Marital discord, past depression, and metabolic responses to high-fat meals: Interpersonal pathways to obesity

Abstract

Background Longitudinal studies have implicated both marital distress and depression in the development of the metabolic syndrome, a risk factor for diabetes and cardiovascular disease. This study addressed the impact of hostile marital interactions and a mood disorder history 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, insulin, glucose, interleukin 6 (IL-6), and tumor necrosis factor alpha (TNF-α) before and after two high-fat meals. During two separate 9.5 hour visits, 43 healthy married couples, ages 24 to 61 (mean=38.22), received either a high saturated fat meal or a high oleic sunflower oil meal, both 930 kcal and 60 g fat. The Structured Diagnostic Interview for DSM-IV assessed mood disorder history. Couples discussed a marital disagreement during both visits; behavioral coding of these interactions provided data on hostile marital behaviors. Results Men and women who displayed more hostile behaviors and who also had a mood disorder history had significantly lower post-meal REE, higher insulin, and higher peak triglyceride responses than other participants, with nonsignificant effects for fat and carbohydrate oxidation. Participants with a mood disorder history had a steeper rise in postprandial IL-6 and glucose than those without a past history. Higher levels of hostile behaviors were associated with higher post-meal TNF-α. The two meals did not differ on any outcome assessed. Conclusions People spend about 18 of every 24 hours in a postprandial state, and dining with one’s partner is a common daily event. Among subjects with a mood disorder history, the cumulative 6.75-hour difference between high and low hostile behaviors translates into 128 kcal, a difference that could add 7.6 pounds/year. Our findings illustrate novel pathways through which chronic marital stress and a mood disorder history synergistically heighten the risk for obesity, metabolic syndrome, and cardiovascular disease.

Depression, daily stressors and inflammatory responses to high-fat meals: when stress overrides healthier food choices

“…Similarly, in our subsequent study with married couples that included the same high-fat meals, men and women who had a mood disorder history and who also displayed more hostile behaviors during the laboratory marital conflict discussions had lower post-meal resting energy expenditure, higher insulin, and higher peak triglyceride responses than other participants (42). …”

Sex Differences in Depression: Does Inflammation Play a Role?

“…For example, obese women report more fatigue than those who are not obese, and both of these factors increase inflammation [37]. When combined with a history of depression, marital distress has been linked to a slower metabolism, which could lead to weight gain and thus promote inflammation [89]. In addition, women are more likely to take on multiple social roles; as a result, they experience more frequent opportunities for stress compared to men [90].…”

Shortened sleep fuels inflammatory responses to marital conflict: Emotion regulation matters

“…Couples were recruited for a parent study of immune responses to high-fat meals (Kiecolt-Glaser et al, 2015b). An initial online screen and follow-up in-person screen determined eligibility.…”

“…Own and partner recent sleep were included as predictors simultaneously to capture the unique effects of one while adjusting for the other. Cytokine models also included a random effect for assay plate to account for plate-to-plate variability and increase precision of estimates (Browne et al, 2013; Kiecolt-Glaser et al, 2015b). …”