Gladstone Nutritional and Environmental Medicine

Stress… and how you can reduce your stress and climate change at the same time.

Stress has been on my mind lately… a couple of recent patient interactions reminded my how intricately our mental and physical health is related. I was so impressed by Prof Pettigrew’s statement in one of my UQ preclinical physiology classes, circa 1987, that I kept it as a quote on my study wall for many years….. “your brain is only two synapses away from organic disease processes“. Of course, time has moved on and more recent research has built on that relatively primitive understanding from my uni days.

I googled “stress” for a definition and I quite like Lifeline Australia’s explanation: “Stress is the body’s way of responding to demand or pressures. It can be caused by both good and bad experiences. In many cases stress is a healthy reaction. It helps us cope with life’s challenges. However too much stress, or prolonged stress can affect our physical and mental health. Taking steps to cope with situations we find stressful is important so we can function and live productive lives.”

In Nutrition and Environmental Medicine we talk about contributors to an increased “allostatic load” which is another term for stress (see link to paper below).

 Stress, as registered by the brain, can be broken up in to four domains:

  • Circadian Disruption
  • Inflammatory Signals
  • Glycaemic Dysregulation
  • Perceived Stress

Most of the time, we tend to focus on number four – perceived stress which can be further broken down in to anxiety/ depression and the neurotransmitter (for example serotonin) imbalances, and to Mental/ Emotional Stress, such as that stemming from relationships, lack of control or burnout. The Lifeline Australia and Better Health Victoria websites both have great tips on how to manage perceived stress.

However, the other three domains are just as important.

Circadian disruption, either via sleep issues or Light/ Dark disruption is very important and easy to ignore in our 24/7 society. Examples of sleep issues, which are amenable to medical care or lifestyle changes are sleep apnoea, pain management and caffeine intake. Examples of light/dark disruption are shift work, jet lag and daylight savings; things which can be beyond our control. But what is in our control is the colour of the light we are exposed to as we go to bed – blue light emitted from our screens can reduce our melatonin production and contribute to allostatic load, not to mention reducing our available sleep time.

Talking about sleep brings to mind Shakespeare’s (Macbeth Act 2: Scene 2) description:

“Sleep that knits up the ravell’d sleeve of care,

The death of each day’s life, sore labour’s bath,

Balm of hurt minds, great nature’s second course,

Chief nourisher in life’s feast,–“

Which, in modern English means:

“Sleep that soothes away all our worries. Sleep that puts each day to rest. Sleep that relieves the weary labourer and heals hurt minds. Sleep, the main course in life’s feast, and the most nourishing”.

We now have a better understanding of the chemical processes at play during sleep, and why good quality sleep that leaves you feeling refreshed and ready to start the day is so important.

Inflammatory Signals are an exploding area of research. Our body communicates with the brain and other parts of the body with an array of chemical messengers, such as the interleukins.

Autoimmune, allergic and infectious diseases all trigger the release of particular chemical messengers, which drive what we see as the disease process – redness, swelling, rash or joint pain for example, but they also drive inflammation in other parts of the body, including the membrane which separates the central nervous system from the rest of the body – the “blood brain barrier”. This in turn can reduce that membrane’s capacity to act as a barrier and protect the brain from chemicals, organisms and proteins that are travelling in the bloodstream.

There is a lot of research towards precision medicine – using biological agents (as opposed to chemicals (drugs)) to target the particular interleukin which is causing the disease process in any one individual person. We are still years off this goal, however, so currently one aim is to reduce these inflammatory messengers by reducing the triggers when we can identify them.

Why we are in a time of increasing incidence of inflammatory, autoimmune disease and cancers is a matter still of scientific debate. Through immunisation and sanitation, we have reduced the burden of death from infectious disease, and through modern obstetric, emergency response and surgical care, we have reduced the burden of perinatal and trauma-related deaths. One would say “well, you have to die of something”, which is absolutely true, but it is the burden of disease which predates one’s passing which has costs both to the individual experiencing the disease, and to society as it pays for the medical care and for lost contribution in the workplace and home. Which is why the next point is so important.

Glycaemic Dysregulation encompasses Obesity, Insulin Resistance and also the consequences of a low fibre and highly processed food diet. Food additives are used in larger amounts and in combinations which were not researched from the point of view of their safety profiles in combination. Food additives can have a physical effect, such as emulsifiers damaging the gut mucus lining, an effect on the microbial population of the gut, through antibiotics and pesticides, and through chemical (drug-like) effects such some colourings and flavourings.

A recent paper by Schnabel et al (2019) showed that consumption of ultraprocessed food at a level of 14.4% of total food consumption, corresponding to 29.1% of total energy intake was associated with a higher risk dying from any cause. Of course, this is an early paper, and more research is needed, but it would make sense to reduce intake of these types of foods to way below the 14.4% quoted in this study.

In other posts on this site, I have talked a bit about Insulin and LCHF in the management of Diabetes and Obesity. At the end of the day, though, this comes back to Michael Pollan’s pithy advice “Eat Food, Not too much. Mostly Plants”. Of course by Food, he means real food, that does not have a long list of unpronounceable ingredients. I would further add that it is real food which your great-grandmother would recognise, grown as locally as possible/practical and where possible farmed/raised on ecologically sound principles. The IPCC recently released a special report on climate change, desertification, land degradation, sustainable land management, food security, and greenhouse gas fluxes in terrestrial ecosystems. They said : Balanced diets, featuring plant-based foods, such as those based on coarse grains, legumes, fruits and vegetables, nuts and seeds, and animal-sourced food produced in resilient, sustainable and low-GHG emission systems, present major opportunities for adaptation and mitigation while generating significant co-benefits in terms of human health.”

All of the Domains of Stress contributing to an increased allostatic load can be helped by exercise. Moderate exercise increases insulin sensitivity, improves sleep and reduces inflammation. Too much exercise, however, is a cause of increased allostatic load. The sweet spot sits at 30-60 minutes of exercise per day. Which particular exercise is right for you depends upon your own circumstances, and you might like to talk to an exercise physiologist or physiotherapist, especially if you have never been an active person. The “trick” is to find something that you enjoy, and that is not a chore, and that you can fit in to your day.

So, in a Nutshell, what can one do to address the root causes of stress?

  • Make sleep a priority. Work out why you don’t feel rested in the mornings and take steps to fix it.
  • Work out what is contributing to inflammation in your system – get on top of whatever allergic/ autoimmune/ inflammatory issue you might have.
  • Eat real food. Minimize processed food. Prioritize food that is healthy for the planet as well as you can with what you have. Even one organic item in your trolley sends a message to the farmer that their endeavours are appreciated and worthwhile.
  • Take a look at your mental health, relationships, feelings of lack of control or burnout. Sometimes there are things you can do to change your circumstances, sometimes there are not, but recognising them is the first step.
  • Find a way to incorporate movement in to your day, but beware of over- exercising.

Everyone will have something that they need to tackle first……It might be pretty simple – that 5 shot caramel latte on the way to work might need to be replaced by something not quite so…..sugary and caffeiney (I know it’s not a word, but it should be).

You don’t have to do this on your own. Your doctor can help you sort out some of the issues in sleep, inflammation and mental health, and work with you as you build your new-and-improved, reduced stress life.

https://www.betterhealth.vic.gov.au/health/healthyliving/stress

https://www.lifeline.org.au/get-help/topics/stress

https://www.researchgate.net/profile/Robert-Paul_Juster/publication/26887860_Juster_RP_McEwen_BS_Lupien_SJ_Allostatic_load_biomarkers_of_chronic_stress_and_impact_on_health_and_cognition_Neurosci_Biobehav_Rev_35_2-16/links/5a5cb9290f7e9b4f78395e83/Juster-RP-McEwen-BS-Lupien-SJ-Allostatic-load-biomarkers-of-chronic-stress-and-impact-on-health-and-cognition-Neurosci-Biobehav-Rev-35-2-16.pdf (Allostatic load biomarkers of chronic stress and impact on health and cognition)

https://www.sparknotes.com/nofear/shakespeare/macbeth/page_58/

https://www.jacionline.org/article/s0091-6749(16)30715-1/fulltext (Interleukins (from IL-1 to IL-38), interferons, transforming growth factor β, and TNF-α: Receptors, functions, and roles in diseases)

https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2723626 (Association Between Ultraprocessed Food Consumption and Risk of Mortality Among Middle-aged Adults in France)

https://www.ipcc.ch/report/srccl/ (Climate Change and Land An IPCC special report on climate change, desertification, land degradation, sustainable land management, food security, and greenhouse gas fluxes in terrestrial ecosystems)

https://nyaspubs.onlinelibrary.wiley.com/doi/abs/10.1196/annals.1367.020 (The Protective Role of Exercise on Stress System Dysregulation and Comorbidities)

Swallow This: Serving Up the Food Industry’s Darkest Secrets

Author: Joanna Blythman
Publisher: HarperCollins UK, 2015
ISBN: 0007548346, 9780007548347