Control Stress for Healthy Eating, Metabolism & Aging | Dr. Elissa Epel
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Dr. Elissa Epel, a professor of Psychiatry and Behavioral Sciences at UCSF and director of the Center on Aging Metabolism and Emotions, joins Huberman Lab to redefine stress not merely as an external event but as how individuals respond to demands exceeding their resources. She emphasizes that while acute stress is a vital survival mechanism involving energy mobilization via mitochondria and ATP, chronic or unmanaged stress leads to exhaustion and biological damage through constant vigilance. A critical distinction made in the discussion is between what happens *to* us versus our interpretation of those events; thoughts are identified as the primary propagators of internal stress. To manage this, Dr. Epel proposes three categories of intervention: top-down strategies involving cognitive reframing to view stress positively, body-based techniques like breathing and exercise that metabolize stress hormones, and environmental changes such as creating "safe zones" with comforting cues like photographs or pets to signal safety to the nervous system. The conversation delves deeply into dietary choices under stress, specifically targeting sugary beverages which Dr. Epel describes as liquid sugar reaching the brain faster than solid food, making them highly addictive due to their rapid impact on insulin and glucose regulation. She argues that these drinks often trap individuals in a hedonic cycle of reward followed by withdrawal rather than providing genuine nourishment. To combat this, she advocates for "dissonance" strategies where people recognize how marketing exploits addiction pathways, suggesting that activating a sense of rebellion against the food industry can be more effective than simple health warnings. Furthermore, Dr. Epel shares findings from her decade-long study on pregnant women, demonstrating that even when weight gain could not always be prevented, mindfulness-based stress reduction training significantly improved insulin sensitivity during pregnancy and resulted in healthier babies with lower obesity rates and better mental health outcomes for mothers years later. Breath work is highlighted as a unique tool because it bridges the conscious mind and unconscious body functions without requiring complex cognitive effort. Dr. Epel discusses her collaboration on studying the Wim Hof method, comparing its effects against traditional mindfulness relaxation and aerobic exercise in randomized trials funded by the John D. and Catherine T. MacArthur Foundation (referred to as the John W. Brinkman Foundation in transcript context). The study revealed that regardless of whether participants engaged in deep relaxation or extreme breathing exercises like those used by Wim Hof, all groups experienced a dramatic reduction in stress, anxiety, and depression after three weeks of daily practice. While specific cellular markers like telomeres may not change quickly, the interventions showed distinct physiological profiles affecting gene expression and nervous system reactivity, proving that multiple paths exist to achieve positive emotional states and resilience. Finally, Dr. Epel addresses how individuals can navigate life's inevitable "waves" by discerning when to exert agency through effort versus when to practice acceptance or release control over uncontrollable circumstances like caregiving responsibilities or global events. She suggests that journaling helps construct a coherent narrative around stressful experiences, allowing people to find meaning and purpose rather than being overwhelmed by rumination. The overarching conclusion is that stress management requires an integrated toolkit combining physical exertion, mindful breathing, cognitive reframing, and environmental design. By leveraging these tools, individuals can transform the negative impacts of chronic stress into opportunities for building resilience, optimizing metabolism, and slowing aging processes, ultimately shifting from a state of constant threat response to one of safety and ease.
Read the full video transcript
welcome to the huberman Lab podcast
where we discuss science and
science-based tools for everyday
[Music]
life I'm Andrew huberman and I'm a
professor of neurobiology and
Opthalmology at Stanford school of
medicine today my guest is Dr Alysa eel
Dr eel is a professor of Psychiatry and
Behavioral Sciences at the University of
California San Francisco she is also the
director of the center on Aging
metabolism and emotions Dr eel's
laboratory focuses on stress and the
many impacts that it has on our brain
and body both negative and positive for
instance her laboratory has shown that
particular forms of stress change our
tiir which are a component of the
genetic Machinery of our cells that
impacts how quickly our cells and
therefore we age we also discuss
exciting work from Dr eel's laboratory
exploring how stress impacts our
behavioral choices in particular which
foods we elect to eat and how we
experience those Foods today you'll
learn how stress and your interpretation
of your stress impacts the different
aspects of your biology and psychology
you'll also learn about several
important stress interventions that Dr
eel's laboratory has explored including
meditation and breath work can
profoundly influence the way that stress
impacts your brain and body both For
Better or For Worse she's also explored
how specific dietary interventions such
as omega-3 fatty acid intake impacts
stress and our response to stress and a
key and important feature I believe of
Dr eel's work is how stress and stress
interventions vary in their
effectiveness depending on whether or
not the subjects in her experiments are
male versus female and their social
status by the end of today's episode I
assure you you will have a much more
thorough understanding of what stress is
and how it changes our biology and
psychology as well as the specific
stress interventions that are going to
be most optimal for you in reducing the
negative effects of stress on the aging
process and on negative behavioral
choices and also how to leverage stress
in order to maximize the positive
effects that stress can have on cellular
metabolism mental health physical health
and performance to learn more about the
work from Dr eel's laboratory as well as
to learn more about her books entitled
the tiir effect and now more recently
the stress prescription you can find
links to those in the show note captions
before we begin I'd like to emphasize
that this podcast is separate from my
teaching and research roles at Stanford
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huberman and now for my discussion with
Dr Alyssa eel Dr eel welcome thank you
so great to have you here we have
colleagues in common and topics of
Interest related to our Laboratories in
common so got a lot of questions today
I'd love to just kick off by you
explaining a little bit about the
different forms of stress you know we
hear stress stress is bad stress can
kill us no one likes to feel stressed
Etc but as you and I both know that's
not the entire picture so love for you
to just educate us a bit on what stress
is and what it isn't uh where it can be
problematic and where perhaps it can
even be beneficial so as a stress
scientist it is a word I use a lot but
it has to be broken down because it has
so many different kind of dimensions and
meaning so there's good and bad stress
there's acute and chronic stress and you
know technically it just means anytime
we feel overwhelmed that we feel like
the demands are too much for our
resources so that's kind of a a very
technical way to put it but really so
much of life is about meeting challenges
and we're never going to get rid of
different stressful situations ations in
life if anything they are increasing and
so it really comes down to not the
stressors of what's happens to us but
really how we respond the stress
response so that's a distinction that
we're still trying to get the field to
talk about stress in a more specific way
so that we can think about what
situations are in your life they might
be difficult ongoing situations like
caregiving or work stress or worrying
about Health your own or
someone's and then there's how are you
coping with it so when something happens
we mount a stress response and we
recover and that's beautiful no harm
done we need that that's why we're here
still alive is that survival response
it's it's a problem these days of just
we keep it alive in our head we keep it
alive with our thoughts our thoughts are
the most common form of stress even
though I expected we would get into
tools to combat stress a little bit
later since you have now told us that
our thoughts are the biggest um sort of
propagator of internal
stress what to your knowledge is the
best way or what are the best ways for
us to manage overthinking and ruminating
on stressful topics because I certainly
experienced stress and when I do I have
tools related to you know breath work
running exercise sleep uh non-sleep deep
rest I'm huge fan of all these sorts of
things but when we succumb to stress and
the thinking patterns take over where
the gears are turning and they won't
stop turning what does the science tell
us about ways to manage those thoughts
should we work with them in the sense
that we try and
rationalize um or understand the basis
of the stress or should we try and
divert our thinking away or is there
some other tool that I'm aware unaware
of yes yes both and right so I like to
bin it in three um three categories so
one is we well I'll just say first of
all we have to have some awareness of
how our mind works or we're just like
you know a subject to thinking our
thoughts are real thinking that it's
helpful to keep ruminating and problem
solving because that's our tendency is
to go toward whatever we think there's
threat or risk and to problem solve but
you could just be stuck there all day in
this kind of threat mode or redm state
and that's just a shame we don't need to
turn on that stress response all the
time but that's where we are as a
society so that's why I I wrote the
stress prescription take any survey even
pre- pandemic and people feel the
majority of people feel an overwhelming
amount of stress so even um this past
year 46% of adults s report feeling
overwhelmed by stress and then you break
it down you're like o this is really bad
for young adults and women and people of
color and so we have these you know
groups that are targeted for
marginalization that are
feeling an extremely high amount of
stress in most of those subgroups so
bottom wouldn't you argue that most most
everyone is feeling more stressed now or
is it just or what do the data say yeah
so I think that I think that we're
we come with different levels of
awareness of our stress and so when I
find someone who really doesn't feel a
lot of stress sometimes I can see right
through that and they're just not aware
and sometimes it really is true they
they're often in a different stage of
life and they control their environment
a lot and they've been through a lot I
mean one of the big patterns in
the population levels of stress is that
the older people are less stressed
period if you're over 65 you have been
through so much solv so much you just
have a better perspective on life and on
stressors and then our adults our young
adults have like four times the level of
stress as our older adults so so we do
you know we don't have to wait till we
get older but there certainly is true
wisdom and resilience that comes with
age for many people um often we're so
used to feeling daily stress from our
Urban and Modern Life that we're we
don't notice it we're just used to it
and so we're going through the day with
kind of like clenched hands and just you
know for listeners just even just taking
a check in now and
noticing how you might be holding stress
in your body that's a huge clue it's a
huge place where we accumulate tension
so we might not be aware that we're
stressed but we're clenching our hands
and in fact um my taxi driver who drove
me here
um let me know that he's exactly that
point that he doesn't realize he stress
until he realizes that he's tensing his
shoulders and his and his fists and so
great signal you know doing a check-in
to like notice where in our body we're
holding stress is step one to releasing
it so um going back to this notion of
overthinking what are the tools that um
are most efficient for dealing with
overthinking or
ruminating uh when people just sort
can't seem to let go of the thing that's
the stress or thinking about not the
stress in their body but the thing that
caused the stress the difficult
conversation the thing that irked them
on social media or in their personal
life or professional life or simply out
in the
world so I I wish I had one answer but
I'm going to say lots of strategies
tackle that and so in those three bins
one our top- down strategies of
awareness and things that we can say to
ourselves since our beliefs and mindsets
can really help us release stress view
stress more positively the second bucket
is um not that the Mind changes the body
but the body changes the mind and those
are the set of strategies that you tend
to use the most right we're we're we're
working stress out of the body we're
metabolizing it we're burning it up and
we get relief it changes our you know
amydala activity and moves us to more an
experience state where we're more in our
somat sensory cortex and then the third
uh bucket is change the scene just
getting away from all the stress
triggers that we have in our office or
in um in the city and being in
environment that we find calming it
might even be just be a corner of the
house but implanting what I call safety
signals we're just these animals that
are conditioned to signals whether we're
aware of it or not so having having
things like comforting pets pictures
smells music why not we need those they
help they add up yeah I like the idea of
having a small physical space or I
suppose it could be a large physical
space but for most people who don't have
the resources some small predesignated
physical space that um represents a a
safe Zone um and uh creating or I should
say populating that safe Zone with
things as you said um as a visual
neuroscientist originally I guess now I
study stress um but uh as a visual
neuroscientist we know that photographs
are extremely powerful cues for the
memory system especially uh actual
physical photographs um and I I believe
there is some work on this that if
people keep a photograph of something
that draws positive memories that that
photograph actually they keep it with
them that actually can be a positive cue
for um alleviating stress and just
enhancing mood um this is probably done
less so nowadays because everyone keeps
things on their phones and it's just
kind of a scroll through but um in any
event you know when we talk about
stress uh it's clear that there's
short-term medium-term long-term stress
you studied all these different forms of
stress um if you would be so kind as to
just give us an overview of the
different forms of stress uh how we can
learn to recognize those and then I'd
love to trans I from there into talking
about uh some of the work that you've
been doing on stress and stress related
eating and stress and how it uh relates
to Aging in particular but before we do
that um to get make sure everyone's on
the same page um if you could just uh
pepper our minds with knowledge about
stress in all its um beautiful and um
not so beautiful
forms so when we think
about stress we usually think feeling
stress you know reporting stress and
that's important what are bodies doing
is also important and it's not always
related to our mind so measuring levels
of the nervous system and how Vigilant
we are is another way that we can
understand stress and that's
particularly important and interesting
because that's how stress gets under the
skin we might not be aware we might
report stress but we're still holding
tension and being much more
sympathetically dominated meaning that
we're our body is Vigilant and scanning
for cues and we don't feel safe and so
we're mobilizing a lot more energy than
we need to and stress is so expensive to
the body the stress response uses a
tremendous amount of energy ATP that's
made by your mitochondria and if we have
that kind of vigilant stress response on
all day we're just going to feel
exhausted and we all feel exhausted at
the stage of the kind of long shadow of
the pandemic and it's really no mystery
because we're not good at turning the
stress response off and that's what we
want to really focus on is understanding
we need to mount a big stress response
to cope with things when we need extra
energy but then we can actually let our
body relax and we can turn it off and
that's where the rumination comes and we
want to catch ourselves rehearsing and
reliving stress or worrying about the
next thing saying right now I'm safe and
you know there's the breathing
strategies I'm right with you where
those are the most direct and fast path
to reducing stress in the body period
yeah our colleague David Spiegel
associate chair of Psychiatry at
Stanford and also a colleague of yours
um as well um has I think said it best
which is that breathing is unique among
the functions of the brain because it
really originates as a brain function
and then extends of course to the body
in that it represents a bridge between
the conscious and the unconscious
because at any given moment we're
breathing and of course at any given
moment we can take control of our
breathing there are very few brain
circuits that impact the body in that
way like I can't suddenly just change my
rate of digestion because I decide to
but we can do that with breathing we
will definitely get into some of the um
work that you've been doing on breath
work particular um I know you have a
study that's actually explored the Wim
Hoff method quite directly one of the
few studies that I'm aware of that's
done that so we'll get to that a little
bit later um so you describe stress as a
way that the body and mind mobilize
energy yeah and I didn't quite answer
your question so there's there's that
acute stress response when everything
every hormone and um cell in our body is
having a stress response and that is
allowing us to reorient focus problem
solve it's really beautiful how much we
can um increase our capacity to do
things during stress and then if it you
know lasts minutes or hours we
eventually recover and that is um what
happens all day in small you know to
small extents with daily stressors we
don't necessarily get so threatened that
we release a lot of cortisol but our
nervous system is going up and down all
day then there are then there's kind of
moderate stressful events that maybe
take days or months to cope with and
what's important there is that noticing
like right now am I really coping
acutely with something or can I restore
so that kind of daily restoration is
very important and then there are
chronically stressful situations that go
on for years many of us not all of us
but many of us have those in our life
These are situations I'll just use
caregiving as an example that we can't
change we we can't change other people
we can't change certain situations or
resources and we
can be thinking about them chronically
problem solving trying to wish things
were different or we can use acceptance
radical acceptance strategies and other
strategies to live well with them and
and so that's a really important
strategy for people who feel like their
their life is going to be stressful
forever because of X or Y that that's
not true you have a harder life you're
going to do more coping but you can
actually be dealing with with
uncontrollable chronic
stress in ways that it's not going to
take that toll on your body I mean I
study chronic stress and how it
accelerate cell aging and I can tell you
there's so much variance between people
people are so different so among
caregivers some of them look as
biologically young or younger than our
controls people with no identifiable big
tough situation in their life I love to
hear about the um lack of inevitability
around aging and stret I I realized that
there's a big landscape of of discussion
around aging and stress for us to cover
but since you brought it up um in one of
your papers there's a beautiful graph
and since a lot of people are listening
not watching and we don't use visual
diagrams for that reason I'll try and
explain this as best I can um you
distinguish between optimal aging
typical aging and accelerated aging I
think everyone I can imagine would want
optimal aging right certainly not
accelerated aging and what's interesting
about this graph in your paper is that
while of course it appears that toxic
stress chronically
unmitigated stress that's makes us feel
like we are at the world's Mercy or the
other people's Mercy will accelerate
aging turns out that underexposure to
stress leads to more rapid aging than
what you describe as
ideal amounts of stress in other words
words that no stress is not the answer
rather to have some stress is ideal if
you want to have so-called optimal aging
could you maybe explain a little bit
about the mechanisms behind that maybe
this is a good opportunity also to um
tell us about your tiir work um so the
questions are how does one measure
optimal versus accelerated aging and why
would it be that some stress is better
than no stress when it comes to aging uh
ideally MH so having no stress means
we're not really living like we're not
engaging in the gifts of Life which are
inevitably have some challenging risk
and let me give you an example one study
took um elderly people who have retired
and they you know Society kind of labels
them as you're kind of done with your
meaningful work in life and um you're
you know you are pretty much not able to
contribute to society I mean there's so
many negative stereotypes of people then
kind of embody and then live um and this
program brought them to work in schools
and tutor Young At Risk students and
what happened to them is they went from
feeling maybe safe and under stressed to
feeling challenged but generative they
they were feeling more purpose they were
feeling like they were growing and they
were feeling like their day had more
meaning they had more relationships they
had these caring relationships with the
students the students had all sorts of
issues and troubles drugs and and maybe
not having lunch poverty and so they
felt the stress of that but they also
saw how much they could help with their
support and their tutoring and in the
study they they took images of the
hippocampus and those who engaged in the
program particularly the men actually
had growth of their hippocampus during
this program so at any stage in life we
can be growing and challenging ourselves
even in our much later years and growing
our brain and you know more than anyone
like what does that hippocampal growth
mean for their well-being and their
cognitive functioning yeah it's
interesting that hippocampus of course a
brain area involved in formation and
recall of memories mostly formation of
memories um it's super interesting
because it's so plastic it's so amenable
to the addition of new memories I think
the most striking study to me is the one
and I should point out that most of the
data say that the addition of new
neurons is not the main reason for
improvements in memory but it is one of
them um but Rusty Gage down at the sulk
Institute did a study in I think the
early 2000s where they took terminally
ill people and these people agreed to
have their bodies injected with a Dy
that would label new neurons and then
after they died their brains were
processed um and they didn't die from
the D injection by the way folks they
died from other causes they were
terminally ill and what they discovered
was that even in terminally ill or or
and some of these people were uh quite
old those people were still generating
new neurons especially in the context of
still trying to learn and and acquire
new information so wow um course they're
dead so they can't apply that
information after that but of course
none of us can right none of the
information that but why not up to when
you die right absolutely absolutely one
other example of this my colleague Dave
Almeida he measures you know daily
stressful events in huge National
populations and a small percentage of
people report no stressors and so you
wonder like what's happening are they
not engaging in life are they really not
having stressors it it looks like they
are it's not just that they're not
getting stressed by things they're not
they're not really going out doing much
and what he found is that their level of
kind of memory and cognition their
cognitive Health was significantly lower
so you can imagine the hippocampal you
know the lack of those um
neuroprogenitor cells they're just not
being stimulated it's super interesting
I wasn't aware of that result so I
appreciate you sharing it I almost have
to wonder if it's like exercise where
you know so many people I think now
everybody hopefully understands that
exercise is going to lower blood
pressure reduce resting heart rate
improve muscus skeletal function and
bone density all that stuff but that if
you took a snapshot of the bodily
response during
exercise blood pressure is way way up
heart rate is way way up stress hormones
are way up cortisol is through the roof
during a hard workout and immediately
afterwards and yet that sets in motion a
series of adaptations that brings you to
a better place most of the time I almost
wonder if stress is the same is there
any evidence that
short bouts of stress provided that
they're managed well meaning that we
don't spend the next 24 or 48 Hours
ruminating on the stressor but that
we're able to move through the stressor
and resolve it in some way that that's
actually beneficial for us because of
the mobilization of energy stores and
maybe maybe even changing our threshold
for reacting to stressors in the future
it's a great question and it's one that
I have been chewing on for a while
because we we know as you said that
physical stressors when they're short
and repeated like high-intensity
interval training They are promoting not
just aerobic fitness but stress Fitness
people feel less rumination less
depression less anxiety so they're kind
of tuning up the nervous system what
about psychological stressors and we we
we know two things so one is I do think
that there is a level of Engagement with
moderate stressors that when we are used
to them we get fit and our stress
resilience builds meaning we're less
threatened by them so let me go deep
onto that we can two people can approach
the exact same stressor and one person
is having a pretty um overreactive
stress response where they basically are
feeling their survival is threatened so
it's high cortisol High Vaso
constriction and uh blood pressure goes
up equally in both but the person who's
feeling super threatened either their
survival or their social survival of
their ego their blood pressure went up
because of the Vaso constriction the
other person who is viewing the same
stressor as I can do this this is a
great Challenge and opportunity I have
what it takes those types of thoughts
generate a different hemodynamic
response which is actually more cardiac
output so blood pressure is going up but
in this healthier way more oxygenation
to the brain better problem solving
they're able to maintain this positive
outlook so we've measured the threat
challenge response in many lab studies
and we know lots of things so if you're
having more of the challenge response at
the end of it you're less inflamed so
just in the lab within an hour or two we
see that they they didn't trigger all
that pro-inflammatory response and their
ters tend to be longer which is a
measure we can talk more about but
basically it looks like they have a
slower speed of
Aging that is super interesting you call
this a stress uh challenge resp response
so we could call this kind of a um two
to be really simplistic two types
of psychological stress response feeling
threatened like you're going to fail
you're embarrassed um you know that
social pain response we know well that
feels terrible um but that also that
huge stress response when we you know we
feel it in our stomach our heart is
pounding it's just an ere exaggerated
response that response biologically is
different and
the thoughts that go with it are
different and we recover a lot slower
and then there's the challenge response
which is this it's more of that kind of
activated um excited response and the
beauty is that there are lots of studies
out there done by emotions and social
psychologists that tilt people toward
the challenge response we can actually
promote that challenge response and so
when you asked about like is it good to
have a repeated stress response
yes if it's if it's manageable right
then we're kind of building the muscle
of stress resilience I'd like to take a
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travel packs and the year supply of
vitamin D3 K2 what are the sorts of
things that people I can do in order
including me I should say um can do in
order to um wage that challenge response
is this purely based on mindset like
instead of saying why me why this why
now I can't believe this is happening is
it a mental pivot to okay this is a
great opportunity for growth I don't
know how I'm going to manage this but
I'll manage this um you know you want to
stop me you got to kill me type of type
of mindset is that is that the the
switch that then the body follows
because this is an interesting instance
where the uh most all the stress
mitigation work that my lab does is
focused on using the body to control the
mind but here we're talking about the
Mind controlling the body first and then
the body following suit which I find um
equally fascinating um so are there some
specific mental scripts that people
follow and are we all able to follow
those those scripts yes to some extent
we control the script we can use that
script to prepare ourselves going into a
stressful situ ation and we can use it
at any point during the stress or so
some of us are just wired to have a big
threat response period maybe it's you
know it's h epigenetics we've inherited
maybe it's tra early trauma that has
shaped us to be ex have this exaggerated
emotional response and yes we and others
have found that trauma sensitizes our
emotional stress response so that we are
feeling more threatened but that's okay
because that's the part we can't control
and we just have to have a lot of
self-compassion
and awareness that okay this is what I
do my body reacts like this but what
happens next that's when we can start to
use those statements self-comforting
self-compassion distancing there's all
sorts of statements that allow us to
then recover more
quickly so when we want to shift from a
uh threatened response to a kind of
challenge
response are there any data that dictate
whether whether or not we should keep
those statements in our head write them
down say them out loud I guess what I'm
trying to do here is trying to get to a
little bit more of the the meat of the
the actionable since since a lot of our
listeners I think we'll be um as I am
very excited about the idea that a mere
shift in our mentality about stress can
give us the opposite outcome I mean
before you were talking about Vaso
constriction and inflammation and all
these bad things to um put it lightly
and then in the challenge response to
stress getting the exact opposite more
vasod dilation more resources used and
more positive effects on the brain and
body so what are some um if if you can
recall from the papers if not that's
fine but I'm just curious what what
those specific tools might every
statement you said Andrew is good it's a
good one the whole trick here is that
people need to find the the strength
statements the stress Shields I call
them that fit them that that feels right
and that they believe and so they I know
I list a bunch of options in chapter 3
which is called be the lion instead of
the gazelle so the the Li and gazelle
are both you know high blood pressure
high stress and the Lion's chasing the
gazelle but the G gazelle's having this
total threat basal constriction response
because um she might die lion might get
dinner right so it's needing to mount
the stress response because it's so
excited to get the tasty dinner for you
know the next few days and so the lion
is having that challenge response and so
we can remind ourselves be the lion we
it's it's not that we're always Ling or
gazelle we get to shape that and so some
of those statements are well let's say
right when when we're going into it list
your resources why have you ever dealt
with any situation like this remind
yourself of past successes remind
yourself of someone you can call or text
or feel supported by remind yourself
that this outcome is not going to ffect
your life in 10 years or five years
that's a distancing kind of um
perspective taking so there's all these
strategies and and you got to use what
works for you telling yourself I got
this I can do it I can get through it I
have what it takes those are all good
Shields and another set is you know we
some of us feel really stressed out by
stress like once we get feel our heart
racing that leads to oh no you know this
is bad for me and so rather than than
getting stressed by stress we actually
want to remind ourselves that this
stress response is empowering this is
going to help me cope my body is excited
my body is doing just what it should
right now so that reframing in Studies
by Wendy Mendes and others my my
colleagues who do this reappraisal
research they have basically train
people to view stress as positive during
the stressful situations in the lab
people
do better they perform better they feel
more positive emotion they problem solve
better they recover more quickly so
pretty powerful stuff yeah that is
powerful stuff I'm wondering if we can
talk about the relationship between
stress and eating and I think that's
also a great opportunity for us to talk
about the opioid system a lot of people
are familiar with the so-called um
opioid epidemic and opioid crisis um you
know sadly you know far too many people
are dying a feny overdose and we all
know about the oxy conton epidemic and
all these people addicted to opioids and
um that's not really what this is about
um what we're about to talk about is the
fact that we have an opioid system
within us that is neurons and other cell
types that can red excuse me can release
substances into our brain and body that
make us feel less pain and make us feel
sedated but at a healthy level right and
yet there are a lot of things besides
drugs that can activate this opioid
system um I think sex activates the
endogenous opioid system as far as I I
last read there was a paper out recently
but also food can do it um and again to
healthy levels um provided the context
is healthy of course what is the
relationship between stress and eating
and eating and the opioid
system stress and eating is an
interesting one so most people when they
feel stressed or you know I'm just going
to ask you do you eat more or less when
you're stressed less definitely I feel
like I can go two three days without
food when I'm when I'm really stressed
but I came up in a profession where um
sadly for me all nighters were part of
the regular until pretty recently a
couple years ago when I just called an
end to that um and no it wasn't just
because of procrastination it was just
work overload um but I can go a long
period of time without eating although I
love to eat mhm uh so I do point out
that I do love to eat and what does the
body feel like when you're in that
stress State when you're not even hungry
you're kind of shut down in your
digestion that I have enough energy from
my neural resources from adrenaline and
generally those periods of time when I'm
not hungry coincide with a uh hyperfocus
on the stressor the deadline whatever it
is in life that that needs tending to
and um food just doesn't appeal to me as
much it doesn't taste as good and it's
not as enticing yeah so we think that
your type of um body temperament is high
sympathetic and so when you have a big
stress response your digestion is is
pretty much shut down like it's would be
the opposite eating would be the
opposite of what your body is telling
you to do I should I'm just going to
forgive me for interrupting uh for those
of you hearing sympathetic we're we're
not talking about sympathy we're talking
about the the sympathetic arm of the
autonomic nervous system which is the
so-call fight ORF flight arm as opposed
to the parasympathetic in any event
sorry to interrupt but want to make sure
that um sometimes people hear sympathy
and then they think emotional sympathy
um I like to think I have that too but
um okay so I so I tend to lean more
towards the sympathetic meaning um more
alertness arousal yeah on the Seesaw of
the autonomic nervous system and I I'm a
High um sympathetic Rector I lose weight
when I go through like writing my
dissertation I look like a skeleton at
the end um but that's not what most
people complain about it's not weight
loss most people complain about
overeating or binge eating when they're
emotional when they're stressed and so
that's the more common pattern and what
that that looks
different both in the brain and
biologically and so what it looks like
is that the stress response is driving
cravings and also let's say high insulin
or an an insulin resistance State and
what goes along with that is tending to
be over away or have obesity and so just
by whe whether it's through conditioning
or genetics having that kind of larger
body with a big stress eating
temperament that is a challenge in life
and I've been you know I've worked with
people with different eating conditions
Eating Disorders Bing eating and it is a
um what's hard about it is number one
it's very common and normative to just
feel like you can't feel safe iated so
it's this compulsive eating tendency
that stress brings you to and so the so
what it mean we measure this it's very
easy to measure it means that people
feel like um they can't control their
eating they don't get full um they think
about food a lot and so stress kind of
exacerbates that tendency and that is a
you know it's a it's a common phenotype
like we've studied it and maybe 50% of
people with obesity have that um do lean
people have that some not many like less
than 20% but what they also have is this
tremendous kind of uh diet what we call
dietary strand or control over their
eating so they're they are able to to um
not overeat even though they're thinking
about food a lot so that's that is you
know that explains that
unusual body of someone who's really
more um still has those compulsive
traits so why does this matter this
makes it really hard to eat well because
when you're stressed you're D you're
craving the comfort food the high fat
high sugar high salt uh depending on
your temperament and that
is that means with repeated bouts of
stress you're just going to be gaining
weight and particularly in the
intraabdominal area that's what we've
seen we've seen it cross-sectionally
we've seen it in Rat studies and mice
studies and now we've seen it in people
in many St for about 10 years I studied
this and the question was is what's
happening in people people the same
thing that's happening in mice if you
stress them out and you give them Oreos
the mice develop binge eating they get
really compulsive and they get this you
know terrible metabolic Health profile
metabolic syndrome where they're they're
round you know their in their belly fat
basically expands like a cushion and
that's because that's this really good
immediate source of energy during stress
so like we're really well-wired to if
our body thinks we're under chronic
stress we're going to store stress fat
or abdominal fat so we can mobilize that
in a second and then the second question
we've asked is can you reverse that with
different interventions can you can you
block the compulsive eating um so I can
I can tell you what we found there but
the opioid system that you mentioned is
certainly involved and in studies with
um people lean people and people with
obesity my colleague Raji sinat yel it's
basically found that when you stress
them out people with obesity are having
a different reward response and they're
having they're the more insulin
resistant they are the more their Reward
Center lights up during stress and
what's causal there like what's the
chicken what's the egg so because I can
imagine these were people that at one
time were not obese who got
stressed um the opioid system reacted in
a particularly uh potent way to food and
they were able to clamp their stress and
so then they become or binge eaters in
the context of stress yeah um and that
leads to insulin insensitivity exactly I
could also imagine that they were
insulin and sensitive therefore they
need to eat more in order to feel kind
of an increase in uh satiety because we
know this um now uh B based on brain and
body mechanisms and then that set off a
Cascade of things leading to obesity um
not that it necessarily matters but
what's causal do we know if I think it
really does matter I think there's been
a you know a mistake of kind of
confounding all obesity with food
addiction and um and metabolic disease
and it's completely heterogenous so I I
think it's the developmental path that
you're describing which is that um
there's a tendency toward having bigger
reward response and hunger during stress
so it becomes a way of coping a
lifestyle and and that is a pathway
toward obesity and
so some obese people have a disregulated
stress response but I but not all of
them I mean it really is a certain type
of person so that's why we target people
with Cravings in all of our intervention
studies now we want to know who has more
of the compulsive eating type because
they need a different set of skills to
cope with stress and to lose weight if
that's their goal there's a drug I'm
sure you're familiar with nxone which is
can block the opioid receptor it's used
to block the opioid receptor in the
context of different types of addiction
have people tried to use ultraone in the
context of binge eating and does it help
people lose weight
because it presumably reduces some of
the rewarding properties of of food
that's one of the very few drug
combinations that has been used for Bing
eting so it was a combination of nxone
and Wellbutrin and I'm not sure at this
moment how much um that's favored for
Bing eating but certainly the early
trials showed that it it really does
damp down on the compulsive eating
interesting so is that a commonly
prescribed uh kit of drugs now for for
obesity I know there's a lot of
excitement nowadays about these
semaglutide yeah um analoges because
they do seem very effective in blocking
hunger especially in type two diabetics
I don't know if you're familiar with but
right there s of all the rage um mostly
because people saw the before and after
photos of Elon he had his shirt off on a
boat and there were some not so nice
comments made about him and then
sometime later he was quite a bit
lighter and um he announced that he had
been taking one of these semaglutide
agonists yeah yeah I really hope that we
come up with um safe and effective drugs
and one thing to think about is that the
the challenge that we all have um
particularly if we're prone to obesity
is the toxic food environment and
particularly the refined sugar and
regardless of what we're on Metformin or
one of these drugs we override it with
our diet and and really the improved
nutrition is the only way to solve it as
a public health problem I mean the drug
companies are saying everyone should be
you know everyone with a certain BMI
should be on one of these new drugs and
it's just rubbish and it's not going to
lead to long-term Health well I I know
you have a colleague there at UCSF um Dr
Robert lustig who's been talking about
sugars and hidden sugars for years and
the problems with that and and we don't
want to demonize sugar is the only cause
of the Obesity epidemic but it's
certainly one of them at least that
that's my belief to the data yes and and
Rob is the biggest proponent of you know
of helping people understand the big
problem in the root is in the processed
food and the sugar and that the drugs
don't touch that we just we override
effects of any drugs with our diet and
and so it's um it's been a a losing
battle really because of the force of
big food and big Pharma so let me go
back to the the the compulsive eating so
we've we've we've um there are some
clues about how to break that cycle so
one is in our weight loss trials or
healthy mindful eating trials we find
that mindful eating is not going to
cause a lot of weight loss period but
the people who benefit most from
learning this kind of calm
self-regulation where you check in with
your hunger you slow down you increase
your awareness of your body so
interceptive awareness
that um type of skill is really critical
for people with compulsive eating and so
in our trials we find that if they
people with compulsive eating if they
get that if they get randomized to the
mindful eating they do better in terms
of their insulin resistance and their
glucose and their long-term weight loss
so that's one good clue and another is
the positive stress pathway looks
important for breaking the compulsive
eating cycle so EX high-intensity
interval training or you know maybe um
some of these other ways that we've been
been talking about to increase the Bly
stress in these short-term ways to
metabolize stress in our body can help
with the Cravings so what would that
look like in the context of let's say
somebody um has the opposite phenotype
to me they get stress and they find
themselves reaching for snack food or
that they simply can't reach satiety
they just want to eat and eat and eat um
what are some of the aside from n treone
and W Butrin and some of these Pres
approaches because I always say while I
value certainly value prescription drugs
in certain context I always feel like
Behavior should come first dos and
don'ts then nutrition then
supplementation and then if and only if
it's still needed prescription drugs but
that's just my bias based on my
observation reasonable I like to think
so uh it also is a uh it starts at a
zero cost um Endeavor I mean behaviors
require time but it certainly um
includes everybody not just those that
have insurance or that live in a
particular region of the US or the world
so anyway um that's my bias and at least
for the time being I'm sticking with it
um it's the basis of a lot of what we
talk about on this podcast but
nonetheless if somebody is uh finding
themselves in that category of of binge
eating or heading towards binge eating
or using food to comfort or alleviate
stress how should they intervene in
their own thoughts and behavior we
talked about the the bins top down
strategies changing the body changing
the scene we need all of those I mean
the the compulsive drive to eat is one
of our you know strongest impulses if
we've developed that pathway and so the
we train people for example in mindful
awareness of separating out emotions
from Hunger so they get really wrapped
up together so just labeling how you're
feeling labeling your H hunger from one
to 10 and figuring out is it am I really
hungry or as a boredom that helps people
and if you do that checkin right before
you eat that helps the most so that's
the top down mindful check-in the uh
other thing we help people do is like
ride the craving surf the herbs so we
deal a lot with soda Drinkers and it is
addictive and there is nothing worse
than drinking sugared soda for our body
so we help people by help um having them
water watch their craving pass and and
knowing that it's a matter of time that
they can surf the urge without jumping
to consuming and so that practice helps
some people especially with
practice the push-ups the taking a walk
the changing the scene getting away from
food is always going to be a huge strong
strategy if you can get yourself away
from it the the problem is as you know
is that the Cravings get you to the
buffet they drive you to the the soda ET
and so just you know creating safe
environments both at home and in the
workplace where you don't have soda is
really important so we tried that at
UCSF my colleagues and I um including
Rob lastig the anti-sugar doctor we just
saw the absurdity of being a medical
center people come with these chronic
diseases and what are they served in the
cafeteria or even at their bedside
sugared Coke in the hospital in the
hospital and so my colleague laor
Schmidt who's uh partly responsible for
the soda tax she rallied the all the um
we went top down to Administration but
bottom up to vendors got rid of all the
soda in all of our hospitals and
campuses and we found two things number
one people who were heavy drinkers lost
weight in the most important Place their
waste heavy soda drinkers mhm so when we
took it out of the workplace they
actually their health improved and
number two those with
compulsive eating they score high on our
our little scale for um reward-based
drive it didn't help them so then we
randomized half of them to get some
extra boost we call it motivational
interviewing where we're really
supporting them more and helping them
you know think of goals like being with
their grandchildren not getting diabetes
and and that little bit of support
helped them TR tremendously and so now
we're trying to roll that out in you
know a big controlled trial but at least
100 hospitals have adopted the um stop
selling sugary drinks because people
don't want to be sick but they can't
help it if they have the reward drive
and if they have the compulsivity and
it's right there at work we're just
working against
Health that's super interesting I I
think that um for most of us we think
about soda as the kind of thing that
maybe we have every once in a while or
that we drank more when we were kids I
seem to have lost my appetite for soda
at some point you just know too much
teen years maybe or just at some point I
I I started to feel like there were
better
Alternatives um and you know like what
well okay well people want ideas yeah
well full confession I mean okay most of
my
nonwater uh beverage consumption is
going to be either coffee um usually
black coffee or nowadays I sometimes we
throw some ketones in there not cuz I'm
on a ketogenic diet but for I do feel
like it makes my uh level of focus and
cognition better pouring in this morning
yeah I do use it before podcast and
we're prepping for podcast it it um
there are good data showing that uh we
can all utilize ketones as a as a brain
fuel even if we're not on ketogenic diet
that's um clear to me based on my
experience and the data as I see them
and understand them um or Yer bate tea
which is just a caffeinated uh tea from
um South America which I like very much
um however I am guilty of drinking the
occasional diet soda every once in a
while and I know that you know some of
my audience will just gasp how could I
do that but we're talking about the
occasional diet coke diet soda the
occasional Diet Coke mostly because I I
don't like the taste of sugary soda and
I actually really like the taste of diet
soda Aspartame is a particularly
rewarding taste for me um and as a
consequence I try and avoid drinking it
more than I might have a can of Diet
Coke once a month maximum usually on a
plane or something like that so that's
the extent of it but if I have the
choice between a really great coffee and
a soda it's going to be coffee or
yerbamate and a soda it's gonna be
yerbamate um or food and soda I'm going
to eat instead and so that's me but I do
recall you know as a teenager soda was
kind of a default you just kind of like
go to the soda fountain and fill the
drink it felt like such a rewarding
thing um and I think the reason we're
drilling into this more deeply is it
sounds to me based on what you said
earlier in my read of the literature
also brings me the idea that
that drinking sugar in the form of
liquid is one of the worst things that
we can do in terms of our bodily
regulation of insulin and glucose um
it's I don't want to use the words empty
calories because that's kind of a loaded
phrase but it is essentially empty
calories it doesn't well it's harmful
calories they're not empty yeah I mean
there no amino acids in there they're no
essential fatty acids and there aren't
many carbohydrates you can really
utilize for um long-term bouts of mental
or physical work so so do you view soda
as one of the um the worst certainly not
the best but one of the worst culprits
out there I mean it is really prominent
especially nowadays also we should
include energy drinks a lot of kids
especially males by the way it's it's
almost this is crazy it's almost
95% of energy drink consumption is males
interesting and I don't know what what
is maybe it's the packaging or who how
the marketing has been pitched but by
the way as soon as I say that someone
will be in the YouTube comments telling
me that that's completely false but we
can point you to the data um so what are
your thoughts on sugary drinks and what
that's doing um how it do you think this
is a reaction to how much stress people
people are experiencing is this like
people's attempt to to inoculate their
stress or is it simply that it tastes
good and it's easy to consume and it's
relatively inexpensive people have not
and we have not really studied the
sugary drinks in the same way we have
studied the comfort food and the binge
eating and
so um my guess is that it is part of a
stress response but even more than that
it's part of the honic cycle so when you
get the sugar especially if it's packed
with caffeine that's going to be a more
addictive drink you get this you know
really feel-good response right away and
then you get the low and it's the
hedonic withdrawal so which is this you
actually feel bad when it's been a while
since you've had it and so then it
drives the compulsivity you want it
again because you want to not because
you want to feel good you want to get
rid of feeling bad so that's what
happens with both food addiction and we
think that happens with sugary drinks
now let me tell you that when you asked
is is a sugary drink one of the worst
things we can do for our health yes
because sugary food doesn't go to our
brain as quickly as a liquid liquid
sugar a sugary drink so think about
cocaine and crack crack goes to the
brain immediately and it's that much
more addictive that's how we think of
liquid sugar The View on sugar I think
is starting to change and I think in the
years to come provided um folks like you
and Dr lustig continue to uh be vocal
about it which I hope you will um I
think it's going to shift things quite a
bit I look at it a little bit like trans
fats you know I was growing up people
ate margarine and now like trans fats
are banned in many cities um it's kind
of incredible how these things have have
changed um over time and it requires an
effort not just on social media but
podcast and I think also
lobbying uh lobbying our politicians
really getting them to understand um
just how pricious the stuff is there's a
lot of social norms that go into like
what's good for for all of us as a as a
group or community and what's personal
choice it's very fiery you know I just
I've heard uh colleague talking about
how bringing junk food or soda to work
is like passive smoking you're like
you're bringing something in that's
going to pollute other people's health
and you shouldn't do it so that's that's
much more edgy and people will fight
them on that um but the the the basic
reality is yeah we're going to eat the
donuts if they're in front of us and so
in it is much more considerate to bring
a bowl of fruit I do love a good donut
every once a
while myute a certain circuit in my
brain I'm glad you brought up smoking I
don't want to take us off topic but as
long as we're venturing into these
general or I should say more General and
yet really important themes around
public health and food you know I
learned something interesting about
smoking and why so few people now smoke
um I always thought that the campaigns
around smoking and how terrible it is
for us showing pictures of lungs that
are you know caked with all this tar and
like you know cancer and all this stuff
was the effective message but what I
learned was that one of the most
effective messaging systems in the in
the the battle against smoking was to
get young people to stop smoking not by
telling them it was bad for them but by
showing them videos of these um rich men
sitting around tables cackling about the
fact that they're making so much money
on the health problems of other people
because of smoking in other words what
they did is they made being a non-smoker
anti-establishment MH and so I find it
very interesting anytime there's
something like soda or highly processed
foods that are so woven into the
establishment it seems like the you can
we can tell people until you know we're
bleue in the face about all the health
concerns with with these things you know
sugar is bad and this is bad highly
processed food is bad some people might
change their behavior but it seems like
for the younger generation the thing
that's most effective is to activate
their sense of rebellion this has been
true for probably hundreds of thousands
of years but it's certainly true in the
last hundred years and let them see that
there is a very strong um
big food sometimes big Pharma but
certainly big food system that is
working against them and that it in
order to take control of their health
actually we want to activate their sense
of rebellion so that they're like no I'm
going to take excellent care of myself
I'm not going to fall victim to this
monetary scheme and here I'm not
pointing to any conspiracy I mean this
has been seen with smoking this has been
seen with a number of different
Pharmaceuticals again not all
Pharmaceuticals are bad this is true of
of a number of different aspects of of
kind of Big Marketing absolutely it's
like pull the blinders off let people
know that we're vulnerable to all the
marketing and that there's there really
are suppression of data behind a lot of
it so it had it's happening with um with
eating disorders too Eric stce who's at
at Stanford with you has been using this
method we call it dissonance showing
people with eating disorders how the
food industry has been manipulative and
has tried to design foods for addiction
for the highest bang for the buck with
dopamine Etc
and so that has helped reduce eating
disorders in these studies and it has
even helped reduce reward drive that
isn't that amazing that the dissonance
could do that so interesting yeah I
think uh what it's telling us is that um
few things are as strong as the um no I
won't I refuse to response in terms of
changing behavior um especially when
there's something to push against so
it's not just a battle with ourselves I
want the soda but I'm not going to drink
it and it becomes a well I want it but I
want it because you are making me think
I want it I don't actually want that so
um I don't know maybe this is getting me
back into my teenage mindset but I think
a sense of rebellion provided it's in
the direction of Health one's own health
and the health of others of course um
can be a positive thing yeah well we do
that with the mindful eating we really
we have them bring in the junkiest
processed food they can think of like a
Twinkie and eat that really slowly and
mindfully and few people finish it
they're like that actually wasn't nearly
as good as the picture of it and the
idea of it and so it's like that reward
predictive error that you've talked
about where they they think the brain is
driving them to have it because of the
advertising and their expectation that
they'll feel good but if they're really
paying attention it's that it's a very
disappointing experience versus we also
have people Savor a piece of good
chocolate whichever they like milk or
dark and that experience teaches them to
eat slowly and really enjoy small
amounts of rewarding food so that
they're not they don't need to feel full
and binge oh so interesting um dark or
milk chocolate dark yeah like us I
actually like the 100% chocolate there's
one brand of Venezuelan chocolate that's
100% which sound it might sound awful
but it's actually quite good it has it I
think that was the first time I could
actually taste the the real elements of
chocolate interesting yeah that is not
rewarding it's way too bitter for me I
need the mouth feel you know give me
some fat in it
oh my well yeah it's hard to find but um
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while we're talking about stress eating
obesity and um here we've also broaden
the discussion to include different
Generations we're talking about teens
and adults um I'd love for you to share
with us your findings around this study
that you did of pregnant women and how
stress and pregnancy and different
patterns of eating and uh physiological
changes that people experience during
pregnancy uh could you share with us
what those findings were because I think
those are relevant not just to people
who are pregnant or planning to become
pregnant but to everybody because I
think they shed light on how we manage
stress and sometimes how we fail to
manage
yeah so with overweight and obesity we
know we can't just change calories it's
just not going to work the next
stressful events going to come along and
people will you know go back to what
their brain is driving them to do is to
you know binge on comfort food and so
we've done these interventions with uh
men and women that show that we can help
them regulate using some of these
mindful eating strategies checking in we
wanted to do this with pregnant women
because when you have excess weight and
you're pregnant you're really vulnerable
to gaining excessive weight during
pregnancy which is not healthy for the
mom or the the The Offspring so we we
did this study it took us probably 10
years total to you know get the Grand
and recruit groups of 10 women who are
pregnant in the same stage and give them
this training in mindful eating mindful
nutrition stress reduction and then my
colleague Nikki B bush has been
following the babies for I think it's
been almost 10 years since then and
here's what we found first of all we
couldn't stop excess weight gain the
women in the control group gained about
about 60% of them gained excess weight
during pregnancy and same with our
mindful group so maybe it's end of story
you'd stop there and say it fails don't
do it there have been so many beautiful
developments in the women who got the
training that we we just keep are you
know being shocked by how impactful this
stress reduction training was it was
just two months of their life but but
pregnancy is a very critical period when
these women were uh changing their
habits and they're very motivated to
help their baby so here's what we found
within that first month of the
intervention they all got this oral
glucose tolerance test so they all got a
they got a blood test to see how well
their body was metabolizing food sugar
and so it's like a by diabetes test and
what we found was that twice as many
women in the no treatment control group
had impaired glucose tolerance during
pregnancy it's a it's a common high risk
and half that many women had this in the
mindfulness group so by reducing stress
they improved their insulin sensitivity
during pregnancy so imagine what that's
doing to the baby too then the the
babies have come out with less obesity
less illnesses in their first year of
life and more of this kind of healthy
stress response when they've been
stressed out in in the lab
study and so then 10 eight years later
we looked at the mental health of the
mom so right after the intervention
eight weeks later everyone in our
mindfulness stress Direction group felt
great they felt less depressed they had
less stress and less anxiety that's what
you'd expect right I mean they just gone
to a weekly class they got all the
support but eight years later they still
showed improved mental health every year
that we measured them they still looked
better so it's probably one of the
longest studies looking at long-term
effects of a mindfulness training and I
don't think it was a coincidence that
was during pregnancy I think this is a
very important time to have these skills
and being in a group adds that social
support piece that we know is powerful
it's an incredible result uh could you
share with us what the mindfulness
intervention was and when it was
initiated when it was stopped so we're
talking about 10 minutes a day of
meditation as many details as you can
possibly give us because I know um even
though I don't think I'll ever be
pregnant um I don't plan on it and uh uh
you never know well um yeah
High 0o minus one probability in my mind
but anyway maybe other people have other
ideas for me but um zero minus one
probability in my mind and yet I'm very
interested in this mindfulness
intervention because it sounds like a
very potent one mhm um so much so that
it's multi having a multigenerational
impact so how many minutes a day um how
many days per week um we had them they
met once a week we they had little
reminder cards I mean we need all the
reminders we can you know Post-its on
the fridge timers in our phone to do
this mindful check-in and so they were
during the week doing this check-in and
it was simply
um a a mindful check in closing their
eyes and
feeling their body feeling their
labeling their emotions so it was
mindful
breathing and then it was some movement
and we taught them prenatal yoga but
really any mindbody movement people like
different things there's
Chiang um there's there's um even just
slow walking would have worked um so it
was uh mindful check-in breathe move my
body that's what the reminder card Said
So Close Your Eyes
and look inside do slow breathing they
also put their hands on their belly and
so they felt that they were taking care
of their baby and then more movement so
they they did increase their
walking and the mindful checkins are as
we were talking about at the very
beginning I would say necessary but not
sufficient we've got to stop during the
day and check in and look inside if
we're not aware of where our mind is we
are just subject to the you know
believing the stressful thoughts
thinking that we need to keep ruminating
their sticky thoughts so the mindful
checken is really important and then I
think the breathing as we've talked
about is is probably the more direct way
that they're influencing the prenatal
environment the uterine environment to
reduce the
stress in that the baby's being exposed
to and the movement refocuses us from
our mind and our ruminative thoughts to
the experiences to what we feel in the
body there's even been a study that
showed that overweight people with a lot
of Cravings if they do the body scan
that's simply focusing on the body from
the head to the toe you know just
reminding ourselves to focus on each
part of the body breathe into it release
tension it's very basic and simple the
body scan significantly reduced
Cravings I mean to me that's it's really
hard to reduce cravings so like just
that refocusing on the body took away
stress anxiety self-referential thoughts
that kind of our favorite topic thinking
about ourself thinking negative thoughts
about oursel to relaxing feeling ease
feeling
well-being I can't help but ask about
what that body skin might have been
doing at a little bit more of a me
mechanistic level um some of the
listeners might be familiar with these
terms but some won't so I'll just um
briefly Define them uh we can perceive
things in terms of exteroception or
basically paying attention to and
focusing on things beyond the confines
of our skin or interception I I realize
you know all this uh but for their sake
um no one really understands
interception go for it so an
interception essentially the sensory the
sensory ination of the of the internal
organs of our own skin that includes
proception and which is our knowledge or
our sense of where our limbs are where
we are relative to gravity all that
stuff and you know it raises this body
scan result that that is the fact that a
brief body scan can reduce Cravings
raises this question in my mind which is
is craving a um heighten sense of
interception or heighten sense of extra
reception so I could think of one form
of craving where for instance the dut
again donuts for me is in front of me
and I'm thinking that I want that and so
I'm almost in complete exteroception but
I'm Tethered to it like my internal
world is Tethered to the dut it's almost
like the dut is in control of me briefly
okay and then I eat it um
but it's hijacked your prefrontal cortex
it's it's hijacked everything yeah and
then if I do a body scan so I'm putting
myself in this experiment in it's kind
of uh hypothetical scenario I'm putting
myself into this experiment I do a body
scan which without question is Shifting
me more towards interoception right I'm
focusing on my skin my heart rate all
these things interception so I could see
how that would draw my attention off of
the external stimulus and reduce craving
and that makes me wonder whether or not
craving is a form of exteroception where
our interception is just exquisitly
locked to
exteroception and if so you know because
I do think this is a remarkable result
it is very hard to stop Cravings I mean
we had a guest on here a former
colleague of mine at at Stanford who's
now the chair of neur surgery at upen uh
School of Medicine which is Casey Halper
I mean they do they literally drill down
through the skull of people who have
been cheating disorder and start
stimulating different brain areas
because these people are so out of
control in terms of their binge eating I
mean that's the kind of intervention
that is considered necessary for a lot
of folks who binge so here you're
telling me a body scan in some
individuals can reduce that and I have
to wonder whether or not it's um somehow
breaking that inter receptive EXT
receptive tether anyway um I'm
speculating here but I'd love your
thoughts on on Bing on craving and
binging and breaking binging um do you
think that there are behavioral
interventions um that could be layered
on top of body scans should we all be
doing body scans routinely yes why not
you know and some people aren't going to
like that lying down is maybe not
comfortable and so any Mind Body
activity is going to do the same it's
going to be you know I think breaking
that link that you talked about yeah I I
find this whole interceptive EXT
receptive balance thing um one of the
more interesting conversations these
days in Neuroscience because we're
starting finally starting to understand
what some of the the circuitries are and
they do link to these reward Pathways in
any event um getting back to the
relationship between stress and food and
maybe even just weaving back a little
bit to the uh opioid
system have there been any long-term
studies of stress intervention you know
in the studies that we do in our
laboratory we get people for a month
they do one intervention we swap them to
another intervention a month we analyze
data takes a couple years to do all that
but we write papers and we move on um
sounds like your lab labatory has been
involved in doing a lot of studies where
you're examining people over a very long
period of time even their children uh
what can we learn about the long-term
outcomes of things like body scans
meditation and then we'll get into
breath work there haven't been that many
long-term studies of stress
interventions now that you mention it I
think the meditation studies are
probably the best example there are some
studies that have either followed people
who have um taken up medic meditation or
just these cross-sectional studies where
you compare a long-term meditator to
someone who's never meditated and they
they are interesting I mean let's talk
about the cross-sectional studies you're
already you know studying someone who
eats like kale chips instead of potato
chips there's a lot of differences in
who decides to be a
meditator we in terms of the health and
biology we have found that there is
slower biological aging and other people
have found that
um in these meditation interventions we
do the short-term ones the inflammatory
Pathways of gene expression are dampened
way down and cross-sectionally other
people like Elizabeth hoi have found
longer tiir in the meditators versus the
controls um so we we haven't really
found tiir lengthening in our short-term
meditation studies but we do find boosts
in tarase activity which is this enzyme
that protects our cell aging slows our
cell aging rilds the tiir so those are
um those are those are studies that
suggest if someone were to continue
meditating they might keep up that
slower rate of
Aging so there's one study we did which
I think was particularly um fun we went
to a retreat center where deepo choer
leads this one we Transcendental
Meditation Retreat so people got a
mantra and they were um focusing for
probably eight hours a day on different
uh yoga meditation and reflective
exercises and then we had half the group
just walk around the resorts take walks
hear some boring Health talks so that
was our control group and what we found
from that study was that in the short
run run a week later everyone felt
fantastic after the week right they
weren't allowed to bring their laptop
and work and they uh ate this great anti
inflammatory diet an ayurvedic diet and
then the gene expression Pathways were
like night and day from day one to the
last day and our model of um machine
learning model was able to identify
people over 90% it could say whether
they were on day one or day seven and
the difference really emerged over the
long run we went and we followed them
about 10 months later and we found that
not everyone felt great 10 months later
the group who learned meditation still
had lower depression but the control
group bounced right back up and then we
looked a little bit further and we saw
that people with early adversity
benefited the most from the meditation
condition uh what was the meditation
condition how long uh per day yeah it
well so they did they learned
transcendental Med sound primordial
sound meditation which is similar to TM
where you have a you're focused
attention on your on a word over and
over but there's also more awareness of
the um the
body and that was you know I I couldn't
say how many minutes a day but it was on
and off during the day okay so
repeatedly but for a fairly short period
of time one week yeah right yeah I've
never done one of these extended
meditation Retreats are you interested
well various people in my life have told
me that I needed to go do a silent
meditation but they probably were
emphasizing the silent part the um uh
still I recommend them I think they're
amazing ways to get to the mind and to
really calm the body in ways like a a
you know a Quantum shift in our level of
stress that we don't get it's very hard
to get in short belts I do a daily
meditation practice but it's a
relatively brief meditation practice I
do tend to focus more on things like
deliberate cold exposure and breath work
and exercise and sunlight and all all
the things I talk about in the podcast
but I'm certainly not averse to uh doing
a longer meditation are all of these um
uh TM meditations are they silent
meditations and they range from what two
days to a week is that well the Retreats
you can always find a retreat that's you
know half a day one day a week two weeks
so you don't go right into a two we you
work up to it so the longest I've ever
done is a two week silent Meditation
Retreat and that was after you know 10
years of doing yearly shorter Retreats
and then when you you know I think it
would be too hard and stressful if you
haven't been able to I mean meditation
can be stressful if it you know you
think that you're failing at it and um
so you need to have kind of developed
the skill a little bit before you go on
the the Retreats and so lots of classes
can do that in online but I think the
short bouts every day are that is what
is the most important message for people
for for managing daily stress and that's
the in the stress prescription it's very
much about how we can do short daily
nudges to reduce our stress arousal so
breathing is the one of the best
body-based examples of getting right
there but there are other ways so being
in nature that's a really strong
stimulus an environment that sends all
sorts of safety signals to us yeah
certainly it's not an either or but it
seems like nowadays A lot of the
discussion that used to be had around
meditation and its ability to evoke
neuroplasticity and things of that sort
has shifted over to a um an increased
focus on psychedelics a common theme on
this podcast but it just seems like in
you know taking the pulse of social
media and the landscape out there
there's so much excitement about
psilocybin both in micro do and macro do
and MDMA and some of the other trials
that are out there that many people are
starting to forget the incredibly rich
and vast literature supporting the use
of even brief meditation practices for
reshaping the mind so I'm glad that um
we're talking about meditation but I
mean even going into plant medicine
experiences is enhanced if you have a
little bit of training in how to in
metacognition how to view the mind and
thoughts you can observe the whole
experience with that much more kind of
calmness skill and wisdom knowing this
is just the mind doing these cool things
so it's not they're not separate and
then I think the the psilocybin
experiences enhance daily meditation so
they really go well together yeah and
just as a little editorial on uh
psychedelics um what's interesting I
think about the clinical data is that um
you know we think of the the Psychedelic
Journey as the time in which all the
changes occur because it has all these
properties of hallucinations and altered
thinking Etc that acts as kind of a
gravitational pull around our our ideas
about what psychedelics do but it's
actually in the window after the
Psychedelic Journey that the actual
rewiring of the brain takes place so
when people talk about integration
afterwards they're not just talking
about the few hours where they're you
know I'm parachuting back down to to uh
uh typical consciousness let's call it
that but that there's this long perhaps
even weeks or monthl long tale of
plasticity and that's actually when most
of the rewiring is happening and which I
find really interesting which is not
unlike meditation where sure in one bout
of meditation you might see a adjustment
or rewiring of the brain but at least
from the book altered traits which I'm a
big fan of um talked about these daily
repeated short meditations or these
longer TM Retreats as they're sometimes
called um in inducing uh this big time
brain plastic
all right well now I'm going to have to
do it and I'll report back to everybody
what my experience was although I might
do it silently um I'd love to talk a
little bit about some of the other
health metrics that you've explored not
just in the context of mindfulness but
um I'm particularly intrigued by uh a
graph here I'm showing my really nerdy
side there's a graph in one of your
papers it's the peard paper 2018 we will
provide a link to to this in the show
note captions if people want to take a
look but it essentially describes the
relationship between mitochondrial
health and mood um in the context of
people who have different type of mood
Tendencies if you um if you would be
willing to just kind of describe the top
Contour of that study and some of the
the points that that you find most
interesting I think it's a fascinating
study and and I I'm so glad you did it
but I'll let you tell us about it yeah
we've we've done these in-depth studies
where we are looking at people under a
lot of daily demand caregivers and then
we look un look at you know normal
people parents of neurotypical children
who still have a lot of stress but we
that we then ask you know does do people
under chronic stress have accelerated
aging so we look at tiir epigenetics
mitochondrial health and then what
explains those who look really good who
look resilient and don't look vulnerable
and so then we can find out like what's
the magic sauce in the day that protects
them from chronic stress so Martin Bard
my colleague who has been obsessed with
mitochondrial Health as a pathway to
understanding both stress and really
health and disease he has developed a
way to measure mitochondrial Health in
humans so we can measure a bunch of
enzymes and then we can adjust it for
how many mitochondria we have so we have
this really nice index we can get from
the blood and in this study
of uh young mothers who were who had
either typical children or children with
autism we found that the caregiving moms
had significantly lower or dampened
mitochondrial activity what that means
is they can't produce as much energy so
if they're feeling more exhausted from
the chronic stress we know why I mean
it's it really is a it was quite
dramatic Martin commented some of those
low levels even looked like people with
some genetic reasons to have low
mitochondrial activity but here's the
beauty of that study we then get to look
with within their day at their mood and
ask what about the caregivers who have
really great
mitochondrial enzymes and and thus
should be making a lot of ATP they had
more positive emotions both waking up
and in the evening but especially in the
evening and what's so interesting that
is all of these daily diary studies of
stress and
mood one of the things we know that
matters for long-term health is how
positive you feel at night so especially
on a stressful day so at the end of a
stressful day can you muster some
feelings of content ease confidence Joy
do you have any of that or has it just
wiped out your positivity and so for
people who feel either low lower
negative or higher positive they tend to
have better health trajectories so like
a decade later less depression less
heart disease less early death so what
so that's why we care so much about
daily moods and in in our study it
looked like the daily mood was really
quite correlated with the mitochondria
levels that same day then we measured
mood like you know days away from that
it was much less correlated so that it's
just our first study on this but it
really leads us to think that our
mitochondria are sensitive to our
thoughts and our feelings probably on a
daily basis incredible so for those of
us that find ourselves in a in a state
St of chronic stress um and here I'm
talking about the kind of stress that
you mentioned before which is you know
there is unlikely to be a Simple
Solution like we're just going to be
grappling with this thing um and you
mentioned the words radical acceptance
which I'd like to uh drill into a little
bit too because this is a a theme in the
self-help literature and it's a a theme
in that now I think in the formal
psychology literature I actually um was
talking to a dialectical TR dialectical
psychology expert recently I think
that's the the the correct title
dialectical behavioral therapy correct
yeah thank you that's common great one
yeah you're you're correct I I was I was
grasping and um that's correct and they
were um talking about um some of the
misconceptions about radical acceptance
because I think a lot of people hear the
words radical acceptance at least is
what they they told me and think oh that
means that you have to just accept what
is and deal with it there's another form
of radical acceptance which is I
radically accept the fact that I'm not
going to deal with this right I'm going
to walk away from it but what you're
talking about is chronic stress of the
sort that really the stressor the fact
that a very close relative or family
member is dealing with a lifelong
condition or the fact that um we can't
extract ourselves from a situation that
we are not in full agency to remove the
stress
or that radical acceptance of that fact
then can ratchet into an understanding
of okay and yet there are tools that we
can use to not just offset the negative
health effects but maybe even thrive in
the context of this essentially turning
what initially was thought of as a curse
into a blessing at least biologically
speaking what are the data around the
practices that can help make that
conversion possible I realize there's a
lot of psychological work that needs to
be done ongoing people need coping
mechanism support groups always better
to have more social support than less of
course but are we again talking about a
daily mindfulness practice or is it
daily mindfulness of a certain type um
what do we know about best practices for
mitigating these essentially
non-negotiable
stressors it's it's a great question and
it's not a quick answer I think it is
partly how we view life and our our
purpose in our own life what's this game
that we know we were born into and even
just the idea that bad things shouldn't
happen sets us up for vulnerability to
feel victimized to feel um like we can't
you know accept bad things that have
happened so so just stepping back and
asking everyone listening do you have a
situation in your life that is unwanted
and you can't
change it could be small it could be
huge how much time do you spend thinking
about
this the more we spend time trying to
problem solve or worry or just wishing
things were
different the more we are
creating a chronic stress
State and so just even taking that first
kind of step back to get perspective on
what are the situations in my life that
stress me out and and which of these can
I Circle those that I can't change
they're still they're on my list so
they're they're on my mind they're still
upsetting they haven't receded in the
background they haven't gone away just
that recognition of this isn't going to
go away is
incredibly powerful because we can as I
say put the baggage down and give
ourselves some relief and some freedom
from from the big space it holds in our
mind and in our body and this is not a
one-time thing it's a practice radical
acceptance is something we practice over
and over to help us loosen our grip on
unwanted situations on letting them
control our well-being and taking up you
know this mental real estate that's so
precious our
attention so I would
um there are statements that we can say
that help
us and it's I have you know there are a
few metaphors so I'm an expert at this
because I have I'm a caregiver and I
often need to refocus from wishing
things were different trying to solve
things
to really um radical acceptance of this
is how things are right now this is the
reality and by just reminding ourselves
that there is freedom within that that
there are things that you can do you can
actually live better live well with
these situations so let me tell you what
we've found from our caregivers we
measure where their mind is at night we
we we ping them and we say in the last
five minutes how much have you been
wishing things were different how much
have you been engaged and focused in
what you're doing
right right before we pinged you and
just those two questions tell us so much
about that person's well-being so people
and actually yes the caregivers are
doing more
of what I'll call suffering wishing
things were different not being present
for their lives but regardless of that
difference whether people are caregiver
or not this negative mind wandering
state of not being present for your your
evening wishing things were different
instead of being engaged
predicts more
unhappiness it
predicts shorter
tares so it it suggests that it's a
pattern that has gone on for days months
and years that has been wearing on
them and so some of the metaphors that I
think are helpful for this are thinking
of yourself think of this unwanted
situation and think of how you're you're
pulling a rope that's attached to a
brick
wall and you're doing that because you
care you want things to be better for
yourself or this
person
and or a group I mean it's it's
something you're passionate about and so
you're pulling and pulling and every day
you're pulling and and you can't move
that brick wall so the only thing that's
happening is that you're chafing your
hands that tens that chronic tension
what if you just drop the
Rope I say that to myself drop the Rope
when I start get you know getting going
on trying to solve unsolvable problems
the brick wall is still there it's never
going to move yet my hands are free and
so I can be freed up to live in the ways
that I do have control over to do things
that help around the edges so I was just
talking with someone who is just so
concerned about about their aging
parents and you know them not getting
the care they need not taking care of
themselves you know things aren't going
well but there was so little that they
could do to help their parents and so by
dropping the Rope for them meant
realizing there were things they could
do being present being
loving uh doing the little bit of care
that they could from a distance was all
they could do and that's enough that's
that loving presence is like a gift that
we don't realize that we we always have
that to give where do you think the
tendency for us to try and pull on brick
walls comes from I mean it's so
non-adaptive um and I've also heard it
St that uh people do this in the reverse
Direction too meaning in time trying to
control the past through current
behaviors as well as trying and control
the future um it's kind of so give me an
example of that yeah this is something I
learned from a guest we had on here Dr
Paul kti's a psychiatrist Who U
extremely skilled psychiatrist who wrote
a book on trauma which I think is the
best book on trauma frankly um and he
talked about how the lyic system that
engages these fight ORF flight responses
has no sense of time and that's why
developmental scripts get reactivated in
particular parent child or caretaker
child uh neural circuits that were
engaged in those relationships when we
were really young get reactivated in
adult relationships I mean in some sense
it doesn't make any sense like why would
the human mind have separate circuits
for adult like romantic attachment
versus child parent attachment this all
sounding very Freudian And yet when you
look at the the Neuro Imaging it's like
you get one set of circuits for
understanding of relationship of course
you adjust according to context and they
get repurposed you don't just set that
aside say that was for childhood what he
said was that the lyic system and the
stress system when activated um distorts
our perception of time and that um this
is what he was uh saying leads to the
what's sometimes called the repetition
compulsion people try and will repeat
the same uh Place themselves into mildly
to severely traumatic circumstances over
and over again despite the presence of a
of a trauma doesn't have to be childhood
trauma you think well that doesn't make
any sense is like the most illogical
thing in the world like you get burned
on the stove and you keep going back to
the stove and the idea is that these
circuits when they get activated really
engage entire like cognitive scripts
that make it very hard to escape it's
like it pulls you into a story that is
exquisitly hard to to to get away from
and so that this repetition compulsion
is an attempt to try and rewrite the
story and this is this is the theory not
just of Freudian psychology but kind of
modern trauma and Neuroscience informed
trauma Therapies in any
event as you describe the this pulling
on a brick wall I find a very compelling
image
um and one that uh makes total sense to
try and drop the Rope as you describe it
because of the incredibly High energetic
demand that pulling on that rope
represents as you said it's sort of a
way of diverting resources toward
something that has no conclusion right
and in dropping the Rope you can divert
those resources toward other things um
so I was just curious again I wasn't
consulted the design phase and I'm
assuming you weren't either but you know
I wonder what
in us uh as scientists I'm just kind of
doing the gunkan experiment here like I
wonder what in US as human beings
compels us to um try and change what we
the
unchangeable
we really really really love control and
we want to control the
future not just because it makes us feel
powerful and happy but because then we
can relax if we know what's going to
happen next if it's
predictable we're that much happier
we're not Vigilant and looking ahead and
being prepared for what might happen so
let me ask you that so I have two whole
chapters in the stress prescription one
is on uncertainty and one is on control
and these drive us crazy until we can
somewhat master and understand how
little control we have and how much
uncertainty there is and will always be
so let me ask you this if you couldn't
plan your day
tomorrow and you wanted to know with
certainty what your plans were what was
going to
happen how much ease and
relaxation would you feel at the not
knowing what's going to happen tomorrow
very little so like on a 1 through 10
scale how much would that drive you
crazy tomorrow tomorrow Saturday so I'm
a little more flexible Monday oh no
Mondays I Mondays are mine I own Monday
no I'm kidding I'm just kidding I love
Mondays it's always been my favorite day
of the week
um uh even when I was in school uh yeah
that would be on that would be a six
yeah six out of 10 and that's not
unusual and we have a scale to measure
how comfortable people are with
certainty and what we already knew was
that being comfortable with uncertainty
is a beautiful but rare resilience
Factor people who tolerate uncertainty
have much less anxiety and depression
and when stressful things happen they
get over it more quickly so we measured
this during the pandemic and what we
found was that intolerance of
uncertainty pretty strongly predicted
pandemic anxiety PTSD depression and
distress about the fires the climate the
climate situation in in California so
this is interest interesting I mean is
this like a fixed personality and we're
just stuck with our rigidity around
wanting certainty or is this something
that we like a muscle that we can
build so I think it's a ladder and I
think there are practices we can do that
help us feel ease with the uncertain
future some of these mindful check-ins
noticing that we are carrying around
uncertainty stress is one way and then
reframing
uncertainty as the beauty of the mystery
of life and the freedom that we can feel
when
we realize we don't control tomorrow we
just go with it and we you know we do
our best and what Delight there is in
just viewing things with curiosity and
just seeing what emerges so even just
our posture here's an exercise for
dealing with
uncertainty instead of like kind of that
alert posture when we're like trying to
take it all in and predict the next
Second and like just lean
back and take some slow breaths we know
that's going to help Orient us and
realize that we can actually face time
in that way by letting it come to us and
receiving what
happens and that's a completely
different body stance than our usual go
mode during the day and that's just a
way of saying
I am in a you know receptive mode and
I'm going to just be curious about what
arises and so I actually learned that on
a Meditation Retreat because I tend to
be type A and I leave a retreat going
from like very relaxed to like that
leaning forward tense of like where's
the to-do list and so carrying with me
that posture of like just see
let time unfold as it will without try
to control
things it's really interesting it gets
right to the heart of something that I
spent a lot of time thinking about in
the context of Stress Management and
also just general thriving which is that
I think that
um about half of the messages that we
get related to stress and Mind Body
interventions relate to adopting this
forward Center of
mass um you know this idea of okay
stress can give us early dementia stress
can limit our sleep stress can impair
our cognition or stress can make us more
resilient stress can activate all sorts
of positive anti-inflammatory Pathways
as well that the mindset matters and
here I'm I'm doing a terrible job of it
but I'm trying to scrape off and um
capture the top uh Contour of the
beautiful work of my colleague uh Dr
Aaliyah Crum who's you know love her
work been on this podcast and is I'm a
huge fan of her work as well and um that
mindset matters because it sh ap's
physiology for sure it uh her data point
to that so there there're these kind of
forward Center of mass type uh
approaches um and these are abundant on
social media um you know different
people come to mind um different
archetypes really have emerged you know
millions and millions of followers that
are the archetypes of when challenge
arises you smash into it you go through
it right um and then on the other hand
there are these stress ation techniques
both mental and physical body oriented
mind oriented Etc that are more of the
sort that you described that are um
they're not um being back on your heels
so to speak like letting things bulldoze
you but are more of this uh receptive
mode and a more of an awareness mode
exactly and I think that um since here
we are at the table to researchers who
uh focus on these issues a lot do you
think it's fair for us
to adopt a sort of a general framework
and model that that perhaps people can
adopt for themselves if they like that
that of course it's not an either or but
that having both of these in one's kit
of tools could be valuable um because
one is less energetically demanding but
of course offers less opportunity for
agency um at least apparently so that's
the leaning back and then the the other
is um certainly gives an opportunity for
agency but we know from 100 years or
more of psychology and psychiat atric
literature and from the emerging
literature on stress mitigation
that it's work it's not something that
is without a cost it can get you far
better results than it were you to just
let stress bulldoze you but that it's
work and so we have to emphasize that
work um in very deliberate ways exactly
I couldn't agree more it's work when we
know it's productive we should work and
when we know there's a brick wall we
should let go so I think of it I like
this forward Mass idea I think of it as
you muscle it and or you release it and
we need both and so that letting go is a
really important wise you know
Discerning way to mitigate stress in the
right situations and the right time and
you know we can't muscle through
everything right so another way I like
to think about it is just the waves of
life like I mean we are in an ocean and
we have small waves we have big waves
some of these tidal waves are going to
hit all of us the global stressors the
the climate disasters that will come and
so when we're not in the middle of a
wave which is when we need to muscle it
we're between waves how much control do
we have to fight the tide there some
it's not black or white we we are we we
can't fight a rip tide we need to go the
direction of the tide but we can
have some control on our Direction and
it kind of goes back to um our colleague
Robert spolsky's very biologically based
idea of us having you know he's a little
bit extreme with a no free will we are
we are influenced by all of these things
around us as well as all of our
biological you know I'll say um
brilliant evolutionary animal instincts
so given all of that we have
have some deterministic forces on us and
within that we get to ease up between
the waves when we can we get to change
our Direction but we're always going to
be hit by the next wave and so it's this
skillful surfing or navigating that we
can do better when we realize when we
control things when we can't when we can
truly feel safe and have ease versus
when we need to kind of gently
padle what do you think is the value of
of journaling and and placing one's own
narrative on stressful circumstances
especially these non-negotiable
circumstances again I'm I'm fascinated
by these because I think it's a category
of stress that's not often talked about
and yet is so prominent so people will
say okay you know dealing with
short-term stress okay well well I would
say like use physiological size or raise
your stress threshold and we'll get back
to that in a little bit um as it relates
to the work you're doing with breath
work but so many stressors are going to
take a year five years we don't know you
know that the uncertainty that you
mentioned earlier or the the certainty
that this is going to go on forever and
so you know what is the um you know for
people that are listening to this and
that and want to start to adopt
practices um do you think that spending
some time creating a written or a spoken
narrative is helpful we hear this but
are there any data that support the use
of journaling as a as a tool I seem to
recall that there there are a few
studies out there but I can't I can't
remember exactly yeah definitely
creating a coherent n narrative is
critical to our ability to make sense
Find meaning find resolution have a
social identity around our lived
experience what happens to us so
narrative is kind of everything right in
stress research it's it's not what
happens to us it's how we're
interpreting it and how we're um how
we're responding to it and I've I've
heard you say the exact same thing when
you've talked about what is stress it's
it's really what narrative we're
creating around it so I think a
narrative of purpose fill in the blank
about what you're what's meaningful to
you but that is why we're different than
just the the um the rats that we study
or the monkeys like they have these
amazing stress responses that are we
have them too and we can't control that
but we have the ability to do this
projection to the Future to ask what is
our purpose in life to see and know that
we are going to die and we can have some
control over how we live and maybe even
how we die and how we want to be
remembered that is so beautiful that
helps us Rise Above This being monkeys
and
clothes I'd love before we wrap for us
to return to this
uh question about breath work and the
study that you're doing one of the I've
known about your work for a very long
time admired it for a very long time and
one of the things that um excited me
about being able to sit down with you
today is that uh our laboratory has
studied breath work your laboratory is
studying breath work and um and I know
that you've been doing a study on the
so-called Wim Hoff method um which I'll
let you familiarize our listeners to
some of them are familiar with the Wim
Hoff method others are not I think a lot
of people think of whim in terms of his
is the ican because of cold exposure but
of course he has um breath work
practices that mirror um things like
Tumo breathing and other things but U
maybe you could tell us a little bit
about what you're doing there and U what
you're interested in discovering I
realize it's too early to give us the
results but um hopefully they'll come
back and do that at another time but
what is the study uh what motivated the
study and and maybe I can convince you
to give us a little teaser of what
you're discovering so for I I for many
years I mean I think my um first paper
when I was a graduate student with Bruce
mckuin was about this idea of positive
physiological stress and so I've always
been wanting to really understand what's
positive stress how can we induce it and
instead for many many too many years
I've been studying the dark side toxic
stress trauma caregiving and how that is
can take a toll on the body without the
right resilience and resources and now
I'm very excited about
the the opportunity to just focus on
different ways that we can stress out
our body and mind in short-term bursts
that might promote stress resilience and
the body based strategies are concrete
they're quick they're um they're also my
favorite strategies I I probably have
internalized a lot of the mindsets and
the you know the that I've learned from
meditation and what I feel the biggest
bang for the buck is you know if I'm um
waking up like super jittery with a big
stress response because of X or Y it is
actually something like a a hit type
workout or taking the dogs for like a
really brisk walk or like burning up
that energy in my body is um a very big
effect size for me personally everyone
has their you know different ways that
they can see the the biggest shifts in
Daily stress so I've been looking for
ways to create positive stress besides
exercise we all know about exercise and
I met whm Hoff at a uh a meeting where
we talked kind of back toback and so we
hadn't I had kind of heard something
about you know crazy Iceman climbing up
the Himalayas I really had he has 27 or
more World Records yeah for that sort of
thing yeah so he so I got to hear I got
to do the breathing with him during this
conference and I just felt like Elation
afterward I was like what was that and
then he heard about tiir and he was like
I need to know if my method is affecting
cell aging he loves research and so we
he helped us design a study that we've
been working on at
UCSF um with my colleagues Wendy Mendes
and Eric prayther it's been many years
and it's funded by the John W brick
Foundation which is very focused on what
are non-drug way ways that we can help
mental health so it was a very good fit
for all of us to come together design
the study and we have been basically
comparing low arousal relaxation methods
mindfulness slow breathing to positive
stress exercise and whim Hoff method and
one of the things that we've learned in
a big way is that regardless of whether
we're creating deep states of ease or
hormetic stress in the body that
short-term burst of either aerobic
activity or the extreme breathing people
feel better period so three weeks later
after this experiment of doing their
practice every day they were either
randomly assigned to the higher rle or
the low rle the level of stress anxiety
and depression fell dramatically in
everyone so many paths to changes in
stress there are probably very different
physiological paths ways and and we can
talk about that more when we um get to
really look in depth at our
physiological data as well as our
blood-based data but what we do know is
that the Wim Hoff method did create
daily positive emotion that increased
over time just like your study on
sighing and so even though there are
different mechanisms they were
selectively boosting feelings of
positivity I love that you know that's
very unusual to get a very selective
positive effect super interesting I
can't wait to hear more about the data
so I I gather and by the way no is a
perfectly fine answer I gather that
you're not going to tell us about the
whether or not there are tiir changes
yet or maybe that's not possible um to
detect in this kind of short-term study
so what we're going to look at we don't
really think that ters can change very
quickly and and tase May so we're going
to look at mitochondrial enzymes tase
and gene expression patterns and as you
know we can look at many different
mechanisms and Pathways with gene
expression patterns especially with
these new kind of assays where you can
look at you know 7,000 different uh
proteins like the somalogic and so we'll
get to see well what's the patter you
know did we really change patterns of
acute stress with these different types
of stress resilience intervention
and in terms of the physiological
reactivity there are ways that we
can examine both the stress response
system parasym the sympathetic nervous
system and the parasympathetic response
system and I will tell you that um while
we're still preparing the results there
were very different profiles from the
different interventions that make us
think that there's a lot of specificity
even though everyone feels better the
the way that they got there is very
different ways that we're impacting both
the nervous system and the
Brain incredible and um I have to say
when I heard that you were studying whim
Hoff method I was positively uh
delighted because I uh I find that there
are so few serious researchers in the
realm of of modern science that are both
explorers and then take what they've um
you know glean from those Explorations
and then take it to the laboratory and
and put rigor on those and really try
and parse mechanism with with of course
all the open-mindedness to whatever the
outcome happens to be right I mean good
science involves um not necessarily
asking questions alone but um raising
hypotheses and being comfortable for
those hypoth hypotheses to be correct or
not correct and I find your work to be
just so incredibly creative and brave in
that way and I love the way that you've
meshed different aspects of your own
personal um journey into these different
practices I don't know what came first
the science of the practices but I I I
have uh I have my guesses but um I must
say it's it's very refreshing and I
think it's exactly exactly what the
world needs right now in terms of tools
for mental health and physical health
because um far too many studies uh try
and isolate variables without
understanding a larger context of like
what are the different types of
stressors and clearly you're addressing
that or you know there's this thing
breath work that some people might think
oh you know the Iceman whm Hoff it's
really esoteric and you know kind of
crazy um I'm certainly not saying that
but that you say well what are the
critical elements from that that we
might be able to extract to understand
this positive ESS phenomenon so I just
um for I want to first of all just say
thank you for doing the incredibly
important work you do and thank you I
mean we were so delighted to um see the
paper you did with David Spiegel and to
know that you're pursuing this path and
um it's very reassuring with your rigor
and your you know depth of background I
I agree with you this these are the
types of studies we need releasing the
inherent power of Rejuvenation that's in
our body is UNT it's relatively untapped
in these rigorous controlled studies and
we just can't reduce inflammation with a
drug we can't reduce stress with a drug
we desperately need to learn how to use
you know the whole range of the nervous
system from the acute stress to the deep
relaxation to heal and to promote these
healthy resilient States I couldn't
agree more and um UCSF is uh very very
fortunate to have you and should they
ever forget that please come to Stanford
instead maybe we can recruit you away
from UCSF and I'm here I'm U being
friendly to my colleagues at UCSF but um
they better treat you right or else
we're coming for you uh and I also just
want to thank you for taking the time
today to share this information also
you've written one F books we will
provide a link to the newest one and
I'll um of course cue people to that
because it sounds like a very rich
source of information and actionable
tools that people can take in terms of
mitigating stress and I I love the idea
that there's this um discussion about
certainty and control uh to elements
that are very prominent in in my life um
for better for worse and all of us all
of us yeah and so really thank you for
the work you're doing thank you for
taking the time to share that work
through books and through podcasts and
especially today on this one I I I know
I speak on behalf of many many people
and I just really want to extend my
gratitude thank you so much and thank
you for for your podcast well it's a
labor of love and it's days like today
and discussions like this that make it
worthwhile so thank you thanks Andrew
thank you for joining me for today's
discussion all about stress aging and
Metabolism with Dr Alyssa eel I hope you
enjoyed the conversation as much as I
did if you'd like to learn more about Dr
eel's Laboratories work or if you'd like
to learn about her books such as the te
miror effect and the stress prescription
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