stress

Posted on Diabetes

Researchers suggest stress explains how obesity causes diabetes

The findings highlight the importance of analyzing the impact of life stressors on those with MS

A study from Rutgers Health and other institutions indicates that stress hormones – not impaired cellular insulin signalling – may be the primary driver of obesity-related diabetes.

“We have been interested in the basic mechanisms of how obesity induces diabetes. Given that the cost of the diabetes epidemic in the U.S. alone exceeds $300 billion per year, this is a critically important question,” said Christoph Buettner, chief of endocrinology, metabolism and nutrition at Rutgers Robert Wood Johnson Medical School and the study’s senior author.

Scientists have long thought obesity causes diabetes by impairing insulin signalling within the liver and fat cells. However, new research shows that overeating and obesity increase the body’s sympathetic nervous system—the “fight or flight” response—and that the increased levels of the stress hormones norepinephrine and epinephrine counteract insulin’s effects even though cellular insulin signalling still works.

The authors observed that overeating in normal mice increases the stress hormone norepinephrine within days, indicating how quickly surplus food stimulates the sympathetic nervous system.

To see what effect this excess hormone production has in spurring disease development, the authors then deployed a new type of genetically engineered mice that are normal in every way but one: They cannot produce stress hormones catecholamines outside of their brains and central nervous systems.

The researchers fed these mice the obesity-inducing high-fat and high-sugar diet, but although they ate as many calories and got just as obese as normal mice, they did not develop metabolic disease.

“We were delighted to see that our mice ate as much because it indicates that the differences in insulin sensitivity and their lack of metabolic disease are not due to reduced food intake or reduced obesity but the greatly reduced stress hormones. These mice cannot increase stress hormones that counteract insulin; hence, insulin resistance does not develop during obesity development.”

The new findings may help explain why some obese individuals develop diabetes while others don’t and why stress can worsen diabetes even with little weight gain.

“Many types of stress – financial stress, marital stress, the stress associated with living in dangerous areas or suffering discrimination or even the physical stress that comes from excessive alcohol consumption — all increase diabetes and synergize with the metabolic stress of obesity,” Buettner said.

“Our finding that even obesity principally induces metabolic disease via increased stress hormones provides new insight into the common basis for all these factors that increase the risk of diabetes. Stress and obesity, in essence, work through the same basic mechanism in causing diabetes, through the actions of stress hormones.”

While it is well known that catecholamines can impair insulin action, the new study suggests that this may be the fundamental mechanism underlying insulin resistance in obesity. The dynamic interplay between stress hormones, which work in opposition to insulin, has long been known. Stress hormones increase glucose and lipids in the bloodstream, while insulin lowers these. However, an unexpected finding of the new study is that insulin signaling can remain intact even in insulin-resistant states like obesity. It’s just that the heightened activity of stress hormones effectively “push the gas pedal harder,” resulting in increased blood sugar and fat levels. Even though the level of insulin’s “braking” effect remains the same, the accelerated gas pedal effect of catecholamines overwhelms the brake effect of insulin and results in relatively diminished insulin action.

“Some colleagues are at first surprised that insulin resistance can exist even though cellular insulin signaling is intact. But let’s not forget that the gas pedal effects of stress hormones are exerted through very different signaling pathways than insulin signaling. That explains why the ability of insulin to ‘brake’ and reduce the release of sugar and fat into the bloodstream is impaired even though insulin signaling is intact because stress signaling is predominant.”

The findings suggest that medications that reduce catecholamines, a term for all the stress-related hormones and neurotransmitters produced by the SNS and the adrenal gland, might help prevent or treat diabetes. However, medicines that block catecholamines, as they are currently used to treat high blood pressure, haven’t shown major benefits for diabetes. This may be because current drugs don’t block the relevant receptors or because they affect the brain and body in complex ways, Buettner said.

Buettner and the study’s first author, Kenichi Sakamoto, an assistant professor of endocrinology at Robert Wood Johnson Medical School, are planning human studies to confirm their findings. They’re also examining the role of the sympathetic nervous system and other forms of diabetes, including Type 1 diabetes.

“We would like to study if short-term overfeeding, as some of us experience during the holidays by gaining five to 10 pounds, increases insulin resistance with heightened sympathetic nervous system activation,” Buettner said.

The findings may ultimately lead to new therapeutic approaches to tackle insulin resistance, diabetes and metabolic disease, focused on reducing stress hormones rather than targeting insulin signaling.

“We hope this paper provides a different take on insulin resistance,” Buettner said. “It may also explain why none of the drugs currently used to treat insulin resistance, except insulin itself, directly increases cellular insulin signaling.”

Posted on Diet

“Want to feel less stressed? Give the Mediterranean diet a try!”

Mediterranean diet

Consuming components of the Mediterranean diet is associated with lower levels of perceived stress and mental distress, according to new research from Binghamton University, State University of New York. Credit Alachua County

Following the Mediterranean diet rather than the traditional Western diet might reduce stress, according to new research conducted by a team from Binghamton University, State University of New York.

Lina Begdache, associate professor of health and wellness studies, said the findings suggest that people can lower their perception of how much stress they can tolerate by following a Mediterranean diet.

“Stress is recognized to be a precursor to mental distress, and research, including our own, has demonstrated that the Mediterranean diet lowers mental distress,” she said. “Thus, one element of the puzzle may be explained by the fact that the Mediterranean diet may be associated with a decrease in the negative components of perceived stress and an improvement in its positive attributes.”  

The Mediterranean diet is plant-based, with healthy fats, and mainly includes wholesome food and a spectrum of natural colours. It stands in sharp contrast to the Western diet, which is known for its high concentration of high-glycemic and low-quality processed foods.

While the Mediterranean diet is known for its benefits to both mental and physical health, little is known about its effect on perceived stress, which is how much stress you are under at any particular time.

To assess this, Begdache and her students surveyed over 1,500 people, asking them what foods they ate and evaluating their perceived stress levelsss. Using a machine learning model, the results show that consuming components of the Mediterranean diet is associated with lower levels of perceived stress and mental distres,s while consuming Western dietary components is correlated with perceived stress and mental anguish.

Begdache said these results close a gap in the literature because most studies on diet and stress focused on how stress affects dietary choices and quality. She and her team are looking at different aspects of brain function and behaviours about dietary patterns.

Posted on Multiple Sclerosis

Stress and Multiple Sclerosis – How it Affects our Symptoms and How to Minimize it

Living with MS (multiple sclerosis) or chronic illness can be stressful! And stress can affect our symptoms. In this video, hear about how stress can affect us, our MS symptoms, and some easy-to-implement tips to help with stress management and symptom management.

Posted on Multiple Sclerosis

Life stressors may contribute to multiple sclerosis flares, disability.

The findings highlight the importance of analyzing the impact of life stressors on those with MS
The findings highlight the importance of analyzing the impact of life stressors on those with MS

A Michigan Medicine-led study finds that stressors across the lifespan — including poverty, abuse and divorce — are associated with worsening health and functional outcomes for people with multiple sclerosis.

Using survey data from more than 700 people with MS, researchers discovered that stressful events occurring both in childhood and adulthood contributed significantly to participants’ level of disability.

The results are published in Brain and Behavior.

“MS is the leading cause of non-traumatic disability among young adults, and additional research is needed to identify these external drivers of disability that can be addressed or prevented, including stress, to improve functional outcomes,” said co-author Tiffany Braley, M.D., M.S., director of the Multiple Sclerosis/Neuroimmunology Division and Multidisciplinary MS Fatigue and Sleep Clinic at University of Michigan Health.

“This knowledge is needed to inform MS research as well as clinical care. Referrals to resources, such as mental health or substance use support could help reduce the impact of stress and enhance wellbeing,” Braley said.

More than 2.8 million people in the world have MS, an autoimmune condition that affects the brain and spinal cord, in which the protective layer of nerve cells is attacked by the body’s immune system. People with MS can experience unique, often painful, exacerbations of their symptoms known as a relapses, exacerbations or “flares”.

Initially in the study, both childhood and adult stressors were significantly associated with worse burden caused by relapse after the onset of the COVID-19 pandemic. However, the association between childhood stressors and disease burden lost significance when further accounting for experiences in adulthood. 

Studies focused on stress and MS that don’t account for the full lifespan, researchers say, could miss vital information or overestimate the relationship between childhood stressors and health outcomes.

“Adverse Childhood Experiences, which we call ACEs, and other childhood stressors could impact immune, inflammatory and behavioral processes throughout life, and reduce resilience to adult stress,” said first author Carri Polick, Ph.D., R.N., who completed this work while at the U-M School of Nursing and is now a postdoctoral fellow in the National Clinician Scholars Program at Duke University.

“It is important to use a lifespan approach in future work to better understand patterns and inform symptom management. For example, we are expanding upon this work to investigate mechanistic pathways through sleep, smoking and mental health, through which stressors may lead to worse MS outcomes including increased disability, pain and fatigue.”