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Cited by 212Posttraumatic Stress Disorder ResearchPhysical Activity and HealthObesity, Physical Activity, Diet

Association between posttraumatic stress disorder and lack of exercise, poor diet, obesity, and co-occuring smoking: a systematic review and meta-analysis

Open access
van den Berk-Clark, Carissa, Secrest, Scott, Walls, Jesse, Hallberg, Ellen, Lustman, Patrick J., Schneider, F. David, Scherrer, Jeffrey F.·2018·Health Psychology
DOI 10.1037/hea0000593PMC PMC5922789
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Abstract

OBJECTIVES: Research has shown that posttraumatic stress disorder (PTSD) increases the risk of development of cardiometabolic disease (CMD) including cardiovascular disease and diabetes. Whether PTSD is also associated with behavioral risk factors (e.g., diet, exercise, smoking and obesity) for CMD, is less clear. METHODS: PubMed, Web of Science, and Scopus databases were searched to obtain papers published between 1980-2016. Studies were reviewed for quality using the Quality of Cohort screen. Significance values, odds ratios (OR), 95% confidence intervals (CI), and tests of homogeneity of variance were calculated. PRINCIPAL FINDINGS: A total of 1,349 studies were identified from our search and 29 studies met all eligibility criteria. Individuals with PTSD were 5% less likely to have healthy diets (pooled adjusted OR = 0.95; 95% CI: 0.92, 0.98), 9% less likely to engage in physical activity (pooled adjusted OR = 0.91; 95% CI: 0.88, 0.93), 31% more likely to be obese (pooled adjusted OR = 1.31; 95% CI:1.25, 1.38), and about 22% more likely to be current smokers (pooled adjusted OR = 1.22; 95% CI: 1.19, 1.26), than individuals without PTSD. CONCLUSIONS: Evidence shows PTSD is associated with reduced healthy eating and physical activity, and increased obesity and smoking. The well-established association between PTSD and metabolic and cardiovascular disease may be partly due to poor diet, sedentary lifestyle, high prevalence of obesity, and co-occurring smoking in this population. The well-established association of PTSD with CMD is likely due in part to poor health behaviors in this patient population. (PsycINFO Database Record

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Crossref · 10.1037/hea0000593

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  • Negative psychological health, including depression, anxiety, and stress, is associated with smoking, lower levels of physical activity, poorer diet quality, and being overweight or obese.

    “As described earlier, negative psychological health, including depression, anxiety, and stress, is associated with smoking, lower levels of physical activity, poorer diet quality, and being overweight or obese. 25,95”

    From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [25]

    The Conclusions (page unavailable) support associations of PTSD with smoking, lower physical activity, and obesity, but the paper does not establish these associations for depression, anxiety, and stress generally. The Conclusions say more research is needed on poor diet; the Results subsection on high-quality, large studies reports an association between PTSD and a healthier diet. (LLM, conf=0.89)

    Experimental — accuracy not yet measured

  • PTSD is linked to elevations in traditional CVD risk factors.

    “Numerous studies have also linked PTSD to elevations in traditional CVD risk factors 23-27”

    From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [25]

  • There is evidence for pyridostigmine, non-steroidal anti-inflammatories, caffeine, and erythropoietin as adjunctive agents in patients who remain symptomatic with the above regimen.

    “There is evidence for the use of pyridostigmine 96 , non-steroidal anti-inflammatories 97 , caffeine 98 and erythropoietin 99 as adjunctive agents in patients who remain symptomatic with the above regime.”

    From The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness (2019) · cites this paper as [98]

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1 of the 48 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. Schnurr PP In Press Understanding Pathways from Traumatic Stress to Physical Health Darmouth National Center for PTSD and Geisel School of Medicine at Dartmouth

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Authors
van den Berk-Clark, C., Secrest, S., Walls, J., Hallberg, E., Lustman, P. J., Schneider, F. D., & Scherrer, J. F.
Affiliations
  • Saint Louis University (US)
  • Washington University in St. Louis (US)
ORCID
Venue
Health Psychology
Publisher
American Psychological Association (APA)
Published
2018-05
Volume
37
Issue
5
Pages
407-416
ISSN
  • 0278-6133 (ISSN-L)
  • 1930-7810
DOI
10.1037/hea0000593
PMC
PMC5922789
OpenAlex
W2800479499
Cited by
212
References
48
Citations by year
2026: 18 · 2025: 29 · 2024: 33 · 2023: 37 · 2022: 31 · 2021: 28 · 2020: 13 · 2019: 19 · 2018: 4
FWCI
18.80
Type
journal article
Language
en
Open access
Licence
Locations
  • Health Psychology (publishedVersion, other-oa)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institutes of Health (R01HL125424)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords
post-traumatic stress disorder, cardiometabolic disease, physical inactivity, diet, obesity, smoking, health behavior, sedentary lifestyle, cardiovascular disease, diabetes mellitus
MeSH terms
Adult, Diet, Female, Humans, Male, Middle Aged, Obesity, Risk Factors, Smoking, Stress Disorders, Post-Traumatic, Health Behavior, Exercise

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