Day 89- Relax Ladies!

Guest Blog Author Amanda Buhl, MPH

Amanda received her Masters in Public Health Nutrition from the University of Washington School of Public Health in March, 2011.

Chronic psychological stress and the daily demands of modern life have profound consequences for human health and wellbeing. In particular, chronic stress appears to be consistently associated with a preference for energy-dense foods, namely those high in fat and sugar (1-9). Evidence from longitudinal studies also suggests that chronic stress may be causally linked to weight gain and greater abdominal and visceral fat (1-3, 10).

Stress contributes to weight gain through both modifications in food choice (eating more calories and “comfort foods” high in fat and sugar) and other, metabolic changes. In conditions of chronic stress, the hormonal balance is shifted toward low levels of fat-preventing anabolic hormones (androgens and IGF-1) and increased levels of cortisol (the main stress hormone) and insulin. Cortisol promotes the accumulation of fat around your middle because abdominal and visceral fat (the particularly unhealthy fat found around your organs) have a greater density of cortisol receptors (2, 3, 11). Also, the combination of insulin and cortisol inhibits fat breakdown and promotes fat storage through activation of lipoprotein lipase, the fat storing enzyme that converts triglycerides into stored fat.

To test the hypothesis that chronic stress is associated with greater levels of overweight and obesity, I examined survey data from 2,000 Seattle households as part of the Seattle Obesity Study (SOS). The SOS is a multidisciplinary study of food access, diet quality, and health among adults in King County led by the University of Washington Center for Obesity Research.

What the data in my study demonstrated was that, particularly among women, there was a STRONG, statically significant, positive association between self-rated stress levels and overweight/obesity (as measured by body mass index), even after controlling for numerous demographic (age, race/ethnicity), socioeconomic (income, education), and lifestyle (physical activity, smoking, fruit and vegetable consumption) variables that we know to be associated with either stress or overweight (or both). So these variables did not affect (or confound) the relationship that was seen here. Among men, a statistically significant association was not seen after controlling for the potentially confounding variables listed above, suggesting that these variables might explain the incidence of overweight in the men in this study more than stress. Though this type of study does not allow us to assume that there is a causal relationship between stress and weight gain, these findings definitely warrant further investigation.

PUNCHLINE: There may be something unique happening in women’s bodies that make us more vulnerable to the effects of stress, particularly the fat-accumulating effects of stress. Recent research has proposed that women may be more sensitive to low levels of corticotrophin releasing factor – the neuropeptide released in the brain in response to stress – signifying a difference between men and women in the physiological response to stress (12). Additionally, research has shown that following a spousal argument, women experience a prolonged stress response (elevated cortisol levels) as compared to men (13). This may suggest a greater vulnerability to social or relationship stress among women.

So ladies (and gents), check your stress levels. Dedicate time each day for activities and exercise outlets you enjoy. Also, develop social support networks where you feel comfortable and can seek guidance and help when you need it. Your body will thank you!

Keep calm and carry on,

Amanda

• Torres SJ, Nowson CA. Relationship between stress, eating behavior, and obesity. Nutrition 2007;23:887-894.
• Epel E. Psychological and metabolic stress: A recipe for accelerated aging? Hormones 2009;8(1):7-22.
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• Pollard TM, Steptoe A, Canaan L, Davies GJ, Wardle J. The effects of academic examination stress on eating behavior and blood lipid levels. International Journal of Behavioral Medicine 1995;2:299-320.
• Kandiah J, Yake M, Jones J, Meyer M. Stress influences appetite and comfort food preferences in college women. Nutrition Research 2005;26:118-123.
• Lui C, Xie B, Chou C-P, et al. Perceived stress, depression and food consumption frequency in the college students of China seven cities. Physiology & Behavior 2007;92:748-754.
• Sims R, Gordon S, Garcia W, et al. Perceived stress and eating behaviors in a community-based sample of African Americans. Eating Behaviors 2008;9:137-142.
• Ng DM, Jeffrey RW. Relationships between perceived stress and health behaviors in a sample of working adults. Health Psychology 2003;22:638-642.
• Chrousos GP. The role of stress and the hypothalamic-pituitary-adrenal axis in the pathology of the metabolic syndrome: neuro-endocrine and target tissue-related causes. International Journal of Obesity 2000;24, Suppl2:S50-S55.
• Epel ES, McEwen B, Seeman T, et al. Stress and body shape: Stress-induced cortisol secretion is consistently greater among women with central fat. Psychosomatic Medicine 2000;62:623-632.
• Bangasser DA, Curtis A, Reyes BA, et al. Sex differences in corticotropin-releasing factor receptor signaling and trafficking: Potential role in female vulnerability to stress-related psychopathology. Molecular Psychiatry 2010;15:896-904.
• Kiecolt-Glaser JK, Newton T, Cacioppo T et al. Marital conflict and endocrine function: Are men really more physiologically affected than women? Journal of Consulting and Clinical Psychology 1996;64(2):324-332.

Day 24-Night Owl

Your alarm goes off and instead of turning over to stretch and getting out of bed, you turn over and hit the snooze button for the 3rd time this morning. Or if you are like me, you hit the snooze button at least 3 times, but you also reset your alarm at least once; thinking to yourself that you can just skip blow drying your hair today because you would rather have the 10 minutes more of sleep.

My new years resolution for 2011 was to become a morning person; that resolution didn't even make it a day. So what gives? Why does my body feel like it needs those 10 extra minutes every morning instead of just getting up like it should be doing? Instead of snoozing in the morning I could have taken my dog for a run or to the park, I could have wrote my blog, I could have made my lunch, I could have read the paper, I could have gone to work on time, there are many other productive things that I could have done, but none seem more important than resetting my alarm. Not only do many people struggle like I do with the alarm clock, but they also rely on caffeine to get themselves going and to be able to function in the morning.

Then we have the opposite side of the spectrum; the morning people. The people that set their alarm the night before and jump out of bed as soon as their alarm goes off for the first time in the morning, and certainly don't need caffeine in the morning to function.

Picture website

So what makes someone a morning person and someone a snoozer?

The body has a natural clock built into it; letting you know when it's time to go to sleep and when it's time to wake up, this is called the circadian rhythm. The normal pattern of the circadian rhythm can be see with cortisol being high in the morning and low in the evening; this rhythm is controlled by the hypothalamus in the brain. The opposite is happening with the hormone Melatonin, which is high at night and low in the morning. Melatonin is controlled by the retina in the eye which can sense light and dark; light inhibits the pineal gland to release melatonin, while dark permits the pineal gland to release melatonin.

Cortisol levels should be the highest in the morning because during sleep the body is going through a natural fasting state. During this fasting state the body requires the adrenal glands to release cortisol in order to break down the storage form of glucose in the body. On average the body will use up 2/3 of its glycogen (which is the stored form of glucose) levels after a typical nights sleep. Even though you are sleeping it doesn't mean that your body doesn't need a constant supply of glucose. As you wake up there is less of a demand for cortisol release since the body doesn't demand as much glucose from gluconeogenesis and glycogenolysis.

The symptoms related to abnormal sleep patterns such as, trouble falling asleep, waking up in the middle of the night, and having a difficult time getting out of bed can be due to an abnormal release of cortisol by the adrenals in the circadian rhythm. Usually the issues are adrenal hyperfunction, which is when cortisol peaks in the evening when it should be low, or adrenal hypofunction, which is when cortisol levels are low in the morning when they should be high.

Lifestyle choices such as, night shifts or early morning commutes can affect the natural circadian rhythm of the body. The people that had these two different lifestyle choices where found to have different body clocks that controlled sleep-wake patterns by adjusting the body temperature and the hormones melatonin and cortisol. Researchers have named morning people "larks" and night people "night owls," and think that these preferences could actually be a genetic trait; although the theory has not yet been proven.

There are several causes for adrenal dysfunction such as blood sugar imbalances, medications, and stress. There are also many other things that adrenal dysfunction can effect such as, thyroid defects, GI issues, liver detoxification dysfunction, brain function, weight gain, and cardiovascular issues; to name a few.

So how can you make sure that your adrenals are working properly?

• Avoid adrenal stimulators- caffeine, allergic foods, highly processed foods, sugar, chemicals, alcohol, nicotine, etc
• Manage blood sugar- eating a protein breakfast soon after waking, eating more small meals throughout the day instead of just 3 large meals, not skipping meals, and including a quality protein source at each meal
• Exercise- make sure you are not overtraining. Aerobic exercises are crucial for maintaining proper adrenal function.
• Relax- take time for yourself to de-stress; however works best for you.
• Sleep- get at least 7 hours of good, uninterrupted sleep each night

Let's see if fixing the underlying physiological issues in our body can help us to retire our snooze button.

Goodnight, ZZZZZZZZZZZZZZZZzzzzzzzzzzz

Pura Vida!

Alica Ryan, NTP