Fagundes Christopher P, Wu E Lydia
Rice University, Houston, TX, USA.
The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Compr Psychoneuroendocrinol. 2021 May 8;7:100058. doi: 10.1016/j.cpnec.2021.100058. eCollection 2021 Aug.
The loss of a spouse is a highly stressful event that puts older adults at increased risk for morbidity and mortality. The risk is highest in the first year to 18 months post-loss; nevertheless, widow(er)s, in general, are at heightened risk of cardiovascular disease (CVD) related morbidity and mortality, and to a lesser extent, non-CVD related morbidity and mortality. The primary goal of this article is to argue for a perspective that considers diet and emotion-induced autonomic, neuroendocrine, and immune dysregulation, in unison, to understand the mechanisms underlying morbidity and mortality in early widowhood. Toward this end, we first summarize our previously published work, as well as work from other investigatory teams, showing that compared with those who were not bereaved, widow(er)s have higher levels of pro-inflammatory cytokine production and more dysregulated autonomic and neuroendocrine activity than non-widow(er)s, independent of health behaviors such as diet. We highlight that a major gap in our current understanding of the biobehavioral mechanisms that underlie the widowhood effect is the role of diet and hypothesize that the adverse health impact of grief and associated negative emotions and diet may be more than additive. Therefore, we propose that diet may be a pathway by which widow(er)s are at higher CVD risk requiring further investigation.
配偶的离世是一件压力极大的事情,会使老年人患病和死亡的风险增加。这种风险在丧偶后的第一年至18个月内最高;然而,一般来说,丧偶者患心血管疾病(CVD)相关疾病和死亡的风险更高,在较小程度上,患非CVD相关疾病和死亡的风险也更高。本文的主要目的是倡导一种观点,即综合考虑饮食以及情绪引发的自主神经、神经内分泌和免疫失调,以理解丧偶初期发病和死亡的潜在机制。为此,我们首先总结我们之前发表的研究成果,以及其他研究团队的工作,这些研究表明,与未丧偶者相比,丧偶者促炎细胞因子的产生水平更高,自主神经和神经内分泌活动的失调程度也比未丧偶者更大,且不受饮食等健康行为的影响。我们强调,在我们目前对丧偶效应背后的生物行为机制的理解中,一个主要差距在于饮食的作用,并推测悲伤及相关负面情绪与饮食对健康的不利影响可能不止是相加的。因此,我们提出饮食可能是丧偶者患CVD风险更高的一个途径,需要进一步研究。