Obesity, metabolic syndrome and depression, is inflammation the underlying link? | Charles Raison
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The link between obesity and behavioral cognitive problems is likely mediated by elevated inflammation since fat cells are significant producers of inflammation. Recent studies have connected cognitive-behavioral disturbance, body mass index, and inflammation. A linear relationship exists between obesity, inflammation, and response to medication. In this clip, Dr. Charles Raison discusses how a pro-inflammatory environment, such as that which occurs with obesity, can contribute to the risk of depression.
- Rhonda: Right. And if you think about it, for example, and you mentioned, I mean, there’s so many things in our environment that are pro-inflammatory: diet, you know, lack of the light exposure changing. But if you look at people that are obese, or people that have metabolic syndrome, most of the time have very high markers of inflammation, not always, but... And they also are more likely to get depressed.
- Charles: Absolutely.
- Rhonda: Has there been any evidence to see whether or not the inflammation is driving that?
- Charles: Oh, yes. Absolutely. The best paper I know, that was done by Lucile Capuron and Andy Miller, Lucille is in Bordeaux, Andy is at Emory, where they looked at, you know, they looked at cognitive behavioral disturbance, body mass index and inflammation, and showed that the link between sort of obesity and these behavioral cognitive problems were mediated by the increased inflammation, right? Anybody in this field knows that body mass index, how fat you are, is the 800 pound gorilla in the room when it comes to the link between inflammation and anything. I mean, there’s just a linear relationship. I just did just this huge study on like 600 people with a large pharmaceutical company where I worked with them on data looking at prediction of inflammation and response to medication. And, you know, man, it’s just a straight line. The heavier you are, especially, and unfortunately for us men, big, big production of... Because we know that fat cells are big producers of inflammation.
- Rhonda: Exactly, right. What about how they’ve been studies looking at whether or not, so those people that are, for example, obese or overweight, and are, you know, have higher levels of inflammatory biomarkers, if they lose the weight, does their depression risk decrease? Like is there any evidence of that?
- Charles: The only data I know of on that, are people that have had these gastric bypass surgeries for weight loss. There is some data showing that they’ve been administered kind of quality of life wellbeing mood stuff, people’s moods get much better. Now it’s confound, though, of course.
- Rhonda: Yeah, of course.
- Charles: Because, you know, all of a sudden you can get into your bikinis.
- Rhonda: Look better. Yeah.
- Charles: But it would be consistent with that idea.
- Rhonda: Yeah. It certainly would be interesting to look at that, you know.
A measurable substance in an organism that is indicative of some phenomenon such as disease, infection, or environmental exposure.
A measurement that serves as a proxy for body fatness. BMI is calculated by dividing an individual’s body weight in kilograms (kg) by their height in meters, squared (m2). It is often considered a flawed measurement, however, because it does not measure overall fat or lean tissue content. BMI is interpreted as follows:
• ≤ 18.49: Underweight
• 18.5 - 24.99: Normal weight
• 25 - 29.99: Overweight
• ≥ 30: Obese
A mood disorder characterized by profound sadness, fatigue, altered sleep and appetite, as well as feelings of guilt or low self-worth. Depression is often accompanied by perturbations in metabolic, hormonal, and immune function. A critical element in the pathophysiology of depression is inflammation. As a result, elevated biomarkers of inflammation, including the proinflammatory cytokines interleukin-6 and tumor necrosis factor-alpha, are commonly observed in depressed people. Although selective serotonin reuptake inhibitors and cognitive behavioral therapy typically form the first line of treatment for people who have depression, several non-pharmacological adjunct therapies have demonstrated effectiveness in modulating depressive symptoms, including exercise, dietary modification (especially interventions that capitalize on circadian rhythms), meditation, sauna use, and light therapy, among others.
A critical element of the body’s immune response. Inflammation occurs when the body is exposed to harmful stimuli, such as pathogens, damaged cells, or irritants. It is a protective response that involves immune cells, cell-signaling proteins, and pro-inflammatory factors. Acute inflammation occurs after minor injuries or infections and is characterized by local redness, swelling, or fever. Chronic inflammation occurs on the cellular level in response to toxins or other stressors and is often “invisible.” It plays a key role in the development of many chronic diseases, including cancer, cardiovascular disease, and diabetes.
A cluster of at least three of five of the following medical conditions: abdominal (central) obesity, elevated blood pressure, elevated fasting plasma glucose, high serum triglycerides, and low high-density lipoprotein (HDL) levels. Some studies estimate the prevalence in the USA to be 34 percent of the adult population. Metabolic syndrome is associated with the risk of developing cardiovascular disease and diabetes.
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