Chronic stress increases vulnerability to diet-related abdominal fat, oxidative stress, and metabolic risk

Kirstin Aschbacher, Sarah Kornfeld, Martin Picard, Eli Puterman, Peter J Havel, Kimber Stanhope, Robert H. Lustig, Elissa Epel

Research output: Contribution to journalArticlepeer-review

75 Scopus citations


Background: In preclinical studies, the combination of chronic stress and a high sugar/fat diet is a more potent driver of visceral adiposity than diet alone, a process mediated by peripheral neuropeptide Y (NPY). Methods: In a human model of chronic stress, we investigated whether the synergistic combination of highly palatable foods (HPF; high sugar/fat) and stress was associated with elevated metabolic risk. Using a case-control design, we compared 33 post-menopausal caregivers (the chronic stress group) to 28 age-matched low-stress control women on reported HPF consumption (modified Block Food Frequency Questionnaire), waistline circumference, truncal fat ultrasound, and insulin sensitivity using a 3-h oral glucose tolerance test. A fasting blood draw was assayed for plasma NPY and oxidative stress markers (8-hydroxyguanosine and F2-Isoprostanes). Results: Among chronically stressed women only, greater HPF consumption was associated with greater abdominal adiposity, oxidative stress, and insulin resistance at baseline (all p's. ≤ .01). Furthermore, plasma NPY was significantly elevated in chronically stressed women (p< .01), and the association of HPF with abdominal adiposity was stronger among women with high versus low NPY. There were no significant predictions of change over 1-year, likely due to high stability (little change) in the primary outcomes over this period. Discussion: Chronic stress is associated with enhanced vulnerability to diet-related metabolic risk (abdominal adiposity, insulin resistance, and oxidative stress). Stress-induced peripheral NPY may play a mechanistic role.

Original languageEnglish (US)
Pages (from-to)14-22
Number of pages9
StatePublished - 2014


  • Abdominal adiposity
  • Metabolic syndrome
  • Obesity
  • Pre-diabetes
  • Psychological stress

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Psychiatry and Mental health
  • Biological Psychiatry
  • Endocrine and Autonomic Systems
  • Medicine(all)


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