How do you adapt to everyday stress?
Ryan Bradley, ND, MPH December 2016
There are so many stress-producing factors in our day-to-day lives already! Add on an unexpected family event, or the holidays, and Wham! You’re in the middle of a major stress response that could worsen everything from how you feel, to your sleep, your energy, and yes, your blood sugar. Some of the ways stress manifests in us include: loss of patience, aggravation, aggression, and fatigue- all of which can quickly turn a pleasant holiday interaction into an unpleasant one (even with family!)
Importantly, one’s stress levels directly impacts how the body responds to eating! A recent double-blind, randomized clinical study evaluated how daily stressors in people with major depressive disorder (MDD) impact the body’s response to different high-fat meals. Even though our definitions may differ of “healthy” and “unhealthy”, the investigators divided participants to either receive an “unhealthy” high saturated fat meal or a “healthier” unsaturated fat meal. The study participants who had no stressors the prior day had a markedly greater inflammatory response to the high saturated fat meal (and no inflammatory response to the unsaturated fat). However, both meals induced inflammation in those participants who experienced stress the day before! So controlling stress is necessary to get the best nutrition, and the least inflammation, from even the healthy foods we eat! Reframed slightly differently, a stress response still impacts your body’s physiology for at least an entire day after the stress has passed.
The occasional stress response is helpful when rapid action is needed, such as swerving away from an oncoming car or needing to meet a work deadline. However, prolonged, chronic stress can be harmful (more information about the stress response can be learned in previous articles here).1 Learning to recognize different physiological responses that arise when we feel overwhelming stress can help to identify and correct stressful responses in the future. Common examples of physical symptoms associated with stress include: shallow breathing, a racing mind, lack of focus, fidgeting, and difficulty sleeping. Creating awareness of when these reactions are starting to occur and consciously shifting them into different reactions or no reaction at all can ultimately result in a more constructive, and preferred outcome. Some techniques many people find effective for helping redirect or manage stress include:
- - Taking slow, deep, full breaths, and equating the length of the inhale to the exhale
- - Closing your eyes (as long as you are in a safe place!)
- - Monitoring caffeine intake
- - Stepping away and getting into the outdoors
- - Exercise
- - Yoga, Tai Chi, Qigong2
- - Mindfulness3 and other Mind-Body techniques4
Other stress-management behaviors may provide more instant gratification, but will “catch up with us” in the long run, including: alcohol consumption, overeating, and being quick to express anger.
Another tool for countering stress worth considering is a type of dietary supplement called “adaptogens”. In herbal medicine, the concept of an adaptogen is an herb that “increases the resistance of an organism to a variety of chemical, biological, and physical stressors”.5“Adaptogenic effects” support resiliency in face of a challenge and, more or less, help the body resist mounting a stress response.5,6 Mechanisms of action of adaptogens include interaction with the brain-adrenal connection (i.e., the hypothalamic-pituitary-adrenal axis) and control of key mediators of the stress, including cortisol.7
One well-studied adaptogen that appears to be particularly helpful in addressing stress-induced fatigue (and perhaps even certain forms of depression) is Rhodiola rosea Rhodiola is commonly known as “golden root” and “arctic root”, and is common to Europe and Asia. R. rosea has been used for centuries for its physical and mental fitness-enhancing properties.5,8,9 Early studies on this plant were conducted in Russia and Scandinavia for decades and only recently in Western Europe and the United States. At least six trials of Rhodiola extract have shown improvements in cognitive performance in individuals experiencing stress:
- A randomized, double-blind, placebo-controlled, parallel-group clinical trial evaluated the effect of a standardized Rhodiola rosea extract on the capacity for mental work in 161 military cadets experiencing fatigue and stress. Participants who received Rhodiola experienced less fatigue while performing a series of strenuous tests, compared to the placebo group (p<0.001).10
- Darbinyan et al. conducted a double-blind cross-over trial in 56 young, healthy physicians, who were tested for mental fatigue and performance before and after their night shifts. The group taking the Rhodiola extract had a statistically significant improvement in performance (p<0.01) after 2 weeks. No side effects were reported.11
- The effects of a single dose of a combination product containing Rhodiola rosea L., Schisandra chinensis, and Eleutherococcus senticosus (Siberian ginseng) extracts were evaluated in a pilot double-blind, placebo-controlled, randomized trial including 40 healthy females with chronic stress. At the end of the study, the treatment group demonstrated improvements in attention, speed, and accuracy while performing stressful cognitive tasks (p<0.05).12
- A 12-week study in 120 adults with physical and cognitive deficiencies evaluated the efficacy and safety of Rhodiola rosea extract combined with vitamins and minerals showed a significant improvement in motivation and concentration (p<0.001). Notably, participants had either been assigned to a group that took 2 capsules of the Rhodiola extract after breakfast or 1 capsule after breakfast and 1 capsule after lunch; the group taking the 2 capsules at once experienced greater improvements. No side effects were reported during the study.13
- Over one hundred participants experiencing life-stress symptoms took 200 mg of Rhodiola rosea extract twice daily for 4 weeks. Participants experienced clinically relevant improvements in stress, disability, functional impairment, and reported an overall therapeutic effect.14
- Spasov et al. assessed the effects of Rhodiola rosea extract for 20 days in 40 foreign students during an examination period. Significant improvements were observed in physical fitness, mental fatigue, and neuro-motor tests (p<0.01). Self-assessment of general well-being was also improved in the treatment group in comparison to placebo (p<0.05).15
Identifying stress reduction practices that work for you is an important part of “life management” and an even more important part of diabetes management. Ideally, we’d all work more to preemptively identify our stress response patterns, and prepare ourselves for stressful situations on the horizon (such as the holidays!). Trying different techniques and having tools readily available to manage stress will serve you, not just in the long term, but immediately to help control your blood sugar! And thinking toward the long game, scientists hypothesize healthful stress management may increase longevity! Whether it’s a meditation practice, a movement practice, or an herbal medicine like Rhodiola, different practices will be appropriate for different situations, so I recommend filling a toolbox with the tools you need for…life…with or without diabetes!
In health, Ryan Bradley, ND, MPH
1. Bradley R. Stress Reduction (Part 1). Diabetes Action Heal Living Artic. 2010.
2. Bradley R. Stress Reduction (Part 2). Diabetes Action Heal Living Artic. 2010.
3. Bradley R. Wishing You a Mindful Holiday Season. Diabetes Action Heal Living Artic. 2013.
4. Bradley R. Stress and Diabetes (Part 3). Diabetes Action Heal Living Artic.
5. Iovieno N, Dalton ED, Fava M, Mischoulon D. Second-tier natural antidepressants: Review and critique. J Affect Disord. 2011;130(3):343-357. doi:10.1016/j.jad.2010.06.010.
6. Levin O. Phyto-adaptogens-protection against stress? Harefuah. 2015;154(3):183-186, 211.
7. Panossian A, Wikman G. Evidence-based efficacy of adaptogens in fatigue , and molecular mechanisms related to their stress protective activity. Curr Clin Pharacology. 2009;4(3):198-219.
8. Amsterdam JD, Panossian AG. Rhodiola rosea L. as a putative botanical antidepressant. Phytomedicine. 2016;23(7):770-783. doi:10.1016/j.phymed.2016.02.009.
9. Recio MC, Giner RM, Máñez S. Immunmodulatory and Antiproliferative Properties of Rhodiola Species. Planta Med. 2016;82(11-12):952-960. doi:10.1055/s-0042-107254.
10. Shevtsov VA, Zholus BI, Shervarly VI, et al. A randomized trial of two different doses of a SHR-5 Rhodiola rosea extract versus placebo and control of capacity for mental work. Phytomedicine. 2003;10(2-3):95-105. doi:10.1078/094471103321659780.
11. Darbinyan V, Kteyan A, Panossian A, Gabrielian E, Wikman G, Wagner H. Rhodiola rosea in stress induced fatigue — A double blind cross-over study of a standardized extract SHR-5 with a repeated low-dose regimen on the mental performance of healthy physicians during night duty. Phytomedicine. 2000;7(5):365-371. doi:10.1016/S0944-7113(00)80055-0.
12. Aslanyan G, Amroyan E, Gabrielyan E, Nylander M, Wikman G, Panossian A. Double-blind, placebo-controlled, randomised study of single dose effects of ADAPT-232 on cognitive functions. Phytomedicine. 2010;17(7):494-499. doi:10.1016/j.phymed.2010.02.005.
13. Fintelmann V, Gruenwald J. Efficacy and tolerability of a Rhodiola rosea extract in adults with physical and cognitive deficiencies. Adv Ther. 2007;24(4):929-939.
14. Edwards D, Heufelder A, Zimmermann A. Therapeutic effects and safety of Rhodiola rosea extract WS® 1375 in subjects with life-stress symptoms--results of an open-label study. Phytother Res. 2012;26(8):1220-1225. doi:10.1002/ptr.3712.
15. Spasov AA, Wikman GK, Mandrikov VB, Mironova IA, Neumoin V V. A double-blind, placebo-controlled pilot study of the stimulating and adaptogenic effect of Rhodiola rosea SHR-5 extract on the fatigue of students caused by stress during an examination period with a repeated low-dose regimen. Phytomedicine. 2000;7(2):85-89. doi:10.1016/S0944-7113(00)80078-1.