The secret to coping with stress - how to protect your brain and body, and feel calmer now | Prof Carmine Pariante

Why stress makes us sick

0:00Welcome to Zoe, Science and Nutrition, where world-leading scientists explain how their research can improve your health.

0:15The wind cuts across an ancient tundra. Somewhere in the distance, a predator creeps ever nearer. An ancient human freezes, heart hammering, muscles tightening, senses sharpening. In the next few seconds, that surge of stress could mean the difference between life and death. Hundreds of thousands of years later, the predator has changed. Now it's an overflowing inbox, a mortgage payment, a sleepless night, a meeting you're already late for.

0:45Not life and death. And yet the feeling can be the same as hearing that saber-toothed tiger's footsteps coming nearer. This powerful stress response kept us safe for thousands of years. Now it's making millions of us sick, and even shortening our lives. Why does stress grip us so powerfully? Why does our body react to modern pressures as if we're still fighting for survival? What can we do to prevent this? In this episode, we're joined by Professor Carmina Parianti, one of the world's leading researchers on stress and how it affects inflammation in our brain.

1:21Together, we'll explore what happens inside the brain and body when stress strikes. Why cortisol has become the internet's favorite hormone. And whether social media posts about cortisol, face, and belly have any basis in science. We'll also tackle some of the biggest questions surrounding stress today. What does the latest research tell us about how it can affect us? Can it really make you feel tired and depressed? Contribute to heart disease and chronic pain? Even increase the risk of dementia? And perhaps most importantly, if stress is woven so deeply into modern life, what can we actually do about it?

1:57Carmina, is stress always a bad thing? No. Can enough mental stress damage my physical health? Yes. Is cortisol something we should always be trying to lower? No. Are there any evidence-based ways to reduce your stress levels? Yes. Are stress and anxiety the same thing? No. Can stress increase the levels of inflammation throughout your body?

2:28Yes. And finally, what's one thing that most people get wrong about stress? Guilt. They feel guilt about it, rather than understanding that it's coming from outside.

Defining what stress actually is

2:41I love that we're talking about stress, because I think that everyone listening to this podcast knows what feeling stressed feels like. And honestly, I feel like I've been stressed since the day nine years ago when I decided to start Zoe with my co-founder. I'm not surprised. So I definitely feel like I live with this. And in the modern age, it feels like stress is coming at us from every corner. Now, I was brought up in England to believe that you should just stay calm and carry on, and that since stress was in the mind, it wasn't real.

3:15It couldn't cause any physical symptoms. And basically, if you could just ignore it, then that was the best thing to do, and you're already starting to smile. And I'm also smiling a little because over the last few years, I've been starting to reassess this upbringing that I had. However, there is a lot of conflicting advice about stress from online influencers, and most of them have something that they want to sell. We know what it means to experience stress, but I realize as I'm saying this, I have no idea what it actually is.

3:48Stress is every situation where the challenge that we're facing is bigger, or this is perceived as bigger than our ability to cope with it, to deal with it. And once you interpret it this way, then you know there's always a mismatch, and there's a personalized mismatch between how you are at the moment in your life on the day and what's happening around you. Stress is not the same for everybody.

4:19And of course, we know this. There are aspects of stress that most of us would consider intolerable, and I'm thinking about, for example, being in a war zone or being a soldier. Even if you choose to actively participate in a situation that would be life-threatening or very stressful. And then, of course, there are situations that most people would find it not stressful, perhaps even relaxing. And then everything in the middle, like from talking to podcasts today, talking to the public, having to give a speech at a wedding, having a difficult job performance, all of that will always be about how you, as a person, perceive that task.

5:04On that day, because it also changed from day to day, and it changed from how prepared you are, and it changed based on what is your kind of background, mental health and well-being at that particular moment. It's a very kind of personal, but also kind of moment-by-moment definition, if you like. What you're saying is stress is when the problem that I feel that I'm dealing with right now is bigger than I'm convinced that I can deal with? Yes. And often it is bigger than you can deal with it.

5:34Sometimes it's bigger than you think you can deal with it. Other times it is really bigger than what you can do about it.

What happens inside the body

5:40So let's take an example. I mean, you mentioned a war zone, but I maybe want to go back into like my mental model of this, which is like our ancestors being chased by a lion. Can you explain a little bit about what's happening in my brain, you know, as that lion is starting to come towards me? I mean, by the time the lion comes towards you, probably your brain almost kind of goes into automatic functioning and is your body taking over? Your sympathetic nervous system gets activated.

6:11So this is a kind of direct system that originates from the brain and makes your heart beat faster, brings more blood to your muscles, kind of prepares you for the immediate run or fight. It also activates the immune system. These are the cells that we use in our daily life to fight infections. And of course, you want to be able to fight infection, to have an immune system that is primed to fight. Because we are going to be injured, you know, it's a lion in front of us.

6:42Even if we run away, we're going to have injured by, you know, the running in a field. And if we get caught, of course, it will be the injuries of the fight. So immune system gets activated. A few minutes after that, cortisol kicks in. Cortisol is a hormone, so it's not directly produced by, if you like, the brain or the central nervous system, but it's downstream to the activation of the brain. And it's produced by a small organ, which is called the adrenal gland, which actually sits on top of our kidney, left and right.

7:14Cortisol goes straight into the bloodstream, produce more glucose, so more sugar in the blood. That's the basis of energy, which will really need it. It kind of also helps shutting down blood flow in organs that we really don't need. So, you know, we don't need blood in the stomach because digestion is not a priority when we have to fight our life. And in the brain, cortisol kind of helps focus on the task ahead. So typically, it kind of narrowed the focus of our attention so that you almost become unaware of things that are not really important,

7:51except, of course, the lion or what you need to do to fight or run. This is more or less what happens. Now, as much as I love the predator models, we need to remember that these are models of acute stress. All of us will encounter acute stress. I mean, we're very unlucky. We encounter severe acute stress, you know, being in a car crash or being assaulted, being exposed to violence. And a lot of us will have intermediate acute stress. But the problem with today's society is much more about chronic stress.

8:22So the question is how a body that was really created for stress so that would only last 15, 20 minutes, half an hour. So the time that you either fight the lion or run away from the lion, how does that body, that stress reaction deal with the fact that today's stressors are mostly psychosocial and continuous rather than acute and disappearing after 20 minutes? I have this vision in my mind now of all these things being switched on in my body, you know, at the point that I see this lion in the distance coming towards me.

8:53I'm really interested to follow up now, actually, on what you're saying about how that might be the same or different in my modern life. I feel, though, that I get very anxious if I know I'm going to be late for a meeting, for example, right? Which feels like that's completely different from a lion. But I definitely think, oh, I'm feeling stressed. I'm going to be late. Is that a completely different set of things that are going on inside my body? I'll never forget the moment that everything shifted for me. I was at a public talk on nutrition, listening to a speaker explain that my gut had trillions of microbes in it and that these bugs shaped every aspect of my health.

9:29That speaker was Professor Tim Spector, one of the world's top 100 scientists, who became my co-founder here at Zoe. Nine years later, Zoe runs the world's largest gut health research study. And the conclusion is simple. Well, gut health is health. How you feel, your long-term health and your digestion are all shaped by the state of your gut. As a listener to this show, you know how important it is to feed your good gut bugs. But I suspect that, like me, you have a busy schedule and often you feel you haven't given them all the different plants they crave.

10:01And that's exactly why we created Daily 30. It's a gut health supplement packed with over 30 plants that you sprinkle onto any meal. It tastes great, adds a satisfying crunch, and gives your gut the diversity it craves. Finally, a healthy, happy that's easy to stick to. I should know. I take it every day. And because we're Zoe, we don't just guess. We test. We put our original Daily 30 formula through a randomized controlled trial, the gold standard of testing. The results blew us away and proved it supports your digestion, energy, and gut health.

10:32That trial helped us develop the formula we have today. Today, Daily 30 is a non-negotiable daily habit for me. So don't put your health off for the future. Go to zoe.com slash Daily 30 and try it today. No, it's just quantitatively different. You have an increase in pro-inflammatory signals. So your inflammation in the blood, so your immune system activation goes up, even if you're doing an exam, for example.

11:04And your cortisol goes up if you're late and you're really worried about it. And your heart will be beating faster if you're anticipating a difficult meeting with your boss. So these mechanisms operate. The magnitude of the intensity, of course, is much higher when we are facing a real life-threatening situation versus a mildly challenging or just kind of worrying concern. There's a range to this as well. It's not like it's either on or off. You can have all of those things you described, like at different levels of intensity.

11:37Yes, absolutely. And this is why people have, for example, stroke or other acute medical kind of complication, undercondition or really intense stress. But they don't have it, luckily, if they're late for a meeting. Because the level of activation, for example, of the sympathetic nervous system, which is the system that increases your heartbeat so they get faster, but also increase your blood pressure so you can get more blood to the brain because that's where you need the blood because, again, you have to decide what to do in front of the lion.

12:14But all of that may only increase a little if we're worried about being late and increase really exponentially a lot if we are facing a life-threatening situation.

The physical toll of chronic stress

12:23In a situation where I feel a lot of stress, as all of these things have been switched on in my body. In fact, some of that is also to, like, my heart beats faster and more blood pressure. Is that related to this idea that you could have a heart attack if you're under too much stress? Absolutely. This is both in terms of chronic activation of the stress systems, which increase your risk of cardiovascular problem really across a variety of mechanisms. Because, unfortunately, having a chronic activation of your stress system is not the same as having the acute activation that we're having in the jungle.

12:58Because in the jungle, our ancestors would face a predator for a few minutes, 20 minutes, half an hour, maybe not even every day. But for us, it's different, right? So it's the stresses of the daily life, the pressure of work, the social isolation, the difficulty we have with the relationship that stays with us every day. So it's continuous. So I think you're saying that there's a big difference between probably what our ancestors experienced, which is very high level of stress, but for the short period of time. And I think you've mentioned this idea of, like, chronic stress. Could you help us to understand what that means?

13:30Because a lot of the conditions that we're now facing today and we're perceiving as stressful are of situations that stayed with us for weeks or months or years. It could be a work pressure. It could be relationship difficulties. It could be, you know, feeling lonely. A lot of the problems that we're facing as a society, they tend to be there for a long time. And so at that point, it's very difficult to switch the biological stress response off because the challenge is always there.

14:01While with the lion, once the lion is gone or if you're dead, we don't need the stress system anymore. And so, Carmina, what's happening in those sort of long-term situations? So, like, I've got a horrible boss and my relationship is difficult and I'm worried if the company is going to go bankrupt, et cetera, et cetera. Is that a completely different set of reactions that's going on in my body from the one you described with the lion? It's the same, but it stays on longer. So, your sympathetic nervous system that is supposed to kind of make your heart beating faster and your blood pressure go up for 20 minutes or half an hour until you deal with the problem actually increases your blood pressure for days and weeks and months in a row.

14:47And, you know, the baseline stays on because the baseline stays on. And then when there's an acute thing happening on top of it, you know, you're starting already from an activated baseline. So, it goes up faster and higher. And it's the same with cortisol. So, your cortisol gets constantly activated. And so, the system is just more responsive. And so, when you're facing a small stress in the context of the ongoing stress, then your cortisol goes up more and goes up higher.

15:19And cortisol, you know, in the short term helps because you want to have more sugar in your blood so that you can, again, have the energy to run. But in the long term, that means your risk of diabetes or metabolic disorders, your risk of weight gain, your cardiovascular problem, all of that goes up. Because it's something that your body is doing not for half an hour, but it's doing it for weeks and months in a row. So, this raised level of cortisol, it's not just that it makes me feel maybe more focused and feel stressed, but actually it's going to increase my risk of serious disease like diabetes, but also risk of weight gain?

15:57Yes, weight gain, together especially with inflammatory component. Because inflammation does the same. So, inflammation also increases our risk of metabolic dysfunction. It kind of potentiate the negative effect of cortisol. So, one of the things that cortisol does is it activates mechanisms of reward so that increased eating as a way of coping with stress. So, some of the negative consequences of the stress are the unhealthful way that we cope with them. That's really interesting. So, you're saying that our modern environment is having the same reaction to me as I'm designed to have against like this scary lion.

16:33It's not quite as high, but it's just on for months. And part of that system is like increasing my inflammation. It's increasing this cortisol. And you're saying that that actually is likely to lead me to put on weight. It's likely to make me eat more. That's slightly crazy. It is, but it's, you know, and the environment, of course, facilitate that. High-fat food and high-sugar food, they have a kind of a rapid anti-stress effect.

17:05They can reduce cortisol because they kind of give you a feeling of reward. Food, obviously, is available to everybody. I guess alcohol, smoking, you know, comes immediately after in terms of availability. And then, of course, when people use drug of addiction, I mean, these are the negative ones. You can add, I guess, social media, scrolling, and everything that takes the pressure away from you, even if for like a minute or an hour. It will be, in a highly stressful situation, it will be a welcome relief.

17:38It's not like I know my cortisol is high, right? So, you're saying that like in my biology, it's sort of saying, oh, if you get that, it's going to reduce, I'm going to feel better. So, I'm sort of learning these behaviors. We now know in our modern world that eating lots of sugar is not going to be good for us. But similarly, alcohol, which I think for many of us, we do think like at the end of a really stressful day, I'd love to have a drink. I definitely can often feel like I would really like a glass of wine. There's a physical relationship to do with the level of pressure that I felt earlier and this raised stress and this raised cortisol.

18:12Yes, and there's also the mental aspect. I mean, of course, all these strategies that we used to cope with stress. I'm really struck that you said that there's not a complete difference between sort of physical and sort of emotional or social threats. Is there really genuinely my body is going to respond in the same way to a really high intensity, like emotional situation as it would to really high intensity situation with like physical threats?

18:44It does. It's only really a matter of quantity and for how long it stays on, all of these mechanisms. We have one way of coping with a stressful situation, which is usually a way that allows us to, as I said, either run away or kill. And unfortunately, modern society, we can, often we cannot run away from the stressors. And most of the time we cannot, you know, kill the stressor metaphorically or physically.

Ancestors versus modern expectations

19:11Why is it that you're saying it's today that we live with this chronic long-term stress? Why wouldn't our ancestors have just been chronically stressed all the time? There's really a lot to unpack here. So, first of all, our ancestors had different expectations on their life, on what is their well-being, if you like, to use a term that probably they would not have used and understood. Probably not a lot of wellness influences back in the savannah. Absolutely. So, they would have had different expectations.

19:42They would know exactly how often they would have been able to eat. And they would know that a lion was always behind the corner. They would have developed strategy to deal with it. And also, they would have developed, I guess, acceptance of what the world around them was. And, you know, this is not dissimilar to a lot of things that have changed over the last 100 years. There have been plenty of discussion how our attitude toward death, for example, has changed in society.

20:13How, you know, 100 years ago, for example, you know, with the infant mortality being much higher, and, of course, illness and medical care being much less developed than today, it was unfortunately a common experience to lose someone in your family, to lose maybe a child. And there was a different relationship with bereavement and the loss of someone. I'm just giving you one of, I guess, hundreds of examples of how society has changed, even recently.

20:46So, we are in a situation now that, if you like, is the worst of possible combinations, where we have high expectation that life should be perfect and everything should go well. But we have less, if you like, spiritual or kind of philosophical frames to make sense of what's happening to us. And we are a society that is more difficult to live with in terms of, you know, more fragmented. We don't have a village where we trust, you know, people who have been living with for our life.

21:22So, I think it's, you know, it's a weird combination of a much better quality of life and a much worse kind of way of dealing with the difficulties that are still here. I'd love to talk about what happens to us today, now that we are living in this long-term stress, and particularly how it affects our health. So, imagine someone is experiencing this, like, low-level, long-term stress.

21:53You know, what symptoms might they notice and what might be going on inside them, perhaps, that they're not even going to be aware of? We're all different in terms of some people tend to express stress in more in a physical way, and some people tend to be more mindful of their emotional well-being and reaction. I think, at the minimum, yeah, what would you imagine someone who's going through a really difficult time? The immediate thing would be disrupted sleep, so inability to fall asleep, maybe ruminating before going to bed about what's happening,

22:26or waking up early in the morning, again, with the kind of waking up with these concerns.

22:32Appetite change. A lot of people, when they're under stress, they stop eating or they eat less, they lose weight. Other people eat more, and sometimes it's like a curve, a shift. So, I know it, not as a scientist, but as a stressed person, that if I'm a little bit stressed, I eat more, but if I'm really stressed, then I stop eating. So, each of us will have this kind of curve. It may, you know, some people only have one style or the other. So, those are both potentially responses to the same underlying stress.

23:05Absolutely. You know, whatever, in a way, whatever works for you or for me at that particular time. But this is a real physical reaction. This isn't just all in my mind, the way I was brought up. Like, there's some real physical things that are happening inside me as a result of the stress responses that you were talking about. Yes, because there's no mind and body and brain separation. You know, it's all one single entity, if you like, communicating. And so, the high level of cortisol stimulates the brain and may, for example, increase hunger as a way of coping with stress.

23:36The food will have a reward effect. So, the pleasant experience of the sugary or fat will give our brain a feeling of kind of pleasure, which will then relax us. And therefore, you know, the body relaxes after that. So, it's a continuous communication between mind, body and brain.

Sleep loss and inflammation

23:57And so, you were saying that if I start living with this long-term stress, like, I start to get these physical effects. And that might be disrupted sleep, appetite change. Is there anything else? Yeah, well, you know, high blood pressure and stomach pain, you know, the famous stress gastritis, problem with indigestion or reflux or gastric acidity. And this, again, is driven, is largely driven by actually cortisol effect on the internal layers of the stomach that the cortisol increase the kind of acidity.

24:29And that's why in very acute situations, people may have, you know, when they're going at severe stress, they may have an acute gastritis. They may need to kind of go and see a doctor just for that. So, these are all kind of consequences of stress. The inflammation goes up, although we don't feel it as much. However, we do feel it a little bit because probably the high level of inflammation during stress is what drives the feeling of fatigue and lack of energy. I can't feel my inflammation directly, but I might feel like this fatigue, this tiredness, this lack of energy.

25:03And that is actually sort of how my brain is aware that my inflammation is higher. Yes, because you need to remember, talking about ancestors again, so when we have an infection, any type of infection, one of the responses of our body to the high level of inflammation is to shut down, so to kind of reduce our physical activity. Think about how you felt last time you had flu, you know, those unlucky, you had COVID, how bad it was physically, how tired we felt.

25:35And this is because the brain is programmed to respond to the high level of inflammation by shutting down kind of what we call the reward system. So, the activity that makes you sick, things that you like, because really you need to kind of sit down and wait so that your body keeps all the energy to fight the infection. And possibly, from an evolutionary point of view, there's also a principle of kind of social isolation, a natural social isolation. So, we stop moving. We just want to kind of be in bed. We don't want to socially interact as a way of protecting our peers from the infection.

26:10So, that's another issue, like ancestral mechanism, similar to the stress, that it works also in daily life. And so, when we are stressed, the inflammation goes up and the brain perceives that almost like if there is an infection going on. And so, it signals the body to feeling really tired and stop doing stuff. That's really interesting. So, my stress can trigger inflammation that is the same as if I actually had got, you know, a cold or flu or something like this.

26:40Absolutely. I mean, if you measure it, you'll see the same levels. Not as high as having, you know, COVID or sepsis or like a real severe infection, but definitely as high as having a cold. So, I could measure that. What would you measure in someone's blood? Today, we take the blood. You can measure what we call cytokines. So, these are chemicals produced by the immune cells, the white cells that are securing our blood. They kind of send it in the blood to communicate with other immune cells that are, you know, in our lymph nodes, in our spleen.

27:13And they go up. There's one that we study a lot. It's called interleukin-6. And, you know, it goes up with depression. It goes up with stress. It goes up acutely with an exam, but it goes up chronically in people who are, you know, for example, as I said, have major depression. I think that's amazing. As I said, I was like, I was definitely brought up in this idea that, you know, your brain and your body are separate, keep calm, carry on. And so, the idea that you could feel stress and there would actually be a chemical you could measure in your blood that's changed that is physically affecting you, you know, there's a pretty big hole in this idea that these are completely separate.

27:49Yes. And in fact, I would argue that if you completely dissociate from the emotional content, if you like, of your life, the risk is that your body keeps feeling stressed and feel the effect of stress. However, you're not even aware of it because you're kind of dissociated from the emotional component. So, it's like, okay, I'm not going to be feeling sad. I'm not going to be feeling worried about it because it's all in my brain. But your body will continue to feel sad. So, these are sort of like the short-term impacts. How serious can this be for our long-term health?

28:24Very serious. I mean, chronic stress that is so embedded in their life that eventually brings clinical anxiety or clinical depression, sort of, you know, with mental illnesses, for example. They die younger because of the ongoing physical effect of, you know, the biological changes that happens to the body and in the brain with high level of stress. As I said, sometimes it's also some of the mechanisms that we use for stress. So, you know, the change in our eating behavior, the use or abuse of alcohol or smoking or substances.

28:58So, it's really true. Like, if I'm highly stressed over long-term, I'm just going to die earlier. You're going to die early and you're going to have a miserable life. And probably the people living with you will have a miserable life too. Well, lots of people living with me might say they're having a miserable life. So, that might be true. You know, stress is an emotional cost. Stress is a physical cost in the body, but it's an emotional cost as well. In the way we behave and the way we communicate with other people around us, including the people that are closer to us. And so, you've mentioned already the fact that if I'm under this stress for a long time, like, that will lead likely to weight gain.

29:34We know that, obviously, that's really bad for your health. You talked about high blood pressure. What about other diseases? And I definitely think that sort of heart attacks are the thing that I have, you know, I think all the way back to before I was born, right? Somehow, the, like, 1960s sort of madmen, everyone was like, you're going to drop dead of a heart attack because of your stress. Like, is that not true? No, no, it's true. And again, these are all the same mechanism kind of focusing on one single, you know, potential kind of negative episode.

30:05Because the increase in food intake or the high level of cortisol, the stimulation of more glucose will also increase your lipid in the blood. That will increase accumulation of cholesterol. And so, your blood vessels start to kind of becoming smaller and smaller and smaller, especially the one in the heart. The inflammation activates the response of cells that are circulating in the blood. They make it stickier, so they stick to the blood walls.

30:36And a coagulation happens, basically like an accumulation of cells that block the flow of blood in the heart. And you have a heart attack. So, all of these mechanisms operate in giving all of these different, if you like, negative effects. Of course, we all come with different predispositions, maybe genetically or, you know, based on how we, the kind of life we had as a child or, you know, the type of nutrition or physical activity or other lifestyle that we have.

31:08So, some people may suffer more in the stomach. Some people may have a heart attack. Some people may, you know, develop diabetes. But they're all downstream negative effects of stress.

How stress shuts down joy

31:17And I know that you conduct a lot of research into inflammation and sort of mental health conditions. And you've already touched on sort of fatigue and lack of energy. But what is happening in the brain, if anything, as a result? And does that affect, like, my mood or anything like that? Yeah. So, we now kind of know that a high level of inflammation is present during depression. It's also present during anxiety and other mental disorders. But it's certainly important in the kind of the creation of at least some of the symptoms of depression.

31:53Inflammation typically affects the reward system. I keep going back to the reward system because there are kind of these areas of the brain that allow us to feel pleasure. And if we don't feel pleasure anymore because this part of the brain gets shut down and it gets shut down by a high level of inflammation, then, of course, our life will become dull and we'll feel sad and unable to ever feel kind of normal again. I think one of the things I often personally struggle with is being able to experience a lot of happiness.

32:25And I definitely have quite a lot of pressure in my life, but I never thought about it being related to that. It sounds like you're saying that stress might lead to impact on my brain that affects my ability to be happy and experience joy. Because that's not so obvious. I think we understand, I can understand the anxiety, but I'm surprised to hear that it would also affect maybe then being able to even feel these positive emotions.

32:58These are all kind of downstream, if you like, negative effect of something that in the short term is helpful. So, again, if we're going back to the idea that you have an infection, you really want your brain to concentrate on fighting the infection. So, you just don't want to be seeking pleasure or pleasurable activities. You don't want to go out. This, again, lasts hours, days, or, you know, you die because of the infection, as a lot of our ancestors would have done, you know, maybe even until 100 years ago when the antibiotics were discovered.

33:31Now, we have these mechanisms that are operating weeks, months, because they're chronic, and one of the downstream effects of this is certainly the fact that inflammation reduced the ability of our brain to respond to reward, so to respond to pleasure. And we know it because if we give the studies that we and others have been conducting in using anti-inflammatory strategies, so literally medications that have been developed for inflammation, so for pain or for autoimmune disorders or inflammatory disorders like arthritis, use this medication in people with depression.

34:08And we can see that we can see that one of the things that lift is this ability to experience pleasure and that, you know, the brain areas that respond to pleasure get to work again, if you like. You can actually sort of scan someone's brain, and if you reduce the inflammation that comes from the stress, like parts of their brain are suddenly sort of switching on that before were sort of dark and switched off. Yeah. That's crazy. Yeah. Well, you know, it's kind of trying to understand how we can help people with depression. I think it's incredibly interesting, this link between stress and inflammation and then inflammation and mood and this idea that there's a continuum, so it's not like you're either clinically depressed or not, you could have some of that.

34:48I'm also partly think I'm struck because we meet so many other scientists talking about other things in our modern life that contribute to inflammation. You know, on this show, we talk a lot about food, for example, and so presumably, if I'm eating a modern Western diet and I have some level of inflammation, if I'm then stressed on top, does that mean my inflammation is therefore going to go even higher? Well, we know that, for example, part of the inflammation in people with major depression or other mental disorder is driven by an increase in weight,

35:24because the fat tissue is actively producing inflammation and putting in the blood. Your inflammation makes the body more metabolically responsive. The stress may increase your food intake, which then, in the context of increased inflammation, will kind of create more problems from a metabolic point of view. So, you know, your body will be more sensitive to developing a high level of cholesterol, a high level of fats in the blood, a high level of sugar. And at the same time, the deposition of fat increases inflammation.

35:58So it's all, unfortunately, they're all kind of negative cycles kind of potentiating each other. Think of a friend or colleague who powers through deadlines and life's challenges on coffee, adrenaline, and too little sleep. Perhaps they feel awful once the pressure lifts. Why not send them this episode? It can help explain when a useful survival response starts becoming a threat to health and actionable advice to help balance what to do. I'm sure they'll thank you.

Cortisol myths and wellness trends

36:24Let's talk about cortisol a little bit longer, because you've mentioned it a lot through this discussion. And I've been struck by that because cortisol has become a bit of an online buzzword recently. But I've now got one of the world experts I'd like to ask you. So there's a lot of people talking about cortisol face and cortisol belly. Like, is there any truth to that? Can cortisol be causing you to lay down fat in these places?

36:56As you were saying, cortisol does increase food intake as a way of coping mechanism with stress. People that have very high level of cortisol, but not because of stress, because of endocrine dysfunction, also tend to put on weight. And unfortunately, we see, for example, who people who take steroids, which is really they're just kind of cortisol, exogenous cortisol. They're kind of medications that mimic cortisol. However, instead of all of that, I think what I don't like, if you like, of the buzz about cortisol, is that somehow it's something that we can measure or interpret or modify.

37:37I mean, yes, cortisol is important in a stress response. However, you know, is that something that we can manipulate beyond just kind of try to have a kind of less stressful life? And certainly it doesn't help to measure it. And there's nothing, you know, pharmacologically you can do to reduce it unless you take, you know, medications that are quite toxic. So I just think stress is not about measuring your cortisol. Coping with stress is not about measuring your cortisol. Coping with stress is about improving the aspect of your life that you can control to make you more able to deal with stress.

38:13I would love to go to that. But first, I have a specific question that the research team said I have to ask. So apparently, also online, there's a lot of noise about a cortisol cocktail that can allegedly reduce your cortisol levels. So they've told you you're going to get cortisol face and cortisol belly. And I'd just love to tell you what's in it so you can tell us all whether it's going to work. Apparently it's orange juice, coconut water, salt, and potassium or magnesium powders. Is this going to fix my cortisol?

38:46To me, it doesn't ring any bell because I cannot link any of this compound or things in the cocktail to anything that particularly would affect cortisol level. So for those of you who've been taking your cortisol cocktail, we recommend you stop. I'd love to talk about, you know, what we can do. But can I even start maybe with like my aim? Should I be aiming to have no stress in my life? It's impossible. It may be actually that that's the reason why we feel so stressed.

39:18It's because we have expectations that we should have a stress-free life. And so it's a continuous disappointment when we are stressed or when we feel stressed. Hence the guilt, you know, because maybe we're doing something wrong because we should not be feeling stressed. So this is completely the wrong way around looking at it. The correct way is like life is difficult. Stress will be behind the corner every moment. And I need to learn how to cope with it.

39:49Avoiding it will only make it worse. So don't try and avoid it. Life is difficult. Let's learn how to cope with it.

Evidence based ways to cope

39:57So could you talk to us now about whether there are any evidence-based things we can do to like handle this stress that inevitably comes our way? Plenty of strategies. The first thing to remember is that stress is perceived as particularly bad when it is what we call uncontrollable stress or something on which we feel we don't have any control. So if I come to this podcast because I want to do it and I really enjoyed the idea, this would be a rewarding experience for me.

40:36If someone obliged me to come to a podcast that I hate because I hate to be talking in front of a microphone, this would be highly stressful. And if I cannot say no to that request, it would feel even more stressful. So the first question we need to ask ourselves is, how much control do I have on the situation that makes me feel really stressed? And sometimes control is about choices. That's the most important strategy of having control on what you feel is stressed and what you feel is stressful.

41:11But you need to start by doing an analysis of the situation. What can you control? And maybe you cannot change your job, but you can maybe work less or you can use better the hours that you're not working so that you're kind of compensating your quality of life. It's a balance. So if you cannot reduce, objectively reduce the stress level, maybe you can increase the positive aspect in your life. And so focus more on the positive aspect, gives more time and more attention to the positive things in your life. Things like spending quality time with family, friends, your hobbies, your passion.

41:50We tend to think of the pleasurable side of life as the weak one, as in, I don't need that. You know, I want to become a very famous professor. I don't need to spend time reading books or, you know, or walking in the woods. But these are essential activities for our well-being. Whatever it is that is important for you, traveling, you know, walking, they generally do reduce level of stress. I mean, we recently did some work using singing groups for mothers that were suffering from postnatal depression.

42:27And we measured literally from before the singing session, one hour singing session, to the end of the singing session, a reduction in cortisol and inflammation. And, you know, this is just one thing that we have been doing. There are hundreds of other studies like this. The same is for walking in the green areas, dedicate time to culture, art, creativity, but also, you know, spending time with friends, you know, having a social network, social support. And, you know, just next to it is the spiritual element, which, again, it doesn't mean that you have to have a religion or have to have a religious group or spiritual, official spiritual, if you like, attitude.

43:09However, things that will feed your soul, if you like, or feed your mind will really help you with the stress. I'm really interested that the first thing that you've gone to is not some sort of meditation, but you've gone straight to both having some control over work and some time with friends and family. That's because you feel these are the biggest things you can do to really... Yes. And, of course, the kind of the more personal lifestyle choices that will help you.

43:41I mean, you know, physical exercise, whatever helps you maintain a kind of physical activity and a healthy, you know, your body will benefit from movement, from physical fatigue.

Exercise as medicine

43:53Could you tell us a bit more about that? Because thinking from my own experience, I started doing the gym about a decade ago, and it was driven by like a physical issue. I was having some pain and then I think supported by the things I was learning sort of through Zoe about how good it was for my long-term health to be doing exercise and resistance training, things like that. But interestingly, I now think about it as being an essential part of sort of managing my mental health.

44:25And, you know, my job is quite stressful. Like I think lots of people listening to this, and I've started to think about like doing that exercise regularly through the week as something that helps me cope mentally. But I have no idea if there's anything real in that or it's just sort of... There is, there is. And, you know, again, in this complex mind, body, brain, exercise does so many things because you can measure inflammation in the blood. And actually, we know that physical exercise is anti-inflammatory. Recent research showing that the muscles actually doing exercise produce chemicals that are against inflammation.

45:03But also, exercise gives a feeling of reward and satisfaction with yourself because, of course, if there is one thing that you can get better at is exercise, whatever it's going to be, because you learn the skills, the technique, your body gets more used to it, whatever it is. There are so many elements that are positive about having like a regular rewarding physical activity, both from a body point of view and from a mental point of view.

45:34And I'm, you know, I do a lot of physical exercise and certainly help me with coping with stress a lot. So the exercise really does have an effect on stress. It does. You need to enjoy it or at the beginning where you don't enjoy it, push it until you start enjoying it. It doesn't come with the first time you go to the gym. I'm sure you had the same, exactly the same. Honestly, it took me years to start to enjoy it. And as I said for years, oh, I don't get any pleasure out of it. It's actually not true anymore. Like I do actually get pleasure from it now.

46:06I did not grow up doing lots of exercise at all. So it's normal that it might take quite a while. Yes, it's different if we were, you know, in some kind of team playing something when we were kids. So we're always used to it. I think for people like, I guess, you and me as well, that we're not very sporty children. It does require time. But I'm now at my fittest level. I've never been as fit as now. And I'm, you know, I'm 60. Well, you don't look 60. So it's definitely working well.

46:37When we talk about exercise, what do you need to do? Like, do you need to be like lifting weights or going for a run to be doing like this exercise is going to help with your stress? I think the most important thing is to doing something that you really like. That increase your heart rate a little bit so that you feel, you need to feel tired after it. You need to feel fatigued while you're doing it. You know, you need to push it yourself a little bit. Could a long walk, for example. Yes, long walk also works. It's always beneficial because you tend to focus on the repetitiveness of the stepping.

47:11And there's a little bit of kind of creates a little bit of meditation, even if you don't want to do it, basically. What about diet and how it can affect stress? And if I'd said that to you 10 years ago, I've been like, that's mad to think that diet could have any impact on stress. But I've definitely been reassessing that myself. What does the science say? When I hit 40, I started feeling tired and sluggish. I remember thinking, great, this is it. It's all downhill from here. But I was completely wrong. It wasn't my age. It was my diet.

47:42It was literally sapping my energy. I was trying to juggle kids, work, and exercise. And back then, I just grabbed whatever food was nearby. I still have that crazy schedule. But what's changed is what I put in my body. Our own research at Zoe has shown that if your digestion feels off, or you're regularly feeling exhausted, it's often because your gut bugs are starving. They thrive on a huge variety of plants, at least 30 different plants a week. And the more, the better. But if you're as stretched as me, it's not always easy to achieve this.

48:13And that's exactly why our scientists developed Daily 30. It's a great-tasting gut health supplement with over 30 plants in every single scoop. I take it every day, without fail. And because we're Zoe, we don't just guess, we test. We put Daily 30 through a randomized controlled trial, the gold standard of testing. The results absolutely blew us away, proving it's good for energy, digestion, and gut health. That trial helped us develop the formula that we have today. So if you're not feeling like yourself, don't settle for feeling sluggish.

48:45Head to zoe.com slash Daily 30 and try it for yourself. The best evidence is on things like fish, you know, fish-rich diets. And after that, with a little bit less evidence, but promising, if you like, evidence, fruit and vegetables. And these are coming from largely studies at the population level, or cultural group that have a diet that is particularly rich in fish, or vegetable, or fruit, or both, or kind of combination,

49:16they tend to have overall, as a population, lower level of depression or lower level of mental disorders. It is possible that you need a lot, if you like, to actually have a therapeutic effect or preventative effect. So we're talking about kind of, you know, eating fish twice a week or having lots of fruit and vegetables every day. I think, again, even just having some kind of control in avoiding the bad food, not in a way that kind of deprives us of the pleasure of chocolate, but at least having a feeling of control that we can actually, we can decrease the sugar intake.

49:51We can decrease the fat intake. You know, feeling of control is always good for our mental health, partly because it has a really positive effect.

Alcohol and phone scrolling

49:59One thing you haven't really mentioned that I would definitely like to ask about is alcohol. Because I am sure there are a lot of people listening to this podcast who say, you know, I know what I do. I've had a really tough day. I get home, maybe I finally got the kids to bed and have that wonderful noise when you take the cork out of a bottle of wine and you're going to pour a glass of wine and you're going to drink it. And I feel like my stress just falls straight off this alcoholic drink. Does alcohol reduce my stress? I guess is the first question in the short term.

50:31No, I mean, it reduces literally for like the 10 minutes, half an hour that you're drinking and you're under the effect. I would argue that actually, if you feel that it's actually reducing your stress a lot while you're drinking, you're probably drinking too much. It's numbing it and then usually it gets worse after. I mean, partly alcohol increased cortisol. People with alcohol problem, they have sky high level of cortisol. They increase inflammation terribly. So people with alcohol dependence and alcohol abuse, they have high level of cortisol and high level of inflammation.

51:04So physiologically, it does everything that you don't want to do because it activates the stress response. I still think it's nice to have a glass of wine or share a bottle of wine with friends at the end of a difficult day. But I think that if you're using it to numb yourself, then A is only going to be very temporarily and B is going to get worse the day after. These are all dysfunctional coping mechanisms or they become dysfunctional at some point. We all enjoy, you know, social media or spending time, you know, scrolling or spending time on the internet.

51:41It could be pleasurable, interesting. And then it becomes numbing because we are so entrenched into, you know, the movement. Well, I love that you've talked about phones because I did want to ask because it feels like there's this growing evidence that they might actually be harmful for us. A lot of people take out the phone almost as a sort of way to de-stress. But is it in fact making us more stressed? It depends what we're doing it. I suspect most of us, that includes me, we're doing it because at the moment we don't want to think of what is worrying us or we don't want to feel the emotion that we are feeling.

52:21Am I saying that people should not have 10 minutes of kind of relief by looking at a mobile phone? Of course not. The same way that people could have, you know, the glass of wine. If you're becoming, you know, being drunk every night or not interacting with your family or with your friends because you're constantly on your phone, then you need to ask yourself, what am I avoiding in my mind by putting all my attention, you know, on the glass or on the phone or whatever it is. The principle of wanting to use all of these strategies, whatever works for us, to numb our emotions are the same across all of this.

52:55So we need to try to understand how we're using it and we're using it in a healthy way that is acceptable or we're using it in an unhealthy way, whatever it is that we're using. So these aren't fundamentally going to help with my stress, whereas then you're talking about these other things like time with my friends and family, actually trying to understand my stress and see if I can have more control over it. You know, exercise, these things can actually reduce my stress genuinely and therefore lead to a sort of long-term improvement in how I feel and my health.

53:26Exactly, because these things are doing it without numbing us. So they are strategies that help us to cope with stress while being present to our stress, while, you know, the negative coping strategies, if you like, are the ones that are numbing the stress, but they're not helping us finding a solution or finding a way of dealing with it. When I'm stressed, I find it really hard to sleep, but then being tired, I think, makes me feel more stressed and it's a sort of vicious cycle.

53:56How much should I worry about this and is there anything I can do? So I think most of the time, a kind of compassionate waiting, accepting this difficult time, accepting that there will be some difficult nights for sleeping and try to minimize things that are disrupting us, you know, again, screen time, try to go to bed always at the same time, not too late, reading maybe or whatever we feel that is distracting, reading a book or whatever helps us kind of relaxing. That's probably the best strategy.

54:28Once it becomes a problem that you cannot work or, you know, you cannot, kind of, it goes beyond just the discomfort of not sleeping, then that's when you need to ask professional advice or help. And of course, there are most kind of more specific psychological intervention. You can do it. I'm not saying that people should take medication for sleeping problem. And certainly when they do, they usually recommend it only for like a, you know, a week or so just to go through the acute phase. Final question. If someone listening to this podcast right now is feeling really stressed, what's the first thing that you would recommend that they do?

55:09Talk about it to a close person, a friend, a relative, partner. Don't keep it inside. Talk about it. Start with that. Kamina, I really enjoyed that.

Accepting life's difficulties

55:23I would like to do a little summary. I mean, the first thing that springs my mind actually is this thing about alcohol that actually increases my cortisol. And so it doesn't actually reduce my stress. It just sort of numbs me to it. Yes. I think the big thing I took away, though, is, you know, stress is natural. Don't feel guilty about it. Life is difficult. So you're going to have stress in your life. And therefore, you're going to cope better with it just by knowing that. But we also have to recognize that having long-term stress is bad for us because it increases this cortisol, encourages us to eat high fat and high sugar food more than we need.

56:00It encourages us to drink alcohol and smoke and all these sorts of things. It is this very deep system within us. And so you describe brilliantly, like, what happens if, like, I saw a tiger in the distance, but it's the same thing maybe if I'm running late for my meeting. This sympathetic nervous system is being turned on. My heart beats fast and my blood pressure goes up. You know, my blood goes to muscles. All of this stuff about, like, being ready to fight or flee, which obviously makes no sense for a meeting, but it's all being switched on. My immune system is being turned on, and this is turning on my inflammation to get ready because it thinks I'm going to get injured.

56:34And it kicks in this cortisol, which you described as being, like, this really key drug that's having a big impact on me. And it also does some funny things, like, you know, switches off the blood flow to my stomach, which helps explain also why, you know, so many people feel, like, these gut problems related to their anxiety. This is all completely natural, and we shouldn't feel worried that we get this, like, short, sharp stress from time to time. The problem is that in our modern life, we tend to live with chronic stress. It doesn't get switched off properly, and it just sort of stays turned on.

57:08That is a problem over months and years. And what you describe is it disrupts our sleep. You know, it causes appetite changes and stomach pains. It increases our inflammation, which is a really big problem. That leads to fatigue and low energy. It increases our cortisol, as that increases how much we eat. So we put on weight. It leads to a risk of diabetes, heart disease. But, you know, ultimately, all of this together means we're going to die younger. So that's a pretty serious physical risk. But interestingly, there's a real mental side to this as well.

57:39Not just the fatigue, but you said you can end up feeling more sadness and an inability to feel pleasure. So, like, it's not just a long-term thing. It's, like, really going to affect how we feel. But the good news is it's not like there's nothing we can do about stress. You said spend time with your friends and family. Understand what the stress is that's causing this deep, ongoing thing. And even just thinking about it, you may feel like I have more control. Maybe not to remove all of that stress, but to think about what else you're doing in your life.

58:12You know, maybe you've got to keep the job, but you can just change a bit the rest of what you're doing to feel like you have more control over it. But exercise is genuinely anti-inflammatory. So try and add exercise into your life. It doesn't have to be, like, lifting weights or running. Actually, if you can do, like, a long walk that you feel tired about afterwards, that could really be reducing your cortisol and reducing this stress. Even better, like, it's getting you out into nature, which you were describing as really beneficial for this.

58:44Be aware of dysfunctional behaviors that are numbing this. And so you talk quite a bit about the phone, for example. It's not really reducing your stress. It's sort of numbing you from the underlying issue. So it's not triggering these positive sort of biological systems that are sort of reducing the cortisol, you know, like the alcohol. And then maybe the final thing that I took away is try to accept that life can be difficult. You know, that maybe the biggest difference between us living in 2026 and our ancestors is our ancestors just assumed that life would be difficult.

59:17And therefore, actually, they didn't have chronic stress because they're just like, well, this is normal. Whereas we feel everything should be easy and perfect and therefore constantly stressed because life isn't matching that. But this isn't real. And if we can come to terms with the fact that life can be difficult, weirdly, we might feel more relaxed. Absolutely. It's the principle of acceptance, you know, accepting the difficulties that we will encounter. You know, it's just part of life. As you can imagine, hosting this podcast, running Zoe, juggling family life, it all keeps me pretty busy.

59:54So I try as best I can to stay energized and show up well in all those parts of my life by fueling my body with the right food, by exercising and by adding a scoop of Daily 30 to my meals every day. If you haven't heard of Daily 30 yet, it's the gut supplement designed by our gut health scientists here at Zoe. It's made of over 30 high quality handpicked plants, including seaweed, fungi and different types of fiber. Better yet, it contains ingredients that support gut health, digestion and energy, which is ideal for packed calendars and busy lives.

1:00:30Simply add one scoop a day to any meal for an extra boost of fiber and plant diversity. And because it tastes delicious on just about anything and adds a satisfying crunch, it quite quickly slots into your life. It's becoming a daily healthy habit you'll always have time for. By the way, whenever we talk about Daily 30 as a good source of fiber, we're required to say that it contains four grams of total fat per serving. Obviously, that's all amazing healthy fats from plants. So order yours today at Zoe.com slash Daily 30.

1:01:03Thanks for listening and see you next time. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye. Bye.