Energetic stress: The reciprocal relationship between energy availability and the stress response

• Type of Material: Article
• Authors: C.S. Harrell, Emory University; Charles Gillespie, Emory University; Gretchen Neigh, Emory University
• Language: English
• Date: 2016-11-01
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2015 Elsevier Inc. All rights reserved.
• Final Published Version (URL): http://dx.doi.org/10.1016/j.physbeh.2015.10.009
• Title of Journal or Parent Work: Physiology and Behavior
• ISSN: 0031-9384
• Volume: 166
• Start Page: 43
• End Page: 55
• Grant/Funding Information: CSH was supported by the American Heart Association Training Grant 14PRE18910002.; GNN was supported by K18MH105098.
• Keywords: Stress; 11-BETA-HYDROXYSTEROID DEHYDROGENASE TYPE-1; DIET-INDUCED OBESITY; DISTAL GUT MICROBIOME; Psychology, Biological; Glucocorticoid; HEART-RATE-VARIABILITY; CORTICOTROPIN-RELEASING-FACTOR; BODY-FAT DISTRIBUTION; MELANOCORTIN RECEPTOR 4; Social Sciences; Behavioral Sciences; Science & Technology; Psychology; Obesity; SELECTIVE LEPTIN RESISTANCE; Metabolic dysfunction; PITUITARY-ADRENAL AXIS; HPA axis; Life Sciences & Biomedicine; IRRITABLE-BOWEL-SYNDROME
• Research Categories: Psychology, Behavioral; Biology, Physiology

Abstract

The worldwide epidemic of metabolic syndromes and the recognized burden of mental health disorders have driven increased research into the relationship between the two. A maladaptive stress response is implicated in both mental health disorders and metabolic disorders, implicating the hypothalamic-pituitary-adrenal (HPA) axis as a key mediator of this relationship. This review explores how an altered energetic state, such as hyper- or hypoglycemia, as may be manifested in obesity or diabetes, affects the stress response and the HPA axis in particular. We propose that changes in energetic state or energetic demands can result in “energetic stress” that can, if prolonged, lead to a dysfunctional stress response. In this review, we summarize the role of the hypothalamus in modulating energy homeostasis and then briefly discuss the relationship between metabolism and stress-induced activation of the HPA axis. Next, we examine seven mechanisms whereby energetic stress interacts with neuroendocrine stress response systems, including by glucocorticoid signaling both within and beyond the HPA axis; by nutrient-induced changes in glucocorticoid signaling; by impacting the sympathetic nervous system; through changes in other neuroendocrine factors; by inducing inflammatory changes; and by altering the gut-brain axis. Recognizing these effects of energetic stress can drive novel therapies and prevention strategies for mental health disorders, including dietary intervention, probiotics, and even fecal transplant.