Marital discord, past depression, and metabolic responses to high-fat meals: Interpersonal pathways to obesity

"I'm Ready This Time": Investigating physiological and emotional habituation to repetitive social stress

BACKGROUND

Repetitive stress is at the nexus of acute and chronic stress, and there is limited knowledge about how physiological and emotional responses change with repeated exposure.

PURPOSE

We examined stress-related biomarkers and emotional responses to repeated social stressors, and we tested behavioral moderators.

METHODS

In Study 1, 42 adults completed the Trier Social Stress Test (TSST) twice, 4 months apart. Serum inflammatory cytokines (interleukin-6 [IL-6], tumor necrosis factor-α [TNF-α]), blood pressure, pulse, salivary cortisol, and state-level anxiety were measured surrounding the stressor. In Study 2, 84 married individuals completed two 20-minute discussions of contentious topics in the marriage, 1 month apart. Serum IL-6, TNF-α, blood pressure, pulse, salivary cortisol, and state affect were collected surrounding the conflict. Trained experimenters rated positive and negative behavior during the conflict.

RESULTS

In the repetitive Trier paradigm, participants reported less anxiety (Ps = .048) and had higher anticipatory IL-6 responses (P = .014) at Visit 2, compared to Visit 1. In the repetitive marital conflict paradigm, participants had lower positive affect (P = .0004), as well as systolic blood pressure (SBP) (P = .009), diastolic blood pressure (P = .0003), and pulse (P = .027) habituation at the second visit. Objectively rated negative conflict behavior interacted with visit to predict TNF-α (P = .025) and SBP (P = .037) responses. Positive conflict behavior did not moderate outcomes (Ps > .06).

CONCLUSIONS

Stress-sensitive systems can habituate or sensitize to even nontraumatic, repetitive social stressors. Patterns of habituation or sensitization may vary by time between repetition, type of social stressor, stress-sensitive system, and participant behavior.

Is age more than a number? Accounting for adult development and aging in the study of psychoneuroimmunology, stress, and health

Traditional stress-and-health models link stressors to their health consequences through a well-characterized cascade. Most of the research assumes that the stress-health sequence unfolds in the same way across adulthood, whether a person is 25 years old or 80. Taking a "developmental" or "lifespan" approach has been synonymous with studying the lasting health impacts of early life experiences. However, theories and evidence from adult development and geroscience suggest that stress-health dynamics evolve in important ways over the adult lifespan-from the stressors that we encounter, to the emotion regulation strategies that we use to confront challenges, to the psychosocial resources at our disposal, to the cellular milieu, and thus to the magnitude of stressors' biological and functional consequences. This critical review synthesizes theoretical perspectives and selected empirical literature on the social-emotional and biological dimensions of aging to promote an Integrative Model of Aging, Stress, and Health. Through this integration, the model illustrates how an interdisciplinary, developmental perspective can enrich our understanding of stress's consequences for health across adulthood. It also seeks to guide a new generation of research questions that confront aging with a multidimensional approach. The piece concludes with personal reflections on the foundational legacy of the author's mentor, Dr. Janice Kiecolt-Glaser.

Psychoneuroimmunology and the research of Janice Kiecolt-Glaser: It informs self-care and the practice of medicine

Dr. Janice Kiecolt-Glaser as an undergraduate obtained a major in psychology and a minor in biological sciences which was an early indication of her budding interest in how the brain talks to a variety of physiologic systems. Early in her research career Jan began to build a research team that eventually consisted of scientists with expertise in a variety of disciplines including virology, immunology, endocrinology, nutrition science, biostatistics, genetics, and the microbiome. Additionally, Jan enlisted the aid of a group of bright energetic pre- and post-doctoral graduate students, obtained numerous NIH grants, and utilized an excellent Clinical Research Center. Over many years Jan directed these teams to help with understanding some of the biologic consequences of common life stressors such as loneliness, academic examinations, marital discord, breast cancer survivorship, and dementia caregiving. In this survey of her accomplishments, I will present some of the highlights of her prolific contributions which have encouraged many to enter the field of psychoneuroimmunology.

The post-Cartesian dilemma: Reuniting the mind and body through psychoneuroimmunology

While today, it might seem absurd to hear anyone claim that stress does not alter all aspects of the human experience, including behavioral, cognitive, affective, and physiological processes. Dr. Janice Kiecolt-Glaser started her career at a time when stress was primarily considered a neuroendocrine response with cardiovascular repercussions. She was part of a small group of innovative scientists who began to push the boundaries of stress research - many contemporary immunologists and virologist disputed their early results in 1980s and 90s - and, yet, they persevered by connecting psychological stress to altered immune function via stress-related neuroendocrine changes. As a clinical psychologist, she focused mainly on human research studies to advance the field of psychoneuroimmunology throughout her career. Her research demonstrates how adversity and psychosocial aspects of human experience alter physiological functioning, primarily immune, and health or, in other words, the embodiment of our lived experiences. This short review is a contextualized synthesis of Dr. Kiecolt-Glaser's key contributions to the fields of psychoneuroimmunology and health psychology and her influence on my present day thinking and research approaches, as well as potential steps forward in our post-pandemic world.

Interpersonal relationships, PNI, and health: Seeds in the 1980s, fruiting trees today

In this contribution to the Special Issue, I highlight how Janice Kiecolt-Glaser's research in the 1980s planted the seeds for two areas of social relationships and health research: loneliness and intimate/marital relationships. I review the foundational "seed" studies from the mid-to late-1980s, the research "saplings" that sprouted and grew during the subsequent twenty years, and the "mature trees" that have gone on to fruit and grow their respective areas of inquiry over the past twenty years. In addition to highlighting the mature trees that have borne rich empirical fruit, my other goal for this contribution is to draw attention to ideas and concepts from Kiecolt-Glaser's work and writing that merit further conceptual and empirical examination in the next generation of research on social relationships, psychoneuroendocrinology, psychoneuroimmunology, and health.

A social science: Using psychoneuroimmunology principles to promote career longevity, productivity, and meaning

Over the past several decades, psychoneuroimmunologists have uncovered key principles (e.g., social support and stress management) that can inform future research content and conduct. That is, psychoneuroimmunology (PNI) can inform how scientists from all disciplines engage in the scientific method in a more sustainable manner. Dr. Janice Kiecolt-Glaser, a PNI pioneer, recently ended her long and celebrated career. Her unique engagement in the scientific method, including her mentorship style, is worthy of closer examination. As her final graduate student, I observed Dr. Kiecolt-Glaser's science and mentorship style at their full maturity. Her scientific content, remarkable in its own right, is the subject of commentaries and accolades; yet, her scientific conduct - the foundation of her success and innovation - deserves further consideration. This article outlines ten research conduct principles that Dr. Kiecolt-Glaser explicitly and implicitly taught: (1) applying the literature to one's own health behaviors; (2) knowing and remembering "the why" behind the science; (3) developing and adhering to a vision; (4) creating a streamlined workflow; (5) embracing team science; (6) pursuing depth and breadth; (7) communicating ideas clearly; (8) engaging in a daily rhythm of science; (9) treating trainees like future primary investigators; and (10) working toward clinical meaningfulness. These principles correspond to PNI findings and account for her health and longevity as a scientist.

Couples-based health behavior change interventions: A relationship science perspective on the unique opportunities and challenges to improve dyadic health

Epidemiological studies indicate that better marital quality is associated with less morbidity and premature mortality. A number of interpersonal processes related to marital quality are also associated with health-relevant surrogate biomarkers across different physiological systems. Despite these replicated correlational findings, few interventions have harnessed interpersonal processes as potential interventions to enhance health. Building on Dr. Janice Kiecolt-Glaser's model of relationships and health, we propose that couples-based health behavior change interventions may represent an effective way to decrease dysregulation across autonomic, endocrine and immune systems and, ultimately, improve dyadic health. Given that the cohabiting partner is an essential part of the social context in which the behavior change is being pursued, it is important to consider the relational issues triggered by dyadic interventions. Using a relationship science perspective, this article reviews the literature on couples' concordance in health behaviors and health outcomes, the potential pathways underlying this concordance, theories of the couple as a self-sustaining social system, dyadic adaptation of individual self-regulation strategies, effective and ineffective social support and social control in couple relationships, the integration of relationship-building and health behavior change strategies, and the consideration of key moderators related to the nature of the relationship and the context surrounding the relationship. These findings highlight the importance of adopting a relationship science perspective when designing and testing dyadic interventions to improve health outcomes. The data reviewed provide insights on how to optimize couples-based health behavior change interventions to reduce physiological dysregulation and improve dyadic health.

A tale of two marital stressors: Comparing proinflammatory responses to partner distress and marital conflict

Marital quality shares ties to inflammatory conditions like cardiovascular disease and diabetes. For decades, research has focused on marital conflict as a primary mechanism given its potential to trigger inflammatory responses. However, longitudinal evidence suggests that marital conflict declines over time, and little attention has been paid to the inflammatory aftermath of other types of marital exchanges. A spouse's emotional distress is an important but overlooked marital context, as partners are exposed to each other's upsetting emotions throughout adulthood. To directly compare reactivity in proinflammatory gene expression to these two marital stressors and to examine differences by age and marital satisfaction, 203 community adults ages 25-90 (N = 102 couples) provided blood samples and rated their negative mood before and after they 1) watched their partner relive an upsetting personal memory and, in a separate visit 1-2 weeks later, 2) discussed a conflictual topic in their relationship. Controlling for age, sex, race/ethnicity, BMI, alcohol use, smoking, and comorbidities, increases in proinflammatory gene expression were significantly larger after the partner's upsetting disclosure than after marital conflict (B = 0.073, SE = 0.031, p = .018). This pattern paralleled emotional reactivity to the tasks, wherein negative mood rose more in response to the partner's disclosure than to marital conflict (B = 4.305, SE = 1.468, p = .004). In sum, proinflammatory and mood reactivity to spousal distress exceeded reactivity to marital conflict, a well-established marital stressor. Findings reveal spousal distress as a novel mechanism that may link marriage to inflammation-related diseases, and even pose risks for both happy and unhappy couples across adulthood.

Psychoneuroimmunology in multiple myeloma and autologous hematopoietic stem cell transplant: Opportunities for research among patients and caregivers

Multiple myeloma (MM) is an incurable cancer and is the leading indication for autologous hematopoietic stem cell transplantation (HSCT). To be eligible for HSCT, a patient must have a caregiver, as caregivers play a central role in HSCT preparation and recovery. MM patients remain on treatment indefinitely, and thus patients and their caregivers face long-term challenges including the intensity of HSCT and perpetual therapy after transplant. Importantly, both patients and their caregivers show heightened depressive and anxiety symptoms, with dyadic correspondence evidenced and caregivers' distress often exceeding that of patients. An extensive psychoneuroimmunology (PNI) literature links distress with health via immune and neuroendocrine dysregulation as well as biological aging. However, data on PNI in the context of multiple myeloma - in patients or caregivers - are remarkably limited. Distress in MM patients has been associated with poorer outcomes including higher inflammation, greater one year post-HSCT hospital readmissions, and worse overall survival. Further, anxiety and depression are linked to biological aging and may contribute to the poor long-term health of both patients and caregivers. Because MM generally affects older adults, individual differences in biological aging may represent an important modifier of MM biology and HSCT treatment outcomes. There are a number of clinical scenarios in which biologically younger people could be prescribed more intensive therapies, with potential for greater benefit, by using a personalized cancer therapy approach based on the quantification of physiologic reserve. Further, despite considerable psychological demands, the effects of distress on health among MM caregivers is largely unexamined. Within this context, the current critical review highlights gaps in knowledge at the intersection of HSCT, inflammation, and biological aging in the context of MM. Research in this area hold promise for opportunities for novel and impactful psychoneuroimmunology (PNI) research to enhance health outcomes, quality of life, and longevity among both MM patients and their caregivers.

Older Adults' Social Profiles and Links to Functional and Biological Aging in the United States and Mexico

OBJECTIVE

Social stress-loneliness, isolation, and low relationship quality-increase risks of aging-related diseases. However, the ways in which they intersect to undermine healthy aging remain poorly understood. We used latent class analysis to identify groups of older adults based on their social stress in both the United States and Mexico. Thereafter, we examined their cross-sectional associations with markers of functional and biological aging.

METHOD

Participants in the Health and Retirement Study (HRS; N = 8316) and Mexican Health and Aging Study (MHAS; N = 15,001) reported their loneliness, isolation (i.e., living alone), and relationship quality with spouse, children, and friends. Outcomes included C-reactive protein, functional limitations, self-rated health, comorbidities, gait speed, and grip strength. Models controlled for demographics, health behaviors, and body mass index.

RESULTS

In both countries, five classes emerged, a supported group and four with elevated social stress: a) strained, b) isolated, c) spousal ambivalence, and d) unhappily married. Compared with the others, strained participants in both samples had greater functional limitations, poorer self-rated health, and more comorbidities, as well as slower gait in HRS and weaker grip in MHAS. Generally, supported participants fared better than the other groups. In HRS, C-reactive protein levels differed between the strained group and others, but these associations were explained by health behaviors and body mass index.

CONCLUSIONS

Older adults in both countries with strained relationships fared worst in their aging-related outcomes, revealing new insights about the links between toxic social stress and unhealthy aging.

Unraveling the Impact of Widowhood Duration on Depression: Does Time Heal All Wounds?

China's aging population has witnessed a surge in widowed older adults, raising concerns about their mental health. Losing a spouse is a profoundly distressing experience with enduring effects on well-being. Despite the proverbial belief in time's healing power, existing studies often neglect the potential decline in depressive symptoms during widowhood. Drawing data from the 2015 and 2018 China Health and Retirement Longitudinal Study, this study delved into the impact of widowhood duration on depression among 8370 older adults and uncovered significantly higher depression scores among widowed individuals, particularly in the initial three years. This study revealed that widowhood contributes to heightened depression levels even after accounting for sociodemographic factors. Although the depressive impact lessens over time, it persists beyond three years, underscoring the need for heightened awareness and support for this vulnerable population.

A healthy balance: the ratio of social support-to-demands is associated with metabolic syndrome

Metabolic syndrome is associated with increased risk for negative health events, decrements in quality of life, and greater health costs. The current study sought to identify whether the ratio of social support to social demands across multiple relationship types (spouse, friends, children, or other family members) were associated with concurrent metabolic syndrome in a nationally representative sample of US adults ages 32-40. Results indicate that the ratio of total social support to social demands was associated with a greater likelihood of meeting criteria for metabolic syndrome, even after statistically controlling for the effects of race, ethnicity, sex, age, income, and prior metabolic syndrome. When considering the relative contributions of each relationship type, greater support relative to demands from friends was the only relationship type that was significantly independently associated with lower likelihood of metabolic syndrome. Although not statistically significant, a trend-level negative association with spousal support/demands emerged, as did a trend-level positive association with support/demands from children. Taken together, the current study reaffirms the relevance of considering social support and demands with regards to metabolic syndrome and highlights the ways in which specific relationships may differentially relate to health risk.

Your suffering is my stressor: Proinflammatory gene expression rises with spousal distress in middle-aged and older couples

Marital quality shares ties to inflammation-related conditions like cardiovascular disease and diabetes. Lab-based studies implicate hostility during marital conflict as a mechanism via inflammatory reactivity, but little attention has been paid to the inflammatory aftermath of other marital exchanges. A spouse's emotional distress is an important but overlooked context for middle-aged and older couples, as conflict declines and networks shrink. To examine the links of spousal distress to changes in proinflammatory gene expression, 38 adults ages 40-81 witnessed their spouse relive an upsetting personal memory aloud, rated their mood before and after, and provided blood samples at baseline and twice post-task; they also shared their own upsetting memory and discussed a marital problem in the interim. Those whose spouse disclosed their upsetting memory with greater emotional intensity showed larger elevations in proinflammatory gene expression 30-40 min and 80-90 min after the task. The association replicated for listeners whose negative mood increased more in response to spousal disclosure. Findings were robust to behavior in the other emotional tasks, race, gender, age, alcohol, smoking, comorbidities, and sagittal abdominal diameter. These novel results identify spousal distress as a key marital context that may escalate inflammation-related health risks.

Marital negativity's festering wounds: The emotional, immunological, and relational toll of couples' negative communication patterns

BACKGROUND

Dyadic stress theories and research suggest that couples' negative communication patterns threaten immune and emotional health, leaving partners vulnerable to illness. Spouses' relationship perceptions can also color how they see and react to marital discussions. To identify pathways linking distressed marriages to poor health, this study examined how self-reported typical communication patterns augmented discussion-based behavioral effects on spouses' blister wound healing, emotions, and discussion evaluations.

METHODS

Married couples completed two 24-hour in-person visits where they had their blood drawn to measure baseline interleukin-6 (IL-6), received suction blister wounds, reported their typical communication patterns (demand/withdraw strategies, mutual discussion avoidance, mutual constructive communication), and engaged in marital discussions. Discussions were recorded and coded for positive and negative behaviors using the Rapid Marital Interaction Coding System (RMICS). Immediately after the discussions, spouses rated their emotions and evaluated the discussion tone and outcome. Wound healing was measured for 12 days.

RESULTS

Couples who reported typically using more demand/withdraw or mutual avoidance patterns had higher baseline IL-6, slower wound healing, greater negative emotion, lower positive emotion, and poorer discussion evaluations. In contrast, couples reporting more mutual constructive patterns reported more favorable discussion evaluations. Additionally, couples' more negative and less positive patterns exacerbated behavioral effects: Spouses had wounds that healed more slowly, reported lower positive emotion, and evaluated the discussions less positively if their typical patterns and discussion-based behaviors were more negative and less positive.

CONCLUSIONS

Couples' typical communication patterns-including how often they use demand/withdraw, mutual avoidance, and mutual constructive patterns-may color spouses' reactions to marital discussions, amplifying the biological, emotional, and relational impact. These findings help explain how distressed marriages take a toll on spouses' health.

Conjoint trajectories of couples' marital and parental conflictual behaviors and later-life mental, physical, and relational health

Conflictual marital and parental relationships mutually reinforce each other generating family-level stress. The cumulative experiences of stressful family conflictual circumstances (a family-level construct of family conflictual circumstances (FCC), based on marital and parental conflictual behaviors) affect a couple's well-being. The present study, utilizing longitudinal data of 370 couples in enduring marriages and a person-centered approach, examined: a) the existence of heterogeneous groups of couples with FCC trajectory patterns, b) whether individual and contextual factors are associated with FCC trajectory patterns, and c) differential later-life health and relational consequences of these groups. We identified four heterogeneous groups of couples with distinct FCC trajectory patterns in the early middle years (from 1990 to 1994; approximately age 40 for both husbands and wives). Personal (neurotic vulnerability) and contextual factors (family financial hardship) influenced the development of the FCC trajectories, and FCC trajectory patterns were consequential for spouses' later mental, physical, and relational health (2001). Two features of the longitudinal synchrony in FCC trajectory patterns (severity and synchrony) were utilized to explain the differential impacts of the trajectory patterns on spouses' later health and relational outcomes.

Frequent Interpersonal Stress and Inflammatory Reactivity Predict Depressive-Symptom Increases: Two Tests of the Social-Signal-Transduction Theory of Depression

The social-signal-transduction theory of depression asserts that people who experience ongoing interpersonal stressors and mount a greater inflammatory response to social stress are at higher risk for depression. The current study tested this theory in two adult samples. In Study 1, physically healthy adults (N = 76) who reported more frequent interpersonal tension had heightened depressive symptoms at Visit 2, but only if they had greater inflammatory reactivity to a marital conflict at Visit 1. Similarly, in Study 2, depressive symptoms increased among lonelier and less socially supported breast-cancer survivors (N = 79). This effect was most pronounced among participants with higher inflammatory reactivity to a social-evaluative stressor at Visit 1. In both studies, noninterpersonal stress did not interact with inflammatory reactivity to predict later depressive symptoms.

Depression and obesity among females, are sex specificities considered?

This study aimed to systematically review the relationship of obesity-depression in the female sex. We carried out a systematic search (PubMed, MEDLINE, Embase) to quantify the articles (controlled trials and randomized controlled trials) regarding obesity and depression on a female population or a mixed sample. Successively, we established whether the sex specificities were studied by the authors and if they reported on collecting data regarding factors that may contribute to the evolution of obesity and depression and that could be responsible for the greater susceptibility of females to those conditions. After applying the inclusion and exclusion criteria, we found a total of 20 articles with a female sample and 54 articles with a mixed sample. More than half of all articles (51.35%, n = 38) evaluated the relationship between depression and obesity, but only 20 (27.03%) evaluated this relationship among females; still, 80% of those (n = 16) presented supporting results. However, few articles considered confounding factors related to female hormones (12.16%, n = 9) and none of the articles focused on factors responsible for the binomial obesity-depression in the female sex. The resulting articles also supported that depression (and related impairments) influencing obesity (and related impairments) is a two-way road. This systematic review supports the concurrency of obesity-depression in females but also shows how sex specificities are ultimately under-investigated. Female sex specificity is not being actively considered when studying the binomial obesity-depression, even within a female sample. Future studies should focus on trying to understand how the female sex and normal hormonal variations influence these conditions.

The gut reaction to couples' relationship troubles: A route to gut dysbiosis through changes in depressive symptoms

The gut microbiota plays a role in a wide range of diseases and disorders, with low microbial diversity and richness emerging as notable risk factors. This longitudinal study addressed the impact of marital quality (assessed by the Couples Satisfaction Index) on changes in depressive symptoms, and gut diversity, richness, and permeability. On two occasions an average of 90 days apart, 162 people provided stool and blood samples, and completed questionnaires. Depressive symptoms, assessed by the Center for Epidemiological Studies Depression Scale (CES-D), increased from visit 1 to visit 2 in those with clinically significant relationship problems, in contrast to the lack of change among their more satisfied counterparts. These changes in depression were consequential: the gut microbiota's diversity and richness decreased in tandem with the increase in depressive symptoms. Lower relationship satisfaction also foreshadowed increases in lipopolysaccharide binding protein from visit 1 to visit 2, reflecting greater translocation of bacterial endotoxin from the gut to blood circulation, a process that fuels inflammation. Lower diversity and richness provide a pathway from depressive symptoms and marital distress to subsequent health risk.

Linking Marital Support to Aging-Related Biomarkers: Both Age and Marital Quality Matter

OBJECTIVES

Marital support is central to couples' relationships, yet support's health implications can vary widely. Guided by attribution bias and aging theories, the current study examined whether age and marital satisfaction moderate the links of perceived and received spousal support to aging-related biomarkers.

METHODS

Couples (N = 93, ages 22-77) rated marital satisfaction, overall perceived spousal support, and the quality of support received from their spouse in a lab-based discussion. Blood samples collected at baseline, immediately post-discussion, 3 hr post-discussion, and end-of-visit were assayed for proinflammatory cytokines tumor necrosis factor (TNF)-α and interleukin (IL)-6, as well as insulin-like growth factor (IGF)-1.

RESULTS

Consistent with predictions, less satisfied older couples who received lower-quality spousal support during their discussion had greater increases in TNF-α than those who received higher-quality support; highly satisfied couples of all ages and less satisfied younger couples did not show these inflammatory changes. Highly satisfied older couples with greater perceived spousal support had lower TNF-α across the day and higher IGF-1.

DISCUSSION

Marital satisfaction and age may shape spousal support's significance for healthy aging. Rose-colored lenses worn only in the most satisfying marriages may protect couples from the possible health risks of low-quality received support and enhance potential benefits of perceived support. For better or worse, these health implications may grow with older age.

The Critical Need to Recognize That Families Matter for Adult Health: A Systematic Review of the Literature

A systemic approach to researching families and health should capture the complex network within which family members are embedded, including multiple family relationships and larger systems of health care. However, much of the families and health research focused on adult family members has focused solely on intimate partnerships, usually the marital relationship. This neglects the remainder of the powerfully influencing family relationships adults retain, and may increasingly focus on as they age. We conducted a systematic review of the families and adult health literature, retaining 72 articles which were subsequently thematically coded to highlight main foci of this area of research. Results highlight six themes, which include family relationship quality, family composition, behavioral factors in health and health care, psychophysiological mediators, caregiving, and aging health. Findings support an underrepresentation of family members, other than the intimate partner, in research on adult health.

Cortisol slopes and conflict: A spouse's perceived stress matters

BACKGROUND

Perceived stress can lead to dysregulated cortisol patterns, including blunted peaks and flatter slopes, which are associated with increased morbidity and mortality risks. Couples' interdependence provides a prime opportunity for partners' stress to disrupt a healthy cortisol pattern. This study examined how individuals' own perceived stress and their partners' perceived stress shape cortisol levels and slopes across the day, as well as how positive and negative behaviors during conflict discussions impact associations between stress and cortisol.

METHODS

Both partners of a married couple (n = 43 couples, 86 individuals) completed a full day in-person visit. Each partner completed the Perceived Stress Scale, and all couples engaged in a 20-min marital problem discussion which was recorded and later coded for positive and negative behaviors using the Rapid Marital Interaction Coding System (RMICS). Partners also provided five salivary cortisol samples across the day, two samples before the conflict and three after the conflict. The dyadic design and analyses provided a way to account for the interdependent nature of married couples' data, as well as to use the Actor-Partner Interdependence Model (APIM) to assess the mutual influence of spouses' stress on cortisol.

RESULTS

Individuals with more stressed partners had flatter cortisol slopes than individuals with less stressed partners, who showed steeper and thus healthier declines across the day. Individuals' cortisol levels at the beginning of the day were similar regardless of their partners' perceived stress, but individuals with more stressed partners had higher cortisol levels 30-min, 1 h, and 4 h after the conflict discussion than those with less stressed partners. Couples' behavior during the conflict moderated the relationship between partner perceived stress and average cortisol; when couples used more negative and less positive behaviors, individuals with more stressed partners had higher average cortisol levels than those with less stressed partners.

CONCLUSION

On a day couples experienced conflict, having a partner with higher perceived stress is associated with dysregulated cortisol patterns, including higher levels and flatter slopes, but having a partner with lower perceived stress is linked to steeper and thus healthier cortisol declines. A partner's stress was particularly consequential for one's own cortisol when couples used more negative and fewer positive behaviors during a conflict discussion. This research adds to the growing literature on pathways connecting marital interactions to important biorhythms and health.

For better and worse? The roles of closeness, marital behavior, and age in spouses' cardiometabolic similarity

Spouses share common risks for cardiometabolic diseases: a person's diabetes or hypertension raises the partner's odds of developing the same condition. The mechanisms responsible for this disease concordance remain poorly understood. To examine three factors that may modulate partners' cardiometabolic similarity-closeness, hostile marital behavior, and age-and to explore whether health behavior concordance plays a role, on two separate occasions 43 healthy couples ages 24-61 provided fasting glucose, metabolic data (fat and carbohydrate oxidation), and resting blood pressure before discussing one of their most severe marital disagreements. Accounting for the fixed effects of sex, age, study visit, and abdominal fat on cardiometabolic levels, we found that aspects of health behavior concordance were associated with greater similarity in glucose, diastolic blood pressure (DBP), and carbohydrate and fat metabolism. Independent of health behavior concordance, partners who felt closer and behaved in a less hostile way had more similar rates of fat oxidation; less hostile partners also shared greater overlap in carbohydrate oxidation. Likewise, fasting glucose and DBP were more similar within older couples compared to younger pairs, beyond the effects of health behavior concordance. In sum, our data captured preclinical similarities in cardiometabolic health among disease-free couples, which may form the basis for their long-term overlapping disease risks. Closer, less hostile, and older couples shared more similar fasting glucose, metabolic data, and blood pressure; importantly, health behavior concordance did not explain all associations. These novel data suggest that multiple paths may lead to couples' shared disease risks.

Psychological and Biological Pathways Linking Perceived Neighborhood Characteristics and Body Mass Index

BACKGROUND

Perceived neighborhood characteristics are linked to obesity, however, the mechanisms linking these two factors remain unknown.

PURPOSE

This study aimed to examine associations between perceived neighborhood characteristics and body mass index (BMI), establish whether indirect pathways through psychological distress and inflammation are important, and determine whether these associations vary by race/ethnicity.

METHODS

Participants were 1,112 adults enrolled in the Texas City Stress and Health Study. Perceived neighborhood characteristics were measured using the Perceived Neighborhood Scale. Psychological distress was measured with the Center for Epidemiological Studies Depression Scale, Perceived Stress Scale and mental health subscale of the Short Form Health Survey-36. Markers of inflammation included C-reactive protein, interleukin-6, and tumor necrosis factor receptor-1. Associations were examined with Structural Equation Modeling.

RESULTS

A model linking neighborhood characteristics with BMI through direct and indirect (i.e., psychological distress and inflammation) paths demonstrated good fit with the data. Less favorable perceived neighborhood characteristics were associated with greater psychological distress (B = -0.87, β = -0.31, p < .001) and inflammation (B = -0.02, β = -0.10, p = .035). Psychological distress and inflammation were also significantly associated with BMI (Bdistress = 0.06, β = 0.08, p = .006; Binflammation = 4.65, β = 0.41, p < .001). Indirect paths from neighborhood characteristics to BMI via psychological distress (B = -0.05, β = -0.03, p = .004) and inflammation (B = -0.08, β = -0.04, p = .045) were significant. In multiple group analysis, a model with parameters constrained equal across race/ethnicity showed adequate fit suggesting associations were comparable across groups.

CONCLUSION

Our study extends the literature by demonstrating the importance of neighborhood perceptions as correlates of BMI across race/ethnicity, and highlights the role of psychological and physiological pathways.

The Impact of Obesity on Sexual Functions and Dyadic Consensus in Patients with Obesity

Background: Obesity is a chronic disease with several co-morbidities that increase morbidity and mortality and decrease quality of life. Psychopathologies are an important group of co-morbidities. In this study, it was aimed to search for the presence of depression and sexual dysfunction in patients with obesity, examine impact of obesity on marital adjustment, and highlight those important problems that are usually overlooked. Methods: Fifty patients who were seen in the obesity outpatient clinic in a random month as case group and gender-matched 50 healthy individuals as control group were included in the study. The inclusion criteria were body mass index (BMI) ≥30 kg/m² and having a sexual partner. The exclusion criteria were having psychiatric/mental or any other chronic illness, using medication that would affect sexual functions, and alcohol/substance abuse. After recording the sociodemographic data, patients were asked to take three internationally validated questionnaires: The Arizona Sexual Experience Scale (ASEX), Dyadic Adjustment Scale (DAS), and Beck Depression Inventory (BDI). Results were analyzed using SPSS. Results: Fifty patients with obesity as case group and 50 normal weight healthy persons as control group were included in the study. BMI and BDI score were significantly higher in the case group than in the control group. DAS score was lower in the case group for consensus and affectional expression than the control group but there was no difference for satisfaction, cohesion, or total score between the groups. ASEX score was higher in the case group than in the control group. Conclusion: Patients with obesity have dyadic consensus problems with their partners. Their excessive weight causes distress and difficulty in expressing their feelings and usually results in marital problems and depression. Evaluation of the patient with a multidisciplinary approach in obesity centers will allow patients to be analyzed in every aspect of obesity including these issues and contribute to the success of the treatment.

Chronic Stress and Negative Marital Quality Among Older Couples: Associations With Waist Circumference

Objective

More than a third of the U.S. population of older adults is obese. The present study tests the Dyadic Biopsychosocial Model of Marriage and Health, which hypothesizes that, among married couples, individual and partner chronic stress predicts increased waist circumference and these links are exacerbated in negative quality marriages.

Method

Participants were from the nationally representative longitudinal Health and Retirement Study (HRS). A total of 2,042 married individuals (in 1,098 married couples) completed psychosocial and waist circumference assessments in 2006 and 2010. Analyses examined whether negative marital quality and chronic stress in Wave 1 (2006) were associated with changes in waist circumference over time.

Results

Actor-partner interdependence models revealed that greater partner stress, rather than individuals' own reports of stress, was associated with increased waist circumference over time. Higher perceived negative marital quality among husbands and lower negative marital quality among wives exacerbated the positive link between partner stress and waist circumference.

Discussion

Consistent with the Dyadic Biopsychosocial Model of Marriage and Health, partner stress has direct associations with waist circumference among couples and this link is moderated by negative marital quality. Thus, dyadic perceptions of stress and negative marital quality are important to consider for understanding marriage and obesity.

Blood level of adiponectin is positively associated with lean mass in women without type 2 diabetes

OBJECTIVE

The objective of this study was to evaluate the relationship between blood levels of adiponectin and leptin with lean body and trunk adipose mass in women with and without type 2 diabetes mellitus (T2DM).

METHODS

This cross-sectional study analyzed baseline data from five previous clinical studies involving postmenopausal women (n = 95). Body composition was assessed by dual-energy x-ray absorptiometry, and appendicular lean mass was calculated based on body mass index (ALMBMI). Adipokines and cytokines were measured by enzyme-linked immunosorbent assay. Linear mixed-effect models with a random study effect were used to investigate the relationship between predictors (eg, adiponectin, leptin), outcomes (eg, ALMBMI, trunk adipose mass), and co-variables (T2DM status, age, interleukin-6, and C-reactive protein).

RESULTS

Postmenopausal women with T2DM had lower ALMBMI than those without T2DM. There was a positive association between blood adiponectin and ALMBMI in postmenopausal women without T2DM, but no association in those with T2DM. Blood leptin was negatively associated with ALMBMI for women regardless of T2DM diagnosis. Blood adiponectin was negatively associated, whereas blood leptin was positively associated with trunk adipose mass for the entire cohort.

CONCLUSIONS

T2DM status moderated the relationship between blood adiponectin and ALMBMI, where blood adiponectin was positively associated with ALMBMI in postmenopausal women without T2DM, but not those with T2DM. Dysregulated metabolism in T2DM may contribute to lower muscle mass in women with T2DM, but future research is required to elucidate this mechanistic link. The negative association between blood leptin and ALMBMI was a novel finding. Future studies will need to more clearly define the relationship between these variables.

Marriage and Gut (Microbiome) Feelings: Tracing Novel Dyadic Pathways to Accelerated Aging

Within a couple, partners influence each other's mental and physical health. This review focuses on how couples' relationships, the partners' individual and joint vulnerabilities, and their health behaviors influence health through changes in the gut microbiota, metabolism, and immune function. Couples' shared stressors and emotions and their intertwined lifestyles and routines serve to promote common disease risks in part through parallel changes in their gut microbiotas. Marital discord, stress, and depression have strong bidirectional links, fueling one another. Chronic marital stress and depression can elevate the risk for obesity, metabolic syndrome, and cardiovascular disease by altering resting energy expenditure, insulin production, and triglyceride responses after unhealthy meals. During stressful times, health behaviors typically suffer-and sleep disturbances, poor diets, and sedentary behavior all influence these metabolic pathways while also promoting gut dysbiosis. Dysbiosis increases intestinal permeability (gut leakiness), providing a mechanistic pathway from marital distress and depression to heightened inflammation and accelerated aging. Age-related changes in the gut microbiota's composition and gut leakiness foster immunosenescence, as well as the progression of inflamm-aging; these age-related risks may be altered by stress and depression, diet, sleep, exercise habits, and developmental shifts in emotion regulation strategies. Consideration of the strong mutual influences that partners have on each other's mood and health behaviors, as well as the biological pathways that underlie these influences, provides a new way to view marriage's health implications.

Marital distress, depression, and a leaky gut: Translocation of bacterial endotoxin as a pathway to inflammation

BACKGROUND

Marital distress and depression work in tandem to escalate risks for inflammation-related disorders. Translocation of bacterial endotoxin (lipopolysaccharide, LPS) from the gut microbiota to blood circulation stimulates systemic inflammatory responses.

METHODS

To investigate increased gut permeability (a "leaky gut") as one potential mechanistic pathway from marital distress and depression to heightened inflammation, this secondary analysis of a double-blind, randomized crossover study examined serial assessments of two endotoxin biomarkers, LPS-binding protein (LBP) and soluble CD14 (sCD14), as well as C-reactive protein (CRP), interleukin 6 (IL-6), and tumor necrosis factor alpha (TNF-α) during two separate 9.5 h visits. The 43 (N = 86) healthy married couples, ages 24-61 (mean = 38.22), discussed a marital disagreement during both visits; behavioral coding of these interactions provided data on hostile marital behaviors, a hallmark of marital distress. The Structured Diagnostic Interview for DSM-IV assessed participants' mood disorder history.

RESULTS

Participants with more hostile marital interactions had higher LBP than those who were less hostile. Additionally, the combination of more hostile marital interactions with a mood disorder history was associated with higher LBP/sCD14 ratios. Higher LBP and LBP/sCD14 were associated with greater CRP production; for example, only 21% of low LBP participants (lowest quartile) had average CRP across the day > 3, compared to 79% of those in the highest quartile. Higher sCD14 was associated with higher IL-6.

CONCLUSIONS

These bacterial LPS translocation data illustrate how a distressed marriage and a mood disorder history can promote a proinflammatory milieu through increased gut permeability, thus fueling inflammation-related disorders.

Marriage, divorce, and the immune system

This article reviews evidence from several lines of work to describe how marriage and divorce can provoke health-relevant immune alterations, including ways that marital closeness can be perilous for health and divorce can be beneficial. The multiple stresses of a troubled relationship are depressogenic, and the development of a mood disorder sets the stage for psychological and biological vulnerability. Depression provides a central pathway to immune dysregulation, inflammation, and poor health; gender-related differences in depression and inflammation can heighten risk for women compared to men. Sleep and obesity can simultaneously feed off depression as they promote it. In addition, spousal similarities in health behaviors, gene expression, immune profiles and the gut microbiota offer new ways to consider the health advantages and risks of marriage and divorce, providing new perspectives on couples' interdependence, as well as new directions for research. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Capturing patients' symptom expression and spouses' cardiovascular responses continuously: The feasibility of examining a mechanism of disease risk in the home

INTRODUCTION

Spousal caregivers face increased cardiovascular risks; lab studies suggest that autonomic reactivity to patients' physical suffering may play a role. To evaluate this mechanism in daily life, our pilot study characterized the feasibility of recruiting couples for a multimethod, in-home assessment. We examined the usability of the resulting data in an effort to link spousal cardiovascular changes to patient pain expression during couples' everyday interactions.

METHOD

For two 48-hr periods, individuals with rheumatoid arthritis (RA) and their partners wore heart monitors while audio-recordings captured couples' in-home interactions. Interbeat intervals were subsetted in 1-, 2-, and 5-min windows before and after each pain expression. Pre-post difference scores in high-frequency heart rate variability (HF-HRV) and heart rate were examined.

RESULTS

Of the 17 screened RA patients, 11 were ineligible, and 3 partners declined. The 3 participating couples completed all study activities. The resulting 288 hr of recordings were coded for patients' RA symptom expression, which varied from none to an average of 11 times daily. One couple had sufficient data for physiological analysis: Contrary to prediction, spouse HF-HRV significantly increased after patient symptom expression.

CONCLUSIONS

Recruitment rates mirrored other couples studies, and enrolled couples complied with study procedures. In-home conversations were reliably coded and successfully linked to spousal ongoing cardiovascular activity. Preliminary findings highlight the importance of optimal sampling windows and suggest symptom expression as a relevant process for some spouses but not others. We offer recommendations for efficiently scaling up the method in future studies. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Maternal Stress Potentiates the Effect of an Inflammatory Diet in Pregnancy on Maternal Concentrations of Tumor Necrosis Factor Alpha

Maternal inflammation during pregnancy is known to adversely impact fetal development, birth outcomes, and offspring physical and mental health. Diet and stress have been identified as important determinants of inflammation, yet their combined effects have not been examined in the context of pregnancy. The aim of this study was to examine the relationship between maternal diet with inflammatory potential and psychological stress, and to determine their interaction effect on concentrations of tumor necrosis factor (TNF)-α across pregnancy. We conducted a prospective longitudinal study of n = 202 women with three assessments during pregnancy, which included: ecological momentary assessment (EMA) of maternal stress using the perceived stress scale (PSS) short version; 24-h dietary recalls from which the dietary inflammatory index (DII) was computed; and serum measurements of TNF-α. Across pregnancy, higher perceived stress was associated with consumption of a more pro-inflammatory diet (r = 0.137; p < 0.05). In a linear regression model adjusted for covariates, DII was positively associated with TNF-α (B = 0.093, p = 0.010). The effect of the pro-inflammatory diet on concentrations of TNF-α was more pronounced in women reporting higher levels of stress (B = 0.134, p = 0.018 for DII*PSS interaction). These results highlight the need to consider nutrition and stress concurrently in the context of inflammation during pregnancy.

When couples' hearts beat together: Synchrony in heart rate variability during conflict predicts heightened inflammation throughout the day

Hostile conflict in marriage can increase risks for disease and mortality. Physiological synchrony between partners-e.g., the linkage between their autonomic fluctuations-appears to capture engagement, or an inability to disengage from an exchange, and thus may amplify the health risks of noxious interactions such as marital conflict. Prior work has not examined the unique health correlates of this physiological signature. To test associations between couples' heart rate variability (HRV) synchrony during conflict and inflammation, 43 married couples engaged in a marital problem discussion while wearing heart monitors and provided four blood samples; they repeated this protocol at a second visit. When couples' moment-to-moment HRV changes tracked more closely together during conflict, they had higher levels of three inflammatory markers (i.e., IL-6, stimulated TNF-α, and sVCAM-1) across the day. Stronger HRV synchrony during conflict also predicted greater negative affect reactivity. Synchrony varied within couples, and was related to situational factors rather than global relationship traits. These data highlight partners' HRV linkage during conflict as a novel social-biological pathway to inflammation-related disease.

Pathways linking racial/ethnic discrimination and sleep among U.S.-born and foreign-born Latinxs

This study examined the association between racial/ethnic discrimination and sleep through psychological distress and body mass index (BMI), and determined whether the aforementioned associations vary between U.S. and foreign-born Latinxs. Participants were 1332 Latinx adults enrolled in the Texas City Stress and Health Study. Multistage sampling methods were used to select participants. A model linking racial/ethnic discrimination with sleep disturbances through direct and indirect (i.e., psychological distress and BMI) paths demonstrated good fit. Greater racial/ethnic discrimination was associated with greater psychological distress and higher BMI. Psychological distress and BMI were also significant predictors of sleep disturbances. The indirect path from racial/ethnic discrimination to sleep disturbances via psychological distress was significant. A model with parameters constrained to be equal between U.S.-born and foreign-born Latinxs suggested associations were comparable between these groups. Our study demonstrated the relevance of racial/ethnic discrimination to sleep disturbances, particularly its association via psychological distress among Latinxs.

Targeting couple and parent-child coercion to improve health behaviors

This phase of the NIH Science of Behavior Change program emphasizes an "experimental medicine approach to behavior change," that seeks to identify targets related to stress reactivity, self-regulation, and social processes for maximal effects on multiple health outcomes. Within this framework, our project focuses on interpersonal processes associated with health: coercive couple and parent-child conflict. Diabetes and poor oral health portend pain, distress, expense, loss of productivity, and even mortality. They share overlapping medical regimens, are driven by overlapping proximal health behaviors, and affect a wide developmental span, from early childhood to late adulthood. Coercive couple and parent-child conflict constitute potent and destructive influences on a wide range of adult and child health outcomes. Such interaction patterns give rise to disturbed environmental stress reactivity (e.g., disrupted sympathetic nervous and parasympathetic nervous systems) and a wide range of adverse health outcomes in children and adults, including dental caries, obesity, and diabetes-related metabolic markers. In this work, we seek to identify/develop/validate assays assessing coercion, identify/develop and test brief interventions to reduce coercion, and test whether changes in coercion trigger changes in health behaviors.

Lovesick: How Couples' Relationships Influence Health

This review highlights recent advances in research addressing intimate partner relationships and health. Consideration of the strong mutual influences that the members of a couple have on each other's mental and physical health trajectories provides a new way to view the health implications of couples' convergence or interdependence; marital closeness can have a clear downside when one partner has mental or physical health problems. Couples' interconnectedness can also be leveraged to promote better treatment outcomes. Major themes include the pivotal role of depression and the importance of gender differences in the pathways from the marital relationship to physiological functioning and health. The health risks and benefits of support are weighed. Additionally, two prominent emerging paths from marital distress to poor health are emphasized: sleep problems and metabolic alterations that promote obesity and its comorbidities.

Lovesick: How Couples' Relationships Influence Health

This review highlights recent advances in research addressing intimate partner relationships and health. Consideration of the strong mutual influences that the members of a couple have on each other's mental and physical health trajectories provides a new way to view the health implications of couples' convergence or interdependence; marital closeness can have a clear downside when one partner has mental or physical health problems. Couples' interconnectedness can also be leveraged to promote better treatment outcomes. Major themes include the pivotal role of depression and the importance of gender differences in the pathways from the marital relationship to physiological functioning and health. The health risks and benefits of support are weighed. Additionally, two prominent emerging paths from marital distress to poor health are emphasized: sleep problems and metabolic alterations that promote obesity and its comorbidities.

Shortened sleep fuels inflammatory responses to marital conflict: Emotion regulation matters

Sleep problems can boost inflammation and may jeopardize interpersonal functioning, risks that may be magnified in couples. This observational study examined the effects of self-reported recent sleep duration on couples' inflammation, inflammatory responses to a problem discussion, interpersonal behavior, and use of emotion regulation strategies (emotion expression, cognitive reappraisal) during conflict. People who slept less had higher stimulated interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) production after the marital problem discussion than those who slept more. However, using emotion expression and cognitive reappraisal strategies during conflict protected couples who slept less from inflammatory reactivity. Specifically, people's short sleep did not relate to inflammatory increases when they expressed their own feelings more or when their partner reappraised or expressed their emotions more. When both partners slept less, couples interacted in a more hostile way than when at least one partner slept more. These data point to the combination of short sleep and marital conflict as a novel path to heightened inflammation, a risk that partners' emotion regulation strategies may counteract. The study also highlights the role of short sleep in more negative or punishing marital behavior.

Magnitude and Timing of the Postprandial Inflammatory Response to a High-Fat Meal in Healthy Adults: A Systematic Review

Research findings over the past several decades have shown that inflammation is a prominent feature of many chronic diseases, with poor diet being one likely inflammatory stimulus. Specifically, a single high-fat meal (HFM) has been suggested to increase inflammation, although there is currently no consensus with regard to the specific changes in many of the proinflammatory markers that are frequently assessed after an HFM. The aim of this systematic review was to objectively describe the postprandial timing and magnitude of changes in 5 common inflammatory markers: interleukin (IL) 6, C-reactive protein (CRP), tumor necrosis factor (TNF) α, IL-1β, and IL-8. Ten relevant databases were searched, yielding 494 results, of which 47 articles met the pre-established inclusion criteria: 1) healthy men and women aged 18-60 y, 2) consuming a single HFM (≥30% fat, ≥500 kcal), and 3) assessing relevant inflammatory markers postmeal for ≥2 h. The only marker found to consistently change in the postprandial period was IL-6: on average, from a baseline of ∼1.4 pg/mL, it peaked at ∼2.9 pg/mL ∼6 h post-HFM (an average relative change of ∼100%). CRP, TNF-α, IL-1β, and IL-8 did not change significantly in 79% (23 of 29), 68% (19 of 28), 67% (2 of 3), and 75% (3 of 4) of included studies, respectively. We conclude that there is strong evidence that CRP and TNF-α are not responsive at the usual time scale observed in postprandial studies in healthy humans younger than age 60 y. However, future research should further investigate the role of IL-6 in the postprandial period, because it routinely increases even in healthy participants. We assert that the findings of this systematic review on markers of inflammation in the postprandial period will considerably aid in informing future research and advancing clinical knowledge.

Depression, daily stressors and inflammatory responses to high-fat meals: when stress overrides healthier food choices

Depression, stress and diet can all alter inflammation. This double-blind, randomized crossover study addressed the impact of daily stressors and a history of major depressive disorder (MDD) on inflammatory responses to high-fat meals. During two separate 9.5 h admissions, 58 healthy women (38 breast cancer survivors and 20 demographically similar controls), mean age 53.1 years, received either a high saturated fat meal or a high oleic sunflower oil meal. The Daily Inventory of Stressful Events assessed prior day stressors and the Structured Clinical Interview for DSM-IV evaluated MDD. As expected, for a woman with no prior day stressors, C-reactive protein (CRP), serum amyloid A (SAA), intercellular adhesion molecule-1 (sICAM-1) and vascular cell adhesion molecule-1 (sVCAM-1) were higher following the saturated fat meal than the high oleic sunflower oil meal after controlling for pre-meal measures, age, trunk fat and physical activity. But if a woman had prior day stressors, these meal-related differences disappeared-because the stressors heightened CRP, SAA, sICAM-1 and sVCAM-1 responses to the sunflower oil meal, making it look more like the responses to the saturated fat meal. In addition, women with an MDD history had higher post-meal blood pressure responses than those without a similar history. These data show how recent stressors and an MDD history can reverberate through metabolic alterations, promoting inflammatory and atherogenic responses.

Erythrocyte linoleic acid, but not oleic acid, is associated with improvements in body composition in men and women

SCOPE

Supplementation with linoleic acid (LA; 18:2Ω6)-rich oils increases lean mass and decreases trunk adipose mass in people. Erythrocyte fatty acids reflect the dietary pattern of fatty acid intake and endogenous metabolism of fatty acids. The aim of this study is to determine the relationship of erythrocyte LA, with aspects of body composition, insulin resistance, and inflammation. Additionally, we tested for relationships of oleic acid (OA) and the sum of long chain omega-three fatty acids (LC-Ω3-SUM), on the same outcomes.

METHODS AND RESULTS

Men and women (N = 139) were evaluated for body composition, insulin resistance, and serum inflammatory markers, IL-6, and c-reactive protein (CRP) and erythrocyte fatty acid composition after an overnight fast. LA was positively related to appendicular lean mass/body mass index and inversely related to trunk adipose mass. Additionally, LA was inversely related to insulin resistance and IL-6. While there was an inverse relationship between OA or LC-Ω3-SUM with markers of inflammation, there were no relationships between OA or LC-Ω3-SUM with body composition or HOMA-IR.

CONCLUSION

Higher erythrocyte LA was associated with improved body composition, insulin resistance, and inflammation. Erythrocyte OA or LC-Ω3-SUM was unrelated to body composition and insulin resistance. There is much controversy about whether all unsaturated fats have the same benefits for metabolic syndrome and weight gain. We sought to test the strength of the relationships between three unsaturated fatty acid in erythrocytes with measurements of body composition, metabolism, and inflammation in healthy adults. Linoleic acid, but not oleic acid or the sum of long-chain omega 3 fatty acids (w3), was associated with increased appendicular lean mass and decreased trunk adipose mass and insulin resistance.

Inflammation: depression fans the flames and feasts on the heat

Depression and inflammation fuel one another. Inflammation plays a key role in depression's pathogenesis for a subset of depressed individuals; depression also primes larger cytokine responses to stressors and pathogens that do not appear to habituate. Accordingly, treatment decisions may be informed by attention to questions of how (pathways) and for whom (predispositions) these links exist, which are the focus of this article. When combined with predisposing factors (moderators such as childhood adversity and obesity), stressors and pathogens can lead to exaggerated or prolonged inflammatory responses. The resulting sickness behaviors (e.g., pain, disturbed sleep), depressive symptoms, and negative health behaviors (e.g., poor diet, a sedentary lifestyle) may act as mediating pathways that lead to further, unrestrained inflammation and depression. Depression, childhood adversity, stressors, and diet can all influence the gut microbiome and promote intestinal permeability, another pathway to enhanced inflammatory responses. Larger, more frequent, or more prolonged inflammatory responses could have negative mental and physical health consequences. In clinical practice, inflammation provides a guide to potential targets for symptom management by signaling responsiveness to certain therapeutic strategies. For example, a theme across research with cytokine antagonists, omega-3 fatty acids, celecoxib, and exercise is that anti-inflammatory interventions have a substantially greater impact on mood in individuals with heightened inflammation. Thus, when inflammation and depression co-occur, treating them in tandem may enhance recovery and reduce the risk of recurrence. The bidirectional links between depression, inflammation, and disease suggest that effective depression treatments could have a far-reaching impact on mood, inflammation, and health.

Recent Developments in the Study of Social Relationships, Stress Responses, and Physical Health

This selective review aims to highlight some of the most recent empirical or theoretical advancements in the study of social relationships as buffers against stress and as protective factors against risk for disease, focusing on articles published between 2013 and 2015. The review summarizes novel findings showing that social relationships can protect individuals against negative health outcomes associated with chronic adversity and can be associated with reduced cumulative physiological damage (allostatic load). There is also evidence that some relationships can be a source of stress. Additionally, recent findings concerning the psychological and neurobiological mechanisms of action for social support, the developmental patterning of social stress-buffering and recent experimental studies attempting to change relationships to affect health are also reviewed.

Sex Differences in Depression: Does Inflammation Play a Role?

Women become depressed more frequently than men, a consistent pattern across cultures. Inflammation plays a key role in initiating depression among a subset of individuals, and depression also has inflammatory consequences. Notably, women experience higher levels of inflammation and greater autoimmune disease risk compared to men. In the current review, we explore the bidirectional relationship between inflammation and depression and describe how this link may be particularly relevant for women. Compared to men, women may be more vulnerable to inflammation-induced mood and behavior changes. For example, transient elevations in inflammation prompt greater feelings of loneliness and social disconnection for women than for men, which can contribute to the onset of depression. Women also appear to be disproportionately affected by several factors that elevate inflammation, including prior depression, somatic symptomatology, interpersonal stressors, childhood adversity, obesity, and physical inactivity. Relationship distress and obesity, both of which elevate depression risk, are also more strongly tied to inflammation for women than for men. Taken together, these findings suggest that women's susceptibility to inflammation and its mood effects may contribute to sex differences in depression. Depression continues to be a leading cause of disability worldwide, with women experiencing greater risk than men. Due to the depression-inflammation connection, these patterns may promote additional health risks for women. Considering the impact of inflammation on women's mental health may foster a better understanding of sex differences in depression, as well as the selection of effective depression treatments.

Work-Related Psychological Injury Is Associated with Metabolic Syndrome Components in Apparently Healthy Workers

Objective

The aim of this study was to evaluate the association between psychological damage caused by common occupational trauma and metabolic syndrome (MES).

Method

571 workers from 20 small Italian companies were invited to fill in the Psychological Injury Risk Indicator (PIRI) during their routine medical examination at the workplace.

Results

Compared to workers with no psychological injury, workers with a high PIRI score had a significantly increased risk of having at least one metabolic syndrome component (adjusted hazards ratio, 1.8; 95% confidence interval, 1.2 to 2.6). There was a significant increase in the risk of hypertriglyceridemia in male workers (OR 2.53 CI95% 1.03-6.22), and of hypertension in female workers (OR 2.45 CI95% 1.29-4.66).

Conclusion

Psychological injury related to common occupational trauma may be a modifiable risk factor for metabolic syndrome.

Effects of culinary spices and psychological stress on postprandial lipemia and lipase activity: results of a randomized crossover study and in vitro experiments

BACKGROUND

Data suggest that culinary spices are a potent, low-calorie modality for improving physiological responses to high fat meals. In a pilot study (N = 6 healthy adults), we showed that a meal containing a high antioxidant spice blend attenuated postprandial lipemia by 30% compared to a low spice meal. Our goal was to confirm this effect in a larger sample and to consider the influence of acute psychological stress on fat metabolism. Further, we used in vitro methods to evaluate the inhibitory effect of spices on digestive enzymes.

METHODS

In a 2 x 2, randomized, 4-period crossover design, we compared the effects of 14.5 g spices (black pepper, cinnamon, cloves, garlic, ginger, oregano, paprika, rosemary, and turmeric) vs. placebo incorporated into a high fat meal (1000 kcal, 45 g fat), followed by psychological stress (Trier Social Stress Test) vs. rest on postprandial metabolism in 20 healthy but overweight adults. Blood was sampled at baseline and at 105, 140, 180, and 210 minutes for analysis of triglycerides, glucose, and insulin. Additional in vitro analyses examined the effect of the spice blend and constituent spices on the activity of pancreatic lipase (PL) and secreted phospholipase A₂ (PLA₂). Mixed models were used to model the effects of spices and stress (SAS v9.3).

RESULTS

Serum triglycerides, glucose and insulin were elevated following the meal (p < 0.01). Spices reduced post-meal triglycerides by 31% when the meal was followed by the rest condition (p = 0.048), but this effect was not present during stress. There was no effect of the spice blend on glucose or insulin; however, acute stress significantly increased both of these measures (p < 0.01; mean increase of 47% and 19%, respectively). The spice blend and several of the individual spices dose-dependently inhibited PL and PLA2 activity in vitro.

CONCLUSIONS

Inclusion of spices may attenuate postprandial lipemia via inhibition of PL and PLA₂. However, the impact of psychological stress negates any influence of the spice blend on triglycerides, and further, increases blood glucose and insulin.

TRIAL REGISTRATION

ClinicalTrials.gov as NCT00954902 .