Mental Stress, Neuroendocrinology, Obesity, Psychological
Conditions
Brief summary
Backgroup/relevance: Overweight and obesity, defined by a respective body mass index of above 25 and 30 kg/m2, are getting increasingly common in all regions of the world. Obesity is currently estimated to be present in more than 10% of the global population while overweight roughly reached an estimate of 40% in 2016. Overweight dramatically increases the risk for a wide range of disorders such as diabetes mellitus and other metabolic and cardiovascular disorders subsumed under the term metabolic syndrome, increasing the risk for life-threatening cardiovascular events such as myocardial infarction and stroke. Similar to other chronic diseases such as mental health disorders, prescribing medication was oftentimes insufficient and should be complemented by patient empowerment to reach sufficient treatment adherence and control of lifestyle factors. Thereby, overweight and obesity can easily be challenged by patients themselves without pharmacological intervention. Overweight may place central in the crossroad between metabolic and mental health for several reasons. Excessive body fat is known to cause subclinical inflammation that was also associated with many psychiatric disorders such as major depression. Similarly, the hypothalamic-pituitary-adrenal axis relevant for stress response was shown to be dysregulated in both metabolic and mental health disorders. Study design: In this study, non-pharmacological interventions are applied in healthy women with overweight or obesity and self-perceived psychological stress. Women staying at the la pura women´s health resort (www.lapura.at/) are invited to partake in the study and receive a short-term intervention of calory restriction. Thereby, either F.X. Mayr or very-low-calory-diet (VLCD) will be applied, reducing calory intake to 700-800 kcal/die. Following random assigment to four treatment arms, half of the women also receive a 7-session clinical-psychological intervention consisting of biofeedback, individualized psycho-education on stress prevention and mindlessness training. Women are assessed at baseline and after two weeks of interventions for metabolic parameters such as insulin functioning, anthropometric parameters such as body weight and body fat, blood parameters such as sex hormones, fat metabolism and liver function, parameters of neuroplasticity such as brain derived neurotrophic factor (BDNF), as well as psychological and biological stress correlates and mental health symptom dimensions.
Interventions
BEHAVIORALCalory Restriction (F.X. Mayr & VLCD)
VLCD restricts calory intake to 630 - 700 kcal per day (20% fat, 34% protein, 46% carbohydrates). F.X. Mayr diet similarly applies calorie restriction to 700 - 800 kcal per day and includes daily ingestion of isotonic magnesium sulfate solution.
BEHAVIORALBiofeedback
Three sessions of biofeedback (50 minutes) over a time frame of 14 days, aimed at improving biological functions and especially heart-rate-variability under stress condition.
Sponsors
Medical University of Vienna
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* women willing to undergo two-weeks of calory restriction * at least 18 years of age
Exclusion criteria
* currently pregnant * any acute or a severe chronic illness
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| PSS score | Baseline, changes over two weeks | Perceived Stress Scale total score |
| BODI | Baseline, changes over two weeks | buron-out-diagnostic-inventory scores, 4 summary items and 3 stress self-ratings |
| BSI | Baseline, changes over two weeks | Brief Symptom Inventory, 9 dimensional subscores and global severity score |
| waist-to-height ratio | Baseline | Anthropometric parameter |
| HbA1c | Baseline | Glycated hemoglobin |
| HOMA-IR | Baseline | Functional parameter for insulin resistance |
| Matsuda Index | Baseline | Functional parameter for insulin sensitivity |
| Body mass index | Baseline, changes over two weeks | weight in relation to height |
| HRV | Baseline, changes over two weeks | heart rate variability |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Testosterone | Baseline, changes over two weeks | Sex hormone |
| Luteinizing hormone | Baseline, changes over two weeks | Sex hormone |
| Follicle-stimulating hormone | Baseline, changes over two weeks | Sex hormone |
| Body fat | Baseline, changes over two weeks | measured by bioimpedance analysis |
| High-density lipoprotein (HDL) | Baseline, changes over two weeks | Lipid metabolism |
| BSRI | Baseline | Bem sex role inventory, female, male, neutral scores |
| Total cholesterol | Baseline, changes over two weeks | Lipid metabolism |
| lean mass | Baseline, changes over two weeks | measured by bioimpedance analysis |
| Phase angle | Baseline, changes over two weeks | ratio of reactance versus electric resistance, measured by bioimpedance analysis |
| Resistin | Baseline, changes over two weeks | Adipocines |
| Leptin | Baseline, changes over two weeks | Adipocines |
| Secretagogin | Baseline, changes over two weeks | Adipocines |
| Adiponectin | Baseline, changes over two weeks | Adipocines |
| BDNF | Baseline, changes over two weeks | brain derived neurotrophic factor |
| Estrogen | Baseline, changes over two weeks | Sex hormone |
Countries
Austria
Outcome results
None listed