Stress wreaks havoc on the mind and body. For example, psychological stress is associated with greater risk for depression, heart disease and infectious diseases. But, until now, it has not been clear exactly how stress influences disease and health.

A research team led by Carnegie Mellon University’s Sheldon Cohen has found that chronic psychological stress is associated with the body losing its ability to regulate the inflammatory response.  Published in the Proceedings of the National Academy of Sciences, the research shows for the first time that the effects of psychological stress on the body’s ability to regulate inflammation can promote the development and progression of disease.

“Inflammation is partly regulated by the hormone cortisol and when cortisol is not allowed to serve this function, inflammation can get out of control,” said Cohen, the Robert E. Doherty Professor of Psychology within CMU’s Dietrich College of Humanities and Social Sciences.

Cohen argued that prolonged stress alters the effectiveness of cortisol to regulate the inflammatory response because it decreases tissue sensitivity to the hormone. Specifically, immune cells become insensitive to cortisol’s regulatory effect. In turn, runaway inflammation is thought to promote the development and progression of many diseases.

Cohen, whose groundbreaking early work showed that people suffering from psychological stress are more susceptible to developing common colds, used the common cold as the model for testing his theory. With the common cold, symptoms are not caused by the virus — they are instead a “side effect” of the inflammatory response that is triggered as part of the body’s effort to fight infection. The greater the body’s inflammatory response to the virus, the greater is the likelihood of experiencing the symptoms of a cold.

In Cohen’s first study, after completing an intensive stress interview, 276 healthy adults were exposed to a virus that causes the common cold and monitored in quarantine for five days for signs of infection and illness. Here, Cohen found that experiencing a prolonged stressful event was associated with the inability of immune cells to respond to hormonal signals that normally regulate inflammation. In turn, those with the inability to regulate the inflammatory response were more likely to develop colds when exposed to the virus.

In the second study, 79 healthy participants were assessed for their ability to regulate the inflammatory response and then exposed to a cold virus and monitored for the production of pro-inflammatory cytokines, the chemical messengers that trigger inflammation. He found that those who were less able to regulate the inflammatory response as assessed before being exposed to the virus produced more of these inflammation-inducing chemical messengers when they were infected.

“The immune system’s ability to regulate inflammation predicts who will develop a cold, but more importantly it provides an explanation of how stress can promote disease,” Cohen said. “When under stress, cells of the immune system are unable to respond to hormonal control, and consequently, produce levels of inflammation that promote disease. Because inflammation plays a role in many diseases such as cardiovascular, asthma and autoimmune disorders, this model suggests why stress impacts them as well.”

He added, “Knowing this is important for identifying which diseases may be influenced by stress and for preventing disease in chronically stressed people.”

In addition to Cohen, the research team included CMU’s Denise Janicki-Deverts, research psychologist; Children’s Hospital of Pittsburgh’s William J. Doyle; University of British Columbia’s Gregory E. Miller;University of Pittsburgh School of Medicine’s Bruce S. Rabin and Ellen Frank; and the University of Virginia Health Sciences Center’s Ronald B. Turner.

The National Center for Complementary and Alternative Medicine, National Institute of Mental Health,National Heart, Lung and Blood Institute and the MacArthur Foundation Research Network on Socioeconomic Status and Health funded this research.

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Seventy-five percent of integrative medicine centers included in a new study about integrative practice reported success treating chronic pain. More than half of centers reported successfully using integrative medicine to treat gastrointestinal conditions, depression/anxiety, cancer and stress.

“Integrative Medicine in America: How Integrative Medicine Is Being Practiced in Clinical Centers Across the United States”, a new study from The Bravewell Collaborative, looked at the patient populations and health conditions most commonly treated with integrative medicine.

“With chronic health issues costing the economy more than $1 trillion a year, it’s essential to find the best treatments and preventive practices,” said Donald Abrams, MD, co-author of the report and professor of clinical medicine at the University of California San Francisco. “The broader use of integrative medicine could fundamentally change how patients are being served in this country.”

Twenty-nine integrative medicine centers were surveyed, including programs at Cleveland Clinic, Duke, Mayo Clinic, Stanford and MD Anderson Cancer Center. All participating centers reported being affiliated with hospitals, health systems and/or medical and nursing schools, suggesting that integrative medicine has now become an established part of healthcare in the U.S.

All of the centers in the study served adult patients and many treated older people (97%), adolescents (86%), children (62%) and individuals at the end of life (66%).

Integrative medicine is an evidence-based approach to care that puts the patient at the center and addresses the physical, emotional, mental, social, spiritual and environmental influences on health. The center directors reported that their centers most frequently prescribe, often in tandem, food/nutrition therapies (65%), supplements (60%), yoga (55%), meditation (51%), traditional Chinese medicine/acupuncture (50%), massage (49%), and pharmaceutical interventions (46%).

Sixty-two percent of the centers have also incorporated lifestyle change programs that emphasize healthy behaviors and actions. As shown in many studies published over the past five years, attention to healthy diet, exercise and stress reduction can help prevent major health issues.

“There is great potential for integrative medicine to help prevent illness and foster lifelong health,” explained Christy Mack, President of The Bravewell Collaborative. “This report suggests that integrative approaches offer promise for increasing the effectiveness of care.”

To view the full report, Integrative Medicine in America, online, visit www.bravewell.org.

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In January 2012, Obesity Action Coalition (OAC) and Obesity PPM will launch a long-term online educational initiative to increase understanding of the complexity of obesity and its many causes. The disease of obesity impacts individuals physically, emotionally, economically and socially.

This initiative will look at various factors, both controllable and uncontrollable, impacting individuals affected by obesity. Running throughout 2012 and 2013, the initiative will take a three-pronged approach: a 14-part series of publicly available webinars, articles addressing aspects of Obesity PPM’s Twelve Pillars model, and social media enriching the dialogue about each event topic. The first live online event will take place in late January 2012.

The Twelve Pillars model describes the relationships between the two categories of factors that impact obesity: individual factors and population-level factors. The six individual factors are cognition, addiction, nutrition, endocrinology and metabolism, exercise and activity level, and sleep, stress and immunity.

The six population level factors are the education system and parenting, workplace and business culture, community and lifestyle planning, food policy, production and delivery, healthcare policy and delivery, and financial instruments and funding.

Following the introductory event in January, each webinar will address one of the twelve factors from the individual and population levels and its relationship to the broader context of obesity, with the final event addressing the relationship between obesity, genetics, and the environmental triggering of gene expression.

The webinars will feature guest speakers, or panels of speakers, providing the latest unbiased, up-to-date information on these topics. By delivering these educational events at no cost to a broad audience, the OAC and Obesity PPM will advance their shared mission to reduce weight bias, social stigma, and discrimination. The content will be appropriate for all audiences seeking a broader understanding of obesity.

Further, by presenting multiple perspectives on controversial topics, the OAC and Obesity PPM will bring to light the extent of scientific, clinical and social work that must be done to both develop effective obesity prevention strategies and improve access to treatment for those affected by obesity.

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