title: Marital discord, past depression, and metabolic responses to high-fat meals: Interpersonal pathways to obesity.
abstract: BACKGROUND
  Longitudinal studies have implicated both marital distress and depression in the development of the metabolic syndrome, a risk factor for diabetes and cardiovascular disease. This study addressed the impact of hostile marital interactions and a mood disorder history on obesity-related metabolic responses to high-fat meals.
  
  
  METHODS
  This double-blind, randomized crossover study included serial assessments of resting energy expenditure (REE), fat and carbohydrate oxidation, triglycerides, insulin, glucose, interleukin 6 (IL-6), and tumor necrosis factor alpha (TNF-α) before and after two high-fat meals. During two separate 9.5h visits, 43 healthy married couples, ages 24-61 (mean=38.22), received either a high saturated fat meal or a high oleic sunflower oil meal, both 930kcal and 60g fat. The Structured Diagnostic Interview for DSM-IV assessed mood disorder history. Couples discussed a marital disagreement during both visits; behavioral coding of these interactions provided data on hostile marital behaviors.
  
  
  RESULTS
  Men and women who displayed more hostile behaviors and who also had a mood disorder history had significantly lower post-meal REE, higher insulin, and higher peak triglyceride responses than other participants, with nonsignificant effects for fat and carbohydrate oxidation. Participants with a mood disorder history had a steeper rise in postprandial IL-6 and glucose than those without a past history. Higher levels of hostile behaviors were associated with higher post-meal TNF-α. The two meals did not differ on any outcome assessed.
  
  
  CONCLUSIONS
  People spend about 18 of every 24h in a postprandial state, and dining with one's partner is a common daily event. Among subjects with a mood disorder history, the cumulative 6.75-h difference between high and low hostile behaviors translates into 128kcal, a difference that could add 7.6pounds/year. Our findings illustrate novel pathways through which chronic marital stress and a mood disorder history synergistically heighten the risk for obesity, metabolic syndrome, and cardiovascular disease.
authors.affiliation: Institute for Behavioral Medicine Research, The Ohio State University Medical Center, Columbus, OH 43210, USA; Department of Psychiatry, The Ohio State University Medical Center, Columbus, OH 43210, USA. Electronic address: Janice.Kiecolt-Glaser@osumc.edu.
authors.forename: Janice K
authors.initials: JK
authors.lastname: Kiecolt-Glaser
authors.affiliation: Department of Psychological and Brain Sciences, University of Delaware, Newark, DE 19716, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Jaremka
authors.affiliation: Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH 43210, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Andridge
authors.affiliation: Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH 43210, USA.
authors.forename: Juan
authors.initials: J
authors.lastname: Peng
authors.affiliation: Health and Rehabilitation Sciences, The Ohio State University Medical Center, Columbus, OH 43210, USA.
authors.forename: Diane
authors.initials: D
authors.lastname: Habash
authors.affiliation: Department of Health Disparities Research, MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Fagundes
authors.affiliation: Institute for Behavioral Medicine Research, The Ohio State University Medical Center, Columbus, OH 43210, USA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Glaser
authors.affiliation: Institute for Behavioral Medicine Research, The Ohio State University Medical Center, Columbus, OH 43210, USA; Department of Psychiatry, The Ohio State University Medical Center, Columbus, OH 43210, USA; Department of Medicine, The Ohio State University Medical Center, Columbus, OH 43210, USA.
authors.forename: William B
authors.initials: WB
authors.lastname: Malarkey
authors.affiliation: Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, Columbus, OH 43210, USA.
authors.forename: Martha A
authors.initials: MA
authors.lastname: Belury
mesh_terms: D000328:Adult; D018592:Cross-Over Studies; D003863:Depression / Q000276:immunology / Q000378:metabolism*; D004041:Dietary Fats / Q000378:metabolism*; D004311:Double-Blind Method; D004734:Energy Metabolism / Q000502:physiology*; D054541:Family Conflict / Q000523:psychology*; D005260:Female; D006791:Hostility; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000276:immunology / Q000378:metabolism / Q000523:psychology; D019518:Postprandial Period; D055815:Young Adult
chemical_list: D004041:Dietary Fats; D007328:Insulin
keywords: Depression; Inflammation; Insulin; Marriage; Resting energy expenditure; Triglycerides