Stress habituation, body shape and cardiovascular mortality

Abstract

High cardiovascular mortality is well documented in lean phenotypes exhibiting visceral fat accumulation. In contrast, corpulent phenotypes with predominantly subcutaneous fat accumulation display a surprisingly low mortality. The term 'obesity paradox' reflects the difficulty in understanding the biological mechanisms underlying these clinical observations. The allostatic load model of chronic stress focuses on glucocorticoid dysregulation as part of a 'network of allostasis' involving autonomic, endocrine, metabolic, and immune mediators. Here, we expand upon the energetic demands of the brain and show that 'habituators' and 'non-habituators' develop divergent patterns of fat distribution. Central to this process is the recurrent rise in the cerebral energy need (arousal) that non-habituators experience during chronic stress. These neuroenergetic alterations promote visceral fat accumulation, subcutaneous fat loss, and atherogenesis with subsequent cardiovascular events. Habituators are more or less protected against such cardiovascular complications, but there is a metabolic trade-off that we shall discuss in the present paper.

Association of occupational stress with waking, diurnal, and bedtime cortisol response in police officers

“…Officers also need support in the aftermath of harm to the physiological systems that respond to stressor exposure, such as increasing awareness of risks and specific practices in police work that may help reduce individual vulnerability to stressors. Helping officers acquire skills to habituate to the stressors of police work may possibly change how exposures affect their physiology over time and perhaps prevent increases in cardiovascular risk (Peters & McEwen, ).…”

“…Reactivity of the HPA axis to induced psychosocial stress has been prospectively associated with the incidence of hypertension (Hamer & Steptoe, ). Four types of physiological responses contribute to and reflect maladaptation to stressor exposures: (a) frequency and intensity of responses, (b) failure to habituate after a repeated stressor exposure, (c) failure to terminate adaptive autonomic and neuroendocrine responses, and (d) failure to respond adequately to a challenge (McEwen & Gianaros, ; Peters & McEwen, ). The cumulative wear and tear of the physical and social environments (allostatic load) dictate an individual's response to stressors and their manifestations (McEwen, ).…”

An Anthropometric Risk Index Based on Combining Height, Weight, Waist, and Hip Measurements

“…The approach used to compute ARI here for hazard of all-cause mortality could also be extended to derive risk indices customized for specific causes of death and morbidity outcomes such as heart disease, stroke, or diabetes, which could facilitate individualized cost-benefit consideration in deciding what medical interventions to undertake [69–71]. One recent study found that anthropometric indices (ABSI and WC/ H ratio) were correlated with Framingham and SCORE 10-year cardiovascular risk estimates in a nationally representative Turkish sample [72], while another study found anthropometry-based indices (specifically ABSI) to predict cardiovascular disease in middle-aged and elderly Dutch adults as well as a risk model that included laboratory measurements [73], highlighting the potential for utilization of a combination of several readily obtained body measurements for cardiometabolic risk assessment.…”

Stress Processes: An Essential Ingredient in the Entrepreneurial Process

“…For example, the better they adjust their beliefs about uncertainty, the better they are able to predict future outcomes, thus reducing stress resulting from uncertainty. However, when the uncertainty becomes chronic and cannot be reduced it leads continuous and ineffective physiological stress reactions that cause depression, cognitive impairment, infarction, and stroke in the long term (Peters & McEwen, 2015).…”