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Week 9 - Stress

Introduction

In week nine we explore how stress can affect our body’s ability to lose weight and what we can do about it. We can’t always avoid stress, but we can change how we respond to it and find ways to reduce its impact on our lives. We’ll give you strategies that help you manage stress which can improve your overall health and well-being as well as support healthy weight loss

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Welcome to week 9 from the Lifestyle Medicine team.

Stress can have an impact on both your ability to lose weight and to keep the weight off. Although you can’t control the stresses in your life, learning to manage how you respond to stress can minimise the impact it has on how you eat and on your mental and physical health.

Learning to manage stress can help you to lose weight and have a noticeable impact on your sense of wellbeing, empowering you to make more healthy lifestyle choices. Let’s take a closer look at how stress can impact your health and your ability to lose weight. We'll also present some strategies to support you to keep those pounds off!

Stress is often unavoidable in life. A certain amount of stress can be positive, helping to motivate you. However, too much stress can lead to weight gain or to getting you off track with your healthy habits. This means finding ways to manage excessive stress is not just vital for your wellbeing, it can also help you to lose weight. Stress can have a significant impact on your overall health (1). For example, if poorly managed, stress can lead to issues with your heart, gut and mental health. Long term stress can also impact your immune system and hormonal balance (1). When you experience ongoing stress you produce larger amounts of the stress hormone, cortisol, which has been found to increase your appetite (2).

Long term stress that is unmanaged can have a different impact on your body weight. Some people will gain weight (3) while others will notice they lose weight. If you find that you gain weight when you’re stressed it's important to manage how you respond to stress. You can do this by focusing on what and when you’re eating and drinking and by introducing some relaxation strategies to build your resilience. Focusing on these can help prevent unwanted weight gain.

Let’s explore the damaging effects of stress and some evidence based tips on how to manage your stress better.

Cortisol and its effect on weight gain and loss

Research has found that people with larger tummy measurements have higher levels of the stress hormone, cortisol, which contributes to this weight gain (4). Higher levels of cortisol are also associated with increased body mass index (BMI) and obesity. The foods you eat can also affect your hormone balance, which can lead to an increased blood cortisol level. Foods that are high in sugar and convenience foods high in processed fats and sugars can increase blood sugar, which then leads to an increased production of cortisol (5). When cortisol is continuously high it can contribute to the background level of inflammation in your body. This is concerning because high levels of inflammation increase your risk factors for a number of diseases.

Regularly eating foods high in sugar and saturated fats can cause you to crave more of these foods due to the dysregulated blood sugars leading to an increased risk that you’ll overeat. If you regularly over eat or eat when you're stressed and emotional this can cause weight gain. Poor sleep will also increase levels of cortisol which can again contribute to weight gain (7).

High levels of stress hormones cause an increase in your appetite, especially for high sugar and fatty foods (8). When eaten regularly, these foods have been found to increase the risk of weight gain and obesity. You might find that when you're under constant stress you end up in a vicious cycle of cravings leading to overeating, so it's vital for both your weight loss and your health in general- to develop habits that increase your resilience to stress. One way to help you understand if stress is causing you to overeat is by keeping a food and symptom diary. You can use this to track when you’re feeling stressed and how your mood affects what you eat. Stress can cause a variety of different symptoms. If you're stressed, it’s likely you’ll be experiencing some of the following common signs and symptoms

People often report that they feel a sense of irritability or anger, or may feel tense, anxious or overwhelmed. For some, stress will lead to a loss of interest in life and trigger low mood or depression. You may notice that you have lost your sense of humour and feel tense or worried. Some people experience physical symptoms when stressed including nausea, stomach problems and headaches. It's very common when you're experiencing regular stress to notice you have a loss of libido or sexual desire. For some, being stressed can lead to experiencing a faster heart rate. If you recognise any of these symptoms and you are concerned, please book an appointment with your GP for a review. As you can see, being stressed can make you feel quite unwell. Follow our top tips to help manage the impact stress has on you.

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Do You Know When You're Stressed?

Do You Know When You're Stressed? Many people live with day-to-day stress from a variety of sources all of the time. External sources of stress often cannot be avoided, making taking responsibility for how you manage stress a real priority for your wellbeing and for your weight loss. Sources of stress can be work related including, for example, having too much work to manage, facing redundancy and even bullying at work. Stress can also come from difficult relationships either at home or at work, financial stress, or caring responsibilities, to name but a few. Being unwell yourself can also create increased physical and emotional stress. The effects of long term stress can be so gradual and subtle that you might not even realise that you're suffering the effects of stress.

Our Top Tips to Managing Stress Related Weight Gain

Finding ways to reduce the effects of the stress you're experiencing is a priority. To help to reduce the negative effects of stress, look at taking part in activities you find relaxing like gentle exercise, getting fresh air or chatting with friends. You might not always be able to control the stress you have in your life but you can minimise the impact it has on your body. What helps to relieve stress varies from one person to another. It's about finding something that works for you. Options to try include; going for a walk, meditation, laughter, keeping a gratitude journal, doing mind puzzles, having a soak in a bath, or chatting with a close friend. Making sure you get enough sleep can also help to reduce the negative effects of stress (9).

Can you eat to reduce the effects of stress?

Eat a low sugar diet, one that is lower in sugary and processed foods. By doing this, you're bringing more balance to both insulin and blood sugar levels and reducing your cortisol levels (10).

Eating a diet that is high in whole foods, fruits and vegetables, herbs, spices, whole grains, good quality lean protein (animal or vegetarian), a little healthy fat and low fat dairy products is important for weight loss. For further advice we have written some eating guidelines for you to follow - Follow our core eating plan, our low carb diet guidelines or our mediterranean diet guidelines available to download for free at the bottom of this page, or -hop back to Week 2 for a reminder.

Specific Nutrients that can play a role in aiding stress management

Magnesium - having low levels of magnesium in your body has been linked to higher levels of stress. Magnesium is known to have a calming effect and can help you get restful sleep (11). Boost magnesium rich foods in your diet. Sources of magnesium include pumpkin seeds, whole grains, dark green leafy vegetables, low-fat milk and yoghurt as well as beans and legumes such as soybeans, baked beans, lentils, and peanuts. Some nuts also contain magnesium such as almonds and cashews.

Taking magnesium as a supplement can upset your stomach. Using a topical magnesium spray or gel instead can prevent this and magnesium is thought to be absorbed well through the skin.

Vitamin C - an antioxidant which can be really useful if you're suffering from high levels of stress, because vitamin C deficiency is common in many stress related conditions (7, 12). Fresh fruits and vegetables contain good levels of Vitamin C, particularly citrus fruits (lemon, orange and grapefruit), peppers, strawberries and cruciferous vegetables (broccoli, kale, cauliflower and cabbage).

B vitamins - eating foods high in B vitamins can be beneficial for you when you're experiencing stress, particularly chronic stress, which can deplete some B vitamin levels and so increase your need for them (13). Food sources of B vitamins include dark green leafy vegetables, chickpeas, kidney beans and nutritional yeast.

What you drink also makes a difference to how much cortisol you produce. Research has found that drinking caffeine rich drinks, such as fizzy drinks, coffee, tea and green tea can increase how much cortisol you produce if you're already experiencing emotional stress (14). We recommend that you reduce the amount of caffeine-containing drinks that you consume each day and swap to low or no-caffeine options instead. Experiment with drinking chamomile tea which has been found to have calming effects and may help alleviate anxiety (15).

Box Breathing Exercise This is a really simple evidence based tool to have in your pocket for use when you're feeling stressed, or when you need a reset. Box breathing exercises can help to create a sense of calm when you're feeling agitated or stressed (16). The great thing about this simple exercise is that you can do it anywhere once you have learnt the principles.

The box breathing technique is a simple breathing exercise using a count of 4, 4, 4 and 4. We advise setting a timer of 60 seconds at a minimum to practise box breathing. You can use the technique with your eyes open or closed, however with your eyes closed it’s easier to bring your full attention to your breath. Try it both ways and see what works best for you.

Here’s the technique:

Box Breathing Exercise:

Breathe in for a count of 4 seconds

Hold for a count of 4 seconds

Breathe out for a count of 4 seconds

Hold on a full exhalation for a count of 4 seconds

Breathe in for a count of 4 seconds

Hold for a count of 4 seconds

Breathe out for a count of 4 seconds

Hold on a full exhalation for a count of 4 seconds

Breathe in for a count of 4 seconds

Hold for a count of 4 seconds

Breathe out for a count of 4 seconds

Hold on a full exhalation for a count of 4 seconds

And repeat the cycle again.

If 4 seconds feels too long for you, you can still benefit from breathing to a count of 3, 3, 3 and 3 and once this is easy for you you can extend it to 4, 4, 4 and 4. This box breathing technique has been shown to efficiently shift your nervous system from the fight or flight state to the rest, digest and heal state. It could be useful to do a few minutes of box breathing before a meeting or presentation, or any situation that you know might be difficult. It’s also useful to use after a stressful experience to calm yourself down and shift your body out of the fight or flight state and back into the rest, digest and heal state. Use it to support your system to relax and relieve stress as often as you need.

References

  • 1. Yaribeygi H, Panahi Y, Sahraei H, Johnston TP, Sahebkar A. The impact of stress on body function: A review. EXCLI J. 2017 Jul 21;16:1057-1072. doi: 10.17179/excli 2017-480. PMID: 28900385; PMCID: PMC5579396.
  • 2. Epel E, Lapidus R, McEwen B, Brownell K. Stress may add bite to appetite in women: a laboratory study of stress-induced cortisol and eating behavior. Psychoneuroendocrinology. 2001 Jan;26(1):37-49. doi: 10.1016/s0306-4530(00)00035-4. PMID: 11070333.
  • 3. Dallman MF, Pecoraro N, Akana SF, La Fleur SE, Gomez F, Houshyar H, Bell ME, Bhatnagar S, Laugero KD, Manalo S. Chronic stress and obesity: a new view of 'comfort food'. Proc Natl Acad Sci U S A. 2003 Sep 30;100(20):11696-701. doi: 10.1073/pnas.1934666100. Epub 2003 Sep 15. PMID: 12975524; PMCID: PMC208820.
  • 4. Donoho CJ, Weigensberg MJ, Emken BA, Hsu JW, Spruijt-Metz D. Stress and abdominal fat: preliminary evidence of moderation by the cortisol awakening response in Hispanic peripubertal girls. Obesity (Silver Spring). 2011 May;19(5):946-52. doi: 10.1038/oby.2010.287. Epub 2010 Dec 2. PMID: 21127479; PMCID: PMC3107005.
  • 5. Dias JP, Joseph JJ, Kluwe B, Zhao S, Shardell M, Seeman T, Needham BL, Wand GS, Kline D, Brock G, Castro-Diehl C, Golden SH. The longitudinal association of changes in diurnal cortisol features with fasting glucose: MESA. Psychoneuroendocrinology. 2020 Sep;119:104698. doi: 10.1016/j.psyneuen.2020.104698. Epub 2020 Jul 13. PMID: 32674946; PMCID: PMC8046490.
  • 6. Scrivo R, Vasile M, Bartosiewicz I, Valesini G. Inflammation as 'common soil' of the multifactorial diseases. Autoimmun Rev. 2011 May;10(7):369-74. doi: 10.1016/j.autrev.2010.12.006. Epub 2010 Dec 30. PMID: 21195808.
  • 7. van der Valk ES, Savas M, van Rossum EFC. Stress and Obesity: Are There More Susceptible Individuals? Curr Obes Rep. 2018 Jun;7(2):193-203. doi: 10.1007/s13679-018-0306-y. PMID: 29663153; PMCID: PMC5958156.
  • 8. Chao A, Grilo CM, White MA, Sinha R. Food cravings mediate the relationship between chronic stress and body mass index. J Health Psychol. 2015 Jun;20(6):721-9. doi: 10.1177/1359105315573448. PMID: 26032789; PMCID: PMC6186388.
  • 9. Hirotsu C, Tufik S, Andersen ML. Interactions between sleep, stress, and metabolism: From physiological to pathological conditions. Sleep Sci. 2015 Nov;8(3):143-52. doi: 10.1016/j.slsci.2015.09.002. Epub 2015 Sep 28. PMID: 26779321; PMCID: PMC4688585.
  • 10. Radulian G, Rusu E, Dragomir A, Posea M. Metabolic effects of low glycaemic index diets. Nutr J. 2009 Jan 29;8:5. doi: 10.1186/1475-2891-8-5. PMID: 19178721; PMCID: PMC2654909.
  • 11. Cuciureanu MD, Vink R. Magnesium and stress. In: Vink R, Nechifor M, editors. Magnesium in the Central Nervous System [Internet]. Adelaide (AU): University of Adelaide Press; 2011. PMID: 29920004.
  • 12. Moritz B, Schmitz AE, Rodrigues ALS, Dafre AL, Cunha MP. The role of vitamin C in stress-related disorders. J Nutr Biochem. 2020 Nov;85:108459. doi: 10.1016/j.jnutbio.2020.108459. Epub 2020 Jul 3. PMID: 32745879.
  • 13. Young LM, Pipingas A, White DJ, Gauci S, Scholey A. A Systematic Review and Meta-Analysis of B Vitamin Supplementation on Depressive Symptoms, Anxiety, and Stress: Effects on Healthy and 'At-Risk' Individuals. Nutrients. 2019 Sep 16;11(9):2232. doi: 10.3390/nu11092232. PMID: 31527485; PMCID: PMC6770181.
  • 14. Lovallo WR, Whitsett TL, al'Absi M, Sung BH, Vincent AS, Wilson MF. Caffeine stimulation of cortisol secretion across the waking hours in relation to caffeine intake levels. Psychosom Med. 2005 Sep-Oct;67(5):734-9. doi: 10.1097/01.psy.0000181270.20036.06. PMID: 16204431; PMCID: PMC2257922
  • 15. Srivastava JK, Shankar E, Gupta S. Chamomile: A herbal medicine of the past with a bright future. Mol Med Rep. 2010 Nov 1;3(6):895-901. doi: 10.3892/mmr.2010.377. PMID: 21132119; PMCID: PMC2995283.
  • 16. Ma X, Yue ZQ, Gong ZQ, Zhang H, Duan NY, Shi YT, Wei GX, Li YF. The Effect of Diaphragmatic Breathing on Attention, Negative Affect and Stress in Healthy Adults. Front Psychol. 2017 Jun 6;8:874. doi: 10.3389/fpsyg.2017.00874. PMID: 28626434; PMCID: PMC5455070.

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