese (OB) children, and if these responses were related to cortisol. Fourteen LN and 11 OB children participated in this study of abdominal lipolysis and salivary cortisol response to breakfast and lunch with an intervening exercise session. Calculated fasting glycerol release was lower in OB than LN (0.645 +/- 0.06 vs. 0.942 +/- 0.11 micromol/ml; P < 0.05). Fasting adipose tissue nutritive flow was lower in OB than in LN subjects, but responses to feeding and exercise were not different. Breakfast elicited a decrease in interstitial glycerol concentration in LN (-33%; P < 0.05), but not in OB (-5%), children, although decreases in glycerol concentration in response to lunch were similar (LN, -41%; OB, -36%). An interaction was evident in the salivary cortisol response to breakfast (LN, no change; OB, increase) and exercise (LN, no change; OB, decrease), but there were no group differences in response to lunch. Alterations in salivary cortisol and lipolysis were not related. These data suggest that salivary cortisol and lipolytic responses are not necessarily linked, but are altered in obesity. Furthermore, prior exercise may improve the antilipolytic response to a meal in OB children.
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Affiliation(s)
- A M Hershberger
- Human Performance Laboratory, Departments of Exercise and Sport Science and Physiology, East Carolina University, Greenville, North Carolina 27858, USA
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21
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Steptoe A, Kunz-Ebrecht SR, Brydon L, Wardle J. Central adiposity and cortisol responses to waking in middle-aged men and women. Int J Obes (Lond) 2004; 28:1168-73. [PMID: 15211363 DOI: 10.1038/sj.ijo.0802715] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Central obesity is associated with disturbances of hypothalamic-pituitary-adrenocortical (HPA) axis function. We investigated whether central adiposity indexed by waist/hip ratio is related to cortisol responses to waking and other measures of salivary cortisol over the working day. PARTICIPANTS In total, 89 men and 83 women aged 47-59 y recruited from the British civil service. All were members of the Whitehall II epidemiological cohort. METHODS Saliva samples were collected on waking, 30 min later, and then at 2-h intervals from 0800-0830 to 2200-2230. A strict procedure for excluding individuals who did not adhere to the sampling schedule was applied. RESULTS Waist/hip ratio in men was positively correlated with the cortisol response to waking (30 min-waking value) after adjusting for age, socioeconomic position, smoking status, alcohol consumption, time of waking, and cortisol level on waking (r=0.29, P=0.009). The cortisol response to waking was negatively related to high-density lipoprotein (HDL) cholesterol (r=-0.25) and positively with total/HDL cholesterol ratio (r=0.25). Associations between the decline in cortisol over the day and waist/hip ratio, HDL cholesterol and total/HDL cholesterol ratios were also significant. No associations were significant in women, and body mass index was unrelated to cortisol. CONCLUSIONS The cortisol response to waking is a dynamic indicator of HPA function that has previously been related to chronic psychological stress. These results confirm a recent Swedish study, and indicate that cortisol responses to waking may be indicative of neuroendocrine disturbance in central obesity.
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Affiliation(s)
- A Steptoe
- Department of Epidemiology and Public Health, University College London, London, UK.
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22
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Ward AMV, Syddall HE, Wood PJ, Dennison EM, Phillips DIW. Central hypothalamic-pituitary-adrenal activity and the metabolic syndrome: Studies using the corticotrophin-releasing hormone test. Metabolism 2004; 53:720-6. [PMID: 15164318 DOI: 10.1016/j.metabol.2004.01.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A number of studies have suggested that the metabolic syndrome (principally, the combination of hypertension, glucose intolerance, and dyslipidemia) is associated with subtle dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis leading to raised circulating cortisol concentrations. The mechanisms underlying these observations are not known. We assessed the salivary cortisol response to awakening and pituitary-adrenal responses during a 100-microg human corticotrophin-releasing hormone (CRH) test and a dexamethasone-suppressed CRH test in a well-characterized group of 65-year-old men (n = 122). In the cohort from which this subgroup was drawn, there were associations between the components of the metabolic syndrome and 9 am cortisol concentration in line with previous studies. However, there were no significant associations between blood pressure, glucose tolerance, and lipid concentrations and the dynamic tests of HPA activity. We therefore found no evidence to suggest that exaggerated pituitary responsiveness or increased central drive to the pituitary, as determined by CRH testing, plays a part in the development of the metabolic syndrome.
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Affiliation(s)
- Alexandra M V Ward
- MRC Environmental Epidemiology Unit, University of Southampton, Southampton General Hospital, Southhampton, UK
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23
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Dickerson SS, Kemeny ME. Acute stressors and cortisol responses: a theoretical integration and synthesis of laboratory research. Psychol Bull 2004; 130:355-91. [PMID: 15122924 DOI: 10.1037/0033-2909.130.3.355] [Citation(s) in RCA: 3343] [Impact Index Per Article: 167.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This meta-analysis reviews 208 laboratory studies of acute psychological stressors and tests a theoretical model delineating conditions capable of eliciting cortisol responses. Psychological stressors increased cortisol levels; however, effects varied widely across tasks. Consistent with the theoretical model, motivated performance tasks elicited cortisol responses if they were uncontrollable or characterized by social-evaluative threat (task performance could be negatively judged by others), when methodological factors and other stressor characteristics were controlled for. Tasks containing both uncontrollable and social-evaluative elements were associated with the largest cortisol and adrenocorticotropin hormone changes and the longest times to recovery. These findings are consistent with the animal literature on the physiological effects of uncontrollable social threat and contradict the belief that cortisol is responsive to all types of stressors.
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Affiliation(s)
- Sally S Dickerson
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA.
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Rydén A, Sullivan M, Torgerson JS, Karlsson J, Lindroos AK, Taft C. Severe obesity and personality: a comparative controlled study of personality traits. Int J Obes (Lond) 2003; 27:1534-40. [PMID: 14634686 DOI: 10.1038/sj.ijo.0802460] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The primary purpose was to assess personality trait differences between the severely obese seeking treatment and a mainly non-obese reference group. We also investigated gender differences and differences between obese patients and obese not seeking treatment. METHOD Personality traits were assessed using 7 of 15 scales from the Karolinska Scales of Personality (KSP): Somatic Anxiety, Muscular Tension, Psychastenia, Psychic Anxiety, Monotony Avoidance, Impulsiveness, and Irritability. Patients from the Swedish Obese Subjects (SOS) intervention study (n=3270, ages 37-57, 71% women) and the SOS reference study (n=1135, 54% women) completed the survey. Data presented in this study were gathered prior to treatment. Significance tests and effects sizes were calculated. RESULTS Although statistically significant differences were found between obese patients and reference subjects on nearly all personality traits, effect sizes were at most moderate. Of the three scales with moderate effects sizes, differences on Somatic Anxiety and Psychastenia could be traced to items tapping condition-specific symptoms, e.g., problems with sweating and breathing as indicators of Somatic Anxiety. Moderate differences on the Impulsiveness scale (men alone) could not be explained by item composition. Further, the obese patients differed from obese in the reference group, and both obese and reference women reported significantly higher levels on Somatic Anxiety, Muscular Tension and Psychic Anxiety compared to men (effect size: small). CONCLUSIONS Our results provided no evidence of a general obese personality profile, instead considerable heterogeneity in personality traits was observed across our obese samples (treatment seekers vs non-seekers, men vs women) and generally only small differences were noted compared to a reference study population. Further research is needed to investigate if the somewhat elevated levels of Impulsiveness, particularly among male obese patients, is affected by weight loss. When assessing personality traits in diseased groups consideration should be given to possible confounding from, e.g., somatic symptoms.
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Affiliation(s)
- A Rydén
- Health Care Research Unit, Institute of Internal Medicine, Sahlgrenska University Hospital, Göteborg University, Sweden.
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25
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Michel C, Levin BE, Dunn-Meynell AA. Stress facilitates body weight gain in genetically predisposed rats on medium-fat diet. Am J Physiol Regul Integr Comp Physiol 2003; 285:R791-9. [PMID: 12816743 DOI: 10.1152/ajpregu.00072.2003] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
To assess the interaction between stress and energy homeostasis, we immobilized male Sprague-Dawley rats prone to diet-induced obesity (DIO) or diet resistance (DR) once for 20 min and then fed them either low-fat (4.5%) chow or a medium-fat (31%), high-energy (HE) diet for 9 days. Stressed, chow-fed DIO rats gained less, while stressed DIO rats on HE diet gained more body weight and had higher feed efficiency and plasma leptin levels than unstressed controls. Neither stress nor diet affected DR body weight gain. While stress-induced plasma corticosterone levels did not differ between phenotypes, DIO rats were initially more active in an open field and had higher hippocampal dentate gyrus and CA1 glucocorticoid receptor (GR) mRNA than DR rats, regardless of prior stress or diet. HE diet intake was associated with raised dentate gyrus and CA1 GR and amygdalar central nucleus (CeA) corticotropin-releasing hormone (CRH) mRNA expression, while stress was associated with reduced hypothalamic dorsomedial nucleus Ob-R mRNA and CeA CRH specifically in DIO rats fed HE diet. Thus a single stress triggers a complex interaction among weight gain phenotype, diet, and stress responsivity, which determines the body weight and adiposity of a given individual.
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Affiliation(s)
- Chantal Michel
- Neurology Service, Veterans Affairs Medical Center, Orange, NJ 07018-1095, USA
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26
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Niaura RS, Stroud LR, Todaro J, Ward KD, Spiro A, Aldwin C, Landsberg L, Weiss ST. Associations between repression, general maladjustment, body weight, and body shape in older males: The normative aging study. Int J Behav Med 2003; 10:221-38. [PMID: 14525718 DOI: 10.1207/s15327558ijbm1003_03] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
We examined relationships between repression, general maladjustment, body mass index (BMI), and waist-to-hip ratio (WHR). The participants were 1,081 healthy older men from the Normative Aging Study. Repression and General Maladjustment Scales of the Minnesota Multiphasic Personality Inventory were composite measures of personality. Repression was associated with lower BMI and WHR, and maladjustment with higher BMI and WHR. However, associations between WHR and personality dimensions were no longer significant when controlling for BMI, but associations between BMI and personality dimensions remained significant when controlling for WHR. These effects were explained by differing relationships between WHR, repression, and maladjustment for normal weight, overweight, and obese individuals. Specifically, associations between repression, maladjustment, and body shape were significant for normal weight and overweight individuals, but not for obese individuals. Health behaviors including smoking did not mediate relationships between repression, maladjustment, and body shape, but might be considered in future studies as mechanisms underlying links between personality and body shape.
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Affiliation(s)
- Raymond S Niaura
- Centers for Behavioral and Preventive Medicine, Brown Medical School and the Miriam Hospital, Providence, RI 02903, USA.
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27
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Rydén A, Karlsson J, Sullivan M, Torgerson JS, Taft C. Coping and distress: what happens after intervention? A 2-year follow-up from the Swedish Obese Subjects (SOS) study. Psychosom Med 2003; 65:435-42. [PMID: 12764217 DOI: 10.1097/01.psy.0000041621.25388.1a] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The study examined effects of weight change on coping and distress in severely obese subjects treated conventionally or undergoing weight reduction surgery. METHODS We used the Obesity Coping (OC) scale measuring emotion-focused, maladaptive coping (Wishful Thinking) and problem-focused, adaptive coping (Social Trust and Fighting Spirit). We also used the Obesity Distress (OD) scale (Intrusion and Helplessness) and the Hospital Anxiety and Depression (HAD) scale. A total of 1146 surgical candidates and 1085 conventionally treated patients completed the OC and OD before treatment and after 24 months. RESULTS Weight gainers reduced their use of both problem- and emotion-focused coping, thus leaving distress levels unchanged. All participants who lost weight decreased in emotion-focused coping and distress. Participants losing 20 kg or more also increased in problem-focused coping, resulting in even greater improvements regarding distress. CONCLUSIONS Two years after starting treatment, the pattern and magnitude of change in coping and distress was the same irrespective of type of treatment and was, instead, related to the amount of weight change (the more weight change the greater the changes in coping and distress). Increases in problem-focused coping required major weight reduction, whereas minor weight gain led to a decrease. Emotion-focused coping decreased irrespective of direction of weight change, suggesting a general intervention effect of receiving professional help and support. These results have implications concerning behavior-based interventions of obese patients.
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Affiliation(s)
- Anna Rydén
- Health Care Research Unit, Institute of Internal Medicine, Sahlgrenska University Hospital, Göteborg University, Sweden.
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28
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Ball K, Mishra GD, Crawford D. Social factors and obesity: an investigation of the role of health behaviours. Int J Obes (Lond) 2003; 27:394-403. [PMID: 12629569 DOI: 10.1038/sj.ijo.0802237] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES This study evaluated a behavioural model of the relation between social factors and obesity, in which differences in body mass index (BMI) across sociodemographic groups were hypothesized to be attributable to social group differences in health behaviours affecting energy expenditure (physical activity, diet and alcohol consumption and weight control). METHODS A total of 8667 adults who participated in the 1995 Australian National Health and Nutrition Surveys provided data on a range of health factors including objectively measured height and weight, health behaviours, and social factors including family status, employment status, housing situation and migration status. RESULTS Social factors remained significant predictors of BMI after controlling for all health behaviours. Neither social factors alone, nor health behaviours alone, adequately explained the variance in BMI. Gender-specific interactions were found between social factors and individual health behaviours. CONCLUSIONS These results suggest that social factors moderate the relation between BMI and weight-related behaviours, and that the mechanisms underlying sociodemographic group differences in obesity may vary among men and women. Additional factors are likely to act in conjunction with current health behaviours to explain variation in obesity prevalence across sociodemographic groups.
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Affiliation(s)
- K Ball
- School of Health Sciences, Deakin University, Australia.
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29
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Abstract
Many studies have shown that fat distribution influences metabolism independently of the effects of total body fat stores. The accumulation of fat in the abdominal area, particularly in the visceral fat compartment, seems to be associated with an increased risk to display complications such as insulin resistance, diabetes, dyslipidemias and atherosclerosis. As reviewed in this paper, the mechanisms explaining this impact of fat distribution is not clearly established, although evidence suggests that free-fatty acids, leptin, TNF-alpha, PPAR-gamma, and F are directly or indirectly involved in this process. Despite a lot of research has yet to be performed to mechanistically characterize the impact of visceral fat on the metabolic profile, there is enough consensus in the literature about its effect to justify its consideration in a clinical setting. In this regard, the use of waist circumference as a clinical marker of variations in visceral fat is highly relevant and should be encouraged. This review also presents an evolutionary perspective according to which body fat gain would have been and may still remain an adaptation that helps to deal with stress and inflammation.
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Affiliation(s)
- C Gasteyger
- Division of Kinesiology, Faculty of Medicine, Laval University, Ste-Foy, Québec, Canada
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Cota D, Vicennati V, Ceroni L, Morselli-Labate AM, Pasquali R. Relationship between socio-economic and cultural status, psychological factors and body fat distribution in middle-aged women living in Northern Italy. Eat Weight Disord 2001; 6:205-13. [PMID: 11808816 DOI: 10.1007/bf03339744] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
This study analyses the relationships between body fat distribution and socioeconomic and psychological factors in a cohort of 426 healthy middle-aged women living in Virgilio, Mantua (Northern Italy). The information concerning their occupational, social and psychological conditions and smoking habits were obtained by means of questionnaires. Psychological factors were investigated using the Italian version of the Illness Behaviour Questionnaire and the Symptom Questionnaire. Anthropometric measurements, body mass index (BMI) (kg/m2), waist/hip ratio (WHR) and clinical/hormonal menopausal status were also collected for each subject. The women reported significantly higher or lower psychological factor scores (symptoms of conversion: p=0.005; perception of disease: p=-0.018; denial: p=0.021; hostility: p=0.57; and laxity: p=0.047) as their WHR increased, thus indicating some concern about their health. In a multiple regression model, their WHR and waist circumference (W) significantly correlated with symptoms of conversion (p=0.005 and p=0.029), and W was also significantly related to the perception of disease (p=0.043). There was a significant inverse correlation between the WHR and educational level (p<0.001). The prevalence of partners who were entrepreneurs or self-employed also decreased as WHR increased (p<0.001). Furthermore, the number of women living in the centre of town significantly diminished, whereas those living in the suburbs or in the country significantly increased (p=0.005). However, using age, BMI and menopausal status as covariates, only the partner's work significantly and negatively correlated with the WHR (p=0.029). These results are consistent with the hypothesis that psychological and socio-economic handicaps are associated with a higher prevalence of abdominal fatness in middle-aged women living in Northern Italy
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Affiliation(s)
- D Cota
- Department of Internal Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Italy
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Vierhapper H, Nowotny P. The stress of being a doctor: steroid excretion rates in internal medicine residents on and off duty. Am J Med 2000; 109:492-4. [PMID: 11042240 DOI: 10.1016/s0002-9343(00)00578-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- H Vierhapper
- Clinical Division of Endocrinology and Metabolism, Department of Internal Medicine III, University of Vienna, Vienna, Austria
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Abstract
Cortisol in obesity is a much-studied problem. Previous information indicates that cortisol secretion is elevated but that circulatory concentrations are normal or low, suggesting that peripheral disappearance rate is elevated. These studies have usually not taken into account the difference between central and peripheral types of obesity. Recent studies using saliva cortisol have indicated that the problem is complex with both high and low secretion of cortisol, perhaps depending on the status of the function of the hypothalamic-pituitary-adrenal gland axis. A significant background factor seems to be environmental stress. The results also suggest that the pattern of cortisol secretion may be important. Other neuroendocrine pathways are also involved, including the central sympathetic nervous system, the gonadal and growth hormone axes, and the leptin system. In concert, these abnormalities seem to be responsible for the abnormal metabolism often seen in central obesity. Several associated polymorphisms of candidate genes may provide a genetic background. Cortisol conversion to inactive metabolites may be a factor increasing central signals to secretion and may add to the increased secretion of cortisol induced by centrally acting factors. Perinatal factors have been found to be involved in the pathogenesis of obesity and its complications. The mechanism involved is not known, but available information suggests that programming of the hypothalamic-pituitary-adrenal axis may be responsible.
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Affiliation(s)
- P Björntorp
- Department of Heart and Lung Diseases, Sahlgren's Hospital, University of Göteborg, Göteborg, Sweden.
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Levin BE, Richard D, Michel C, Servatius R. Differential stress responsivity in diet-induced obese and resistant rats. Am J Physiol Regul Integr Comp Physiol 2000; 279:R1357-64. [PMID: 11004005 DOI: 10.1152/ajpregu.2000.279.4.r1357] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The relationship between stress and obesity was assessed in male rats selectively bred to develop either diet-induced obesity (DIO) or diet resistance (DR) when fed a high-energy, 31% fat diet for 3 wk followed by 2 wk on a hyperphagic liquid diet (Ensure). One-half of the rats of each phenotype were subjected to moderate daily, unpredictable stress (cage changing, exposure to conspecific, swim, and immobilization stress, intraperitoneal saline injection) during the 5 wk. Both stressed and unstressed DIO rats were 26% heavier and ate 27% more than comparable DR rats at onset and had 48% lower basal morning plasma corticosterone levels. Stressed DR rats gained less weight and had significant elevations of basal morning corticosterone but reduced basal sympathetic activity (24-h urine norepinephrine) over 5 wk compared with their unstressed DR controls. Terminally, there was a 35% increase in the paraventricular nucleus corticotropin-releasing hormone mRNA expression. On the other hand, stressed DIO rats showed only a transient early increase in open-field activity and a terminal increase in basal corticosterone levels as the only effects of stress. Thus DIO rats are hyporesponsive to chronic stress compared with DR rats. This is in keeping with several other known differences in hypothalamopituitary and autonomic function in this model.
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Affiliation(s)
- B E Levin
- Neurology Service, Department of Veterans Affairs Medical Center, East Orange 07018, USA.
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