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Chronic stress, ghrelin levels predict future food cravings, weight gain
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In healthy adults, higher baseline circulating total ghrelin levels are associated with higher frequencies of food cravings at 6 months, whereas baseline chronic stress predicts future weight gain during the same period, according to findings published in Obesity.
“To our knowledge, this is the first prospective naturalistic study in a community sample that demonstrates that higher levels of fasting total ghrelin were predictive of future food cravings,” Ariana M. Chao, PhD, RN, CRNP, a postdoctoral fellow at the University of Pennsylvania School of Nursing and Center for Weight and Eating Disorders at the University of Pennsylvania’s Perelman School of Medicine, and colleagues wrote. “These results suggest that ghrelin plays a role in increasing motivation and subjective craving for foods and in reward-based eating, particularly for complex carbohydrates and starches.”
Chao and colleagues analyzed data from 339 adults recruited from the community for studies examining the mechanisms of underlying stress, self-control and addictive behaviors (mean age, 29 years; mean BMI, 26.7 kg/m2; 56.9% women; 70.2% white; 27.4% current smokers). Participants completed the 62-item Cumulative Adversity Interview at baseline and 6 months to assess chronic stress, as well as the 28-item Food Craving Inventory to measure general and specific food cravings during the past month. Researchers collected fasting blood samples to measure cortisol, homeostatic model assessment of insulin resistance (HOMA-IR), circulating plasma total ghrelin, leptin, insulin and glucose at baseline and 6 months.
Researchers used paired t tests to assess changes in food cravings, BMI and chronic stress over 6 months; morning cortisol levels, ghrelin, leptin, insulin and chronic stress were used to predict changes in weight and frequency of food cravings over 6 months. Longitudinal analyses were conducted using linear fixed-effects models.
Women in the cohort had higher baseline levels of ghrelin (P = .02), leptin (P < .001), cortisol (P < .001), chronic stress (P = .003) and cravings for sweets (P = .001), according to the researchers.
During 6 months, 49.9% of participants gained weight; average weight gain was 3.5 kg. Food cravings and chronic stress decreased over 6 months (P < .05). Researchers found that higher baseline levels of total ghrelin predicted higher total food cravings at 6 months (P = .04), whereas cortisol (P = .09), leptin (P = .06), insulin (P = .85) and chronic stress (P = .17) did not predict changes in food cravings over time. Results persisted after adjustments for demographics, baseline BMI and food cravings.
In post hoc analyses conducted with food craving subscales, researchers observed that higher baseline total ghrelin predicted an increase in the frequency of cravings for carbohydrates and starches during 6 months (P = .002), but was not associated with cravings for high-fat foods, sweets or fast food.
Higher baseline levels of cortisol (P = .002), insulin (P = .008) and chronic stress (P = .03) were each predictive of greater future weight gain. Participants reporting higher baseline chronic stress had a mean 6-month weight gain of 1.05 kg vs. a 0.5-kg gain for those reporting lower chronic stress, according to the researchers.
“In the current study, the effect size was small,” the researchers wrote. “It is possible that measurement of acylated ghrelin alone would have been a more robust and sensitive predictor of future food cravings and weight gain. Despite this caveat, the previous research ... together with the present study findings suggests that ghrelin increases food craving and possibly the hedonic value of food over time, thereby contributing to increased food intake.”
The researchers noted that there may have been “floor effects” in the study, as overall levels of chronic stress in the cohort were low and metabolic parameters were largely within normal limits. – by Regina Schaffer
Disclosure: The NIH supported this study. The researchers report no relevant financial disclosures.
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