Connecting the Dots: The Mind–Body Interplay within Metabolic and Cardiovascular Health

The existence of a bidirectional association between mental health and cardiometabolic diseases is arguably well-established and has been well-documented at this point.[1,2] Psychiatric illness, including depressive and anxiety disorders, are associated with increased risk of developing cardiovascular disease and metabolic syndrome. Conversely, conditions such as obesity, diabetes, and cardiovascular abnormalities are frequently accompanied by substantial psychological burden.[3-5] Despite this well-established interrelationship, clinical care often remains detached and distinct, with mental and physical health being addressed in parallel, rather than via an integrated framework. Collectively, the following studies underscore that alongside routine monitoring of physiological parameters, the assessment and treatment of mental health conditions must be embedded across the entire continuum of cardiometabolic disease prevention and management. Reflecting this perspective, this issue of Heart and Mind brings together a diverse collection of contributions that examine the complex and dynamic interplay between the mind and body. Thomas Rutledge and Rebecca Greco present their work entitled “Changes in Psychiatric Symptoms, Eating Disorder Behaviors, and Health Behaviors Following Six Months of GLP-1 Treatment for Obesity: A Pre-to-Post-Treatment Study.” This retrospective study examined participants, specifically military veterans, receiving glucagon-like-peptide-1 (GLP-1) medications for the treatment of obesity. Among 90 participants who completed a pre-treatment survey, 40 were also able to complete an additional post-treatment survey after six months of GLP-1 therapy. The authors observed statistically significant improvement in depressive symptoms, sleep quality, eating behaviors, pain perception as well as other general mental health indicators. These findings suggest that improvements in weight and metabolic health may be accompanied by equally meaningful gains in psychological well-being, dysfunctional or disordered eating patterns, and even quality of life. The paper “Narrative Review on Long COVID and the Interplay between the Cardiovascular and Autonomic Systems, with a Focus on Dysautonomia and the Management Thereof” was contributed by Yorissa Padayachee et al. This narrative review synthesizes evidence from multiple databases, examining the long-term cardiovascular and autonomic nervous system sequelae of COVID-19, particularly in patients presenting with dysautonomia. The authors highlight that Long COVID often manifests as a chronic relapsing condition characterized by persistent cardiopulmonary symptoms, with dysautonomia emerging as a prominent and increasingly recognized feature. They advocate for a multidisciplinary and holistic management approach, emphasizing non-pharmacological strategies such as intravascular volume expansion, respiratory as well as general physical rehabilitation, psychosocial intervention, and deep breathing exercises, in addition to pharmacological options when these are indicated. The review underscores the need for further high-quality research, including randomized controlled trials, to clarify underlying mechanisms and to inform a patient-centred care approach for this debilitating condition. “Causal Associations between Height and Heart Failure: A Mendelian Randomization Study” was conducted by Yuxuan Liu and colleagues. This study utilized publicly available genome-wide association study summary data, including data from the UK Biobank, and employed a two-sample Mendelian randomization approach to investigate the causal effect of genetically predicted height on the risk of heart failure (HF). A total of 496 height-associated single nucleotide polymorphisms were included as instrumental variables. Summary statistics included data on height from 461,950 individuals and on HF from 977,323 individuals. The analysis outcome demonstrated a one-standard deviation increase in genetically predicted height was associated with a 6% higher risk of HF. This association remained significant even with multivariable adjustment for confounders such as body mass index, blood pressure, and lipids, reaching an 11.1% increased risk. Reverse causality analysis uncovered no evidence for an effect of HF on height. These findings suggest that greater height may be considered an independent risk factor for HF, with potential implication in screening and prevention strategies, as well as in future research into underlying biological pathways. An article titled “Different Insulin Resistance Surrogates and Risk of All-Cause and Cardiovascular Mortality among Adults with Metabolic Syndrome-Like Characteristics: Evidence from NHANES 1999–2018 – A Cohort Study” was presented by Feng Hu et al. The authors evaluated the predictive value of four insulin resistance (IR) surrogate indices – homeostasis model assessment of insulin resistance (HOMA-IR), triglyceride-glucose (TyG), metabolic score of insulin resistance (METS-IR), and estimated glucose disposal rate (eGDR) – for mortality risk among adults carrying features of metabolic syndrome. Using data from 11,841 individuals drawn from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2018, the study demonstrated that eGDR exhibited the strongest association with all-cause mortality, particularly among adults under sixty in the United States, in comparison to the other three indices. The work “Integrative Approaches in Oncology: The Mental Health Benefits of Tai Chi and Qigong” is contributed by Giuseppe Marano et al. This article synthesizes existing information on the psychological mechanisms underlying Tai Chi and Qigong (TCQ), and offers guidance for the development of more personalized and feasible implementation strategies in the oncology setting. A diagnosis of cancer often precipitates significant psychological distress, potentially resulting in anxiety, depressive symptoms, and direct impact on quality of life. TCQ, which integrates gentle movement, meditation practice and controlled breathing, has been shown to modulate the autonomic nervous system and hypothalamic–pituitary–adrenal axis, reducing stress hormones such as cortisol while improving heart rate variability. The authors advocate for the incorporation of TCQ into comprehensive cancer care as a low-cost, accessible complementary therapy, while emphasizing that it should augment, and not replace, conventional oncological treatment. Furthermore, they call for higher-quality randomized controlled trials, employing standardized methodologies and sampling in the broader population. In summary, future clinical practice worldwide should strive to dismantle traditional disciplinary silos by embedding multidisciplinary collaboration across psychiatry, cardiology, endocrinology, oncology and related fields. It is essential to develop psychological and behavioral interventions that are easily accessible, culturally sensitive, and grounded in evidence. It is only by recognizing mental health difficulty as a core component of cardiometabolic health, rather than a secondary comorbidity, can the goal of “whole-person health” be realized.[6]