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Meta-Analysis
. 2018 May;37(5):407-416.
doi: 10.1037/hea0000593.

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

Carissa van den Berk-Clark  1 , Scott Secrest  1 , Jesse Walls  1 , Ellen Hallberg  1 , Patrick J Lustman  2 , F David Schneider  1 , Jeffrey F Scherrer  1
Affiliations
Meta-Analysis

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

Carissa van den Berk-Clark et al. Health Psychol. 2018 May.

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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Conflict of interest statement

Conflict of Interest: None

Figures

Figure 1
Figure 1
PRISMA Flow Diagram
See this image and copyright information in PMC

References

    1. Ainsworth BE, Jacobs DR, Leon AS. Validity and reliability of self-reported physical activity and status: the Lipid Research Clinics questionaire. Medicine and Science in Sports and Exercise. 1993;25(1):92–98. - PubMed
    1. Atwoli L, Stein DJ, Koenen KC, McLaughlin KA. Epidemiology of posttraumatic stress disorder: prevalence, correlates and consequences. Curr Opin Psychiatry. 2015;28(4):307–311. doi: 10.1097/yco.0000000000000167. - DOI - PMC - PubMed
    1. Beckham JC, Lytle BL, Vrana SR, Hertzberg MA, Feldman ME, Shipley RH. Smoking withdrawal symptoms in response to a trauma-related stressor among Vietnam combat veterans with posttraumatic stress disorder. Addictive behaviors. 1996;21(1):93–101. - PubMed
    1. Boscarino JA. A prospective study of PTSD and early-age heart disease mortality among Vietnam veterans: implications for surveillance and prevention. Psychosom Med. 2008;70(6):668–676. doi: 10.1097/PSY.0b013e31817bccaf. - DOI - PMC - PubMed
    1. Boscarino JA, Chang J. Electrocardiogram abnormalities among men with stress-related psychiatric disorders: implications for coronary heart disease and clinical research. Ann Behav Med. 1999;21(3):227–234. - PubMed

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