Ending the Food-Stress Cycle

“I’m exhausted and hungry literally all the time,” Susan (not her real name), an accomplished 47-year-old high school principal, told me at our first meeting. She came to me for help managing her weight and the prediabetes her doctor said was getting ever closer to needing medication that Susan didn’t want to take. Over the last year, she said, her digestion had changed: She was bloated, gassy, and uncomfortable more of the time. She’d been trying to turn things around, “but healthy food,” she said, “is the absolute last thing I want to eat.”

As she related her story, Susan touched my heart, because she felt so alone in her struggle. Today in America, however, she is far from alone. Susan was technically overweight, but what concerned me more were the laboratory biomarkers of health risk—she had high triglycerides and an A1c (a long-term marker of blood sugar) that was creeping steadily higher. Based on her story and situation, it was clear to me that her diet and exercise habits wouldn’t shift until she found a way to do the emotional work that could set the stage for change.

A Stressed-Out Nation

For 11 years now, the American Psychological Association (APA) has done an annual Harris poll called Stress in America, exploring aspects of stress. In 2018, they found that worry about healthcare costs was consistently high regardless of income—it’s keeping us all up at night. In 2017, the poll found that 95 percent of Americans who follow the news are stressed about the fate of our country. Stress by any measure is increasing, and the greatest impact may be on younger people. In addition, the 2013 report suggested that about one-third of us habitually eat in response to stress. The APA’s annual findings seem to repeat three points: there’s always something to be stressed about, we are seriously stressed, and it is affecting our health. The nutritional impact of stress is profound.

Something about our American identity, however, leads us to minimize the far-reaching effects of stress. While we acknowledge that we are super stressed, few of us are utilizing the techniques that can address what we are experiencing. Kripalu is packed with talented teachers offering a banquet of effective tools—yoga, mindfulness, mental reframing and learned optimism, even meditative coloring—that can do the trick if practiced skillfully. 

Get Stressed, Eat Comfort Food, Repeat

Let’s take a peek inside Susan’s body. As she makes her way through her busy day—racing from one high-pressure encounter to the next, helping children with behavior issues too severe for her teachers to handle, keeping her school budgets balanced with fewer and fewer resources—her body is awash with the stress hormone cortisol, along with epinephrine and norepinephrine, creating the “fight-or-flight” neurologic response.

A cascade of biochemistry preps and sustains her for battle: muscles clenched, energy and blood sugar mobilized and flowing. Once an immediate stressor is past, the epinephrine and norepinephrine subside, but cortisol can stay elevated for hours (possibly indefinitely if stress is chronic like Susan’s). Cortisol, among other things, stimulates fat and carbohydrate metabolism and the secretion of insulin, stimulating hunger.

Susan’s nutrition throughout the day consisted of grabbed and gobbled sandwiches eaten at her desk—on a good day. Other days, she went to the vending machine or skipped meals altogether. Most evenings she spent unwinding with TV and takeout.

When Susan eats during her stress-filled day, her physiology is not ready to digest what she’s taking in. The tension in her gut can actually create a gassy inflammatory process. The microbes in her digestive system, so essential to immune and overall health, aren’t functioning at capacity. So, she begins to experience gas and bloating, which make her feel unwell and uncomfortable, which causes her to seek comfort. So she manages her stress by eating comforting foods in the evening, creating a cycle of poor digestion and feeling poorly.

Like so many of us, Susan needs some help to step out of that cycle; she doesn’t have the energy to get a program rolling. How did we begin? Not with big changes in what she ate, but on two fronts—first by addressing stress, then with a small shift around food.

Small, Doable Self-Care Changes

To address stress, we started small, with a two- to five-minute morning metta (loving-kindness) meditation. My friend and colleague Stephen Cope teaches an easy-to-remember version:

May I be happy,
May I be healthy,
May I stand in the light of my own true self.

Each morning Susan was to sit quietly and repeat that short blessing to herself, for just two minutes.

On the food front, we bolstered dietary fiber, which helps manage the blood sugar rollercoaster that can exacerbate stress. This can be done quickly and easily by taking a fiber supplement (like psyllium seed husk in water, for example) before eating.

Once she did these two things consistently, at least three days per week (getting to that point took two months of trial, error, and coaching), we added a simple, balanced breakfast consisting of fresh fruit and a hardboiled egg or a handful of nuts. I asked that she take at least 10 minutes to eat breakfast, and taught her how to eat as a continuation of her morning meditation. On her own, she designed a ritual for her midday meal that included a few long breaths, followed by a slowly eaten yogurt, nuts, and a piece of fruit. These practices laid the groundwork for Susan to being making steady, incremental shifts in her eating and other choices, in a targeted process called Medical Nutrition Therapy—an evidence-based approach to diet and life changes to address health and medical conditions.

Food that supports emotional well-being for a particular person depends on their genetics, lifestyle, and health. Generally, we can find balance with a diet rich in healthy fats from foods like avocados and nuts; nutrient-dense greens, citrus, vegetables, and herbs; and slow carbohydrates like whole grains. For some, a keto-friendly diet—higher in fat and lower in carbohydrates—works, though this approach requires you to stick to the plan, monitor your health, and drink plenty of water.

In typical fashion, slow shifts worked like a dream for Susan … sometimes. Other times, she backslid or completely fell off the wagon and had to begin again. This is the ebb and flow of life, and part of the process of making sustainable change. Over time, Susan gained a variety of tools that helped her move forward. Within six months, her biomarkers suggested that she didn’t need medication to manage her blood sugar and blood lipids. For now, she is metabolically healthy.

Her life is still hectic, and her days still overflow with stress. That has not changed. Her choices and how she manages stress, however, are dramatically different. She has more energy, a greater awareness of what’s happening inside her body, and a toolkit for practicing self-care, no matter what’s happening around her.

Find out about nutrition programs with Annie B. Kay at Kripalu.

Sample more food-related videos, recipes, and articles: The Om of Yum

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