The reviews this month are an attempt to connect the dots between PNIE and other holistic areas of interest including behavior, exercise and nutrition

Townsend Letter for Doctors and Patients, Dec, 2003 by Robert A. Anderson

Solowij N, Stephens RS, Roffman RA et al. Cognitive functioning of long-term heavy cannabis users seeking treatment. JAMA 2002 Mar 6;287(9):1123-31

COMMENT: Long-term heavy cannabis users showed impairments in memory and attention that endured beyond the period of intoxication and worsened with increasing years of regular marijuana use. Even short term users performed poorly on a time estimation test. Another recent study found suboptimal metabolism in the left pre-frontal cortex in long-term marijuana users very much like the PET scan findings in young people with attention-deficit hyperactivity disorder. Many patients of holistic practitioners may not want advice about their recreational drug use, but practitioners need to be aware of the results of well-done studies and communicate it to clients and patients where possible.

Stress and interleukin-6

In 211 middle-aged men and women undertaking stressful tasks, natural killer cell counts changed and were positively associated with heart rate variability responses independent of age, sex, socioeconomic status, smoking, and change in hematocrit. Heart rate 45 minutes post-stress was positively associated with plasma interleukin-6, and with tumor necrosis factor-[alpha] changes versus baseline, independently of covariates.

Owen N, Steptoe A. Natural killer cell and proinflammatory cytokine responses to mental stress: associations with heart rate and heart rate variability. Biol Psychol 2003 May; 63(2):101-15

COMMENT: Individual differences in sympathetically-driven cardiac stress responses were associated with natural killer and proinflammatory cytokine responses to psychological stress. Interleukin-6 is a vary important cytokine playing a significant role in the inflammatory response. This study links stress and the cellular and chemical responses of the immune system. While much more work needs to be done to differentiate all the potential actions of IL-6 and, it is apparent that stress, at least when unmanaged, may have downside effects in the immune system.

Diabetes and stress

Researchers in Sweden identified a cluster of environmental factors related to the metabolic syndrome, often a precursor to type II diabetes, including psychosocial and socio-economic stress, traits of depression and anxiety, alcohol consumption and smoking (all known to activate hypothalamic centers). A polymorphism of the glucocorticoid receptor gene, with 13.7% homozygotes in the male Swedish population, paralleled receptor dysfunction, and appeared to be responsible for the associated insulin resistance, central obesity and hypertension. Results suggested that a hypothalamic arousal syndrome, with parallel activation of the hypothalamic-pituitary-adrenal axis and the central sympathetic nervous system, was responsible for development of endocrine abnormalities, insulin resistance, central obesity, dyslipidemia and hypertension, leading to frank disease, including type II diabetes.

Bjorntorp P, Holm G, Rosmond R. Hypothalamic arousal, insulin resistance and Type 2 diabetes. Diabet Med 1999 May; 16(5):373-83