Early life adversity and/or posttraumatic stress disorder severity are associated with poor diet quality, including consumption of trans fatty acids, and fewer hours of resting or sleeping in a US middle-aged population: A cross-sectional and prospective study

Abstract

Background Early life adversity (ELA) and post-traumatic stress disorder (PTSD) are associated with poorer psychological and physical health. Potential underlying mechanisms and mediators remain to be elucidated, and the lifestyle habits and characteristics of individuals with ELA and/or PTSD have not been fully explored. We investigated whether the presence of ELA and/or PTSD are associated with nutrition, physical activity, resting and sleeping and smoking. Methods A cross-sectional sample of 151 males and females (age: 45.6±3.5 y, BMI: 30.0±7.1kg/m2) underwent anthropometric measurements, as well as detailed questionnaires for dietary assessment, physical activity, resting and sleeping, smoking habits and psychosocial assessments. A prospective follow-up visit of 49 individuals was performed 2.5 years later and the same outcomes were assessed. ELA and PTSD were evaluated as predictors, in addition to a variable assessing the combined presence/severity of ELA–PTSD. Data were analyzed using analysis of covariance after adjusting for several socioeconomic, psychosocial and anthropometric characteristics. Results Individuals with higher ELA or PTSD severity were found to have a poorer diet quality (DASH score: p=0.006 and p=0.003, respectively; aHEI-2010 score: ELA p=0.009), including further consumption of trans fatty acids (ELA p=0.003); the differences were significantly attenuated null after adjusting mainly for education or income and/or race. Further, individuals with higher ELA severity reported less hours of resting and sleeping (p=0.043) compared to those with zero/lower ELA severity, and the difference remained significant in the fully adjusted model indicating independence from potential confounders. When ELA and PTSD were combined, an additive effect was observed on resting and sleeping (p=0.001); results remained significant in the fully adjusted model. They also consumed more energy from trans fatty acids (p=0.017) tended to smoke more (p=0.008), and have less physical activity (PTSD p=0.024) compared to those with no or lower ELA and PTSD severity. Adjustments for sociodemographic factors and/or BMI rendered results of the above life style parameters non-significant. The analysis of the prospective data showed similar trends to the cross-sectional analysis, further supporting the conclusions, although statistical significance of results was lower due to the lower number of participants. Conclusion Fewer hours of resting and sleeping and poorer diet quality are linked to ELA and/or PTSD, indicating that these pathways might underlie the development of several metabolic abnormalities in individuals with ELA and/or PTSD. Differences in terms of diet quality are significantly attenuated by race and/or education and/or income, whereas differences in other lifestyle habits of individuals with and without ELA and/or PTSD, such as physical activity, are mostly explained by confounding sociodemographic variables and/or body mass index.

Endocannabinoid concentrations in hair are associated with PTSD symptom severity

“…Individuals with PTSD also showed a poorer diet quality with a higher consumption of trans-fatty acids in traumatized individuals (Gavrieli et al, 2015). In our study, hair concentrations of OEA decreased significantly with increased PTSD symptom intensity which suggests that impairments in OEA signaling could be a mediating factor in the increased prevalence of fat consumption, obesity, insulin resistance and cardiovascular risk commonly seen in patients with PTSD .…”

“…In our study, hair concentrations of OEA decreased significantly with increased PTSD symptom intensity which suggests that impairments in OEA signaling could be a mediating factor in the increased prevalence of fat consumption, obesity, insulin resistance and cardiovascular risk commonly seen in patients with PTSD . Additional lifestyle factors, which could increase cardiovascular risk in individuals with PTSD, include a lack of physical activity (Gavrieli et al, 2015). Exercise has also been shown to improve symptoms in PTSD patients (Rosenbaum et al, 2015b).…”

Anxiety Disorders and Cardiovascular Disease

“…Anxious individuals tend to have increased dietary cholesterol intake, elevated total energy intake, sedentary lifestyle, and decreased physical activity [46], consistent with the finding that patients with PD and GAD have increased odds of dyslipidemia, obesity, diabetes, and substance use [47, 48]. Patients with PTSD have poor diet quality (with most energy obtained from fatty acids), decreased physical activity, increased obesity, and increased rates of smoking [49]. Among cardiac patients, anxiety is associated with a lower likelihood of adhering to a number of risk-reducing recommendations after MI, including smoking cessation, social support utilization, and stress reduction [50].…”

Longitudinal associations between post-traumatic stress disorder and metabolic syndrome severity

“…At the same time, PTSD-related increases in reactive oxygen species (Miller et al, 2014; Gautam et al, 2015; Atli et al, in press) may alter the expression of genes important for regulating metabolic processes, ultimately compounding metabolic dysregulation (Grattagliano et al, 2008). In addition, PTSD-related poor sleep (Gavrieli et al, 2015; Talbot et al, 2015), unhealthy diet (Hall et al, 2015), insufficient exercise (Georgiades et al, 2000; Hall et al, 2015), cigarette and alcohol use (Dennis et al, 2014), and psychotropic medication use (Vancampfort et al, 2015) may exert effects on metabolic health that additively and/or synergistically further contribute to the cascade of broad metabolic dysfunction.…”