Background and Purpose. High sensitivity C-reactive protein (hs-CRP), a measure of inflammatory response, is now considered an independent marker for coronary heart disease. Psychological stress also affects the immune system and influences the inflammatory response. Ladwig, et al (2003) found a significant positive association between hs-CRP levels and depression (F=4.9, p^.008) in 726 obese males, even after adjusting for smoking, high blood pressure and age. This study investigated if there was a similar association between increased hs-CRP levels and psychological stress in overweight and obese males.

Method. Sixty-one overweight (n=28) or obese (n= 33) males, ages 20-35, were recmited to participate in a cross-sectional study. Variables assessed were body mass index (BMI), body fat percentage, blood pressure, perceived stress using Cohen et al’s (1983) Perceived Stress Scale (PSS), and hs-CRP blood levels.

Results. There was no linear association between PSS score and hs-CRP (Spearman’s rho r=.06, p= 65). Only 11 (18.0%) subjects had hs-CRP levels above 3, the level considered to be high risk, while almost half (n=28, 45.9%) had levels less than 1. Statistically significant Spearman’s rho correlations were found between hs-CRP and BMI (r=.55, p=.00001), hs-CRP and body fat percentage (r=.59, p^.OOOOOl), and a trend for perceived stress score and BMI (r=.23, p=.07). Levels of hs-CRP were higher in obese than overweight subjects (mean = 2.7 vs 0.9, p=.00003).

Conclusion. This study confirmed an association of hs-CRP with BMI and body fat but showed no linear relationship of chronic stress of daily life to hs-CRP levels.

Importance to Preventive Care. Although this study did not find an association between chronic stress and hs-CRP, previous research indicates that acute stressors do play a role in increasing this measure of inflammatory response. Preventive care specialists need to consider reducing obesity and possibly accounting for acute, rather than chronic, stressors when prescribing lifestyle changes needed for optimal health.


School of Public Health

First Advisor

Helen Hopp Marshak

Second Advisor

Lee Berk

Third Advisor

Edward Fujimoto

Fourth Advisor

Brenda Rea

Degree Name

Doctor of Public Health (DrPH)

Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Overweight; Obesity -- psychology; Stress, Psychological; Coronary Disease -- psychology; Depression -- immunology.



Page Count

ix; 83

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives