2

Dr. Matthew Roberson

3

13 FAT-BURNING FOODS TO EASE

STRESSTake a minute to ask anyone—including yourself—how they’re doing or how they might describe themselves. Chances are you’ll hear words like “busy,” ”rushed,” or “swamped.” You know the drill; these are just ways that folks communicate that they’re stressed. Stress is ubiquitous, and for most people, it serves as the backdrop of their lives. This has led some to refer to stress as the “wallpaper of the 21st century.”

Many people celebrate stress and pride themselves on being busy. In fact, a good deal of folks would tell you that they wouldn’t know what to do with themselves if they weren’t so busy. The fact of the matter, however, is that stress is distracting, and it can prevent you from making smart decisions and thinking clearly and proactively. Even more, stress can have negative effects on well-being, learning, focus, relationships, communication, body composition, and virtually all other domains of life.

Make no mistake about it, some stress is important. It’s called eustress, and we wouldn’t get better in any area of life without it (e.g., learn, get stronger, grow). Good stress is short-lived, infrequent, is over quickly, can be part of a positive life experience, inspires you to action, and leaves you off better than you were before.

On the other hand, bad stress, which is called distress, lasts a long time, is chronic and ongoing, is negative, depressing, and demoralizing, demotivates and paralyzes you, and breaks you down, leaving you worse off than you were before.

The cumulative sum of all of the stressors (physical, mental, emotional) in your life—both good and bad—is often referred to as your allostatic load. We need a certain amount of stress where we have just the right amount of stress—not too much, not too little, and

4

lasting the right amount of time—that we can recover from and get better as a result. You can think of this like the story of Goldilocks and the Three Bears (i.e., Goldilocks Principle).

It’s important to know that we each have our own individual stress “sweet spot.” Factors like age, life experience, personality type, and stress resilience all play key roles and influence how we perceive events, situations, challenges, etc. In other words, what one person views as a eustress (or, not stressful at all) may be viewed as a distress by another individual. The crux of this report focuses on the negative effects of too much stress—particularly the “bad” kind—and how certain lifestyle factors can help ease stress and lighten your allostatic load.

From a body composition standpoint, stress has been associated with weight gain, which it may drive through multiple pathways:1,2

1. Through eating behaviors and diet quality 2. Through biological processes

With regard to the latter, excess stress or the inability to cope with stress may contribute to storing excess belly fat (i.e., visceral fat). You may be familiar with the “stress hormone” cortisol, which appears to have a direct connection to fat accumulation, and in particular, abdominal fat.

Studies have shown that folks with high waist-hip ratios tend to have poor coping skills and secrete more cortisol when faced with a stressful situation. This suggests a relationship between cortisol and abdominal fat accumulation, and additional studies have identified a similar association between cortisol concentrations, coping skills, chronic stress, and excess belly fat.3,4

There are a number of potential explanations for the stress-cortisol-belly fat connection. For instance, the enzyme (i.e., HSD) that “activates” cortisol from its inactive form (i.e., cortisone) is more prevalent in visceral fat than subcutaneous fat tissue.5 What’s more, visceral fat tissue has greater blood flow and four times as many cortisol receptors (compared to subcutaneous).4 Even more, research shows that cortisol increases lipogenesis, which is the process of fat synthesis and storage.6

5

It’s important to note that the hormone cortisol is not inherently “bad.” In fact, it serves a very important physiological function. In the short-term, along with the catecholamines, cortisol is essential for adaptation, homeostasis, and survival.7 For instance, cortisol (which belongs to the glucocorticoid family of hormones) has a profound effect on blood sugar regulation, as its role is to liberate glucose when blood sugar levels are low. Obviously, that would be very important during acute periods of stress when energy is needed (e.g., fasting, exercise).

However, issues arise when stress is long-lasting, which can have damaging effects on the body and health. In excess, cortisol can negatively impact cardiovascular health, body weight, energy levels, and well-being.

The impact of stress on eating behaviors and diet quality is a profound one, and stress has been associated with higher caloric intake, increased saturated fat and sugar consumption, and poor diet quality.2

“Emotional eating” is defined as eating to relieve negative emotions (e.g., unhappiness, anxiety, or anger), and stress has been well documented as a key negative emotion involved in emotional eating.8 Emotional eaters typically consume more calories, they eat more frequently, and they indulge in greater amounts of highly palatable, high-calorie, sweet, high-fat foods in response to emotional stress.9–12

It’s no secret that stress can be a “trigger” for overeating. In fact, research shows that around 70% of individuals increase their food intake during periods of stress.13,14 Females, overweight individuals, and folks who think about food or body weight obsessively are more likely to eat when stressed.15

As one might expect, research also shows that stress-induced eating typically involves a predisposition for high-sugar and high-fat foods, which are “comfort foods” known to provide strong rewarding effects and reinforce snacking.16

Studies have shown that emotional eaters may try to regulate the negative emotions caused by everyday life through eating behavior, and while their chosen “foods” may provide short-term “comfort” from stress, they also drive appetite for these unhealthy foods at the same time, which ups the risk of weight gain. The benefits on mood may be

6

fleeting, but for most people, the short-lived feelings of well-being may be sufficient to promote repeated attempts to boost mood through stress eating patterns.17

This pattern of stress-induced, emotional eating creates a negative, vicious, perpetuating cycle of overeating and weight gain, followed by restriction, which again leads to overeating and weight gain.15,18,19

While stress has a potent impact on eating behaviors and diet quality, the converse is also quite true: Preoccupation with food and dieting can be a tremendous source of stress.

According to Kiefer et al, cognitive dietary restraint (CDR) is defined as “chronic preoccupation with weight and attempts at restricting food intake.”20 CDR refers to the psychological fixation on food, eating, body weight, etc. Ironically, despite the preoccupation with food intake and body weight, studies have shown that individuals with higher scores on CDR scales experience less weight loss.

Researchers believe that CDR is a significant form of psychological stress, and studies have found positive associations between CDR and shortened telomeres (a biomarker of aging), reduced bone density, irregularities in the menstrual cycle, increased levels of C-reactive protein (a biomarker of inflammation), increased blood pressure (a risk factor for cardiovascular disease), and more.

As it relates to the present discussion, it stands to reason that the constant preoccupation with food and body is a form of stress. Sure enough, numerous studies have shown that dietary restraint is associated with higher levels of cortisol.21,22 Researchers propose that CDR presents as a “subtle but chronic psychological stressor.”20

In its very essence, CDR is like the antithesis of “body knowledge.” Where there may be signs of body knowledge present (e.g., “I feel icky.”), CDR essentially involves the constant overriding of the signals that the body is—or may be—sending. CDR is like a constant tug-of-war between brain and body that relies on extrinsic cues and unrealistic expectations.

In a similar manner, CDR does not employ the basic tenets of self-compassion, as it ignores self-kindness, mindfulness, and common humanity. For instance, CDR does not incorporate self-forgiveness, being kind to oneself, giving oneself a break, or focusing

7

on the process. Rather, CDR is outcome-centered and involves beating oneself up mentally (and physically) in a non-compassionate way. Further, CDR involves isolation of oneself, which ignores the concept that we all have challenges and make mistakes.

Along these lines, being self-critical is a major component of cognitive dietary restraint. In essence, being self-critical is the exact opposite of being self-compassionate. Compared to self-critical individuals, self-compassionate folks:

• Perform better• Are more resilient• Feel less depressed and/or anxious• Have better relationships, feel more secure in relationships, get along with people

more effectively• Are more emotionally intelligent and less egocentric• Are more satisfied with life• Are better able to take risks, are less afraid of failure• Learn, grow, and develop more effectively• Are better at providing social support• Are psychologically healthier overall

According to compassion research, self-compassion involves three parts:

1. Self-kindness: a conscious attitude of kindness; being understanding and nurturing to yourself instead of harshly critical and judgmental. It is not self-indulgence or self-destructive pleasure seeking; you do things that truly make you feel better and sustain you.

2. Common humanity: you realize it’s not just you; everyone has challenges, makes mistakes, and feels down and inadequate; see yourself as part of a larger whole.

3. Mindfulness: state of nonjudgmental, conscious awareness and self-observation.

With that in mind, as a first step to overcoming dietary restraint and being excessively self-critical, we recommend practicing self-compassion every day.

Before moving into specific stress-reducing foods, it’s critical to discuss several other lifestyle variables that can help ease stress. Stress management can be tricky, but

8

there are a number of things that you can start practicing daily that can all contribute to healthy stress levels:

1. Yoga has been shown to exert powerful “anti-stress” effects and cortisol-reducing capabilities.23,24

2. Mindfulness meditation, which is a form of meditation where you focus your awareness on your breathing and body in the present moment, has been shown to lower both stress and cortisol levels.25

3. Regular physical activity, managing finances, and healthy relationships can all contribute to healthy stress levels.

4. Shinrin-yoku, which is also known as “forest bathing,” typically involves taking a leisurely walk in nature. Forest bathing is commonly practiced for the purpose of relaxation and stress management, and studies show that it can reduce sympathetic nervous system activity (i.e., fight or flight), increase parasympathetic nervous system activity (i.e., rest and digest), and lower cortisol levels.26,27

In addition, there may certain dietary supplements that can help reduce cortisol and lower stress. While herbalists have known this for centuries, more and more research suggests that certain herbs (i.e., adaptogens) may be helpful in combating cortisol and improving stress levels. For instance, Rhodiola rosea has been shown to decrease cortisol levels, exert an anti-fatigue effect, increase the ability to concentrate, and lower stress.28 Another adaptogenic herb, Ashwagandha has been shown to have a dramatic cortisol lowering effect.29

Brings a whole new meaning to the phrase, “Take a chill pill,” doesn’t it?

1. Dark Chocolate

Dark chocolate is rich in cocoa polyphenols, which have been shown to have a potent stress-relieving effect. Studies have shown that consumption of dark chocolate can reduce stress in highly-stressed individuals as well as healthy individuals. What’s more, consuming chocolate lowers perceived

9

stress and also decreases levels of cortisol.30–32

As mentioned, cocoa is one of the richest sources of antioxidants (e.g., flavanols, polyphenols).33 The link between stress and oxidative status in the human body is now well-established.34 Along these lines, supplementation with antioxidants and consuming antioxidant-rich foods are considered beneficial strategies for improving stress. There is a strong possibility that flavonoid-rich chocolate consumption may reduce stress through a reduction of oxidative stress.

2. Red Wine

Like dark chocolate (i.e., cocoa) and other dark, rich-colored fruits, red wine (i.e., grapes) is a rich source of antioxidant polyphenols (e.g., anthocyanins).35 One of the best-known polyphenols found in red wine is resveratrol, and a number of studies have demonstrated the anti-inflammatory activity of resveratrol and its ability to promote a healthy inflammatory response.36 Resveratrol also seems to modulate the body’s inflammatory response and oxidative status by reducing both the production of inflammatory molecules as well as the formation of free radicals.37

Resveratrol has also been purported to prevent obesity, and a number of studies have demonstrated the anti-obesity super powers of this polyphenol. For instance, research has shown that resveratrol decreases the synthesis of fat and reduces the uptake of fat by the body’s fat cells. In addition, resveratrol increases the body’s ability to burn fat for fuel (in the muscles and liver).38

Interestingly, resveratrol has been shown to “brown” white adipose tissue (i.e., body fat), and along these lines, it also seems to increase metabolic rate and calorie expenditure via activation of brown adipose tissue (BAT) thermogenesis. Simply put, BAT is unique in that it burns body fat to produce heat (i.e., thermogenesis), and as a result, BAT thermogenesis is currently being investigated as an anti-obesity target.39,40

While resveratrol seems to be the most popular antioxidant associated with red wine,

10

the beneficial effects of red wine cannot be solely accounted for by this polyphenol due to its low concentration and bioavailability.41 In a recent study published in the journal PLoS One, researchers from Hungary demonstrated that malvidin, the most abundant anthocyanin polyphenol in red wine, possesses potent antioxidant and anti-inflammatory activity, and the effects of malvidin “at least partially account for the positive effects of moderate red wine consumption.”42 This is important to note because it highlights that a combination of red wine polyphenols—not a single compound—may be needed to derive the touted health benefits.

In addition, red wine may have a beneficial effect on the balance of gut bacteria (i.e., gut microbiome), which can have a profound impact on feelings of mood, feelings of well-being, and anxiety. In a recent study published in the American Journal of Clinical Nutrition, researchers from Spain found that daily consumption of red wine for 4 weeks significantly increased the amount of beneficial microbes (e.g., Enterococcus, Prevotella, Bacteroides, Bifidobacterium, Bacteroides uniformis, Eggerthella lenta, and Blautia coccoides–Eubacterium rectale) in healthy human participants. The researchers attributed this to the prebiotic-like effects of the polyphenols found in wine.43

Altogether, moderate amounts of red wine—1 glass (i.e., 5 ounces) per day for women and 1 – 2 glasses per day for men—may be beneficial to help ease stress and promote health. It’s important to note, however, that drinking alcohol in excess appears to increase the body’s production of pro-inflammatory molecules, according to researchers from the University of North Carolina.44

In other words, this is not an excuse to start drinking or to drink excessively. Rather, enjoy a glass of wine with friends or family over dinner; research also shows that people with more positive social support and interaction have lower levels of cortisol.45

3. Protein Ice Cream

Ice cream is a unanimous comfort food; unfortunately, the overwhelming majority of commercially-available ice cream preparations are loaded with refined sugar, saturated fat, and calories. Not surprisingly, they’re void of

11

metabolism-supporting, appetite-satiating nutrients like protein, fiber, healthy fats, and essential nutrients. Simply put, they would not fit the bill of a “healthy” snack. However, with just a few tweaks, you can take ice cream off your “taboo” list. Here are some healthy options.

Simple Protein Ice Cream

Ingredients:

• 1 – 2 scoops BioTRUST® Low Carb• 1 – 2 tbsp almond butter• 1 – 3 ounces unsweetened almond milk

How to make it:

Place your almond butter in a bowl and then add protein powder. Wisk in the almond milk slowly, and then mix the powder, almond butter, and milk, until you have a pudding-like substance. If you want, you can eat this right now and call it protein pudding. Alternatively, you can put it in the freezer for 30-45 minutes for an ice cream-like consistency.

Frozen Banana Ice Cream

Ingredients:

• 1 – 2 scoops BioTRUST Low Carb• 1 frozen banana, cut into pieces (before freezing)• 1 – 2 tbsp natural peanut butter or almond butter• 1 – 3 tbsp unsweetened almond milk• Optional mix-ins: dark chocolate, berries, coconut pieces, nuts, seeds

How to make it:

Put all ingredients into blender or food processor and blend until smooth. If you prefer chunks of your “mix-ins,” mix some or all in by hand after blending. Recipe can be enjoyed immediately or put in the freezer.

12

4. Fatty Fish

Cold-water, fatty fish (e.g., salmon, mackerel, herring, anchovies, sardines) are rich in omega-3 fatty acids, which boost mood and ease anxiety and stress. In one study, researchers from France evaluated the effects of supplementation with omega-3 fatty acids on the stimulation of the sympathetic nervous system and stress hormones. They found that three weeks of omega-3 supplementation significantly blunted cortisol and sympathetic nervous system activity when participants were challenged with a mental task.46

In a randomized controlled trial published in the Journal of the International Society of Sports Nutrition, researchers from Gettysburg College assessed the effects of supplementation with omega-3 fatty acids on cortisol levels. After 6 weeks of supplementation, they found that participants’ levels of cortisol were reduced. Not only that, participants who supplemented with fish oil also significantly reduced body fat and increased calorie-burning lean mass.47

5. Kiwifruit, Oranges, Grapefruit, Pineapples & Berries

What makes this group of fruits stand out as stress-busting is that they’re excellent sources of vitamin C, which studies suggest can curb stress and fortify the immune system. In one study, German researchers found that, when faced with a stressful situation (i.e., public speaking), healthy young adults who supplemented with vitamin C experienced reduced blood pressure, a decreased stress response, and significant reductions in the hormone cortisol.48

Of course, fruits like these are also rich in antioxidants, which help control oxidative

13

stress, and subsequently, stress. Studies show that low intakes of antioxidants are linked to higher levels of cortisol.49 Anthocyanins, the phytonutrients that give berries their dark color, have been shown to inhibit cortisol secretion and improve overall quality of life in healthy volunteers.50

6. Spinach & Leafy Greens

Spinach and other leafy greens are great sources of the mineral magnesium, which regulates cortisol and calms the nervous system. Research has shown that supplementation with magnesium can reduce cortisol levels when study participants are faced with a stressful challenge.51 Supplementation with magnesium also led to reductions in sleeping cortisol levels and significant increases in slow-wave sleep, which contributed to normalize age-related changes in sleep patterns in older study participants.52

Spinach is also an excellent source of several B vitamins (e.g., B2, B6, Folate), and the research on the importance of B vitamins for dealing with stress is well-documented. For instance, research has identified that chronic stress depletes vitamin B6 while supplementation with B6 vitamins could be a therapeutic strategy in reducing stress.53,54

B vitamin supplementation has been shown to lead to improved ratings of stress, mental health, and vigor as well as improved cognitive performance when faced with intense mental processing tasks.55

In a recent randomized controlled trial, researchers from Australia examined the effects of supplementation with B vitamins on workplace stress and mood variables in a group of full-time employed adults who subjectively reported feeling stressed. After 3 months, the participants who supplemented with B vitamins reported significantly lower personal strain and a reduction in confusion and depressed mood.56

14

7. Nuts & Seeds

Like spinach, nuts (e.g., cashews, almonds) and seeds (e.g., pumpkin, sesame, sunflower) are good sources of magnesium. Research has shown that magnesium deficiency induces anxiety and initiates the body’s stress response (e.g., increase in the production of stress hormones); conversely supplementation with magnesium has been shown to reduce anxiety-related behaviors.57

Nuts and seeds also tend to be good sources of the mineral zinc. Research has shown that lower zinc intakes appear to be associated with anxiety and depressed mood, and supplementation with zinc leads to significant improvements in anxiety and mood.58

Another stress-easing property of nuts and seeds is their crunchiness. Interestingly, chewing (i.e., mastication) is an effective behavior for coping with stress. Researchers believe that chewing causes changes in the hypothalamic-pituitary-adrenal axis (HPA axis), which is responsible for initiating the hormonal response to stress. Under stressful circumstances, mastication attenuates stress-induced increases in stress hormones (e.g., cortisol, catecholamines).59

8. Chewing Gum

Based on the previous section, you may have seen this one coming. That’s right, chewing gum does more than freshen breath. In a randomized controlled trial published in the journal Physiology & Behavior, Australian researchers found that chewing gum prior to a stressful task significantly reduce anxiety, stress, and cortisol levels and led to significantly better alertness and performance on the task.60

In another study, Japanese researchers found that regular gum chewing led to reduced anxiety, improved mood, and decreased feelings of fatigue compared to placebo. Additional research has shown that perceived level of stress decreases after chewing

15

gum, and conversely, increases when participants abstain from gum chewing.61

9. Smart CARBS

You may recall from the introduction that one of the primary functions of the hormone cortisol is to make sure that blood glucose levels are sufficient, as cortisol serves to increase and maintain normal blood glucose concentrations. It stands to reason, then, that eating carbohydrates and naturally increasing blood glucose levels would decrease cortisol output. This is, in fact, true, and the hormone insulin, which is secreted in response to increasing levels of blood sugar, counteracts cortisol.

What’s more, carbohydrates promote the release of serotonin, a “feel-good” neurotransmitter that soothes, calms, and reduces anxiety. Along these lines, research also suggests that consuming some unrefined carbohydrates may improve sleep quality and how long it takes to fall asleep.62

Not surprisingly, serotonin is also closely linked to stress and emotional states like anxiety and arousal.63 It’s true, serotonin attenuates stress, and normal, healthy levels of serotonin lead to feelings of satisfaction and well-being. As one might expect, low levels of serotonin are related to negative mood and reduced feelings of well-being.

Serotonin also plays a crucial role in the regulation of appetite and satiety, as it acts in both the brain and the gut to induce feelings of fullness and satisfaction.64,65 In fact, serotonin works opposite of the hunger hormone ghrelin. That’s right, while high levels of ghrelin stimulate appetite, high levels of serotonin induce satiety and reduce appetite.

With all of that in mind, carbs can be a good food source to ease stress, and we recommend centering the majority of your intake around “smart carbs” like the following:

1. Colorful, starchy vegetables (e.g., sweet potatoes, purple potatoes, winter squashes)

2. Colorful fruits (e.g., berries)3. Other sweet/starchy fruits and vegetables (e.g., bananas, plantains, potatoes)4. Legumes (e.g., lentils and beans)

16

5. Whole, intact grains (rather than foods made from processed flours), including whole or steel-cut oats; wild, brown, or red rice; quinoa, amaranth, or buckwheat groats; sprouted grains; kamut or spelt grains; maize; millet; and barley

6. Other whole grain products (e.g., sprouted grains)

10. Chamomile Tea

Chamomile is one of the oldest, most widely used and well-documented medicinal plants in the world and has been recommended for a variety of healing applications. Chamomile is widely regarded as a mild sedative and sleep-inducer, and it has been used traditionally to promote sleep and induce calming effects.

The relaxing effects of chamomile may be due to the flavonoid apigenin, which binds to benzodiazepine receptors in the brain. Benzodiazepines are a class of drugs that are used primarily for treating anxiety and insomnia. In one study, researchers found that chamomile reduced the stress-induced increase in plasma adrenocorticotropic hormone (ACTH), which is the precursor hormone to cortisol.66

11. Black Tea

It may come somewhat as a surprise that black tea makes the list considering that it contains caffeine, which increases cortisol levels both at rest and during periods of stress.67 However, tea has anecdotally been associated with stress relief, and research shows that regular black tea consumption may help you recover from stressful events more quickly.

In a randomized controlled trial published in the journal Psychopharmacology, researchers from London assessed the effects of black tea consumption on a variety of variables including participants’ cortisol responses to acute stress. After 6 weeks of drinking 4 cups of black tea daily, participants experienced lower cortisol levels in response to challenging behavioral tasks, and what’s more, they reported greater

17

subjective relaxation.68

Researchers suspect that the stress-easing properties of tea may be due, at least in part, to its theanine content. On its own, theanine has been shown to have anti-stress and anxiolytic (i.e., anxiety inhibiting) effects, including reducing subjective stress and anxiety in response to a task.69

When theanine is added to caffeine, it preferentially modulates the effects of caffeine. For instance, theanine nullifies many of the common adverse effects of the caffeine (e.g., jitters, anxiety, inability to focus, increased blood pressure). Caffeine also has been shown to reduce cerebral blood flow (which means less oxygen-rich blood), an effect that is negated when it is combined with theanine.70

Theanine increases activity in the alpha frequency band in the brain, which has been shown to be reduced when caffeine is ingested by itself. Alpha brain waves are crucial to focusing attention, and this explains why theanine has been shown to contribute to a calm, yet alert, focus.71 The combination of theanine plus caffeine has been shown to improve reaction time, working memory, and alertness while reducing tiredness.

12. Yogurt & Kefir

Unless you’ve been living under a rock, you’ve likely heard of probiotics. While probiotics can have a profound effect on digestion and immunity, perhaps some of the most impactful research on probiotics comes in the areas of anxiety, depression, and mood.

This shouldn’t come as too much of a surprise; after all, the gut is colloquially termed the “second brain.” It has its own entire nervous system network called the Enteric Nervous System (ENS), which has approximately 100 million neurons and uses/secretes most of the same neurotransmitters as the Central Nervous System (CNS), including 90 – 95% of the body’s serotonin, half of its dopamine, and a large quantity of melatonin.

In a study spearheaded by Dr. John Cryan, researchers found that supplementation with Lactobacillus rhamnosus reduced stress, anxiety, and depression-related behaviors

18

in mice.72 The researchers found that the probiotics altered receptors in the brain for GABA, a calming neurotransmitter. GABA dysregulation is implicated in depression, anxiety, irritable bowel syndrome, fibromyalgia, and chronic fatigue syndrome.

Studies like these have prompted researchers, including Dr. Cryan, to term certain probiotics, including those in the Bifidobacterium genera, “psychobiotics” due to their effects on well-being and their anti-depressant and anti-anxiety activities.73

In a study published in the British Journal of Nutrition, French researchers found that two weeks of supplementation with a probiotic formulation, including Lactobacillus heretics and Bifidobacterium longum, yielded beneficial psychological effects—including decreased depression, anxiety, and hostility and lower cortisol levels—in healthy human volunteers.74

Yogurt is one of the most commonly consumed probiotic-rich foods. While not as popular as yogurt, kefir, which is a complex fermented dairy product created through the fermentation of milk by a large, diverse community of lactic acid bacteria and yeasts (i.e., kefir grain), is a dramatically more robust source of probiotics. In fact, kefir may contain DOZENS of different strains of probiotics, including various species from the Lactobacillus, Lactococcus, Streptococcus, Leuconostoc, Oenococcus, Acetobacter, and Bifidobacterium families as well as various healthy yeast and fungal species.75

13. Fermented Veggies

Like yogurt and kefir, fermented veggies (e.g., sauerkraut, pickles) are also excellent sources of probiotics, and along those same lines, they have the potential to ease stress and boost mood by fortifying the “gut-brain” connection. A recent study published in the journal Psychiatry Research demonstrated that more frequent consumption of fermented foods was associated with fewer symptoms of social anxiety, suggesting that fermented foods that contain probiotics may have a protective effect against social anxiety.76

Make no mistake about it, stress is individualistic, complex, and multifactorial. Likewise,

19

stress management, which is necessary for optimizing the way you look, feel, and perform, is the product of numerous lifestyle factors, one of which is nutrition. But it’s important to remind you that nutrition is just one of a number of components of effectively managing stress, albeit an important one. However, there’s no magic bullet and no single food is going to be a substitute for poor stress management nor will it mitigate excess, chronic stress.

20

References:1. Block JP, He Y, Zaslavsky AM, Ding L, Ayanian JZ. Psychosocial Stress and

Change in Weight Among US Adults. Am J Epidemiol. 2009;170(2):181-192. doi:10.1093/aje/kwp104.

2. Richardson AS, Arsenault JE, Cates SC, Muth MK. Perceived stress, unhealthy eating behaviors, and severe obesity in low-income women. Nutr J. 2015;14:122. doi:10.1186/s12937-015-0110-4.

3. Moyer AE, Rodin J, Grilo CM, Cummings N, Larson LM, Rebuffé-Scrive M. Stress-induced cortisol response and fat distribution in women. Obes Res. 1994;2(3):255-262.

4. Epel ES, McEwen B, Seeman T, et al. Stress and body shape: stress-induced cortisol secretion is consistently greater among women with central fat. Psychosom Med. 2000;62(5):623-632.

5. Morris KL, Zemel MB. 1,25-dihydroxyvitamin D3 modulation of adipocyte glucocorticoid function. Obes Res. 2005;13(4):670-677. doi:10.1038/oby.2005.75.

6. Lee M-J, Fried SK. The glucocorticoid receptor, not the mineralocorticoid receptor, plays the dominant role in adipogenesis and adipokine production in human adipocytes. Int J Obes 2005. 2014;38(9):1228-1233. doi:10.1038/ijo.2014.6.

7. McEwen BS. Plasticity of the hippocampus: adaptation to chronic stress and allostatic load. Ann N Y Acad Sci. 2001;933:265-277.

8. Walfish S. Self-assessed emotional factors contributing to increased weight gain in pre-surgical bariatric patients. Obes Surg. 2004;14(10):1402-1405. doi:10.1381/0960892042583897.

9. Oliver G, Wardle J, Gibson EL. Stress and food choice: a laboratory study. Psychosom Med. 2000;62(6):853-865.

10. Vicennati V, Pasqui F, Cavazza C, et al. Cortisol, energy intake, and food frequency in overweight/obese women. Nutr Burbank Los Angel Cty Calif. 2011;27(6):677-680. doi:10.1016/j.nut.2010.07.016.

11. Kim Y, Yang HY, Kim A-J, Lim Y. Academic stress levels were positively associated with sweet food consumption among Korean high-school students. Nutrition. 2013;29(1):213-218. doi:10.1016/j.nut.2012.08.005.

21

12. Macedo DM, Diez-Garcia RW. Sweet craving and ghrelin and leptin levels in women during stress. Appetite. 2014;80:264-270. doi:10.1016/j.appet.2014.05.031.

13. Stone AA, Brownell KD. The stress-eating paradox: Multiple daily measurements in adult males and females. Psychol Health. 1994;9(6):425-436. doi:10.1080/08870449408407469.

14. Epel E, Jimenez S, Brownell K, Stroud L, Stoney C, Niaura R. Are stress eaters at risk for the metabolic syndrome? Ann N Y Acad Sci. 2004;1032:208-210. doi:10.1196/annals.1314.022.

15. Greeno CG, Wing RR. Stress-induced eating. Psychol Bull. 1994;115(3):444-464.16. Adam TC, Epel ES. Stress, eating and the reward system. Physiol Behav.

2007;91(4):449-458. doi:10.1016/j.physbeh.2007.04.011.17. Gibson EL. The psychobiology of comfort eating: implications for

neuropharmacological interventions. Behav Pharmacol. 2012;23(5-6):442-460. doi:10.1097/FBP.0b013e328357bd4e.

18. Laitinen J, Ek E, Sovio U. Stress-related eating and drinking behavior and body mass index and predictors of this behavior. Prev Med. 2002;34(1):29-39. doi:10.1006/pmed.2001.0948.

19. Polivy J, Herman CP. Distress and eating: why do dieters overeat? Int J Eat Disord. 1999;26(2):153-164.

20. Kiefer A, Lin J, Blackburn E, Epel E. Dietary restraint and telomere length in pre- and post-menopausal women. Psychosom Med. 2008;70(8):845-849. doi:10.1097/PSY.0b013e318187d05e.

21. Rideout CA, Linden W, Barr SI. High cognitive dietary restraint is associated with increased cortisol excretion in postmenopausal women. J Gerontol A Biol Sci Med Sci. 2006;61(6):628-633.

22. McLean JA, Barr SI, Prior JC. Cognitive dietary restraint is associated with higher urinary cortisol excretion in healthy premenopausal women. Am J Clin Nutr. 2001;73(1):7-12.

23. Thirthalli J, Naveen GH, Rao MG, Varambally S, Christopher R, Gangadhar BN. Cortisol and antidepressant effects of yoga. Indian J Psychiatry. 2013;55(Suppl 3):S405-S408. doi:10.4103/0019-5545.116315.

24. Vedamurthachar A, Janakiramaiah N, Hegde JM, et al. Antidepressant efficacy and hormonal effects of Sudarshana Kriya Yoga (SKY) in alcohol dependent individuals. J Affect Disord. 2006;94(1-3):249-253. doi:10.1016/j.jad.2006.04.025.

25. Turakitwanakan W, Mekseepralard C, Busarakumtragul P. Effects of mindfulness

22

meditation on serum cortisol of medical students. J Med Assoc Thail Chotmaihet Thangphaet. 2013;96 Suppl 1:S90-S95.

26. Park BJ, Tsunetsugu Y, Kasetani T, Kagawa T, Miyazaki Y. The physiological effects of Shinrin-yoku (taking in the forest atmosphere or forest bathing): evidence from field experiments in 24 forests across Japan. Environ Health Prev Med. 2010;15(1):18-26. doi:10.1007/s12199-009-0086-9.

27. Li Q, Kobayashi M, Kumeda S, et al. Effects of Forest Bathing on Cardiovascular and Metabolic Parameters in Middle-Aged Males. Evid-Based Complement Altern Med ECAM. 2016;2016. doi:10.1155/2016/2587381.

28. Olsson EM, von Schéele B, Panossian AG. A randomised, double-blind, placebo-controlled, parallel-group study of the standardised extract shr-5 of the roots of Rhodiola rosea in the treatment of subjects with stress-related fatigue. Planta Med. 2009;75(2):105-112. doi:10.1055/s-0028-1088346.

29. Auddy B, Hazra J, Mitra A, Abedon B, Ghosal S. A Standardized Withania Somnifera Extract Significantly Reduces Stress-Related Parameters in Chronically Stressed Humans: A Double-Blind, Randomized, Placebo-Controlled Study. JANA. 2008;11(1):50-56.

30. Martin F-PJ, Rezzi S, Peré-Trepat E, et al. Metabolic Effects of Dark Chocolate Consumption on Energy, Gut Microbiota, and Stress-Related Metabolism in Free-Living Subjects. J Proteome Res. 2009;8(12):5568-5579. doi:10.1021/pr900607v.

31. Wirtz PH, von Känel R, Meister RE, et al. Dark chocolate intake buffers stress reactivity in humans. J Am Coll Cardiol. 2014;63(21):2297-2299. doi:10.1016/j.jacc.2014.02.580.

32. Al Sunni A, Latif R. Effects of chocolate intake on Perceived Stress; a Controlled Clinical Study. Int J Health Sci. 2014;8(4):393-401.

33. Miller KB, Hurst WJ, Payne MJ, et al. Impact of alkalization on the antioxidant and flavanol content of commercial cocoa powders. J Agric Food Chem. 2008;56(18):8527-8533. doi:10.1021/jf801670p.

34. Aschbacher K, O’Donovan A, Wolkowitz OM, Dhabhar FS, Su Y, Epel E. Good stress, bad stress and oxidative stress: insights from anticipatory cortisol reactivity. Psychoneuroendocrinology. 2013;38(9):1698-1708. doi:10.1016/j.psyneuen.2013.02.004.

35. Bitsch R, Netzel M, Frank T, Strass G, Bitsch I. Bioavailability and Biokinetics of Anthocyanins From Red Grape Juice and Red Wine. J Biomed Biotechnol. 2004;2004(5):293-298. doi:10.1155/S1110724304403106.

23

36. de la Lastra CA, Villegas I. Resveratrol as an anti-inflammatory and anti-aging agent: mechanisms and clinical implications. Mol Nutr Food Res. 2005;49(5):405-430. doi:10.1002/mnfr.200500022.

37. Candelario-Jalil E, de Oliveira ACP, Gräf S, et al. Resveratrol potently reduces prostaglandin E2 production and free radical formation in lipopolysaccharide-activated primary rat microglia. J Neuroinflammation. 2007;4:25. doi:10.1186/1742-2094-4-25.

38. Aguirre L, Fernández-Quintela A, Arias N, Portillo M. Resveratrol: Anti-Obesity Mechanisms of Action. Molecules. 2014;19(11):18632-18655. doi:10.3390/molecules191118632.

39. Chechi K, Nedergaard J, Richard D. Brown adipose tissue as an anti-obesity tissue in humans: Brown fat in humans. Obes Rev. 2014;15(2):92-106. doi:10.1111/obr.12116.

40. Wang S, Liang X, Yang Q, et al. Resveratrol induces brown-like adipocyte formation in white fat through activation of AMP-activated protein kinase (AMPK) α1. Int J Obes. 2015;39(6):967-976. doi:10.1038/ijo.2015.23.

41. Gescher AJ, Steward WP. Relationship between mechanisms, bioavailibility, and preclinical chemopreventive efficacy of resveratrol: a conundrum. Cancer Epidemiol Biomark Prev Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol. 2003;12(10):953-957.

42. Bognar E, Sarszegi Z, Szabo A, et al. Antioxidant and anti-inflammatory effects in RAW264.7 macrophages of malvidin, a major red wine polyphenol. PloS One. 2013;8(6):e65355. doi:10.1371/journal.pone.0065355.

43. Queipo-Ortuno MI, Boto-Ordonez M, Murri M, et al. Influence of red wine polyphenols and ethanol on the gut microbiota ecology and biochemical biomarkers. Am J Clin Nutr. 2012;95(6):1323-1334. doi:10.3945/ajcn.111.027847.

44. Crews FT, Bechara R, Brown LA, et al. Cytokines and alcohol. Alcohol Clin Exp Res. 2006;30(4):720-730. doi:10.1111/j.1530-0277.2006.00084.x.

45. Rosal MC, King J, Ma Y, Reed GW. Stress, social support, and cortisol: inverse associations? Behav Med Wash DC. 2004;30(1):11-21. doi:10.3200/BMED.30.1.11-22.

46. Delarue J, Matzinger O, Binnert C, Schneiter P, Chioléro R, Tappy L. Fish oil prevents the adrenal activation elicited by mental stress in healthy men. Diabetes Metab. 2003;29(3):289-295.

47. Noreen EE, Sass MJ, Crowe ML, Pabon VA, Brandauer J, Averill LK. Effects of

24

supplemental fish oil on resting metabolic rate, body composition, and salivary cortisol in healthy adults. J Int Soc Sports Nutr. 2010;7:31. doi:10.1186/1550-2783-7-31.

48. Brody S, Preut R, Schommer K, Schürmeyer TH. A randomized controlled trial of high dose ascorbic acid for reduction of blood pressure, cortisol, and subjective responses to psychological stress. Psychopharmacology (Berl). 2002;159(3):319-324. doi:10.1007/s00213-001-0929-6.

49. Diaz E, Ruiz F, Hoyos I, et al. Cell damage, antioxidant status, and cortisol levels related to nutrition in ski mountaineering during a two-day race. J Sports Sci Med. 2010;9(2):338-346.

50. Stockton A, Al-Dujaili E. Biophenols-rich pomegranate extract intake inhibits salivary cortisol and 11[beta]-HSD1 activity and improves overall quality of life scores in healthy volunteers. Endocr Abstr. March 2014. doi:10.1530/endoabs.34.P344.

51. Golf SW, Happel O, Graef V, Seim KE. Plasma aldosterone, cortisol and electrolyte concentrations in physical exercise after magnesium supplementation. J Clin Chem Clin Biochem Z Klin Chem Klin Biochem. 1984;22(11):717-721.

52. Held K, Antonijevic IA, Künzel H, et al. Oral Mg(2+) supplementation reverses age-related neuroendocrine and sleep EEG changes in humans. Pharmacopsychiatry. 2002;35(4):135-143. doi:10.1055/s-2002-33195.

53. Ford AH, Flicker L, Singh U, Hirani V, Almeida OP. Homocysteine, depression and cognitive function in older adults. J Affect Disord. 2013;151(2):646-651. doi:10.1016/j.jad.2013.07.012.

54. Stoney CM. Plasma homocysteine levels increase in women during psychological stress. Life Sci. 1999;64(25):2359-2365.

55. Kennedy DO, Veasey R, Watson A, et al. Effects of high-dose B vitamin complex with vitamin C and minerals on subjective mood and performance in healthy males. Psychopharmacology (Berl). 2010;211(1):55-68. doi:10.1007/s00213-010-1870-3.

56. Stough C, Scholey A, Lloyd J, Spong J, Myers S, Downey LA. The effect of 90 day administration of a high dose vitamin B-complex on work stress. Hum Psychopharmacol Clin Exp. 2011;26(7):470-476. doi:10.1002/hup.1229.

57. Sartori SB, Whittle N, Hetzenauer A, Singewald N. Magnesium deficiency induces anxiety and HPA axis dysregulation: Modulation by therapeutic drug treatment. Neuropharmacology. 2012;62(1):304-312. doi:10.1016/j.neuropharm.2011.07.027.

58. Russo AJ. Decreased zinc and increased copper in individuals with anxiety. Nutr Metab Insights. 2011;4:1-5. doi:10.4137/NMI.S6349.

25

59. Kubo K, Iinuma M, Chen H. Mastication as a Stress-Coping Behavior. BioMed Res Int. 2015;2015:e876409. doi:10.1155/2015/876409.

60. Scholey A, Haskell C, Robertson B, Kennedy D, Milne A, Wetherell M. Chewing gum alleviates negative mood and reduces cortisol during acute laboratory psychological stress. Physiol Behav. 2009;97(3-4):304-312. doi:10.1016/j.physbeh.2009.02.028.

61. Zibell S, Madansky E. Impact of gum chewing on stress levels: online self-perception research study. Curr Med Res Opin. 2009;25(6):1491-1500. doi:10.1185/03007990902959283.

62. Peuhkuri K, Sihvola N, Korpela R. Diet promotes sleep duration and quality. Nutr Res. 2012;32(5):309-319. doi:10.1016/j.nutres.2012.03.009.

63. Graeff FG, Guimarães FS, De Andrade TG, Deakin JF. Role of 5-HT in stress, anxiety, and depression. Pharmacol Biochem Behav. 1996;54(1):129-141.

64. Voigt J-P, Fink H. Serotonin controlling feeding and satiety. Behav Brain Res. 2015;277:14-31. doi:10.1016/j.bbr.2014.08.065.

65. Schellekens H, De Francesco PN, Kandil D, et al. Ghrelin’s Orexigenic Effect Is Modulated via a Serotonin 2C Receptor Interaction. ACS Chem Neurosci. 2015;6(7):1186-1197. doi:10.1021/cn500318q.

66. Srivastava JK, Shankar E, Gupta S. Chamomile: A herbal medicine of the past with bright future. Mol Med Rep. 2010;3(6):895-901. doi:10.3892/mmr.2010.377.

67. Lovallo WR, Farag NH, Vincent AS, Thomas TL, Wilson MF. Cortisol responses to mental stress, exercise, and meals following caffeine intake in men and women. Pharmacol Biochem Behav. 2006;83(3):441-447. doi:10.1016/j.pbb.2006.03.005.

68. Steptoe A, Gibson EL, Vuononvirta R, et al. The effects of tea on psychophysiological stress responsivity and post-stress recovery: a randomised double-blind trial. Psychopharmacology (Berl). 2007;190(1):81-89. doi:10.1007/s00213-006-0573-2.

69. White DJ, de Klerk S, Woods W, Gondalia S, Noonan C, Scholey AB. Anti-Stress, Behavioural and Magnetoencephalography Effects of an l-Theanine-Based Nutrient Drink: A Randomised, Double-Blind, Placebo-Controlled, Crossover Trial. Nutrients. 2016;8(1). doi:10.3390/nu8010053.

70. Dodd FL, Kennedy DO, Riby LM, Haskell-Ramsay CF. A double-blind, placebo-controlled study evaluating the effects of caffeine and L-theanine both alone and in combination on cerebral blood flow, cognition and mood. Psychopharmacology (Berl). 2015;232(14):2563-2576. doi:10.1007/s00213-015-3895-0.

26

71. Owen GN, Parnell H, De Bruin EA, Rycroft JA. The combined effects of L-theanine and caffeine on cognitive performance and mood. Nutr Neurosci. 2008;11(4):193-198. doi:10.1179/147683008X301513.

72. Bravo JA, Forsythe P, Chew MV, et al. Ingestion of Lactobacillus strain regulates emotional behavior and central GABA receptor expression in a mouse via the vagus nerve. Proc Natl Acad Sci. 2011;108(38):16050-16055. doi:10.1073/pnas.1102999108.

73. Dinan TG, Stanton C, Cryan JF. Psychobiotics: a novel class of psychotropic. Biol Psychiatry. 2013;74(10):720-726. doi:10.1016/j.biopsych.2013.05.001.

74. Messaoudi M, Lalonde R, Violle N, et al. Assessment of psychotropic-like properties of a probiotic formulation (Lactobacillus helveticus R0052 and Bifidobacterium longum R0175) in rats and human subjects. Br J Nutr. 2011;105(5):755-764. doi:10.1017/S0007114510004319.

75. Bourrie BCT, Willing BP, Cotter PD. The Microbiota and Health Promoting Characteristics of the Fermented Beverage Kefir. Front Microbiol. 2016;7. doi:10.3389/fmicb.2016.00647.

76. Hilimire MR, DeVylder JE, Forestell CA. Fermented foods, neuroticism, and social anxiety: An interaction model. Psychiatry Res. 2015;228(2):203-208. doi:10.1016/j.psychres.2015.04.023.