While researchers have documented some of the behavioral contributors to fluctuation in individuals' lipid levels (e.g., nutrition patterns, smoking exercise), little attention has been given to psychosocial stress. Early reports utilizing accountants, race car drivers, and air traffic controllers provided some uncontrolled data associating stress with cholesterol increases. Yet, no empirical research on stress that concomitantly examines other related influences is available. This paucity of data is probably due to 1) lack of objective measures of stress and 2) difficulty in measuring lipid subfractions. The primary aim of this proposed revised 2.5-year epidemiologic study is to investigate the variability of lipids and specifically the effects of stress on serum triglyceride levels, total cholesterol, HDL, and LDL. Based on the results of our recent pilot study, and our research observations, our primary hypothesis predicts significant positive associations between stress level and triglycerides. A total of 228 public accountants (148 men and 80 women to provide comparable power between the sexes) will be recruited from the greater Birmingham area. Participants will be evaluated monthly for 18 months, across three stressful and non-stressful work intervals (i.e., tax seasons). We will also collect data (during this same time frame) to closely monitor the following variables that may affect lipids: dietary intake (including alcohol, caffeine, total calories, total fat, saturated fat, and dietary cholesterol), smoking, and physical activity, and oral contraceptive use, pregnancy status and menstrual stage among the women. Additionally, a proposed substudy presents a unique opportunity for us to investigate the relation between stress and triglyceride-rich lipoproteins in the formation of foam cells.
