Strained marriages ‘harm women’ — BBC news.

Women are more likely than men to suffer damage to their health from being in a strained marriage, research suggests.

US psychologists found wives in tense marriages were prone to risk factors for heart disease, stroke and diabetes.

In comparison, husbands seemed relatively immune from such problems.

Details of the study, based on 276 couples who had been married for an average of 20 years were presented to the American Psychosomatic Society.

Each couple filled out questionnaires designed to assess the good and bad aspects of married life.

They were also rated for how depressed they appeared to be, based on their self-reported symptoms.

Doctors then carried out a battery of tests to assess whether or not the volunteers were showing signs of metabolic syndrome – a collection of symptoms pointing to a raised risk of serious disease, such as heart problems.

Women in strained marriages were more likely to be depressed and to have a greater number of symptoms of metabolic syndrome.

But although husbands in unhappy marriages were also depressed, they did not show signs of physiological damage to their health.

Researcher Nancy Henry, from the University of Utah, said the team had expected to find that negative aspects of a bad marriage, such as arguing and being angry, would translate into both mental and physical problems for both sexes.

She said: “We found this was true for wives in this study, but not for husbands.

“The gender difference is important because heart disease is the number-one killer of women as well as men, and we are still learning a lot about how relationship factors and emotional distress are related to heart disease.”

Professor Tim Smith, who co-led the research, said there was good evidence that a healthy diet and regular exercise could reduce a woman’s risk of metabolic syndrome.

However, he said: “It’s a little premature to say they would lower their risk of heart disease if they improved the tone and quality of their marriages – or dumped their husbands.

“The immediate implication is that if you are interested in your cardiovascular risk – and we all should be because it is the leading killer for both genders – we should be concerned about not just traditional risk factors such as blood pressure and cholesterol but the quality of our emotional and family lives.”

Christine Northam, a counsellor for the charity Relate, said there was plenty of evidence that people in a stable, happy relationship enjoyed both good health and a longer life expectancy.

She said: “The gender difference could be partly due to the fact that women’s hormonal profile is more complex than men’s.

“Women also tend to worry more about their health than men.”

The *British Medical Journal* issued the following announcement:

A healthy lifestyle halves the risk of premature death in women

Research paper: Combined impact of lifestyle factors on mortality: a
prospective cohort study in US women

Over half of deaths in women from chronic diseases such as cancer and
heart disease could be avoided if they never smoke, keep their weight in
check, take exercise and eat a healthy diet low in red meat and trans-
fats, according to a study published on today.

BBC News released an article: “Worry ‘ups men’s diabetes risk.'”

Here are some excerpts:

[begin excerpts]

Anxiety, depression and sleepless nights increase the risk of diabetes
in men, a Swedish study suggests.

Researchers found men with high levels of “psychological distress” had
more than double the risk of developing type 2 diabetes than those with
low levels.

*Journal of the American Medical Association* (Vol. 299 No.
23, June 18, 2008) includes a study: “Examining a Bidirectional Association
Between Depressive Symptoms and Diabetes.”

The article is by Sherita Hill Golden, MD, MHS; Mariana Lazo, MD, MSc;
Mercedes Carnethon, PhD; Alain G. Bertoni, MD, MPH; Pamela J. Schreiner,
PhD; Ana V. Diez Roux, PhD; Hochang Benjamin Lee, MD; & Constantine
Lyketsos, MD, MHS.

Here’s how the article begins:

[begin excerpt]

The prevalence of clinical depression and presence of elevated
depressive symptoms are higher among persons with diabetes compared with
the general population. These associations may be related to
increased risk of depressive symptoms in individuals with diabetes,
increased risk of type 2 diabetes in individuals with depressive
symptoms, or both. Several but not all longitudinal studies have
reported that elevated depressive symptoms are associated with incident
type 2 diabetes. Several factors associated with depressive
symptoms, including obesity-promoting health behaviors (eg, physical
inactivity, hypercaloric diets) and activation of the
neuroendocrine and inflammatory responses (resulting in
increased cortisol, catecholamines, and cytokines), can induce insulin
resistance and the development of type 2 diabetes.

A diagnosis of diabetes or the burden of dealing with its complications
might might also lead to symptoms of depression. We previously showed
an association between prevalent depressive symptoms and treated type 2
diabetes; however, because our analysis was cross-sectional, we could
not determine the temporality of this association. Two prospective
studies of adults have shown that type 2 diabetes is associated with an
increased risk of depressive symptoms; however, several other
studies have shown no association. Other research suggested
that obesity and insulin resistance, precursors to type 2 diabetes, are
associated with a lower risk of developing depression.

[end excerpt]

Here’s how the Discussion section begins:

[begin excerpt]

These findings suggest that individuals with elevated depressive
symptoms have a modest increased risk of developing type 2 diabetes
during follow-up, independent of sociodemographic, economic, and
metabolic factors. Although this association was no longer statistically
significant after adjustment for lifestyle factors, point estimates were
largely unchanged by adjustment, suggesting that the association between
depressive symptoms and incident type 2 diabetes is not fully explained
by lifestyle risk factors. We also found that among individuals without
elevated depressive symptoms at baseline, treated type 2 diabetes was
associated with a significantly higher odds of developing depressive
symptoms during follow-up, independent of BMI, socioeconomic status, and

In contrast with the findings for treated type 2 diabetes, individuals
with impaired fasting glucose and those with untreated type 2 diabetes
had reduced risk of incident depressive symptoms, although the
association with untreated type 2 diabetes was imprecisely estimated and
did not reach our prespecified level of statistical significance due to
small numbers. In both analyses, findings were comparable across race/
ethnicity. To our knowledge, this is the first population-based study to
show a bidirectional longitudinal association between type 2 diabetes
and elevated depressive symptoms within the same cohort.

[end excerpt]

Here’s how the article ends: “The biological mechanisms by which
depression and type 2 diabetes are associated remain unclear. However,
the present study contributes to a growing body of literature indicating
a bidirectional association between these 2 serious long-term diseases.
Future studies should determine whether interventions aimed at modifying
behavioral factors associated with depressiion will complement current
type 2 diabetes prevention strategies. Finally, these findings suggest
that clinicians should be aware of increased risk of elevated depressive
symptoms in individuals with treated type 2 diabetes and consider
routine screening for depressive symptoms among these patients.”

The author note states that correspondence about the article may be sent
to Sherita Hill Golden, MD, MHS, Johns Hopkins University School of
Medicine, Division of Endocrinology and Metabolism, 2024 E Monument St,
Ste 2-600, Baltimore, MD 21205 (<sahill [at] jhmi . edu>).