It's Sabotage!

STRESS!!!

You're eating paleo-style, working out regularly, trying to be a good citizen, and you're still gaining or can't lose that stubborn weight.  What gives?  What sinister force so deviously undermines even our most carefully planned health and fitness strategies?  That's right, our old friend Stress.  It has been with us since the beginning and plays a useful role in our fight or flight response; however, stress today is ever-present.  Like hyperinsulinemia (perpetually elevated insulin), stress levels are a serious threat to our health and normal metabolic functioning.  Let's chip away at this humungous topic and try to come up with some anti-stress strategies.  Ready for an opus?  Here we go!

Stress Produces Cortisol

Cortisol is a hormone antithesis of insulin--it brings sugar back into your bloodstream.  It is catabolic, which means it breaks down protein in muscle to release glucose back into the bloodstream for quick energy.  Catabolism = breaking down; anabolism = building.  For the nerds amongst you, here's a trick I used from my biology undergrad days: catabolism is for cats and anabolism is for ants.  Need an image?  Think of carnivorous cats tearing into the flesh of their prey as opposed to ants busily building ant hills or anabolic steroids building muscle mass to protect against becoming a "Girly Man."  I know a little something called CrossFit that produces surprisingly similar results with real world functionality! ;)

Want to know more about the mechanics of stress?  Dr. Eades, author of Protein Power, gives a good overview of the specific biochemical process of being stressed.

Cortisol is a vital hormone necessary to your survival.  The roles it plays are both good to deal with the stress event and bad if perpetuated.  Cortisol mobilizes your body to deal with stress, so everything it does is for that purpose, at the expense of normal body functioning.  Everything is give and take.  This is why prolonged elevated cortisol levels are a bad thing.  The cascade continues and body functioning cannot return to normal.  This is bad because it breaks down muscle and plays a role in repositioning fat to visceral/abdominal areas (the kind that correlates with nasties like diabetes).  It can also blunt your sensitivity to insulin, increase insulin resistance, create hypertension (high blood pressure), impair kidney function, suppress your immune system, impair fertility and threaten pregnancy, reduce growth hormone, and reduce the strength of connective tissues (like the loss of collagen from skin).  Yikes.

Need a more personal example of the ravages of cortisol?  Adrenal fatigue.  Think it can't happen to you, think again.  A normal mother of two hit an adrenal wall and it nearly killed her.  Here is her story posted by Organic & Thrifty: Part 1, Part 2, and Part 3.  Yes, it is extreme, but it is real.  Better than just a long list of scary terms that could happen.  Here is another more scientific, but still personal exploration into adrenal fatigue from Animal Pharm author Dr. B G, a pharmacologist.

So we've learned that you NEED cortisol, you just don't always need it sky high.  Cortisol can spell ruin for even your most carefully planned low-carb, blood sugar regulating diet if you stress out.  I am not going to go into ALL the ways you can find stress in your life.  You know what makes you stressed--basically anything and everything.  Most of us are Bisy Backsons a la Tao of Pooh, basically always on the go ('Bisy Backson' is a term defining the perpetually busy person.  It comes from a note left by a hurried Rabbit always on to the next Important Thing telling Pooh he was busy and would be back soon).  What we DO want to figure out are ways to keep cortisol in check when it starts to creep up and stay up.

Ways to Manage Cortisol


So you want to maintain cortisol levels that aren't too high all the time and don't dip too low either, since that isn't a good thing either.  There are a few ways to do this:
1.  Stress-reducing Strategies
2.  Nutrition
3.  Supplementation

1. Stress-Reducing Strategies to Reduce Cortisol

This is important.  In fact, these are the most important ways you can reduce cortisol.  You need to combat stress at its roots, not put a bandaid on it afterwards.  Here are some ways and sources for more information.

• Just Breathe

Go ahead, it works.  Take a deep breath and let it out slowly.  Center yourself and feel yourself rise to meet the challenge.  This reminds me of something I learned in public speaking: touch your fingers together to feel the comfort of connecting to yourself for strength and support.  You got this.

• Get Ye To Nature

Yes, the hippie shit works, pardon my language.  If you haven't stopped to breathe and listen in the woods, you are living an artificial life cooped up in your man-made cage.  Be in awe of that which is so much bigger than yourself.  Is the stress you feel really all that important to get so upset about?  Try to think bigger.

• Indulge in Massage

Pampering is a great way to feel alive and reduce stress.  Stress produces muscle tension that can lead to headaches and more problems.  Have someone release that tension through massage (and acupuncture like Beth Dorsey at Points for Wellness for Santa Cruzers).  Don't have a "someone," invest in a shiatsu pillow and heatable pillow like this.  Seriously, they work wonders and also cover the Take Time for Yourself provision below.

• Be Prepared 

Reduce your stress by preparing for it.  Do what you can to avoid it getting out of control.  Take notes, make lists, map directions beforehand, practice first, and assemble what you'll need.  Prepare for the situations ahead of you so that you will not be caught off guard.  You will be a cool cucumber in the face of challenge.

• Take Time for Yourself

For YOURSELF--not your family, friends, kids, spouse, pets, etc.  Spend some time with YOURSELF and get to know who you are.  Read a book, relax, go for a walk, meditate, stretch--just spend some time centering yourself and doing something for yourself.  Sometimes we feel pulled every which way and leave no time for ourselves.  Do yourself a favor and give yourself some ME time.

• Put It in Perspective

Yes, it seems overwhelming at times, but take a step back.  Are the dishes in the sink really something to get upset about?  I too have cried with frustration at the seemingly unsurmountable tasks ahead of me, but then I try to think bigger and put it in perspective.  In the whole scheme of things, does it really matter if I do the dishes now or let them sit so that I can preserve my sanity and reduce my stress?  Try to pick your battles and know that it is okay to not be Superman or Wonder-woman every day.

This applies to diet too.  I read a good quote from Paleochix the other day: 

“I eat Paleo to live better, I don’t live to eat Paleo better.”

Most of us are products of many years of bad eating and unhealthy habits.  It's within reason to expect our minds to want things that our bodies know isn't good for us.  There is also a whole world out there eating differently than we are.  This is life.  I say: cheat to keep yourself sane.  If you can be sane without cheating, congratulations--you're stronger than most of us!  If you need to cheat, make it matter.  If you try to keep your diet clean 80-90% of the time, then when you cheat, it shouldn't put you back to square one. 

Although critics may jump all over this recommendation--to them, I say: the results speak for themselves.  The results of the nutrition are improved health and performance--there is enough evidence from scientific studies and personal experience to say this with complete confidence.  "The results speak for themselves" also has a double meaning.  If you cheat hard, you'll fall hard; those results also speak for themselves.  Listen to your body and nourish rather than harm.  

It also helps when stressed to keep your nutrition in line as much as possible.  It is so easy for us to fall down the spiral of increased carbs, which spells more hunger, sleepiness, even depression.  Stress causing sugar cravings has been documented and researched, as summarized by Dr. Eades.  Instead of giving in to sugar (in its many carbohydrate forms), try to reach for healthy protein and fat for increased clarity, satiety, and satisfaction.  

• Get Some Sleep 

Screw the 7 hour minimum or the 9 hour maximum--get as much rest as you need and you need at least 8 hours.  Here is the CDC page on sleep.  And Mark's Daily Apple just had a great post on sleep too.  Sleep for Heart Health is discussed at The Heart Scan Blog.  I can't emphasize enough how important adequate sleep is or how out of whack we can make our bodies through artificial light and activities that disconnect us from the light-dark cycles we evolved upon.  Read Lights Out for more details and here is a study finding a link between cortisol-regulating gene expression in visceral fat being linked to circadian rhythms (our sleep-wake cycle).  Get the sleep you need in a dark room free from technology.  Period.  And invest in a comfy bed--it does wonders! (I know because I had been sleeping uncomfortably on a futon on the floor for the past six months.  Teaches me not to put off something that important...)

• Exercise and Play

Use exercise to fight stress.  For that hour or so YOU ARE FREE from your other life--it's just you, your body, and the workout, hopefully with some others to share the experience and help motivate you.  We were meant to move, not sit with our butts glued to chairs for hours upon hours on end.  Make exercise a part of your life--not a chore, but something you love.  Use trial and error to figure out what that something is.  Play like you are five years old again.  Do you remember what it is like to see lava between the stones of the front path or feel the giddiness of anticipation as you hide from your approaching seeker?  Find that feeling again.  

Check out CrossFit.  It's life-changing.  I CrossFit, and I left my 9 to 5 to teach CrossFit, so obviously I am sold.  There is something so invigorating about lifting heavy weight off the ground, on your shoulders or back, or overhead.  Just being able to move your body with some sense of awareness to time and space (send your butt back, stick your heels, activate your shoulders, find midline stability) is truly empowering.  You really get to know yourself and start thinking along the lines of what you can do rather than cannot.  :)

Note: DON'T OVERTRAIN.  That leads to more cortisol.  Take rest days--recovery is even more important than the workout.  The three days on, one day off or five on, two off with a week off every couple of months is the MAXIMUM for long term sustainability (for most people, freaks aside).  Many of us need to more regularly take rest days, and that is OKAY.  And please don't engage solely in chronic steady state aerobic training (i.e. endurance only) as discussed by Dr. Kurt Harris at PaNu, since it just elevates your cortisol and eats away your body.  Need proof, check out the physique of marathon runners versus that of short track runners--which would you rather be?

• Slow Down!

Don't be a Bisy Backson (from the Tao of Pooh).  Not that I endorse the "do nothing" strategy, but I think there is wisdom gained through understanding one's limitations and not being in constant motion flitting from one task to the next until crashing at night.  Take driving aggressively versus defensively.  I think racing to each traffic light, tailgating a millimeter behind another car's bumper, and weaving lane to lane to be a recipe for a heart attack if not an accident.  Why make your life so needlessly stressful?  Stress over the important stuff and live your life one moment at a time, not for some destination but the journey itself.  To illustrate, here is a great story by Chinese philosopher Chuange-tse from the Tao of Pooh:

There was a man who disliked seeing his footprints and his shadow.  He decided to escape from them, and began to run.  But as he ran along, more footprints appeared, while his shadow easily kept up with him.  Thinking he was going too slowly, he ran faster and fasters without stopping, until he finally collapsed from exhaustion and died.  

If he had stood still, there would have been no footprints.  If he had rested in the shade, his shadow would have disappeared.  

• Be Comfortable in Your Skin

Okay, this one is really hard for me and for most women and probably most men.  We are so caught up in what we "should" look like that we are never happy with how we do look.  This isn't to say that you shouldn't work towards a healthier you, just don't stress out about it.  If you constantly weigh yourself or obsess about food and your figure, how is that going to solve anything?  You are just producing more cortisol and laying on the abdominal fat.  If you haven't before, watch this Dove Commercial for what it really takes to be a model.  You'll be surprised.  Don't look outward for the perfect You, look inward.  Making yourself more calm, happy, and in control will shine through and make you beautiful.  


Bottom line:  Take these steps to reduce your stress and preserve your health and sanity for years to come!

Other Resources: 

Read more on what Zen To Fitness called Staying Out of Starvation Mode in their recent blog post.  

2. Nutrition to Regulate Cortisol

Obviously, proper nutrition sets you up for success.  It's the base of CrossFit's athletic pyramid for a reason (thanks CrossFit Peachtree for the image!) (Note: when I diagram it, I also include Sleep with Nutrition and after this post, I think I will add Stress-Reducing Strategies).  It is just common sense to eat what nourishes rather than harms (which is mostly foods we evolved upon).  We can quibble over the specifics, but eat paleo-style and watch your carbohydrate intake.  Try to keep your carbs low glycemic and low in quantity, except for veggies--go wild with those!  They'll add some important minerals (like magnesium and zinc) and vitamin C that help keep cortisol in check.

Post workout nutrition is a great time to harness the increased metabolic rate that will get protein to your cells to build and repair muscle stressed during the workout.

According to an article by Tom Venuto, author of Burn the Fat, Feed the Muscle (thanks Tara Grant for the link!):

Carbohydrate consumed with lean protein immediately after training has a cortisol suppressing effect. High glycemic index (GI) carbs in particular, cause an insulin spike, which not only helps restore muscle glycogen, stimulates protein synthesis and kick starts the recovery process, it also helps lower the exercise-induced rise in cortisol. 

Robb Wolf has more specifics to share (note: PWO means post workout):

The idea of a PWO meal containing carbs (and protein) is to take advantage of a period of time in which the muscles are particularly insulin sensitiveve. We can fly nutrients into the muscle “under the radar” via a mechanism called “non insulin mediated glucose transport”. Amino acids are also taken in during this time and may play a synergistic role in both glycogen repletion but also decreasing inflammation that accompanies hard training. Said another way, you recover from exertion faster. So, what should ya eat? We actually want a starchy carb as our primary carb. Yams and sweet potatoes are great options as they are also highly nutritious. Fruit should be used sparingly in this meal if one is focused on optimized glycogen repletion as fructose refills liver glycogen first, and once liver glycogen is full we up-regulate the lipogenic activity of the liver and start down the road towards fat gain and insulin resistance.

Of course, Robb does have a high-carb or low-carb post-workout discussion here, that contradicts the high-carb rule post workout.  For health and weight maintenance, Robb suggests a low-carb post workout (LC-PWO) meal with protein and fat primarily:

...part of what we want with this PWO meal is the MAINTENANCE of insulin sensitivity. If we totally top off our glycogen stores PWO we impair insulin sensitivity and make it damn tough to lean out. So, one way to look at this is the a LC-PWO meal is focusing on muscular recovery and growth, while minimizing or limiting the effects of insulin or carbohydrate. This is in stark contrast with what we will see in the case of the high carb PWO meal. From my perspective this is THE PWO meal of choice from a health promotion standpoint. 

The low-carb meal he suggests:

In this situation the PWO meal of whey protein + coconut milk is providing quickly digested protein which will reverse catabolic actions of training, with just a bit of fat to suppress the normal glucose release of a large protein meal via glucagon.

A big HOWEVER:

...although a low carb PWO meal is preferable for health, for longevity I think an OCCASIONAL HC-PWO meal is of benefit for a variety of reasons. Some of what I will cover in the book relates to two facts which seem at odds:

What is the metabolic profile most associated with EFFECTIVE aging? Answer: the ability to metabolize fat for energy.

What Helps to ensure this profile? OCCASIONAL bouts of glycolysis (large amounts of carbs).

To this end, once one is healthy, but following a low-carb approach drop in one HC-PWO meal every 5-7 days. Post burner is a perfect time.

Although confusing, this discussion is important to have since most sources just point you towards high glycemic carbs + protein post workout and never look back.  I suggest you read up on it to form your own decision.  Here is a great summary of post-wod nutrition information: CrossFit Santa Clara Nutrition.

Additional tools to reduce cortisol?  Limit your caffeine intake since it raises cortisol levels.  I'll pretend that doesn't include the teas I am totally addicted to ;)

3. Supplementation to Manage Cortisol

This is a grey area.  Supplementation can lead you down a slippery slope of dependency on the drug industry that has profit more in mind than your health.  I am definitely more inclined to find what I need through real, whole foods.

That being said, I am a proponent of fish oil supplementation since I buy into the arguments that we just cannot get enough from our diet and that it does so much good for our recovery and health.  Fish oil supplementation can aid your cortisol regulation because omega-3 fatty acids reduce cortisol levels.  According to one summary on cortisol supplementation:

In a number of clinical tests, fish oil has been shown to reduce cardiovascular risk in women and men. Preliminary research has shown that fish oil may help individuals cope with psychological stress and lower their cortisol levels. In a study published in 2003, researchers gave seven study volunteers 7.2 grams per day of fish oil for three weeks and then subjected them to a battery of mental stress tests. Blood tests showed that these psychological stressors elicited changes in the subjects’ heart rate, blood pressure, and cortisol levels. After three weeks of fish oil supplementation, however, the rise in cortisol levels secondary to stress testing was significantly blunted, leading the authors to conclude that supplementation with omega-3 fatty acids from fish oil “inhibits the adrenal activation elicited by a mental stress, presumably through effects exerted at the level of the central nervous system.”

This is yet another reason why fish oil supplementation is beneficial to your diet.  Check out my last post, the Starter Series: 3. Eat Fat for more information on fish oil.

Vitamin C is another way to reduce cortisol levels.  There is definitely something going on between cortisol and vitamin C--the vitamin seems to regulate cortisol and be involved in its production and regulation (so it can turn it on as well as off).  Here is one study showing a relationship between high cortisol and low ascorbate (vitamin C in the body).  Listen to this researcher's conclusion in Science Daily about vitamin C in our ancestral diet:

Recommending a sharper look at the present RDA, Campbell said he believes that our prehistoric ancestors probably consumed large amounts of vitamin C in a tropical diet rich in fruits. "If so, the physiological constitution we have inherited may require doses far larger than the present RDA to keep us healthy under varying environmental conditions, including stress."

Okay, nice to see they are looking into our evolutionary past, but I have to take some issues with this.

1.) Is a tropical diet rich in fruit really characteristic of our ancestral past?  Probably not.  We were on the move fast and fruit is seasonal, even in the wet/dry climates close to the equator.  Mark's Daily Apple just had an excellent post about fructose availability and seasonality--check it out!  He also painted the scene of our evolutionary stomping ground in this post, which wasn't a tropical paradise.

2.) Fructose isn't all that great for us.  Read Just Say No...To Juice? for more on that juicy topic.

3.) The mixed bag.  Sure, I'd love for people to switch to fruit to satisfy their sweet teeth, but massive consumption of fruit just leads you down the Always Hungry Carb Crash Zombie route--I know, I have been there.  So am I crazy to worry about a food pyramid that still places grains at the base and might endorse even more fruit in the diet (which, I might add are very hard to eat local and seasonally), which further tilts the seesaw in favor of carbohydrate at the expense of protein (inadequate as it is) and fat (relegated to the tippy top)?

Okay, back to the vitamin C story.  Vitamin C as you know from our Starter Series on veggies is present in our leafy greens, as well as our fruit.  So we can get a healthy dose from a rich, varied diet.  But is it enough?  Should we supplement?

Good questions.  I am still trying to find the answers myself.  I had been taking Emergen-C before bed to help regulate cortisol overnight.  I need to look more into the research here, but I read the recommendation from Robb Wolf, so I have tried it out.  I've read that cortisol hits a high before rising (our internal alarm clock) and after high stress like post-workout, so I am not 100% sure why take vitamin C before bed, except perhaps it helps keep levels in check overnight and reduce that morning spike.  Why not after a workout?  Updated 4/13/2010, according to Robb:

Keep in mind that food consumption etc will help blunt cortisol. Overly aggressive management of the inflammation can actually undermine some of the benefits of training. vit-c can be used acutely to reduce cortisol but PWO may not be the best time. Pre-bed to help relax, or during the day to help with chronically elevated cortisol is good to go. 

Until now I have looked past the plethora of processed, corn-derived products on the label of Emergen-C, but they have been eating away at me for a long time.  Updated 4/13/2010: I just switched to buffered Vitamin C, 1000mg.  I am trying out taking it before bed and with breakfast--I'll see how that goes.  UPDATED 4/14/2010: With the need for morning cortisol to keep me awake til lunch, I am not taking it at breakfast anymore, since breakfast is already lowering levels and the berries I have already have vitamin C, so any more is overkill and might lead me down the path of sleepiness.  Trial and error at work!

I have to share an interesting snippet from an online article on adrenal fatigue by Dr. Rodger Murphree:

Individuals with low adrenal function are usually not hungry when they wake up. They instead rely on chemical stimulants (coffee, sodas, cigarettes, etc.) to get them going. These stimulants raise blood sugar levels as well as serotonin levels. However, these stimulants also increase adrenaline and cortisol levels. This curbs their appetite even further. However, the body needs to break the eight hour fast (breakfast) it has been under. The brain especially needs to fed; forty percent of all food stuff fuel goes to maintain proper brain function. This is one reason a person may have problems with “Fibro fog” and mood disorders (anxiety and depression).

Cortisol levels are at their highest around 8:00 a.m. A person may be hypoglycemic (low blood sugar) and their cortisol levels will be extremely high in the morning. They may feel nauseated, mentally and physically drained, jittery, suffer from headaches, and eating is the last thing they want to do. They need to eat anyway! A small snack (avoid simple sugars) is all they need until hunger comes, usually a couple of hours later. Then they should eat another balanced snack to tie you over until lunch. They should never skip lunch! It’s best to eat little meals throughout the day.

Note: I don't fully endorse the article or multiple meals throughout the day.  I believe intermittent fasting can be beneficial too and with low carb intake, you don't need many small meals because you are fat-fueled, not tied to the whims of carbohydrate-induced blood sugar spikes (for more on the dangers of eating too often on a low-carb diet read Primal Wisdom's post--this is so good I may have to devote an entire post to it!).  However, that part I quoted is something I can identify with--at least in the past.  I hated eating breakfast and now that it is back to routine for me, I enjoy it and look forward to it, even if I am not ravenously hungry.

In addition to the summary article above, here is another article from Think Muscle describing more possible supplements, and another from Whole 9 specifying CrossFitters; HOWEVER, make sure you also read this article by Tom Venuto (cited above too) on if we even need supplementation for cortisol maintenance in the first place.  For now, I think I might let the vitamin C run out and do away with it, see what happens.  I am really reluctant to supplement beyond the fish oil, vitamin D, and B-complex (the last one is probably unnecessary).

What do you think?  I'd love to hear reader opinions and experiences!  So how are you going to take steps to reduce your stress?

References used extensively:
http://www.ironmagazine.com/article154.html

http://en.wikipedia.org/wiki/Cortisol

http://www.thinkmuscle.com/ARTICLES/jalali/cortisol.htm