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The role of functional foods in the psychobiology of health and disease

Published online by Cambridge University Press:  14 December 2007

Mark Hamer*
Psychobiology Group, Department of Epidemiology and Public Health, University College London, 1–19 Torrington Place, ondon WC1E 6BT, UK
Gail Owen
Unilever Health Institute, Unilever R&D, Vlaardingen, The Netherlands
Joris Kloek
Unilever Health Institute, Unilever R&D, Vlaardingen, The Netherlands
*Corresponding author: Dr Mark Hamer, fax +44 20 7916 8542, email
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The effect of psychological stress on health is becoming a serious concern, with figures from the World Health Organization showing that stress-related disorders affect nearly 450 million individuals worldwide. Heightened physiological stress responses and psychosocial factors have been linked to disease pathways such as hypertension and CVD. This has prompted significant interest within the scientific community, public health bodies and industry to employ interventions to control and reduce the impact of stress on health. There is now strong potential for functional foods to offer stress management benefits. Various physiological pathways have been targeted by specific dietary supplements for stress reduction, including the hypothalamic–pituitary–adrenal axis and sympathetic nervous system. Presently there are a number of ingredients, which include vitamin C, milk proteins, a number of herbal extracts (ginkgo biloba, ginseng, kava, valerian and lemon balm), and n-3 fatty acids, that have demonstrated potential stress reactivity-lowering and mood-enhancing effects, although further work is required to substantiate the efficacy in human subjects. Dietary supplements that can alleviate excessive stress responses may play an increasingly important role for the maintenance of health in a stressful environment. However, future research should employ a greater range of measures that will provide stronger evidence to substantiate functional food claims for stress relief.

Research Articles
Copyright © The Authors 2005


Amri, H, Drieu, K & Papadopoulos, V (1997) Ex vivo regulation of adrenal cortical cell steroid and protein synthesis, in response to adrenocorticotropic hormone stimulation, by the ginkgo biloba extract EGb 761 and isolated ginkgolide B. Endocrinology 138, 54155426.CrossRefGoogle ScholarPubMed
Amri, H, Drieu, K & Papadopoulos, V (2003) Transcriptional suppression of the adrenal cortical peripheral-type benzodiazepine receptor gene and inhibition of steroid synthesis by ginkgolide B. Biochemistry and Pharmacology 65, 717729.CrossRefGoogle ScholarPubMed
Andrews, RC, Herlihy, O, Livingstone, DE, Andrew, R & Walker, BR (2002) Abnormal cortisol metabolism and tissue sensitivity to cortisol in patients with glucose intolerance. Journal of Clinical Endocrinology and Metabolism 87, 55875593.CrossRefGoogle ScholarPubMed
Barnett, PA, Spence, JD, Manuck, SB & Jennings, JR (1997) Psychological stress and the progression of carotid artery disease. Journal of Hypertension 15, 4955.CrossRefGoogle ScholarPubMed
Benton, D (2002) Selenium intake, mood and other aspects of psychological functioning. Nutritional Neuroscience 5, 363374.CrossRefGoogle ScholarPubMed
Benton, D & Donohoe, RT (1999) The effects of nutrients on mood. Public Health Nutrition 2, 403409.CrossRefGoogle ScholarPubMed
Benton, D, Ruffin, MP, Lassel, T, Nabb, S, Messaoudi, M, Vinoy, S, Desor, D & Lang, V (2003) The delivery rate of dietary carbohydrates affects cognitive performance in both rats and humans. Psychopharmacology 166, 8690.CrossRefGoogle ScholarPubMed
Bilia, AR, Gallori, S & Vincieri, FF (2002) Kava-kava and anxiety: growing knowledge about the efficacy and safety. Life Science 70, 25812597.CrossRefGoogle ScholarPubMed
Black, PH (2003) The inflammatory response is an integral part of the stress response: implications for atherosclerosis, insulin resistance, type II diabetes and metabolic syndrome X. Brain, Behavior and Immunology 17, 350364.CrossRefGoogle ScholarPubMed
Black, PH & Garbutt, LD (2002) Stress, inflammation and cardiovascular disease. Journal of Psychosomatic Research 52, 123.CrossRefGoogle ScholarPubMed
British Heart Foundation 2004 Stress and Your Heart. London: British Heart Foundation.Google Scholar
Brody, S, Preut, R, Schommer, K & Schurmeyer, TH (2002) A randomized controlled trial of high dose ascorbic acid for reduction of blood pressure, cortisol, and subjective responses to psychological stress. Psychopharmacology 159, 319324.CrossRefGoogle ScholarPubMed
Cardinal, BJ & Engels, H-J (2001) Ginseng does not enhance psychological well-being in healthy, young adults: results of a double-blind, placebo-controlled, randomised clinical trial. Journal of the Americal Dietetic Society 101, 655660.Google ScholarPubMed
Carroll, D, Ring, C, Hunt, K, Ford, G & Macintyre, S (2003) Blood pressure reactions to stress and the prediction of future blood pressure: effects of sex, age, and socioeconomic position. Psychosomatic Medicine 65, 10581064.CrossRefGoogle ScholarPubMed
Carver, CS, Scheier, MF & Weintraub, JK (1989) Assessing coping strategies: a theoretically based approach. Journal of Personality and Social Psychology 56, 267283.CrossRefGoogle ScholarPubMed
Chapman, CM, Beilby, JP, McQuillan, BM, Thompson, PL & Hung, J (2004) Monocyte count, but not C-reactive protein or interleukin-6, is an independent risk marker for subclinical carotid atherosclerosis. Stroke 35, 16191624.CrossRefGoogle ScholarPubMed
Chin, JP, Gust, AP, Nestel, PJ & Dart, AM (1993) Marine oils dose-dependently inhibit vasoconstriction of forearm resistance vessels in humans. Hypertension 21, 2228.CrossRefGoogle ScholarPubMed
Choi, S, Horsley, C, Aguila, S & Dallman, MF (1996) The hypothalamic ventromedial nuclei couple activity in the hypothalamo-pituitary-adrenal axis to the morning fed or fasted state. Journal of Neuroscience 16, 81708180.CrossRefGoogle ScholarPubMed
Cohen, S & Williamson, G (1988) Perceived stress in a probability sample of the United States. In The Social Psychology of Health: Claremont Symposium on Applied Social Psychology, 3167. [Spacapan, S, Oskamp, S, editors]. Newbury Park, CA: Sage.Google Scholar
Coleman, CI, Herbert, JH & Reddy, P (2003) The effects of Panax ginseng on quality of life. Journal of Clinical Pharmacy and Therapeutics 28, 515.CrossRefGoogle ScholarPubMed
Cropley, M, Cave, Z, Ellis, J & Middleton, RW (2002) Effect of kava and valerian on human physiological and psychological responses to mental stress assessed under laboratory conditions. Phytotherapy Research 16, 2327.CrossRefGoogle ScholarPubMed
Dallman, MF, Pecoraro, N, Akana, SF, La Fleur, SE, Gomez, F, Houshyar, H, Bell, ME, Bhatnagar, SLaugero, KD & Manalo, S (2003) Chronic stress and obesity: a new view of 'comfort food'. Proceedings from the National Academy of Science USA 100, 1169611701.CrossRefGoogle Scholar
Deferne, JL & Leeds, AR (1996) Resting blood pressure and cardiovascular reactivity to mental arithmetic in mild hypertensive males supplemented with blackcurrant seed oil. Journal of Human Hypertension 10, 531537.Google ScholarPubMed
Delarue, J, Matzinger, O, Binnert, C, Schneiter, P, Chiolero, R & Tappy, L (2003) Fish oil prevents the adrenal activation elicited by mental stress in healthy men. Diabetes and Metabolism 29, 289295.CrossRefGoogle ScholarPubMed
de Leon, MJ, McRae, TRusinek, H, Convit, A, De Santi, S, Tarshish, C, Golomb, J, Volkow, N, Daisley, K, Orentreich, N & McEwen, B (1997) Cortisol reduces hippocampal glucose metabolism in normal elderly, but not in Alzheimer's disease. Journal of Clinical Endocrinology and Metabolism 82, 32513259.Google Scholar
Diplock, A, Aggett, P, Ashwell, M, Bornet, F, Fern, E & Roberfroid, M (1999) Scientific concepts of functional foods in Europe Consensus Document. British Journal of Nutrition 81, S1–27.Google Scholar
Epel, E, Lapidus, R, McEwen, B & Brownell, K (2001) Stress may add bite to appetite in women: a laboratory study of stress-induced cortisol and eating behavior. Psychoneuroendocrinology 26, 3749.CrossRefGoogle ScholarPubMed
Esler, M & Parati, G (2004) Is essential hypertension sometimes a psychosomatic disorder? Journal of Hypertension 22, 873876.CrossRefGoogle ScholarPubMed
Facchinetti, F, Neri, I & Tarabusi, M (2002) Eleutherococcus senticosus reduces cardiovascular stress response in healthy subjects: a randomized, placebo-controlled trial. Stress and Health 18, 1117.CrossRefGoogle Scholar
Faulx, MD, Wright, AT & Hoit, BD (2003) Detection of endothelial dysfunction with brachial artery ultrasound scanning. American Heart Journal 145, 943951.CrossRefGoogle ScholarPubMed
Folkow, B (1990) Structural factor in primary and secondary hypertension. Hypertension 16, 89101.CrossRefGoogle ScholarPubMed
Ghiadoni, L, Donald, AE, Cropley, M, Mullen, MJ, Oakley, G, Taylor, M, O'Connor, G, Betteridge, J, Klein, N, Steptoe, A & Deanfield, JE (2000) Mental stress induces transient endothelial dysfunction in humans. Circulation 102, 24732478.CrossRefGoogle ScholarPubMed
Gibson, L & Green, MW (2002) Nutritional influences on cognitive function: mechanisms of susceptibility. Nutrition Research Reviews 15, 169206.CrossRefGoogle Scholar
Goldstein, IB & McDonald, RH (1986) Biochemical indices of cardiovascular reactivity. In Handbook of Stress, Reactivity, and Cardiovascular Disease, pp. 187206. [Matthews, KA, Weiss, SMDetre, T, Dembrski, TM, Falkner, B, Manuck, SB and Williams, RB, editors]. New York: John Wiley & Sons.Google Scholar
Gonzalez-Bono, E, Rohleder, N, Hellhammer, DH, Salvador, A & Kirschbaum, C (2002) Glucose but not protein or fat load amplifies the cortisol response to psychosocial stress. Hormones and Behavior 41, 328333.CrossRefGoogle ScholarPubMed
Gottdiener, JS, Kop, WJ, Hausner, E, McCeney, MK, Herrington, D & Krantz, DS (2003) Effects of mental stress on flow-mediated brachial arterial dilation and influence of behavioral factors and hypercholesterolemia in subjects without cardiovascular disease. American Journal of Cardiology 92, 687691.CrossRefGoogle ScholarPubMed
Graeff, FG, Guimaraes, FS, De Andrade, TG & Deakin, JF (1996) Role of 5-HT in stress, anxiety, and depression. Pharmacology, Biochemistry and Behavior 54, 129141.CrossRefGoogle Scholar
Grassi, G & Esler, M (1999) How to assess sympathetic activity in humans. Journal of Hypertension 17, 719734.CrossRefGoogle ScholarPubMed
Health and Safety Executive 2002 Self-reported Work Related Illness in 2001/02 – Results from a Household Survey [Jones, JR, Huxtable, CS, Hodgson, JT and Price, MJ, editors]. Wales: Health and Safety Executive.Google Scholar
Horner, HC, Packan, DR & Sapolsky, RM (1990) Glucocorticoids inhibit glucose transport in cultured hippocampal neurons and glia. Neuroendocrinology 52, 5764.Google ScholarPubMed
Hugdahl, K (1996) Psychophysiology. Cambridge, MA: Harvard University Press.Google Scholar
Jennings, JR, Kamarck, TW, Everson-Rose, SA, Kaplan, GA, Manuck, SB & Salonen, JT (2004) Exaggerated blood pressure responses during mental stress are prospectively related to enhanced carotid atherosclerosis in middle-aged Finnish men. Circulation 110, 21982203.CrossRefGoogle ScholarPubMed
Jern, S (1991) Effects of acute carbohydrate administration on central and peripheral hemodynamic responses to mental stress. Hypertension 18, 790797.CrossRefGoogle ScholarPubMed
Jern, S, Bergbrant, A, Bjorntorp, P & Hansson, L (1992) Relation of central hemodynamics to obesity and body fat distribution. Hypertension 19, 520527.CrossRefGoogle ScholarPubMed
Jezova, D, Duncko, R, Lassanova, M, Kriska, M & Moncek, F (2002) Reduction of rise in blood pressure and cortisol release during stress by ginkgo biloba extract (EGb 761) in healthy volunteers. Journal of Physiology and Pharmacology 53, 337348.Google Scholar
Jorm, AF, Christensen, H, Griffiths, KM, Parslow, RA, Rodgers, B & Blewitt, KA (2004) Effectiveness of complementary and self-help treatments for anxiety disorders. Medical Journal of Australia 181, S29–S46.Google ScholarPubMed
Kamarck, TW, Everson, SA, Kaplan, GA, Manuck, SB, Jennings, JR, Salonen, R & Salonen, JT (1997) Exaggerated blood pressure responses during mental stress are associated with enhanced carotid atherosclerosis in middle-aged Finnish men: findings from the Kuopio Ischemic Heart Disease Study. Circulation 96, 38423848.CrossRefGoogle ScholarPubMed
Kaplan, JR, Pettersson, K, Manuck, SB & Olsson, G (1991) Role of sympathoadrenal medullary activation in the initiation and progression of atherosclerosis. Circulation 84,(Suppl.), VI23–VI32.Google ScholarPubMed
Kennedy, DO, Little, W & Scholey, AB (2004) Attenuation of laboratory induced stress in humans following acute administration of Melissa officinalis (lemon balm). Psychosomatic Medicine 66, 607613.CrossRefGoogle Scholar
Kennedy, DO, Scholey, AB, Tildesley, NT, Perry, EK & Wesnes, KA (2002 a) Modulation of mood and cognitive performance following acute administration of Melissa officinalis (lemon balm). Pharmacology, Biochemistry and Behavior 72, 953964.CrossRefGoogle Scholar
Kennedy, DO, Scholey, AB & Wesnes, KA (2002 b) Modulation of cognition and mood following administration of single doses of ginkgo biloba , ginseng, and a ginkgo/ginseng combination to healthy adults. Physiology and Behavior 75, 739751.CrossRefGoogle Scholar
Kennedy, DO, Wake, G, Savelev, S, Tildesley, NT, Perry, EK, Wesnes, KA & Scholey, AB (2003) Modulation of mood and cognitive performance following acute administration of single doses of Melissa officinalis (lemon balm) with human CNS nicotinic and muscarinic receptor-binding properties. Neuropsychopharmacology 28, 18711881.CrossRefGoogle ScholarPubMed
Kim, DH, Moon, YS, Jung, JS, Min, SK, Son, BK, Suh, HW & Song, DK (2003 a) Effects of ginseng saponin administered intraperitoneally on the hypothalamo-pituitary-adrenal axis in mice. Neuroscience Letters 343, 6266.CrossRefGoogle ScholarPubMed
Kim, DH, Moon, YS, Lee, TH, Jung, JS, Suh, HW & Song, DK (2003 b) The inhibitory effect of ginseng saponins on the stress-induced plasma interleukin-6 level in mice. Neuroscience Letters 353, 1316.CrossRefGoogle ScholarPubMed
Kirschbaum, C, Gonzalez, BE, Rohleder, N, Gessner, C, Pirke, KM, Salvador, A & Hellhammer, DH (1997) Effects of fasting and glucose load on free cortisol responses to stress and nicotine. Journal of Clinical Endocrinology and Metabolism 82, 11011105.Google ScholarPubMed
Kirschbaum, C, Wolf, OT, May, M, Wippich, W & Hellhammer, DH (1996) Stress- and treatment-induced elevations of cortisol levels associated with impaired declarative memory in healthy adults. Life Sciences 58, 14751483.CrossRefGoogle ScholarPubMed
Kleijnen, J & Knipschild, P (1992) Ginkgo biloba. Lancet 340, 11361139.CrossRefGoogle ScholarPubMed
Kris-Etherton, PM, Harris, WS & Appel, LJ (2003) Omega-3 fatty acids and cardiovascular disease: new recommendations from the American Heart Association. Arteriosclerosis, Thrombosis and Vascular Biology 23, 151152.CrossRefGoogle ScholarPubMed
Kris-Etherton, PM, Hecker, KD, Bonanome, A, Coval, SM, Binkoski, AE, Hilpert, KF, Griel, AE & Etherton, TD (2002) Bioactive compounds in foods: their role in the prevention of cardiovascular disease and cancer. American Journal of Medicine 113, 71S–88S.CrossRefGoogle ScholarPubMed
Lembo, G, Vecchione, C, Izzo, R, Fratta, L, Fontana, D, Marino, G, Pilato, G & Trimarco, B (2000) Noradrenergic vascular hyper-responsiveness in human hypertension is dependent on oxygen free radical impairment of nitric oxide activity. Circulation 102, 552557.CrossRefGoogle ScholarPubMed
Lehmann, E, Kinzler, E & Friedmann, J (1996) Efficacy of a special kava extract (Piper methysticum) in patients with states of anxiety, tension and excitedness of non-mental origin – a double-blind, placebo-controlled study of four weeks treatment. Phytomedicine 3, 113119.CrossRefGoogle ScholarPubMed
Levine, GN, Frei, B, Koulouris, SN, Gerhard, MD, Keaney, JF Jr & Vita, JA (1996) Ascorbic acid reverses endothelial vasomotor dysfunction in patients with coronary artery disease. Circulation 93, 11071113.CrossRefGoogle ScholarPubMed
Light, KC (2001) Hypertension and the reactivity hypothesis: the next generation. Psychosomatic Medicine 63, 744746.CrossRefGoogle ScholarPubMed
Little, K & Penman, E (1989) Measuring subacute mood changes using the profile of mood states and visual analogue scales. Psychopathology 22, 4249.CrossRefGoogle ScholarPubMed
Lupien, SJ, Gillin, CJ & Hauger, RL (1999) Working memory is more sensitive than declarative memory to the acute effects of corticosteroids: a dose-response study in humans. Behavioral Neuroscience 113, 420430.CrossRefGoogle ScholarPubMed
Lüscher, TF & Vanhoutte, PM (1990) The Endothelium: Modulator of Cardiovascular Function. Boca Raton, FL: CRC Press.Google Scholar
Maes, M & Meltzer, H (1995) The serotonin hypothesis of major depression. In Psychopharmacology: the Fourth Generation of Progress. pp. 933944. [Bloom, F and Kupfer, D, editors]. New York: Raven.Google Scholar
Manuck, SB, Adams, MR, McCaffery, JM & Kaplan, JR (2000) Behaviorally elicited heart rate reactivity and atherosclerosis in ovariectomized cynomolgus monkeys. Arteriosclerosis, Thrombosis and Vascular Biology 17, 17741779.CrossRefGoogle Scholar
Marcilhac, A, Dakine, N, Bourhim, N, Guillaume, V, Grino, M, Drieu, K & Oliver, C (1998) Effect of chronic administration of ginkgo biloba extract or ginkgolide on the hypothalamic-pituitary-adrenal axis in the rat. Life Science 62, 23292340.CrossRefGoogle ScholarPubMed
Markus, CR & Lammers, JH (2003) Effects of ginkgo biloba on corticosterone stress responses after inescapable shock exposure in the rat. Pharmacology, Biochemistry and Behaviour 76, 487492.CrossRefGoogle ScholarPubMed
Markus, CR, Olivier, B & de Haan, EHF (2002) Whey protein rich in alpha-lactalbumin increases the ratio of plasma tryptophan to the sum of the other large neutral amino acids and improves cognitive performance in stress-vulnerable subjects. American Journal of Clinical Nutrition 75, 10511056.CrossRefGoogle Scholar
Markus, CR, Olivier, B, Panhuysen, GE, Van Der Gugten, J, Alles, MS, Tuiten, A, Westenberg, HG, Fekkes, D, Koppeschaar, HF & de Haan, EE (2000 a) The bovine protein alpha-lactalbumin increases the plasma ratio of tryptophan to the other large neutral amino acids, and in vulnerable subjects raises brain serotonin activity, reduces cortisol concentration, and improves mood under stress. American Journal of Clinical Nutrition 71, 15361544.CrossRefGoogle ScholarPubMed
Markus, CR, Panhuysen, G, Tuiten, A & Koppeschaar, H (2000 b) Effects of food on cortisol and mood in vulnerable subjects under controllable and uncontrollable stress. Physiology and Behavior 70, 333342.CrossRefGoogle ScholarPubMed
Marmot, MG, Smith, GD, Stansfeld, S, Patel, C, North, F, Head, J, White, I, Brunner, E & Feeney, A (1991) Health inequalities among British civil servants: the Whitehall II study. Lancet 337, 13871393.CrossRefGoogle ScholarPubMed
Matthews, KA, Katholi, CR, McCreath, H, Whooley, MA, Williams, DR, Zhu, S & Markovitz, JH (2004) Blood pressure reactivity to psychological stress predicts hypertension in the CARDIA Study. Circulation 110, 7478.CrossRefGoogle ScholarPubMed
Miles, DS & Gotshall, RW (1989) Impedance cardiography: noninvasive assessment of human central hemodynamics at rest and during exercise. Exercise and Sport Science Reviews 17, 231263.Google ScholarPubMed
Mills, DE & Ward, RP (1986) Effects of eicosapentaenoic acid (20:5 omega 3) on stress reactivity in rats. Proceedings of the Society for Experimental Biology and Medicine 182, 127131.CrossRefGoogle ScholarPubMed
Monahan, KD, Wilson, TE & Ray, CA (2004) Omega-3 fatty acid supplementation augments sympathetic nerve activity responses to physiological stressors in humans. Hypertension 44, 732738.CrossRefGoogle ScholarPubMed
Mori, TA, Watts, GF, Burke, V, Hilme, E, Puddey, IB & Beilin, LJ (2000) Differential effects of eicosapentaenoic acid and docosahexaenoic acid on vascular reactivity of the forearm microcirculation in hyperlipidemic, overweight men. Circulation 102, 12641269.CrossRefGoogle ScholarPubMed
National Institute of Mental Health 1994 Anxiety Disorders. Bethesda, MD: National Institute of Mental Health.Google Scholar
O'Brien, E, Asmar, R, Beilin, L, Imai, Y, Mallion, JM, Mancia, G, Mengden, T, Myers, M, Padfield, P, Palatini, P, Parati, G & Pickering, T, et al. (2003) European Society of Hypertension recommendations for conventional, ambulatory and home blood pressure measurement. Journal of Hypertension 21, 821848.CrossRefGoogle ScholarPubMed
Parati, G, Bilo, G & Mancia, G (2004) Blood pressure measurement in research and in clinical practice: recent evidence. Current Opinion in Nephrology and Hypertension 13, 343357.CrossRefGoogle ScholarPubMed
Pittler, MH & Ernst, E (2002) Kava for treating anxiety – a meta-analysis of randomized trials. Perfusion 15, 474.Google Scholar
Radegran, G (1999) Limb and skeletal muscle blood flow measurements at rest and during exercise in human subjects. Proceedings of the Nutrition Society 58, 887898.CrossRefGoogle ScholarPubMed
Rai, D, Bhatia, G, Sen, T & Palit, G (2003) Anti-stress effects of ginkgo biloba and Panax ginseng: a comparative study. Journal of Pharmacological Sciences 93, 458464.CrossRefGoogle ScholarPubMed
Rapin, JR, Lamproglou, I, Drieu, K & DeFeudis, FV (1994) Demonstration of the ‘anti-stress’ activity of an extract of ginkgo biloba (EGb 761) using a discrimination learning task. Generic Pharmacology 25, 10091016.CrossRefGoogle ScholarPubMed
Reynolds, RM, Walker, BR, Syddall, HE, Whorwood, CB, Wood, PJ & Phillips, DI (2001) Elevated plasma cortisol in glucose-intolerant men: differences in responses to glucose and habituation to venepuncture. Journal of Clinical Endocrinolology and Metabolism 86, 11491153.CrossRefGoogle ScholarPubMed
Rosmond, R & Björntorp, P (2000) The hypothalamic-pituitary-adrenal axis activity as a predictor of cardiovascular disease, type 2 diabetes and stroke. Journal of Internal Medicine 247, 188197.CrossRefGoogle ScholarPubMed
Rosmond, R, Dallman, MF & Bjorntorp, P (1998) Stress-related cortisol secretion in men: relationships with abdominal obesity and endocrine, metabolic and hemodynamic abnormalities. Journal of Clinical Endocrinolology and Metabolism 83, 18531859.Google ScholarPubMed
Ross, R (1999) Atherosclerosis – an inflammatory disease. New England Journal of Medicine 340, 115126.CrossRefGoogle ScholarPubMed
Rousseau, D, Moreau, D, Raederstorff, D, Sergiel, JP, Rupp, H, Muggli, R & Grynberg, A (1998) Is a dietary n-3 fatty acid supplement able to influence the cardiac effect of the psychological stress? Molecular Cellular Biochemistry 178, 353366.CrossRefGoogle ScholarPubMed
Rozanski, A, Blumenthal, JA & Kaplan, J (1999) Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation 99, 21922217.CrossRefGoogle ScholarPubMed
Salonen, JT & Salonen, R (1993) Ultrasound B-mode imaging in observational studies of atherosclerotic progression. Circulation 87,(Suppl.), II56–II65.Google ScholarPubMed
Sapolsky, RM (1990) Adrenocortical function, social rank, and personality among wild baboons. Biological Psychiatry 28, 862878.CrossRefGoogle ScholarPubMed
Sapolsky, RM (1996) Why stress is bad for your brain. Science 273, 749750.CrossRefGoogle ScholarPubMed
Sapolsky, RM, Krey, LC & McEwen, BS (1986) The neuroendocrinology of stress and aging: the glucocorticoid cascade hypothesis. Endocrinology Reviews 7, 284301.CrossRefGoogle ScholarPubMed
Sapolsky, RM, Zola-Morgan, S & Squire, LR (1991) Inhibition of glucocorticoid secretion by the hippocampal formation in the primate. Journal of Neuroscience 11, 36953704.CrossRefGoogle ScholarPubMed
Sawazaki, S, Hamazaki, T, Yazawa, K & Kobayashi, M (1999) The effect of docosahexaenoic acid on plasma catecholamine concentrations and glucose tolerance during long-lasting psychological stress: a double-blind placebo-controlled study. Journal of Nutritional Science and Vitaminology (Tokyo) 45, 655665.CrossRefGoogle ScholarPubMed
Schwartz, JE, Warren, K & Pickering, TG (1994) Mood, location and physical position as predictors of ambulatory blood pressure and heart rate: application of a multi-level random effects model. Annals of Behavioral Medicine 16, 210220.Google Scholar
Sherwood, A, Allen, MT, Fahrenberg, J, Kelsey, RM, Lovallo, WR & van Doornen, LJP (1990) Methodological guidelines for impedance cardiography. Psychophysiology 27, 123.Google ScholarPubMed
Singh, JP, Larson, MG, Tsuji, H, Evans, JC, O'Donnell, CJ & Levy, D (1998) Reduced heart rate variability and new-onset hypertension: insights into pathogenesis of hypertension: the Framingham Heart Study. Hypertension 32, 293297.CrossRefGoogle ScholarPubMed
Solzbach, U, Hornig, B, Jeserich, M & Just, H (1997) Vitamin C improves endothelial dysfunction of epicardial coronary arteries in hypertensive patients. Circulation 96, 15131519.CrossRefGoogle ScholarPubMed
Spieker, LE, Hurlimann, D, Ruschitzka, F, Corti, R, Enseleit, F, Shaw, S, Hayoz, D, Deanfield, JE, Luscher, TF & Noll, G (2002) Mental stress induces prolonged endothelial dysfunction via endothelin-A receptors. Circulation 105, 28172820.CrossRefGoogle ScholarPubMed
Speilberger, CD (1983) Manual for Stait-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press.Google Scholar
Steptoe, A, Magid, K, Edwards, S, Brydon, L, Hong, Y & Erusalimsky, J (2003) The influence of psychological stress and socioeconomic status on platelet activation in men. Atherosclerosis 168, 5763.CrossRefGoogle ScholarPubMed
Strike, PC & Steptoe, A (2004) Psychosocial factors in the development of coronary artery disease. Progress in Cardiovascular Diseases 46, 337347.CrossRefGoogle ScholarPubMed
Strike, PC, Wardle, J & Steptoe, A (2004) Mild acute inflammatory stimulation induces transient negative mood. Journal of Psychosomatic Research 57, 189194.CrossRefGoogle ScholarPubMed
Taddei, S, Virdis, A, Ghiadoni, L, Magagna, A & Salvetti, A (1998) Vitamin C improves endothelium-dependent vasodilation by restoring nitric oxide activity in essential hypertension. Circulation 97, 22222229.CrossRefGoogle ScholarPubMed
Taylor, W, Usher, JL, Walsh, A, Salmon, P & Shenkin, A (2003) Effect of micronutrient supplementation on cytokine response to examination stress. Brain, Behavior and Immunology 17, 209 Abstr.Google Scholar
van Eck, M, Berkhof, H, Nicolson, N & Sulon, J (1996) The effects of perceived stress, traits, mood states, and stressful daily events on salivary cortisol. Psychosomatic Medicine 58, 447458.CrossRefGoogle ScholarPubMed
Volz, HP & Kieser, M (1997) Kava-kava extract WS1490 versus placebo in anxiety disorders – a randomized placebo-controlled 25-week outpatient trial. Pharmopsychiatry 30, 15.CrossRefGoogle ScholarPubMed
Vrijkotte, TG, van Doornen, LJ & de Geus, EJ (2000) Effects of work stress on ambulatory blood pressure, heart rate, and heart rate variability. Hypertension 35, 880886.CrossRefGoogle ScholarPubMed
Wardle, J & Gibson, EL (2002) Impact of stress on diet: processes and implications. In Stress and the Heart. pp. 124150. [Stansfeld, SA and Marmot, MG, editors]. London: BMJ Books.Google Scholar
Weiner, H (1992) Perturbing the Organism: the Biology of Stressful Experience. Chicago: University of Chicago Press.Google Scholar
Wheatley, D (2001) Kava and valerian in the treatment of stress-induced insomnia. Phytotherapy Research 15, 549551.CrossRefGoogle ScholarPubMed
World Health Organization 2001 The World Health Report 2001. Mental Health: New Understanding, New Hope. Geneva: World Health Organization.Google Scholar