Goals of diet therapy in stress management

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Stress, Nutrition and Diet

See also: Workplace Stress

When we encounter something stressful, our nervous system and adrenal glands send signals to the rest of the body to help us think more clearly and be ready for a physical response – should it be required. 

This is a basic instinct that we have evolved to help us cope with potentially dangerous situations and is known as the “fight or flight” response.

However in modern life we can become stressed for many reasons other than impending danger and yet our bodies’ reaction is the same.  With their pre-determined instincts, our bodies’ still prepare our minds in this instinctive way and give less priority to other, less urgent, functions. 

Digestion is one such function that is given a lower priority during stressful situations, this is not good as poor digestion can make us feel unwell and this in turn can be a source of stress.

Chronic (long term) stress has been linked to the tendency of the body to store fat around the middle (stomach).

Poor stress-management, for some people, is perhaps the most significant barrier to weight loss.

Being aware of how your body works and deals with stress can help you to manage stress and stressful situations. After a stressful period the human body can go into a ‘recovery mode’ where increased appetite and food cravings become more prevalent. At the same time metabolic rates drop to conserve energy. Being aware of these patterns can help you manage your stress levels and through nutrition and diet you can help your body recover from stressful periods more rapidly and minimise negative effects such as weight gain.

Tips for Reducing Stress Through Diet

On Stressful Days, Eat Little and Often

This will keep your metabolism ticking over all day and you will minimise peaks and troughs in energy levels.

Eat breakfast, even though you may not feel hungry or believe you do not have enough time. Eating breakfast helps to kick start your metabolism for the day and also helps to stabilise your blood sugar level which will in turn reduce stress. Choose fruit or fruit juice and a whole-grain cereal for maximum benefits.

Eat Well Throughout the Day

Make sure you eat at least five portions of fruit and vegetables each day and focus on foods containing Vitamins B and C, and Magnesium:

• B Vitamins can help you feel more energetic after a stressful episode. Bananas, leafy green vegetables, avocados, nuts, seeds and also meat, fish and dairy products all contain essential B vitamins.

• Vitamin C – The adrenal glands contain the largest store of vitamin C in the body and are important in the production of stress hormones.  Eat citrus fruit such as oranges, tomatoes, peppers, kiwi fruit, leafy green vegetables, broccoli and other foods rich in Vitamin C.

• Magnesium – Can help to relax muscles and reduce anxiety. Increase your magnesium intake by eating nuts, especially Brazil nuts, but also hazelnuts and peanuts. Leafy green vegetables, whole grains, especially oats, brown rice and beans are also good sources of magnesium.  You can also take a relaxing bath with a good handful of Epsom salts (available at your pharmacist) as these contain magnesium that can be absorbed through your skin.

See our pages: Vitamins and Dietary Minerals for more detailed information about vitamins and minerals.

As well as trying to maximise your intake of certain foodstuffs, you should also be aware of the negative effects of others and therefore try to minimise them.

Caffeine

Caffeine is found mostly in coffee, tea, some soft drinks and chocolate, can have negative effects on the body if taken in high quantities.  Try to wean yourself off caffeine by substituting coffee or tea with decaffeinated versions, herbal tea, or green tea (which is also full of antioxidants).  Substitute sugary and caffeinated soft drinks with sparkling water or (preferably diluted) fruit juice and you will reduce your caffeine and sugar intake.  Since caffeine can stay in your body for six hours or more, avoid all caffeinated drinks after lunchtime and you will sleep better. Getting adequate sleep is an important factor in reducing stress levels.

Alcohol, Sugar, Salt and Nicotine

You should aim to reduce your intake of alcohol, sugar and salt. Consumption of these items are all known to strip the body of essential nutrients and undo the work of a healthier diet. Stop smoking! Although reaching for a cigarette may feel like instant stress relief it actually causes greater stress over time.

By watching our diet, increasing our intake of stress-busting nutrients and limiting our intake of stress-inducing substances we can feel better about ourselves and our well-being, as well as give our bodies the chance to cope with, and recover from, stressful situations.

Other Stress-Busting Techniques:

Exercise:

Even some gentle exercise can help reduce stress levels and combined with a healthier diet will probably lead to weight loss. Yoga and tai chi are particularly good, as is swimming. Take time to relax.  Breathing exercises, meditation and yoga will all help reduce stress.

See our page: The Importance of Exercise for more information.

Relax:

Take time out to relax. You may feel as though you have to force yourself to relax if you are not used to it but it is worth the effort. Learning to relax can help you manage your stress more effectively.

See our section: Relaxation Techniques for more information.

Sleep:

Make sure you get sufficient and quality sleep. Eating healthier and avoiding excessive caffeine will help you sleep well and for longer periods.

See our page The Importance of Sleep for more information. You can assess your levels of daytime sleepiness with the Epworth Sleepiness Scale.

Socialise:

Spend time with friends and family, talk to them about problems you are having and find time to laugh together. Simply talking and interacting with others can help relieve stress and boost self-esteem.

See our: Improving Self-Esteem page for more information.

Get help:

If you are experiencing a lot of stress over a long period of time, or are at all worried about how stress is affecting you, then seek help. See your doctor who may recommend a counsellor or some alternative stress relief techniques such as massage, acupuncture or alternative medicine.

You may find our page: What is Counselling? useful.

If you are experiencing stress in your workplace, speak to your line manager or human resources department.

Also see our page: Workplace Stress.

Further Reading from Skills You Need

The Skills You Need Guide to Stress and Stress Management

Understand and Manage Stress in Your Life

Learn more about the nature of stress and how you can effectively cope with stress at work, at home and in life generally. The Skills You Need Guide to Stress and Stress Management eBook covers all you need to know to help you through those stressful times and become more resilient.

Nutrition and Stress

Too rushed or stressed to eat well? Think again!! Good nutrition is an important stress management tool. When our bodies are poorly fed, stress takes an even greater toll on our health. Nutrition and stress are interlinked. Here are some tips to eat well for academic success:

1. Eat regularly. Your brain needs glucose to work at its best. Eating regularly throughout the day helps keep your blood glucose stable. Studies have shown that more stable blood sugar levels are associated with better academic performance.
2. Get your unsaturated fats. Omega-3 fatty acids found in walnuts, flax seed and fish oil are associated with brain function. Deficiencies of this fatty acid can result in depression and/or anxiety.
3. Eat your veggies. Fruits and vegetables contain vitamins and minerals like copper, zinc, manganese, and vitamins A, E and C. Leafy greens are especially good for you. These vitamins and minerals work to neutralize harmful molecules produced when your body is under stress.
4. Add high-fiber foods. High fiber intake has been associated with greater alertness and decreased perceived stress. So add fiber-rich foods like oatmeal, nuts, beans, fruits and vegetables to your diet.
5. Trade caffeine for more sleep. Caffeine leads to increased blood pressure and may make you anxious, especially if you are already prone to anxiety. While consuming caffeine may seem to help you concentrate better, some studies show that caffeine only restores what is lost through lack of sleep. Instead of turning to caffeine, try the natural grade booster – sleep!  
6. Stock up on nutrient-dense snacks. If you know that a stressful or busy time is approaching, prepare by stocking up on quick, healthy snacks. Aim to incorporate two food groups at snack time. Some examples are granola with yogurt, almonds and pretzels, carrots with hummus or a cheese stick with fruit.

Remember…
How you deal with stress matters. Sometimes people turn to unhealthy coping mechanisms such as eating/not eating, drinking excessive amounts of alcohol, etc. These are short term solutions that can create long term problems. Aim to be consistent with the basics of eating well, moving your body, getting adequate sleep, and enjoying your free time. Use constructive coping mechanisms like talking with someone you trust, journaling, meditating, etc. If stress continues to negatively impact your quality of life, consider getting help.

Stress is a common problem in most societies. There are three main types of stress that may occur in our everyday lives: acute (a brief event such as a heated argument or getting stuck in a traffic jam), acute episodic (frequent acute events such as work deadlines), and chronic stress (persistent events like unemployment from a job loss, physical or mental abuse, substance abuse, or family conflict). Many of us may experience a combination of these three types.

Our bodies react to all types of stress via the same mechanism, which occurs regardless if the stress arises from a real or perceived event. Both acute and chronic stressors cause the “fight-or-flight” response. Hormones are released that instigate several actions within seconds: pumping blood and oxygen quickly to our cells, quickening the heart rate, and increasing mental alertness. In prehistoric times, this rapid response was needed to quickly escape a dangerous situation or fight off a predator. However all types of stress can trigger this response, as described in more detail below:

• A very small region at the base of the brain, called the hypothalamus, sets off the reaction and communicates with the body through the autonomic nervous system (ANS). This system regulates involuntary responses like blood pressure, heart rate, breathing, and digestion. The ANS signals nerves and the hormone corticotropin to alert the adrenal glands, located on the top of each kidney, to release a hormone called adrenaline into the blood. [1]
• Adrenaline (also known as epinephrine) quickens the heart rate and increases blood pressure so more blood circulates to the muscles and heart to support a boost of energy. More oxygen in the blood is available to the heart, lungs, and brain to accommodate faster breathing and heightened alertness. Even one’s vision and hearing may become sharpened.
• If stress continues, the adrenal glands release another hormone called cortisol, which stimulates the release of glucose into the blood and increases the brain’s use of glucose for energy. It also turns off certain systems in the body to allow the body to focus on the stress response. These systems include digestion, reproduction, and growth.
• These hormones do not return to normal levels until the stress passes. If the stress does not pass, the nervous system continues to trigger physical reactions that can eventually lead to inflammation and damage to cells.

With acute stress, the event is brief and hormone levels will gradually return to normal. Acute episodic and chronic stress repeatedly trigger the fight-or-flight response causing a persistent elevation of hormones, leading to a risk of health problems: [2]

• Digestive issues (heartburn, flatulence, diarrhea, constipation)
• Weight gain
• Elevated blood pressure
• Chest pain, heart disease
• Immune system problems
• Skin conditions
• Muscular pain (headaches, back pain, neck pain)
• Sleep disruption, insomnia
• Infertility
• Anxiety, depression

How Chronic Stress Affects Eating Patterns

Chronic stress can affect the body’s use of calories and nutrients in various ways. It raises the body’s metabolic needs and increases the use and excretion of many nutrients. If one does not eat a nutritious diet, a deficiency may occur. [2] Stress also creates a chain reaction of behaviors that can negatively affect eating habits, leading to other health problems down the road.

• Stress places a greater demand on the body for oxygen, energy, and nutrients. Yet people who experience chronic stress may crave comforting foods such as highly processed snacks or sweets, which are high in fat and calories but low in nutrients. [3]
• People feeling stress may lack the time or motivation to prepare nutritious, balanced meals, or may skip or forget to eat meals.
• Stress can disrupt sleep by causing lighter sleep or more frequent awakenings, which leads to fatigue during the day. [4] In order to cope with daytime fatigue, people may use stimulants to increase energy such as with caffeine or high-calorie snack foods. The reverse may also be true that poor-quality sleep is itself a stressor. Studies have found that sleep restriction causes a significant increase in cortisol levels. [4]
• During acute stress, the hormone adrenaline suppresses the appetite. [5] But with chronic stress, elevated levels of cortisol may cause cravings, particularly for foods high in sugar, fat, and calories, which may then lead to weight gain. [5,6]
• Cortisol favors the accumulation of fat in the belly area, also called central adiposity, which is associated with insulin resistance and an increased risk of type 2 diabetes, cardiovascular disease, and certain breast cancers. [5,7-9] It also lowers levels of the hormone leptin (that promotes satiety) while increasing the hormone ghrelin (that increases appetite). [3]

Tips to Help Control Stress

• Healthy diet. A balanced diet can support a healthy immune system and the repair of damaged cells. It provides the extra energy needed to cope with stressful events. Early research suggests that certain foods like polyunsaturated fats including omega-3 fats and vegetables may help to regulate cortisol levels. [10] If you frequently rely on fast food because you are tired or too busy to prepare meals at home, consider meal planning, a practice that can help save time in the long run, ensure more balanced healthful meals, and prevent weight gain.
• Mindful eating. When we “stress-eat,” we eat quickly without noticing what or how much we’re eating, which can lead to weight gain. Mindful eating practices counteract stress by encouraging deep breaths, making thoughtful food choices, focusing attention on the meal, and chewing food slowly and thoroughly. This increases enjoyment of the meal and improves digestion. Mindful eating can also help us realize when we are eating not because of physiological hunger but because of psychological turbulence, which may lead us to eat more as a coping mechanism.
• Regular exercise. Physical activity will help to lower blood pressure and stress hormone levels. Aerobic exercise like walking and dancing increases breathing and heart rate so that more oxygen reaches cells throughout the body. This reduces tension in muscles, including the heart.
• Meditation or deep breathing techniques. Fast, shallow breathing and erratic thoughts occur in response to stress. Therefore, take slow deep breaths to reduce muscular tension, lower the heart rate, and calm the mind. Whenever you feel stressed, breathe slowly, focusing on each in- and out-breath. Through this simple act, your parasympathetic nervous system kicks in and can help you calm down. If you’d like some guidance, try this short mindful breathing exercise. Additionally, certain exercises like yoga and tai chi emphasize deep breathing and a focused mind.
  • Research has also found that meditation training may lengthen or prevent the shortening of protein structures called telomeres. [11] Telomeres generally shrink in length with age and in those experiencing chronic stress; this can lead to the death of cells and inflammation, which is associated with an increased risk of age-related dementia and cardiovascular disease. Meditation practice has been associated in some studies with greater telomere activity and length in response to a reduction in anxiety, chronic stress, and cortisol levels.
• Mental health counseling or other social support. Feeling alone can add to stress. It can help to talk through feelings and concerns with a trusted individual. Often, just realizing that you are not alone and that your feelings are not unusual can help lower stress.
• Practicing work-life balance. Use vacation and personal time, or just set aside an hour a day. A periodic escape from the pressures of work can do wonders to reduce stress, increase productivity, and decrease the risk of physical and mental illnesses that are associated with workplace burnout.
• Schedule fun activities or hobbies at least once a week. Gardening, reading, enjoying music, getting a massage, hiking in nature, and cooking a favorite recipe are examples of welcome stress relievers.
• Good sleep hygiene. Stress can cause a heightened sense of alertness, which delays the onset of sleep as well as cause interrupted sleep throughout the night. This can prevent one from entering the deeper sleep stages in which the body repairs and grows tissue and supports a healthy immune system. The REM (rapid eye movement) sleep stage in particular helps with mood regulation and memory. Aim for 7-9 hours of sleep a night by slowing down about 30 minutes before bedtime. Controlling stress through the other tips listed above can also improve sleep quality.

References

1. Waxenbaum JA, Reddy V, Varacallo M. Anatomy, Autonomic Nervous System. [Updated 2020 Apr 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539845/
2. Gonzalez MJ, Miranda-Massari JR. Diet and stress. Psychiatric Clinics. 2014 Dec 1;37(4):579-89.
3. Sinha R. Role of addiction and stress neurobiology on food intake and obesity. Biological psychology. 2018 Jan 1;131:5-13.
4. Geiker NR, Astrup A, Hjorth MF, Sjödin A, Pijls L, Markus CR. Does stress influence sleep patterns, food intake, weight gain, abdominal obesity and weight loss interventions and vice versa?. Obesity Reviews. 2018 Jan;19(1):81-97.
5. Torres SJ, Nowson CA. Relationship between stress, eating behavior, and obesity. Nutrition. 2007 Nov 1;23(11-12):887-94.
6. Chao AM, Jastreboff AM, White MA, Grilo CM, Sinha R. Stress, cortisol, and other appetite‐related hormones: Prospective prediction of 6‐month changes in food cravings and weight. Obesity. 2017 Apr;25(4):713-20. *Multiple authors report funding disclosures.
7. Huang T, Qi Q, Zheng Y, Ley SH, Manson JE, Hu FB, Qi L. Genetic predisposition to central obesity and risk of type 2 diabetes: two independent cohort studies. Diabetes Care. 2015 Jul 1;38(7):1306-11.
8. Harris HR, Willett WC, Terry KL, Michels KB. Body fat distribution and risk of premenopausal breast cancer in the Nurses’ Health Study II. Journal of the National Cancer Institute. 2011 Feb 2;103(3):273-8.
9. Dale CE, Fatemifar G, Palmer TM, White J, Prieto-Merino D, Zabaneh D, Engmann JE, Shah T, Wong A, Warren HR, McLachlan S. Causal associations of adiposity and body fat distribution with coronary heart disease, stroke subtypes, and type 2 diabetes mellitus: a Mendelian randomization analysis. Circulation. 2017 Jun 13;135(24):2373-88.
10. Soltani H, Keim NL, Laugero KD. Diet Quality for Sodium and Vegetables Mediate Effects of Whole Food Diets on 8-Week Changes in Stress Load. Nutrients. 2018 Nov;10(11):1606.
11. Conklin QA, Crosswell AD, Saron CD, Epel ES. Meditation, stress processes, and telomere biology. Current opinion in psychology. 2019 Aug 1;28:92-101.

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