Psychological stress, body shape and cardiovascular events: Results from the Whitehall II study

Kubera, Britta; Kohlmann, Thomas; Peters, Achim

doi:10.1016/j.cpnec.2021.100104

Cited by 3 publications

(2 citation statements)

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“…At these predilection sites, turbulences can trigger mechanisms that can lead to plaque formation, atherosclerosis, and, in the worst case, myocardial infarction or stroke (Stone et al, 2012). There is strong evidence that people with the lean-but-wide-waisted phenotype have the greatest cardiovascular risk and the obese-but-narrow-waisted phenotype have the least (Berentzen et al, 2010;Petursson et al, 2011;Cameron et al, 2012;Hamer and Stamatakis, 2012;Ortega et al, 2013;Krakauer and Krakauer, 2014;Hu et al, 2018;Berglund et al, 2019;Kim et al, 2019;Kubera et al, 2022). That psychosocial stress is a cause of myocardial infarction is supported by two randomized controlled trials: an anti-stress program, i.e., cognitive behavioral therapy, could lower the incidence of cardiovascular events and mortality (Orth-Gomer et al, 2009;Gulliksson et al, 2011).…”

Section: Toxic Stressmentioning

confidence: 99%

“…In psychosomatic medicine, it is very well known that people who feel uncertain-not knowing what will happen next-are more likely to develop somatic diseases such as myocardial infarction, stroke, type 2 diabetes mellitus or obesity (Heraclides et al, 2011;Kubera et al, 2022). In 1956, the first psychosomatic workshop was held "On the mysterious leap from mind to body. "…”

Section: Introductionmentioning

confidence: 99%

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Obesity and Type 2 Diabetes Mellitus Explained by the Free Energy Principle

2022

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According to the free energy principle, all sentient beings strive to minimize surprise or, in other words, an information-theoretical quantity called variational free energy. Consequently, psychosocial “stress” can be redefined as a state of “heightened expected free energy,” that is, a state of “expected surprise” or “uncertainty.” Individuals experiencing stress primarily attempt to reduce uncertainty, or expected free energy, with the help of what is called an uncertainty resolution program (URP). The URP consists of three subroutines: First, an arousal state is induced that increases cerebral information transmission and processing to reduce uncertainty as quickly as possible. Second, these additional computations cost the brain additional energy, which it demands from the body. Third, the program controls which stress reduction measures are learned for future use and which are not. We refer to an episode as “good” stress, when the URP has successfully reduced uncertainty. Failure of the URP to adequately reduce uncertainty results in either stress habituation or prolonged toxic stress. Stress habituation reduces uncertainty by flattening/broadening individual goal beliefs so that outcomes previously considered as untenable become acceptable. Habituated individuals experience so-called “tolerable” stress. Referring to the Selfish Brain theory and the experimental evidence supporting it, we show that habituated people, who lack stress arousals and therefore have decreased average brain energy consumption, tend to develop an obese type 2 diabetes mellitus phenotype. People, for whom habituation is not the free-energy-optimal solution, do not reduce their uncertainty by changing their goal preferences, and are left with nothing but “toxic” stress. Toxic stress leads to recurrent or persistent arousal states and thus increased average brain energy consumption, which in turn promotes the development of a lean type 2 diabetes mellitus phenotype. In conclusion, we anchor the psychosomatic concept of stress in the information-theoretical concept of uncertainty as defined by the free energy principle. In addition, we detail the neurobiological mechanisms underlying uncertainty reduction and illustrate how uncertainty can lead to psychosomatic illness.

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Section: Toxic Stressmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Obesity and Type 2 Diabetes Mellitus Explained by the Free Energy Principle

2022

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The principle of ‘brain energy on demand’ and its predictive power for stress, sleep, stroke, obesity and diabetes

Peters

Sprengell

Kubera

2022

Neuroscience & Biobehavioral Reviews

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Stress-induced obesity in mice causes cognitive decline associated with inhibition of hippocampal neurogenesis and dysfunctional gut microbiota

Liu,

Zhao,

et al. 2024

Front. Microbiol.

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Effects of stress on obesity have been thoroughly studied in high-fat diet fed mice, but not in normal diet fed mice, which is important to clarify because even on a normal diet, some individuals will become obese under stress conditions. Here we compared mice that showed substantial weight gain or loss under chronic mild stress while on a normal diet; we compared the two groups in terms of cognitive function, hypothalamic–pituitary–adrenal signaling, neurogenesis and activation of microglia in hippocampus, gene expression and composition of the gut microbiome. Chronic mild stress induced diet-independent obesity in approximately 20% of animals, and it involved inflammatory responses in peripheral and central nervous system as well as hyperactivation of the hypothalamic–pituitary–adrenal signaling and of microglia in the hippocampus, which were associated with cognitive deficits and impaired hippocampal neurogenesis. It significantly increased in relative abundance at the phylum level (Firmicutes), at the family level (Prevotellaceae ucg − 001 and Lachnospiraceae NK4a136), at the genus level (Dubosiella and Turicibacter) for some enteric flora, while reducing the relative abundance at the family level (Lactobacillaceae and Erysipelotrichaceae), at the genus level (Bacteroidota, Alistipes, Alloprevotella, Bifidobacterium and Desulfovibrio) for some enteric flora. These results suggest that stress, independently of diet, can induce obesity and cognitive decline that involve dysfunctional gut microbiota. These insights imply that mitigation of hypothalamic–pituitary–adrenal signaling and microglial activation as well as remodeling of gut microbiota may reverse stress-induced obesity and associated cognitive decline.

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Psychological stress, body shape and cardiovascular events: Results from the Whitehall II study

Cited by 3 publications

References 53 publications

Obesity and Type 2 Diabetes Mellitus Explained by the Free Energy Principle

Obesity and Type 2 Diabetes Mellitus Explained by the Free Energy Principle

The principle of ‘brain energy on demand’ and its predictive power for stress, sleep, stroke, obesity and diabetes

Stress-induced obesity in mice causes cognitive decline associated with inhibition of hippocampal neurogenesis and dysfunctional gut microbiota

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