Simple Test Can Tell If You’re Stressed Out

Stress is often called “the silent killer” because of its stealthy and mysterious effects on everything from heart disease to mental health.

Now researchers at the University of Cincinnati have developed a new test that can easily and simply measure common stress hormones using sweat, blood, urine or saliva. Eventually, they hope to turn their ideas into a simple device that patients can use at home to monitor their health.

The results were published this month in the journal American Chemical Society Sensors.

“I wanted something that’s simple and easy to interpret,” said Andrew Steckl, an Ohio Eminent Scholar and professor of electrical engineering in UC’s College of Engineering and Applied Science.

“This may not give you all the information, but it tells you whether you need a professional who can take over,” Steckl said.

UC researchers developed a device that uses ultraviolet light to measure stress hormones in a drop of blood, sweat, urine or saliva. These stress biomarkers are found in all of these fluids, albeit in different quantities, Steckl said.

“It measures not just one biomarker but multiple biomarkers. And it can be applied to different bodily fluids. That’s what’s unique,” he said.

Steckl has been studying biosensors for years in his Nanoelectronics Laboratory. The latest journal article is part of a series of research papers his group has written on biosensors, including one that provides a review of methods for point-of-care diagnostics of stress biomarkers.

Personal experience helping his father with a health crisis informed his research and opinion that a home test for various health concerns would be incredibly helpful.

“I had to take him quite often to the lab or doctor to have tests done to adjust his medication. I thought it would be great if he could just do the tests himself to see if he was in trouble or just imagining things,” Steckl said. “This doesn’t replace laboratory tests, but it could tell patients more or less where they are.”

UC received grant funding for the project from the National Science Foundation and the U.S. Air Force Research Lab. Steckl said the military studies acute stress in its pilots and others who are pushing the edges of human performance.

“Pilots are placed under enormous stress during missions. The ground controller would like to know when the pilot is reaching the end of his or her ability to control the mission properly and pull them out before a catastrophic ending,” Steckl said.

But the UC device has widespread applications, Steckl said. His lab is pursuing the commercial possibilities.

“You’re not going to replace a full-panel laboratory blood test. That’s not the intent,” Steckl said. “But if you’re able to do the test at home because you’re not feeling well and want to know where you stand, this will tell whether your condition has changed a little or a lot.”

UC graduate Prajokta Ray, the study’s first author, said she was excited to work on such a pressing problem for her Ph.D. studies.

“Stress harms us in so many ways. And it sneaks up on you. You don’t know how devastating a short or long duration of stress can be,” Ray said. “So many physical ailments such as diabetes, high blood pressure and neurological or psychological disorders are attributed to stress the patient has gone through. That’s what interested me.”

Ray said taking exams always gave her stress. Understanding how stress affects you individually could be extremely valuable, she said.

“Stress has been a hot topic over the past couple years. Researchers have tried very hard to develop a test that is cheap and easy and effective and detect these hormones in low concentrations,” she said. “This test has the potential to make a strong commercial device. It would be great to see the research go in that direction.”

UC is at the forefront of biosensor technology. Its labs are examining continuous sweat testing and point-of-care diagnostics for everything from traumatic brain injury to lead poisoning.

Steckl, too, has been a preeminent innovator at UC. His papers have been cited more than 13,000 times, according to Google Scholar. In 2016, he used salmon sperm, a common byproduct of the fishing industry, to replace rare earth metals used in light-emitting diodes for a new kind of organic LED.

“We’re device engineers at heart,” Steckl said. “We don’t shy away from things we don’t know much about to begin with. We look for opportunities. That’s a hallmark of electrical engineers. We’re not smart enough not to go where we shouldn’t. Sometimes that pays off!”

Source: University of Cincinnati


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Stressed at Work and Trouble Sleeping? It’s More Serious than You Think

Sophia Antipolis wrote . . . . . . . . .

Work stress and impaired sleep are linked to a threefold higher risk of cardiovascular death in employees with hypertension. That’s the finding of research published today in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology (ESC).

Study author Professor Karl-Heinz Ladwig, of the German Research Centre for Environmental Health and the Medical Faculty, Technical University of Munich, said: “Sleep should be a time for recreation, unwinding, and restoring energy levels. If you have stress at work, sleep helps you recover. Unfortunately poor sleep and job stress often go hand in hand, and when combined with hypertension the effect is even more toxic.”

One-third of the working population has hypertension (high blood pressure). Previous research has shown that psychosocial factors have a stronger detrimental effect on individuals with pre-existing cardiovascular risks than on healthy people. This was the first study to examine the combined effects of work stress and impaired sleep on death from cardiovascular disease in hypertensive workers.

The study included 1,959 hypertensive workers aged 25–65, without cardiovascular disease or diabetes. Compared to those with no work stress and good sleep, people with both risk factors had a three times greater likelihood of death from cardiovascular disease. People with work stress alone had a 1.6-fold higher risk while those with only poor sleep had a 1.8-times higher risk.

During an average follow-up of nearly 18 years, the absolute risk of cardiovascular death in hypertensive staff increased in a stepwise fashion with each additional condition. Employees with both work stress and impaired sleep had an absolute risk of 7.13 per 1,000 person-years compared to 3.05 per 1,000-person years in those with no stress and healthy sleep. Absolute risks for only work stress or only poor sleep were 4.99 and 5.95 per 1,000 person-years, respectively.

In the study, work stress was defined as jobs with high demand and low control – for example when an employer wants results but denies authority to make decisions. “If you have high demands but also high control, in other words you can make decisions, this may even be positive for health,” said Professor Ladwig. “But being entrapped in a pressured situation that you have no power to change is harmful.”

Impaired sleep was defined as difficulties falling asleep and/or maintaining sleep. “Maintaining sleep is the most common problem in people with stressful jobs,” said Professor Ladwig. “They wake up at 4 o’clock in the morning to go to the toilet and come back to bed ruminating about how to deal with work issues.”

“These are insidious problems,” noted Professor Ladwig. “The risk is not having one tough day and no sleep. It is suffering from a stressful job and poor sleep over many years, which fade energy resources and may lead to an early grave.”

The findings are a red flag for doctors to ask patients with high blood pressure about sleep and job strain, said Professor Ladwig. “Each condition is a risk factor on its own and there is cross-talk among them, meaning each one increases risk of the other. Physical activity, eating healthily and relaxation strategies are important, as well as blood pressure lowering medication if appropriate.”

Employers should provide stress management and sleep treatment in the workplace, he added, especially for staff with chronic conditions like hypertension.

Components of group stress management sessions:

  • Start with 5 to 10 minutes of relaxation.
  • Education about healthy lifestyle.
  • Help with smoking cessation, physical exercise, weight loss.
  • Techniques to cope with stress and anxiety at home and work.
  • How to monitor progress with stress management.
  • Improving social relationships and social support.

Sleep treatment can include:

  • Stimulus control therapy: training to associate the bed/bedroom with sleep and set a consistent sleep-wake schedule.
  • Relaxation training: progressive muscle relaxation, and reducing intrusive thoughts at bedtime that interfere with sleep.
  • Sleep restriction therapy: curtailing the period in bed to the time spent asleep, thereby inducing mild sleep deprivation, then lengthening sleep time.
  • Paradoxical intention therapy: remaining passively awake and avoiding any effort (i.e. intention) to fall asleep, thereby eliminating anxiety.

Source: European Society of Cardiology


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Comfort Food Leads to More Weight Gain During Stress

Australian researchers have discovered a new molecular pathway in the brain that triggers more weight gain in times of stress.

It’s no secret that overindulging on high-calorie foods can be detrimental to health, but it turns out that under stress, watching what you eat may be even more important.

A team led by Professor Herbert Herzog, Head of the Eating Disorders laboratory at the Garvan Institute of Medical Research, discovered in an animal model that a high-calorie diet when combined with stress resulted in more weight gain than the same diet caused in a stress-free environment. The researchers revealed a molecular pathway in the brain, controlled by insulin, which drives the additional weight gain.

They publish their findings in the journal Cell Metabolism.

“This study indicates that we have to be much more conscious about what we’re eating when we’re stressed, to avoid a faster development of obesity,” says Professor Herzog.

The brain’s comfort food ‘centre’

Some individuals eat less when they’re stressed, but most will increase their food intake – and crucially, the intake of calorie-dense food high in sugar and fat.

To understand what controls this ‘stress eating’, the Garvan researchers investigated different areas of the brain in mice. While food intake is mainly controlled by a part of the brain called the hypothalamus, another part of the brain – the amygdala – processes emotional responses, including anxiety.

“Our study showed that when stressed over an extended period and high calorie food was available, mice became obese more quickly than those that consumed the same high fat food in a stress-free environment,” explains Dr Kenny Chi Kin Ip, lead author of the study.

At the centre of this weight gain, the scientists discovered, was a molecule called NPY, which the brain produces naturally in response to stress to stimulate eating in humans as well as mice.

“We discovered that when we switched off the production of NPY in the amygdala weight gain was reduced. Without NPY, the weight gain on a high-fat diet with stress was the same as weight gain in the stress-free environment,” says Dr Ip. “This shows a clear link between stress, obesity and NPY.”

A downward spiral to obesity

To understand what might control the NPY boost under stress, the scientists analysed the nerve cells that produced NPY in the amygdala and found they had receptors, or ‘docking stations’, for insulin – one of the hormones which control our food intake.

Under normal conditions, the body produces insulin just after a meal, which helps cells absorb glucose from the blood and sends a ‘stop eating’ signal to the hypothalamus feeding centre of the brain.

In the study, the scientists discovered that chronic stress alone raised the blood insulin levels only slightly, but in combination with a high-calorie diet, the insulin levels were 10 times higher than mice that were stress-free and received a normal diet.

The study showed that these prolonged, high levels of insulin in the amygdala caused the nerve cells to become desensitised to insulin, which stopped them from detecting insulin altogether. In turn, these desensitised nerve cells boosted their NPY levels, which both promoted eating and reduced the bodies’ normal response to burn energy through heat, the study showed.

“Our findings revealed a vicious cycle, where chronic, high insulin levels driven by stress and a high-calorie diet promoted more and more eating,” explains Professor Herzog. “This really reinforced the idea that while it’s bad to eat junk food, eating high-calorie foods under stress is a double whammy that drives obesity.”

While insulin imbalance is at the centre of a number of diseases, the study indicates that insulin has more wide-spread effects in the brain than previously thought.

“We were surprised that insulin had such a significant impact on the amygdala,” says Professor Herzog. “It’s becoming more and more clear that insulin doesn’t only impact peripheral regions of the body, but that it regulates functions in the brain. We’re hoping to explore these effects further in future.”

Source: Garvan Institute of Medical Research.

Stress in Childhood and Adulthood Have Combined Impact on Hormones and Health

Adults who report high levels of stress and who also had stressful childhoods are most likely to show hormone patterns associated with negative health outcomes, according to findings published in Psychological Science, a journal of the Association for Psychological Science.

One of the ways that our brain responds to daily stressors is by releasing a hormone called cortisol — typically, our cortisol levels peak in the morning and gradually decline throughout the day. But sometimes this system can become dysregulated, resulting in a flatter cortisol pattern that is associated with negative health outcomes.

“What we find is that the amount of a person’s exposure to early life stress plays an important role in the development of unhealthy patterns of cortisol release. However, this is only true if individuals also are experiencing higher levels of current stress, indicating that the combination of higher early life stress and higher current life stress leads to the most unhealthy cortisol profiles,” says psychological scientist Ethan Young, a researcher at the University of Minnesota.

For the study, Young and colleagues examined data from 90 individuals who were part of a high-risk birth cohort participating in the Minnesota Longitudinal Study of Risk and Adaptation.

The researchers specifically wanted to understand how stressful events affect the brain’s stress-response system later in life. Is it the total amount of stress experienced across the lifespan that matters? Or does exposure to stress during sensitive periods of development, specifically in early childhood, have the biggest impact?

Young and colleagues wanted to investigate a third possibility: Early childhood stress makes our stress-response system more sensitive to stressors that emerge later in life.

The researchers assessed data from the Life Events Schedule (LES), which surveys individuals’ stressful life events, including financial trouble, relationship problems, and physical danger and mortality. Trained coders rate the level of disruption of each event on a scale from 0 to 3 to create an overall score for that measurement period. The participants’ mothers completed the interview when the participants were 12, 18, 30, 42, 48, 54, and 64 months old; when they were in Grades 1, 2, 3, and 6; and when they were 16 and 17 years old. The participants completed the LES themselves when they were 23, 26, 28, 32, 34, and 37 years old.

The researchers grouped participants’ LES scores into specific periods: early childhood (1-5 years), middle childhood (Grades 1-6), adolescence (16 and 17 years), early adulthood (23-34 years), and current (37 years).

At age 37, the participants also provided daily cortisol data over a 2-day period. They collected a saliva sample immediately when they woke up and again 30 minutes and 1 hour later; they also took samples in the afternoon and before going to bed. They sent the saliva samples to a lab for cortisol-level testing.

The researchers found that neither total life stress nor early childhood stress predicted cortisol level patterns at age 37. Rather, cortisol patterns depended on both early childhood stress and stress at age 37. Participants who experienced relatively low levels of stress in early childhood showed relatively similar cortisol patterns regardless of their stress level in adulthood. On the other hand, participants who had been exposed to relatively high levels of early childhood stress showed flatter daily cortisol patterns, but only if they also reported high levels of stress as adults.

The researchers also investigated whether life stress in middle childhood, adolescence, and early adulthood were associated with adult cortisol patterns, and found no meaningful relationships.

These findings suggest that early childhood may be a particularly sensitive time in which stressful life events — such as those related to trauma or poverty — can calibrate the brain’s stress-response system, with health consequences that last into adulthood.

Young and colleagues note that cortisol is one part of the human stress-response system, and they hope to investigate how other components, such as the microbiome in our gut, also play a role in long-term health outcomes.

Source: Association for Psychological Science

Stress-related Disorders Linked to Heightened Risk of Cardiovascular Disease

Stress related disorders — conditions triggered by a significant life event or trauma — may be linked to a heightened risk of cardiovascular disease (CVD), finds a large Swedish study published in The BMJ today.

The risk of severe and acute CVD events, such as cardiac arrest and heart attack, was particularly high in the first six months after diagnosis of a stress related disorder, and within the first year for other types of CVD.

Most people are, at some point during their life, exposed to psychological trauma or stressful life events such as the death of a loved one, a diagnosis of a life threatening illness, natural disasters, or violence, write the authors.

And there is building evidence which suggests that severe stress reactions to significant life events or trauma are linked to the development of CVD.

But previous studies have mainly focused on male veterans or those currently active in the military with posttraumatic stress disorder (PTSD), or PTSD symptoms. And because of the smaller size of these samples, data on the effects of stress reactions on different types of CVD are limited.

So to shed some light on this, researchers used Swedish population and health registers to explore the role of clinically diagnosed PTSD, acute stress reaction, adjustment disorder, and other stress reactions in the development of CVD.

They controlled for family background, medical history, and underlying psychiatric conditions.

The researchers matched 136,637 people from an “exposed cohort” who were diagnosed with a stress related disorder between January 1987 and December 2013 with 171,314 full siblings who were free of stress related disorders and CVD.

For each exposed person, 10 people from the general population who were unaffected by stress related disorders and CVD at the date of diagnosis of the “exposed” patient were randomly selected.

Exposed and unexposed people were then individually matched by birth year and sex.

Severe stress reactions to significant life events or trauma were linked to a heightened risk of several types of CVD, especially during the first year after diagnosis, with a 64% higher risk among people with a stress related disorder compared to their unaffected sibling.

The findings were similar for people with a stress related disorder compared to the general population.

And there was a stronger link between stress related disorders and early onset CVD — cases of disease which developed before the age of 50 — than later onset ones.

Out of all studied CVDs, the excess risk during the first year was strongest for heart failure, and for major blood clots (embolism and thrombosis) after one year.

There were similar associations across sex, calendar period, medical history, and family history of CVD. But those who were diagnosed with a stress disorder at a younger age had a heightened risk of CVD.

This is an observational study based on the Swedish population and, as such, can’t establish cause. The authors point out evidence from other studies suggesting a biological link between severe stress reactions and cardiovascular disease development. And they can’t rule out the role of other unmeasured behavioural factors, such as smoking and alcohol intake.

But they say that their study is the first to explore the association between a number of stress related disorders, including but not limited to PTSD, and several types of CVD using sibling-based comparisons, among both men and women.

And doctors need to be aware of the “robust” link between stress related disorders and a higher subsequent risk of cardiovascular disease, particularly during the months after diagnosis, they add.

“These findings call for enhanced clinical awareness and, if verified, monitoring or early intervention among patients with recently diagnosed stress related disorders,” they conclude.

In a linked editorial, Professor Simon Bacon from Concordia University in Canada, says that the design of the study “allows us to make reasonable assumptions about the similarity of the environment, lifestyles, and health behaviours between those with a disorder and their paired siblings without one. Such assumptions allow inferences about other alternative potential pathways linking these disorders to CVD outcomes.”

In the future, well designed studies evaluating more appropriate interventions will be critical, not only to confirm the inferences of the new study but also to provide real benefits to patients,” he concludes.

Source: Science Daily


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