The Stress Solution Read online

  But there’s a problem with restricting FODMAPs for too long. It means we’re not giving our gut bugs the healthy foods they need. While it controlled Belinda’s symptoms, every time we tried to introduce healthy but high FODMAP foods back into Belinda’s diet her symptoms would get worse. It was only when I added meditation and deep breathing to her routine that she was able to start eating the alphabet again. Belinda is still doing well to this day, but it was only when I tackled her diet and her stress that her threshold moved. That calmed the whole system down, she dropped beneath her stress threshold, and then I was able to start expanding her diet, which gave her more resilience and a greater buffer against MSDs.

  SEVEN FOOD-RELATED TIPS THAT WILL IMPROVE YOUR GUT HEALTH

  1. When you are eating out, try something new from the menu. This will help to diversify your diet and help you eat the alphabet.

  2. Look for new foods to buy. When in the supermarket, be on the lookout for a type of fibre-rich plant food that you have never tried before.

  3. Give yourself a twelve-hour window every day without food, for example, if you finish your evening meal at 7 p.m., don’t have your breakfast until 7 a.m. the next day. (See here for more information on time-restricted eating.)

  4. Try to limit eating snacks between meals – research suggests that our gut bugs thrive when they get a break from food. A new set of gut bugs comes in and cleans up the gut wall.

  5. Skip a meal now and again. We do not need to eat three meals a day. Many of us do very well on only two. If you’re not feeling hungry, don’t eat. It is not harmful to miss breakfast, or dinner, now and again. If you are on medications that can lower your blood sugar (e.g. gliclazide for type 2 diabetes) it is best to discuss with your doctor.

  6. Eat fermented foods such as kimchi, sauerkraut or kefir. These are foods that introduce beneficial bacteria into your body, thus improving your gut health.

  7. Avoid artificial sweeteners – research suggests that they are detrimental to your gut bugs.

  PROBIOTICS

  Although eating a more diverse diet is the best thing we can do to ensure a thriving microbiome, it’s also possible to introduce ‘good’ bacteria directly into the gut by taking probiotic supplements. These bacteria, although not taking up permanent residence in our guts, help encourage the growth of beneficial bugs as they are passing through. While research on probiotics is exploding, it’s important to stress that much more work is needed to confirm exactly which strains are helpful for which complaints. In addition, there is a huge variation in quality between manufacturers.

  Recent research powerfully suggests that such interventions can affect the way our brains function. One 2017 study showed that pregnant women who were given a particularly well-studied organism, Lactobacillus rhamnosus, as a probiotic had significantly lower rates of depression and anxiety after they’d given birth. Another test involved twenty-two men being given a probiotic capsule of a bacterium called Bifidobacterium longum. After being exposed to a stressor, they ended up with lower levels of the stress response hormone cortisol, felt less anxious and had an enhanced capacity to memorize material, as compared with a control group. This was a small study but hopefully it will soon be repeated on a larger group. Another exciting experiment is looking at whether the administration of probiotics can help treat US veterans who are suffering from post-traumatic stress disorder (PTSD).

  SEVEN NON-FOOD TIPS TO IMPROVE YOUR GUT HEALTH

  1. Only take antibiotics when absolutely necessary. If you do need to take them, I would always recommend taking a probiotic such as Saccharomyces boulardii at the same time. Note, French hospitals have been giving probiotics with antibiotics for years. It amazes me that we haven’t yet followed suit in the UK.

  2. Avoid non-essential medications. We are learning that many drugs, including paracetamol and the proton pump inhibitors which reduce our stomach’s acid production, can have a negative impact on the microbiome.

  3. Lower your stress. Too much stress has a negative impact on your gut bugs and can increase the leakiness of your gut. The tips in this book are designed to help you with this.

  4. Get adequate sleep. Good-quality, refreshing sleep is good for your microbiome.

  5. Don’t try to be ‘too’ clean. A modern obsession with hygiene means that we are nuking many of our gut bugs with constant use of antibacterial sprays and hand-washing.

  6. Don’t over-exercise. Too much exercise (see here) can be detrimental to your gut health.

  7. Speak to a healthcare professional about whether you would benefit from taking a high-quality probiotic supplement.

  Chapter 8

  MAKE EXERCISE WORK FOR YOU

  What I’m about to say might seem a little surprising after we’ve spent so long discovering how damaging stress can be, but a little bit of stress can actually be a good thing. It’s via our stress response that exercise transfers its benefits to the body. We stress our muscles at the gym and they grow back stronger. Exercise is one of the best ways to pull yourself out of a damaging stress state that’s been caused by too many Micro Stress Doses (MSDs). Over time, it will help you bring down the levels of stress hormones such as cortisol and adrenaline and reduce inflammation. Exercise, when done in the right dose, sends your brain information that you are thriving.

  But it is possible to over-exercise. Too much sweat and panting can drive up inflammation, put your immune system on high alert and cause your body more stress. Exercise is information. Too long on the treadmill and it’s as if your body starts thinking, ‘What’s going on out there? She can’t stop running! There must be some sort of war on!’ It switches you into stress state. I understand that this isn’t the most useful health advice you’ve ever received. So how do we find the balance? Well, in order to grasp the complex relationship between exercise and stress, we must first take a peek at the laws of dose response.

  HORMESIS

  There’s an important concept in medical science called hormesis. It was first discussed in the context of stress nearly twenty years ago by Dr Edward Calabrese, a professor in public health at the University of Massachusetts. It relates to the fact that exposure to a small amount of a stressor can actually do the body good, while exposure to a large amount can be detrimental. For instance, a small amount of cortisol helps your brain work better, improving the function of your hippocampus, the memory centre in your brain. You might have an exam or a meeting with your boss and you’re a bit nervous but find this stress helps you pull things from your brain that you haven’t thought about in a long time. This is a perfect example of stress behaving as it should, nudging you into a higher level of performance during the fleeting moments when you feel you might be in danger. But when that same process is prolonged, the cortisol that made your hippocampus work so much better instead damages it, which can lead to a multitude of problems, not least the development of memory problems as we get older, including Alzheimer’s.

  You can also view exercise through the lens of hormesis. With the right intensity and in the right dose, working out can be a phenomenal antidote to stress. If we’ve had a bad day, a burst of activity in the gym or on the squash court or a jog can leave us feeling relieved and refreshed. But it can also harm us. One of my best friends has two young kids and works in a very busy job in IT. His way of managing the stresses of a work week and a young family include going for a jog. He knows when he jogs for half an hour, twice a week, he can cope with all the other problems in his life. When he gets his jogs in, he performs well at work, he gets on with his wife and he’s a great dad. But three weeks ago an old schoolfriend was in town and invited him to go on a two-and-a-half-hour run. So the next Sunday, that’s just what he did. And it killed him. For the next two or three days he snapped at his kids and reacted more negatively to what his wife was telling him. He realized, on reflection, that it was too much for him. Half an hour was a bullet of calm but, by doing five times the amount of that same form of exercise, it became a cannonball of stres
s. It stressed his biology, which stressed his mood, which stressed his social environment, and all that turned back on him and caused yet more stress.

  HOW EXERCISE FIGHTS STRESS

  Study after study has shown that the right amount of exercise can be incredibly beneficial for a variety of psychological conditions, including depression and anxiety. One even found that regular workouts can be more effective for treating depression than medication. Exercise ameliorates stress in multiple ways. One of the major problems with the human stress response is that it evolved to put us in fight-or-flight mode, which prepares us for dealing with the kinds of serious physical problems we’d have encountered tens of thousands of years ago. But today’s stressors are very rarely physical (as much as we might want them to be) – we won’t do much good by physically assaulting or running away from our email inbox. But that’s what our bodies are primed to do. Exercise gives it what it needs and is expecting: a physical workout that helps ease us out of fight-or-flight mode.

  It also helps the body practise moving more fluidly in and out of the stress state. When we exercise, levels of various ‘stress’ hormones such as cortisol and adrenaline go up in the short term. The same hormones rise when we’re stressed through other means. Regular physical activity teaches our stress response system how to recover more efficiently and means our stress responses can operate much more efficiently when we’re being attacked by our daily MSDs. Exercise also seems to help us reorganize our brains so that they’re more resistant to MSDs. In 2013 researchers at Princeton University found that mice which exercised showed large increases in a brain chemical called GABA, which is known to help switch the brain into its calm state. Remarkably, they even showed an increase in the brain cell activity that helps dampen down anxiety and lessen the effects of an overactive stress response.

  Next time you’re feeling overwhelmed or anxious, try doing a quick burst of exercise. It can be a quick two minutes of bodyweight exercises (such as press-ups or lunges), dancing to your favourite tunes for a few minutes, ten minutes of a high-intensity workout or a brisk walk around the block. Once you have done it, observe how stressed you are feeling, compared to before. Almost always, your stress levels will have gone down.

  TELOMERES

  There is another important mechanism by which exercise can help reduce the impact of stress on the body, and that’s through its effect on our telomeres. Deep inside our cells are chromosomes which carry all our genetic material. If you imagine chromosomes as being like very tiny shoelaces, telomeres are the protective caps you find at the end of them. If your telomeres are damaged, your chromosomes can start to fray, which is a key sign of cellular ageing. Cellular ageing means our bodies are ageing!

  Research by scientists such as Nobel Prize-winners Dr Elizabeth Blackburn and Dr Elissa Epel suggests that various lifestyle factors may keep us young by preventing the shortening of our telomeres. They argue that low stress levels, good-quality sleep, a diet full of minimally processed wholefoods and time spent in nature all help.

  But exercise seems to play a role as well. A 2010 study demonstrated that stressed-out women who carried out vigorous exercise had longer, more healthy telomeres than their inactive, stressed-out counterparts. Incredibly, this effect could be seen with only fourteen minutes of vigorous daily activity. The researchers concluded that ‘vigorous physical activity appears to protect those experiencing high stress by buffering its relationship with telomeres’. The key take-home from this and other studies is that we ought to reduce the amount of time we sit, as well as aim for moderate amounts of physical activity every week.

  HOW TO FIND YOUR PERFECT DOSE

  Your perfect dose of exercise will depend on the state of the rest of your life. You should always be asking yourself whether your body needs a restorative workout or an intense one. If you’ve been super busy at work and didn’t sleep particularly well, it may be that you’re closer to your stress threshold and would benefit from a restorative form of exercise such as yoga or Pilates rather than pounding away on the treadmill. It’s crucial to start listening to your body. When you do, you’ll start to become more in tune with what kind of workout your body needs.

  Signs that you might be over-exercising include:

  • Inability to sleep at night following a vigorous workout

  • Sleeping too much, compared to your norm, and still feeling exhausted

  • Waking up with your heart racing the day after an intense workout

  • Feeling exhausted for the rest of the day following a workout

  • Feeling irritable and moody after an increase in the intensity of your exercise

  • Frequently getting ill (for example, coughs and colds)

  • Impaired heart-rate variability (see here)

  YOUR DAILY EXERCISE PRESCRIPTION

  I’d like you to do a form of stress-busting exercise every single day. Physical activity is the perfect antidote to stress. Stress doesn’t take a day off, so neither should physical activity. It can be as simple as a ten-minute walk at lunchtime, a high-intensity interval session or a long one-hour jog – you choose! The key is to move your body as much as possible each day, in any way you like. Importantly, pay attention to how you feel afterwards to ensure that you start to tune into your body and how you are feeling. Try and make sure that you are doing the right kind of activity that is in harmony with the rest of your lifestyle.

  BURN THE STRESS AWAY

  Over the past few years there’s been some incredible research carried out on ‘hyperthermia’, or the increase of core body temperature. It’s been found that if you raise your core temperature to 38.5º C – which is the sort of level you’d reach when hot and sweaty with fever – for about an hour or so, it can reduce stress and raise mental function. Studies of sauna therapy have shown such treatment can alleviate the symptoms of depression, while research in Japan found that a sauna a day, for five days a week, over a course of four weeks reduced the stress state and increased the thrive state.

  A study of Bikram Yoga (a form of ‘hot yoga’) found that it significantly reduced the symptoms of depression. Heat, which can be a form of ‘good stress’ on the body, and exercise, such as yoga, both induce the release of beta-endorphins, which help relieve pain and elevate mood. Could it be that the beneficial stress induced by heat and the beneficial stress induced by yoga have their effects magnified when you put them together?

  My experience with a fifty-five-year-old patient called Simon has led me to strongly suspect something like this is going on. He’d been struggling with his mood, had not got on well with therapy and had been on multiple antidepressants, but found that none of them worked for him. He was the sort of patient who would come in every few months frustrated that his mood was flat and that we just weren’t getting anywhere. Then one day he met a woman on a dating website who invited him to a hot-yoga class. Remarkably, for several days after the session, he felt elated and happy. I assumed that this was simply because he’d found love. But they soon stopped seeing each other, Simon joined a different hot-yoga class and reports experiencing a significant and sustained improvement in mood.

  Why not try hot yoga for yourself and see how it makes you feel? If hot yoga doesn’t appeal, what about spending some time in a sauna or steam room? You can even try doing some light stretches or yoga moves while in there, if you have room and it’s not too busy!

  SEVEN GREAT WORKOUTS YOU MAY NOT HAVE CONSIDERED

  1. Indoor climbing: Exercise that demands concentration, which forces us to switch off.

  2. Open-water swimming: There’s something incredibly therapeutic about being in open water, such as oceans, lakes and rivers. Even if you are unable to swim regularly in an open-water setting, indoor swimming still has tremendous benefits. One of the best things about swimming, whether open water or indoor, is that you can’t have your phone with you, so it forces you to switch off from the stresses of the outside world.

  3. T’ai chi or yoga in the forest or
local park.

  4. Skipping: A free and quick way to burn off excess ‘stress energy’ – all you need is a skipping rope.

  5. A run in nature: If you already run regularly in urban areas, try switching it up sometimes with a run in nature.

  6. Nordic walking – a four-wheel-drive version of walking: It is a whole-body workout using your feet as well as your arms, by using poles.

  7. Ground living: Try to spend more time on the floor, kneeling, squatting or balancing on yoga balls when you eat, read or watch TV to counter all that time we spend slumped over computers.

  HEART-RATE VARIABILITY

  People often think that the heart should beat like a metronome, following a strict, clock-like rhythm. Surprisingly, this is incorrect. The amount of time taken from one heartbeat to the next should vary. When we’re functioning well and are comfortably distant from our stress threshold, we have high heart-rate variability (HRV). From one beat to the next there’s a change in rhythm and strength. It’s a reflection that the body is capable of adapting to a constantly changing environment. I often think about it as a marker of resilience – our body’s ability to cope with stress.

  But when we’re overdoing things, this variability goes. Low HRV has been linked to multiple poor health outcomes, such as all-cause mortality and heart disease. There are many different things that can lower HRV including infections, temperature, inflammation as well as traumatic Macro Stress Doses. However, for the vast majority of us, what affects our HRV the most on a daily basis is the relentless bombardment of MSDs that leave us feeling drained. Low HRV indicates that our body is in stress state and not thrive.