Coping Strategies Influence Cardiometabolic Risk Factors in Chronic Psychological Stress: A Post Hoc Analysis of A Randomized Pilot Study.

Deborah Armborst, Norman Bitterlich, Birgit Alteheld, Daniela Rösler, Christine Metzner, Roswitha Siener

Journal: Nutrients 2022;14(1):77

PMID: 35010951

Plain Language Summary

Chronic psychological stress is increasingly recognized as a significant contributor to mental and physiological disorders in modern societies. The individual response to chronic stressors and resulting disorders depends on numerous factors. The aim of this study was to investigate the cardiometabolic risk profile in participants with ‘high’ and ‘very high’ chronic stress loads and the impact of positive and negative coping factors used. This study is a post hoc analysis of a randomised pilot study. For this analysis, baseline data were available for 62 chronic psychologically stressed participants, of whom 61 participants (43 women and 18 men) were included in the intention-to-treat (ITT) population. Results indicate that: - perceiving high chronic stress is significantly associated with the criteria of the metabolic syndrome. - on the contrary, a very high perceived chronic stress load seemed to be rather associated with mental health risk than with cardiometabolic risk. - inflammation and oxidative stress markers significantly correlated with cardiometabolic risk parameters. - stress load can be coped with in diverse ways and that the coping strategy is crucial for cardiometabolic risk. Authors conclude that long-term studies are necessary to examine further adaptations to chronic stress and to evaluate individual stress-management strategies.

Abstract

Chronic psychological stress can result in physiological and mental health risks via the activation of the hypothalamic-pituitary-adrenal (HPA) axis, sympathoadrenal activity and emotion-focused coping strategies. The impact of different stress loads on cardiometabolic risk is poorly understood. This post hoc analysis of a randomized pilot study was conducted on 61 participants (18-65 years of age) with perceived chronic stress. The Perceived Stress Questionnaire (PSQ), Psychological Neurological Questionnaire (PNF), anthropometric, clinical and blood parameters were assessed. Subjects were assigned to 'high stress' (HS; PSQ score: 0.573 ± 0.057) and 'very high stress' (VHS; PSQ score: 0.771 ± 0.069) groups based on the PSQ. Morning salivary cortisol and CRP were elevated in both groups. Visceral adiposity, elevated blood pressure and metabolic syndrome were significantly more frequent in the HS group vs. the VHS group. The fatty liver index (FLI) was higher ( = 0.045), while the PNF score was lower ( < 0.001) in the HS group. The HS group was comprised of more smokers ( = 0.016). Energy intake and physical activity levels were similar in both groups. Thus, high chronic stress was related to visceral adiposity, FLI, elevated blood pressure and metabolic syndrome in the HS group, while very high chronic stress was associated with psychological-neurological symptoms and a lower cardiometabolic risk in the VHS group, probably due to different coping strategies.

Address: Department of Urology, Medical Nutrition Science, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.; Department of Biostatistics, Medicine and Service Ltd., Boettcherstr. 10, 09117 Chemnitz, Germany.; Department of Nutrition and Food Sciences, Nutritional Physiology, University of Bonn, Nussallee 9, 53115 Bonn, Germany.; Bonn Education Association for Dietetics r. A., Fuerst-Pueckler-Str. 44, 50935 Cologne, Germany.; Bonn Education Association for Dietetics r. A., Fuerst-Pueckler-Str. 44, 50935 Cologne, Germany.; Clinic for Gastroenterology, Metabolic Disorders and Internal Intensive Medicine (Medical Clinic III), RWTH Aachen, Pauwelsstr. 44, 52074 Aachen, Germany.

DOI: 10.3390/nu14010077