title: Chronic stress increases vulnerability to diet-related abdominal fat, oxidative stress, and metabolic risk.
abstract: BACKGROUND
  In preclinical studies, the combination of chronic stress and a high sugar/fat diet is a more potent driver of visceral adiposity than diet alone, a process mediated by peripheral neuropeptide Y (NPY).
  
  
  METHODS
  In a human model of chronic stress, we investigated whether the synergistic combination of highly palatable foods (HPF; high sugar/fat) and stress was associated with elevated metabolic risk. Using a case-control design, we compared 33 post-menopausal caregivers (the chronic stress group) to 28 age-matched low-stress control women on reported HPF consumption (modified Block Food Frequency Questionnaire), waistline circumference, truncal fat ultrasound, and insulin sensitivity using a 3-h oral glucose tolerance test. A fasting blood draw was assayed for plasma NPY and oxidative stress markers (8-hydroxyguanosine and F2-Isoprostanes).
  
  
  RESULTS
  Among chronically stressed women only, greater HPF consumption was associated with greater abdominal adiposity, oxidative stress, and insulin resistance at baseline (all p's≤.01). Furthermore, plasma NPY was significantly elevated in chronically stressed women (p<.01), and the association of HPF with abdominal adiposity was stronger among women with high versus low NPY. There were no significant predictions of change over 1-year, likely due to high stability (little change) in the primary outcomes over this period.
  
  
  CONCLUSIONS
  Chronic stress is associated with enhanced vulnerability to diet-related metabolic risk (abdominal adiposity, insulin resistance, and oxidative stress). Stress-induced peripheral NPY may play a mechanistic role.
authors.affiliation: Department of Psychiatry, University of California, San Francisco, CA, United States; The Institute for Integrative Health, Baltimore, MD, United States. Electronic address: kirstin.aschbacher@ucsf.edu.
authors.forename: Kirstin
authors.initials: K
authors.lastname: Aschbacher
authors.affiliation: California School of Professional Psychology, Alliant International University, San Francisco, CA, United States.
authors.forename: Sarah
authors.initials: S
authors.lastname: Kornfeld
authors.affiliation: Center for Mitochondrial and Epigenomic Medicine, Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA, United States.
authors.forename: Martin
authors.initials: M
authors.lastname: Picard
authors.affiliation: Department of Psychiatry, University of California, San Francisco, CA, United States.
authors.forename: Eli
authors.initials: E
authors.lastname: Puterman
authors.affiliation: Department of Molecular Biosciences and Nutrition, University of California, Davis, CA, United States.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Havel
authors.affiliation: Department of Molecular Biosciences and Nutrition, University of California, Davis, CA, United States.
authors.forename: Kimber
authors.initials: K
authors.lastname: Stanhope
authors.affiliation: Department of Pediatrics, University of California, San Francisco, CA, United States; Institute for Health Policy Studies, University of California, San Francisco, CA, United States.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Lustig
authors.affiliation: Department of Psychiatry, University of California, San Francisco, CA, United States. Electronic address: EEpel@lppi.ucsf.edu.
authors.forename: Elissa
authors.initials: E
authors.lastname: Epel
mesh_terms: D050153:Abdominal Fat; D050154:Adiposity; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004032:Diet; D005260:Female; D006304:Health Status; D006801:Humans; D007333:Insulin Resistance; D008875:Middle Aged; D009478:Neuropeptide Y / Q000097:blood; D018384:Oxidative Stress; D011446:Prospective Studies; D012307:Risk Factors; D013315:Stress, Psychological / Q000378:metabolism* / Q000523:psychology*
chemical_list: D009478:Neuropeptide Y
keywords: Abdominal adiposity; Metabolic syndrome; Obesity; Pre-diabetes; Psychological stress