Elsevier

Biological Psychiatry

Volume 77, Issue 7, 1 April 2015, Pages 653-660
Biological Psychiatry

Archival Report
Daily Stressors, Past Depression, and Metabolic Responses to High-Fat Meals: A Novel Path to Obesity

https://doi.org/10.1016/j.biopsych.2014.05.018Get rights and content

Abstract

Background

Depression and stress promote obesity. This study addressed the impact of daily stressors and a history of major depressive disorder (MDD) 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, cortisol, insulin, and glucose before and after two high-fat meals. During two separate 9.5-hour admissions, 58 healthy women (38 breast cancer survivors and 20 demographically similar control subjects), mean age 53.1 years, received either a high saturated fat meal or a high oleic sunflower oil meal. Prior day stressors were assessed by the Daily Inventory of Stressful Events.

Results

Greater numbers of stressors were associated with lower postmeal REE (p = .008), lower fat oxidation (p = .04), and higher insulin (p = .01), with nonsignificant effects for cortisol and glucose. Women with prior MDD had higher cortisol (p = .008) and higher fat oxidation (p = .004), without significant effects for REE, insulin, and glucose. Women with a depression history who also had more stressors had a higher peak triglyceride response than other participants (p = .01). The only difference between meals was higher postprandial glucose following sunflower oil compared with saturated fat (p = .03).

Conclusions

The cumulative 6-hour difference between one prior day stressor and no stressors translates into 435 kJ, a difference that could add almost 11 pounds per year. These findings illustrate how stress and depression alter metabolic responses to high-fat meals in ways that promote obesity.

Section snippets

Design and Overview

This double-blind, randomized, crossover study assessed metabolic responses following high-fat meals. Women received one high saturated fat meal and one high oleic sunflower oil meal during two separate full-day visits to the Clinical Research Center (CRC), a hospital research unit, with the meal order randomized. Visits were spaced 1 to 4 weeks apart. The institutional review board approved this study, and each participant provided informed consent.

After fasting for 12 hours, a catheter was

Primary Analyses

A larger number of stressors was associated with a steeper postprandial decline in postmeal energy expenditure (Figure 1), controlling for premeal resting energy expenditure (REE), age, lean body mass, trunk fat, physical activity, and past depression, as evidenced by a significant stressors by time interaction (p = .008). For subjects with no prior day stressors, the estimated postmeal energy expenditure slope was −54 kJ per hour, and with each additional stressor, the slope decreased by an

Discussion

This study provides novel evidence of metabolic pathways through which prior day stressors and past depression facilitate weight gain over time. Greater numbers of prior day stressors were associated with decreased postmeal energy expenditure. The cumulative difference between one recent stressor and no stressors over 6 hours translates into 435 kJ, averaged across meal type and group and all controlling variables. This difference would add up to almost 11 pounds across a year.

Greater numbers

Acknowledgments and Disclosures

This study was supported in part by National Institutes of Health Grants CA131029, CA154054, UL1TRR025755, and CA016058. The sponsor had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.

The authors report no biomedical financial interests or potential conflicts of interest.

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