Stress, eat, repeat?

This BBC podcast is supported by ads outside the UK. At the BBC, we go further so you see clearer. Through frontline reporting, global stories and local insights, we bring you closer to the world's news as it happens. And it starts with a subscription to BBC.com. Giving you unlimited articles and videos, add free podcasts and the BBC news channel Streaming Live 24/7. Subscribe to trusted independent journalism from the BBC. Find out more at BBC.com/join. Does stress affect how you eat? Yes. All the time. It makes me eat more. Yeah, I come for eat, I don't save very mainly. So crisps, peanuts, things like that. It's my crutch. I think you're eating habits change because you don't have time to eat at the normal times. So you eat at the wrong times and you eat the wrong foods. You tend to eat more junk food, I think. I think you eat whatever's quick and easy rather than what you probably should eat. It's more fruit and veg and things, but I suppose it's a speed and ease of accessing. And how do you feel after you've eaten it? Probably a bit guilty, yeah. I think I eat more when I'm stressed. I think I stress eat. It calms you down a little bit, don't you? What kind of things do you go for when you're stressed? Not the good stuff, the crisp, the chocolate, mainly chocolate, a bit of ice cream. Does it do the job? It does. Would you percent? This is the food chain from the BBC World Service. I'm Ruth Alexander, and this week we're exploring how stress affects your appetite, why it happens, what it does to your body, and what you can do about it. So let's meet our guests. My name is Rajita Sinha, I'm a professor of psychiatry and neuroscience and child study at the Yale University School of Medicine, which is a new haven Connecticut in the USA. I'm also director of the Yale Interdisciplinary Stress Center, which is one that we started now over a decade and a half ago, to really look at the stress biology and its impact on our behaviors and our health and on stress-related illnesses and outcomes. What got you interested in stress in the first place? My work ever since I was in graduate school was on emotions and the interaction of emotions with cognition in the brain. And emotions, when I was in school, was very much a thought of as a mind thing, and really it's a whole body and mind thing. And so I got very interested in the idea that we needed to study this in a way that would really target the interactions between the brain and the body and back for the whole person, and that's what got me started. And Mitu, would you tell us a little bit about yourself, please? My name is Mitu Sterone, I have a background in near ophthalmology and neuroscience research. And I'm also the author of Stress Proof and High Proficient and writing these books were the source of my interest in stress. What made you want to write them in the first place? So during my time as a near ophthalmologist, actually here in London, I was exposed to lots of cases of autoimmune conditions, such as multiple sclerosis, autoimmune conditions that affect the nervous system. And when talking to patients, of course, you record and recognize all the factors that play a part in the disease. But invariably, most patients would mention something like, "Oh, I had a very stressful summer or stressful event, and that led to relapse." And then I realized that actually stress is this formless thing that's clearly playing a role in all of these conditions, but we're not really grasping what it's all about. And let's start with the very basics, then. What is stress, Regina? What stress is really your body and mind's response to challenging and overwhelming situations that in the moment, you may feel like you can't do anything about it. Very simply, situations in environmental triggers, like events, can get it going. However, there are internal things that can get it going as well, like our thoughts and anxieties, what we consume in our body. And it changes in our body that may signal a distress state, like sleep deprivation, for example, or thirst, or extreme hunger. It can challenge our very robust stress biology, which we do have. That is really our alarm system, which we've known for a long time. It's what tells the body right from the cells, every cell in our body to our mind that something's not okay. What happens inside our bodies then when we're stressed? The purpose is really to help us adapt, right? You might feel your heartbeat faster. So there are lots of what we call stress signals that get triggered. And then there is a cascade of events that occur as a function of that, which also allow us to think about doing something in response to that stress. That's your acute stress response. That's not chronic stress. That's the acute stress response. And the goal there is, of course, to adapt, right? Acute meaning, that's how we respond to a kind of one-off situation. Chronic stress, though, is your kind of long-term everyday stress that people sometimes feel because of their situation or because, as you said, it could be that ill-health. Yes. Yes, that's exactly right. So acute would be something that's happening a sort of a one-off situation that's just occurred, like a boss is irritating you today at work. And those have their power. But then if it's a boss that is actually doing this to you every day, there's sort of repeated stressors that are occurring as a function of that one stimulus or that one trigger. That's when you've got chronic stress. That's when that can build into chronic stress. So I guess what the point I'm making is that we like to break it up into acute and chronic, but these can merge as well, right? The key features of those are that you have less control, so the uncontrollability of it and then the unpredictability of it. So the fact that you don't know what's going to come at you or when it's going to come at you and that you're not going to be able to do a whole lot to change it in that moment. And Mitu, what happens inside your body when you are under chronic stress? Stress really begins in the brain. When your brain perceives an environment or a situation that it feels it's not prepared for, it pushes a default button and that default button sets into play a whole range of pathways that prepare yourself for any kind of attack. And there are seven pathways, at least seven pathways that are affected, including, as Regina said, your emotional reaction, your immune system. You have an immediate inflammatory reaction at that moment. If you test your blood, you'll find a rise in inflammatory markers. You suddenly feel a surge in motivation. Your reward pathways become more active. You have this interplay of hormones of cortisol and so on, which actually happens a little bit later, but that's part of that access. And you also have other variables in there, including things that are happening to your circadian system. So these are all short-term, instant reactions. One of them also is relevant to our conversation today. You become momentarily insulin resistant. So there's a surge of blood sugar in your blood. All of these happen at the moment you have a sudden, instant bout of psychological stress. Now, all of these pathways are great in the short term, but you know, just because a little is good doesn't mean more is better. They don't have straight line linear effects, which means that if you keep the button down, what's beneficial often flips if the button is kept pressed down for too long. So for instance, if you have an acute bout of stress, you have a surge in motivation. And you can think of it as when our ancestors were running away from a lion or a woolly mammoth, you needed to want to run away. You didn't want to be the kind of person that said, "Oh, well, I'm just going to give up now. I'm going to sit under a tree and watch what happens. You want to run away." So you have that surge in motivation. But if you keep the button pressed down, you actually develop the opposite. Your motivation goes down. So people with chronic stress suffer from a decline in motivation, which then continue to contribute to things like depression and other things. That's one thing. Another thing that happens in chronic stresses, for instance, you have a surge of blood sugar in your bloodstream because you become temporarily insulin resistant. But we know that people with chronic stress actually develop insulin resistance. So they develop metabolic dysfunction. Again, we can see that if the button is pressed down for a short period of time, it's great, but if it's pressed down for too long, there's a malfunction. So other things associated with chronic stress are insulin resistance, chronic inflammation. So we know that a little bout of inflammation is actually protective. If you had an open wound, a little bit of inflammation would have protected you. But if that doesn't go away or if the button stays pressed down too often. So if you don't have any recovery, for instance, between two bouts of stress and the button just never gets itself turned off, at that point you start developing chronic inflammation. And really, when you develop chronic stress, what that actually does is your reaction to acute stress becomes abnormal. So why does stress seem to affect our appetite? Let's hear a bit more from people I've been speaking to while out and about in South Manchester, England. Oh, I always eat more when I'm stressed. I don't, I'm the other way. I feel almost too sick to eat, so I won't eat because I'll be kind of in like overdrive almost. I feel like I can't chew or focus on anything like that if I am really stressed. So it's like a vicious cycle because then I won't sleep because I'm stressed. So I will be more hungry, but then I can't eat food. So it will go on really until either whatever I'm stressed about is resolved or until I'm so hungry that I can't actually eat something. So yeah, it's a bit of a difficult one, yeah, yeah. And when you're stressed, you tend to eat more, you say? Yeah, I would say it's like, it's definitely like a coping mechanism. Short term distraction pleasure, that sort of thing. It's a distraction from fixing the problem of the stress, I guess. It doesn't ease the stress. Depends what the stress is, but I wouldn't say no, no, no, no, not necessarily. I feel like you're in a bit of a treat yourself mode. I have found that when there's been a stressful day in particular at work, I will go into the kitchen that is filled with treats and be like, right, okay, I need to have something because I deserve like sugar or whatever because that's kind of how it makes sense in my brain. I'm like, okay, I'm going to treat myself because I deserve it. And all the willpower goes out the window, right, right? Treat time, definitely. Personally, I think I'm a mix of the two. I can eat more if I'm stressed or sometimes it's kind of depending on the type of stress. If it's an emotional stress, I lose my upper tides. I wonder, can you too relate to what people were saying there? Absolutely. I mean, I remember when I was studying for my exams. I felt sick. I felt sick before an exam. And we of course now know that one of the reasons that this might happen is because there is a direct pathway between your gastroenterstinal system so between your stomach and intestines and your brain. And one of the things that happens during acute stress is something called vagal withdrawal. And that actually influences the motility in your gut. Different people will be affected in a different way. So for some people, this sort of problematic, this sort of dysfunction suppresses your appetite. But then on the other hand, we also know that the moment you get acutely stressed, your brain needs sugar. Your brain needs to make sure there is ample sugar around your body, really, just for itself. So because your brain wants to make sure of that, one of the things that does happen is we sort of reach for sugar. So those of us who don't have that knotted feeling to quite that extent, feel the need to reach for something to increase their fuel to cope with whatever life is throwing at them at that moment that they think they're not prepared for. So if you go to foods when you're stressed are sweet, high calorie carbs, don't beat yourself up about it. It's not your fault. We're just wired that way. Absolutely. The reason why we do it is not because we are weak. It's not because we don't have willpower. It's not because we're not disciplined. It really is because we are evolutionally wired to reach for fuel energy resources at times of danger. With sugar, actually, it's very interesting because if you are going through intense acute stress, so stress in the moment, then taking something sweet actually calms your stress response. And there are even studies that show that when taking people and putting them into a laboratory, giving them sugar, sweetened drinks versus artificial sweetened drinks, those with sugar, sweetened drinks actually end up having a slightly muted, slightly lower stress response to a bout of psychological stress that's been artificially induced. That said, should your experience of stress become chronic and should you do this frequently, you actually end up at high risk of developing a metabolic disorder. So at that point, this relationship between your brain and sugar consumption becomes abnormal. So it's best not to do that. Brigita. Yeah, I was going to say I just want to add to that. I think, you know, how much weight we carry around in our bodies actually changes our adaptation to stress as well. And that really has to do with how we're processing glucose and fuel. If you have high levels of glucose around and insulin is not doing its job to sort of break down glucose, then we have the condition of insulin insensitivity, even before you're fully insulin resistance. You have insensitivity. So you might have a lot more glucose floating around, but your brain isn't getting in as easily, right? And so there is a natural drive to do things that would increase the level of glucose. So if you're under stress over a prolonged period of time, you may be driven to eat more that may lead to weight gain, which will have a knock on effect on things going on inside your body, which may make you less able to cope with that stress that you're under. So it's a vicious circle. It is exactly a vicious cycle and we call it the feed-forward cycle, which is one thing leads to the other, and that then promotes the next thing that gets you stuck in that cycle. So it is a vicious cycle. It's harder to break because we do get stuck in it. Can you be suffering from chronic stress without knowing it? Absolutely. Absolutely. So as Riddy to set, when you're acutely stressed, we all recognize those instant sort of feelings. We recognize our hearts racing. We recognize, and maybe our hands shaking, the feeling of tightness in the stomach. But if you're chronically stressed, the signs or the symptoms to you can actually be very subtle. So for instance, you could in the long term become quite acclimatized to the fact you are under constant tension, but when you pop to see your doctor, they might notice your blood pressure is gradually rising, or they might notice your developing cholesterol abnormalities, or you might notice you're developing a little bit of fat around your middle. So these are signs that suggest that chronic stress may be at play. You're listening to the food chain from the BBC World Service. At the BBC, we go further so you see clearer. With a subscription to BBC.com, you get unlimited articles and videos, hundreds of ad free podcasts, and the BBC News Channel streaming live 24/7. From less than a dollar a week for your first year, read, watch, and listen to trusted independent journalism and storytelling. It all starts with a subscription to BBC.com. Find out more at BBC.com/unlimited. I'm Ruth Alexander, and this week we're looking at how stress affects our appetites and what you might be able to do about it. With Professor Rajita Sinha of the Yale Stress Centre and author and neuroscience researcher, Dr. Mitu Stironi. We've been talking about how stress can drive us to reach for unhealthy foods. But if you know you've got a stressful period coming up at work, say, could you prepare for that and eat a stress-busting diet? I asked Rajita. It's hard sometimes to control the sugar when you're under stress. That's true. For healthy or unhealthy, you know, for a range of us, we all can get it so cut up in the stressor that you might not pay as much attention to what you're eating. So I do think that preparing for a stressful period, there are a few behavioral things we like to suggest. For example, you know, keep things that are junk foods or unhealthy foods out of the house. Just not buying them. It's a very practical thing. Keep them out of easy reach. Out of easy reach because you are going to tend to reach out for them or feel tempted. And that can be hard. The other piece, I think, is to think about regular healthy small meals throughout the day. That can edge off this hunger and craving that your listeners may be thinking about. And so I think just some very basic things. The other piece of that is to make sure your social network is well set up. And that you're eating with those who are sort of thinking about healthy foods as well. And sort of in the same spirit, sort of working to what we like to think is break that connection. Between stress and our minds. There's, you know, people talk about having a food brain. And that food brain can be promoted under conditions of stress. So food brain, your mind is always on food and wondering off to think of, "Hmm, could there be some ice cream in the freezer?" Right. And what do I need? I need some comfort. We tell ourselves stories, right? And so I need some comfort. This bad period is coming. I want to make sure I have these things in place. And in fact, those are going to exactly be the triggers that might get you in trouble in terms of eating a little extra. I mean, eating can be very sneaky. Without even realizing we can eat more than we had wanted, even if it's small quantities of it. And so, and then it just sort of again builds one thing leads to the next. And so there are some basic practical things I think that could be of help. Mitu. Well, one of the things I'd suggest for preparing for a period of chronic stress is, or preparing for a period of stress, even if it's not chronic, is really, really focusing on sleep as a major factor. Simply because sleep resets the trio of organs that are involved in the stress reaction. Also, if you are sleep deprived, all the cravings, the need for more food, the need for sugary food, is actually amplified because sleep deprivation results in your brain requiring more energy, more fuel, or thinking it requires more energy, more fuel, because it's not functioning, it's not working as healthily as it should be. It's one of the reasons we reach for the wrong foods when we're stressed, that we actually have impaired decision making when we're feeling like this. With decision making and stress, what's so interesting is, because stress very, very generally is your brain pushing on a button, thinking it's not prepared for what is to come, so we're going to just be on default ultra, ultra preparation mode. Now, when it pushes on that button, there is a sort of a state change that takes place in the brain. So the prefrontal cortex, which is the part of the brain that is really key for thinking analysis, really planning ahead, and so on. And there is an interplay between the hormones and the chemicals we can say that are released during stress, in that as soon as you start becoming a little bit wired, or a little bit jittery, the concentration of these hormones become high enough to actually take this part of the brain offline through a very interesting interplay of receptors. So really, if you want to prepare for a period of stress, trying to do all the things that keep your baseline absolutely normal and keeps the prefrontal cortex engaged is one of the other ways in which you can prepare. So sleep is a great thing, the second thing is, of course, exercise, because exercise ensures or it improves autonomic flexibility. You also have myocaine release, which helps your brain function, and all of these go to helping the part of the brain that's responsible for decision making. Stay active, stay engaged, and play a role. Problem is, of course, when you're stressed, you're often short on time, and some of these things are easiest said than done, aren't they? But could you give us an idea of which foods might be considered stress busters? Which foods should you get in your fridge and your freezer if you want food to be part of your arsenal against stress? That's a great question. I think foods that don't do glucose spikes are very important. So, for example, sugary foods will give you a glucose spike. High carb foods will give you glucose spike. So pizza, for example, will do that. Protein, rich, or carbs that are healthy carbs, lentils, whole grain foods, the Mediterranean diet, for example, as people talk about, and as has been shown to be helpful in part of a healthy diet. Me too. Yeah, now I bring in two things here. I would bring in, first of all, when you're preparing for the stressful experience. I would also bring in the root of circadian rhythmicity. So, we know about cortisol. We know that we release cortisol when we are stressed. But cortisol actually has a 24-hour rhythm. And there's a small spike in the morning, and then that gradually goes down. If you eat in the evening, you release cortisol after every meal, regardless of what you eat. But if you eat in the evening, you're getting this abnormal cortisol spike, and that is feeding into your circadian rhythm and distorting it. So, looking ahead to when you are going to be stressed, I would suggest really, really trying to observe meal times, which are in line with your circadian rhythm. So, eating at the right times of the day. And knowing everything, you both know about stress, our bodies, and the foods we go for, and the foods we should go for. Do you actually manage, in those stressful moments, to resist the primeval urges and to eat well? Do you do it? Well, I certainly try, but I'll also be the first to admit that I've found my hand in the freezer before I've known it. And it would be with the carton of ice cream, right? And so, I think there are things you can do to keep yourself in check, and being aware and engaged is really important. And I do that every day. I try to do that every day. But a lot of what I'm talking about, food being sneaky, I've cut myself feeling that. Well, look at that. I just had that extra bite. I didn't need it. I think I've eaten food before, but I only realised I've kind of done it afterwards in these stress moments. I think I take the approach that it's okay, but prepare, prepare, prepare. So, use the, you know, the older Darje off, make hay while the sunshine. So, whenever I'm not in a period of stress, I do absolutely everything possible to make sure my metabolism is okay, and then, you know, to do all the right things, not do any of the wrong things, exercise, sleep, looking at what I'm eating. And then I know that if I do slip up during periods of stress, it's okay. I've built resilience, and I try to reenter that as soon as possible. So, it's more sort of a forgiveness that I've learned to develop. And really making absolute use of the times when I'm not stressed to make sure my baseline is as optimal as possible. Well, that feels like really good news. Regita, you're nodding too. That's right. I think that's a great way of thinking about it. I love that, me too. It's so important to take it every day. You might trip up, and that's okay. And the important thing, I would just, the forgiveness is such a nice concept. The other thing is, when your mind goes to those anxiety thoughts about screwing up, don't give yourself a hard time about it. Even if, you know, it is what it is. It's already happened. You look ahead. Thank you. Enjoy the ice cream and move on. That's right. Professor Regita Sinha and Dr. Mitties Daroni, do you have your own tips for keeping stress and its effects under control? Let us know by emailing the [email protected]. From me and the rest of the team, producers, Beatrice Pickup and Izzy Greenfield and editor Sarah Wadeson. Thanks for listening and join us again next week. [Music] At the BBC, we go further so you see clearer. Through frontline reporting, global stories and local insights, we bring you closer to the world's news as it happens. And it starts with a subscription to BBC.com. Giving you unlimited articles and videos, add free podcasts and the BBC news channel Streaming Live 24/7. Subscribe to trusted independent journalism from the BBC. Find out more at bbc.com/join.