Dr. Elissa Epel: Control Stress for Healthy Eating, Metabolism & Aging

Dr. Alyssa Epel on Stress and Aging

Introduction

• Dr. Alyssa Epel is a professor of psychiatry and behavioral sciences at the University of California, San Francisco
• Director of the Center on Aging, Metabolism, and Emotions
• Focuses on stress and its impacts on the brain and body, both negative and positive
• Explores how stress impacts behavioral choices, such as food selection and experience
• Author of books “The Telomere Effect” and “The Stress Prescription”

Dr. Alyssa Epel on Stress and Aging

Introduction

• Dr. Alyssa Epel is a professor of psychiatry and behavioral sciences at the University of California, San Francisco
• Director of the Center on Aging, Metabolism, and Emotions
• Focuses on stress and its impacts on the brain and body, both negative and positive
• Explores how stress impacts behavioral choices, such as food selection and experience
• Author of books “The Telomere Effect” and “The Stress Prescription”

Understanding Stress

• Stress can be good or bad, acute or chronic
• Technically, stress occurs when demands exceed resources
• Much of life involves meeting challenges, and stressors are inevitable
• The stress response is more important than the stressor itself
• Acute stress responses followed by recovery are normal and necessary for survival
• Problems arise when stress responses are prolonged due to rumination and overthinking

Managing Stressful Thoughts

• Thoughts are the most common form of stress
• Awareness of how the mind works is crucial for managing stress
• Three categories of stress management:
• Rationalizing or understanding the basis of the stress
• Diverting thinking away from the stressor
• Other tools, such as breath work, exercise, sleep, and non-​​sleep deep rest
• Surveys show that a majority of people feel overwhelmed by stress, with young adults, women, and people of color experiencing higher levels of stress
• Some individuals may not be aware of their stress levels, while others genuinely experience less stress

Stress and Aging

• Dr. Epel’s laboratory has shown that certain forms of stress can change telomeres, which are components of the genetic machinery of cells that impact the rate of cellular aging
• Stress interventions, such as meditation and breath work, can influence how stress affects the brain and body
• Dr. Epel’s research also explores how specific dietary interventions, like omega‑3 fatty acid intake, impact stress and stress responses
• The effectiveness of stress interventions can vary depending on factors like gender and social status

By understanding the different forms of stress and learning how to manage stress responses, individuals can reduce the negative effects of stress on aging and behavioral choices, while maximizing the positive effects of stress on cellular metabolism, mental health, physical health, and performance.
Stress and Aging

• Older people tend to be less stressed 
  • They have been through a lot and have a better perspective on life
  • Young adults have four times the level of stress as older adults
• Daily stress from urban and modern life 
  • Often not noticed, but held in the body as tension
• Overthinking and rumination 
  • Strategies to deal with it: 
    1. Top-​​down strategies of awareness, beliefs, and mindsets
    2. Body changes the mind — working stress out of the body
    3. Change the scene — creating a calming environment with safety signals
• Breathing as a direct and fast path to reducing stress 
  • Unique among brain functions as it can be consciously controlled
• Different forms of stress 
  • Acute stress response — short-​​term, allows for problem-​​solving and increased capacity
  • Moderate stress — lasts days or months, requires daily restoration
  • Chronic stress — lasts years, requires acceptance and coping strategies
• Variance in how stress affects aging 
  • Some people with chronic stress show little to no accelerated aging
• Optimal aging vs. accelerated aging 
  • No stress is not ideal; some stress is necessary for optimal aging
  • Engaging in challenges and risks is part of living a full life
• Example: elderly people tutoring at-​​risk students 
  • Transition from feeling safe and understressed to challenged but generative
  • Contributing to society and feeling a sense of purpose

Telomere Work

• Telomeres are the protective caps at the ends of chromosomes 
  • They shorten with each cell division, eventually leading to cell death
• Chronic stress can accelerate telomere shortening 
  • Resulting in accelerated aging and increased risk of age-​​related diseases

• Strategies to maintain telomere length and promote healthy aging

  • Managing stress through mindfulness, exercise, and social support
  • Adopting a healthy lifestyle, including a balanced diet and sufficient sleep
    Growth and Challenge in Later Years

• Engaging in programs that help others can lead to personal growth and a sense of purpose

  • Example: Teachers working with students facing issues like poverty and drug use
  • Study showed hippocampal growth in participants, particularly men, during the program
  • Hippocampus is involved in the formation and recall of memories

Hippocampus and Memory Formation

• Hippocampus is highly plastic and amenable to the addition of new memories 
  • Rusty Gage’s study at the Salk Institute: terminally ill people injected with a dye that labels new neurons 
    • After death, their brains showed new neuron generation, especially when still trying to learn and acquire new information

Stress and Cognitive Health

• Dave Almeida’s study on daily stressful events in large populations 
  • Small percentage of people reported no stressors, but had lower cognitive health
  • Lack of stimulation for hippocampal neuroprogenitor cells

Two Types of Psychological Stress Response

• Feeling threatened (fear of failure, embarrassment, social pain) 
  • Overreactive stress response, slower recovery
• Challenge response (activated, excited response) 
• Healthier hemodynamic response, better problem-​​solving, positive outlook
• Less inflammation, longer telomeres (indicating slower aging)

Promoting the Challenge Response

• Engaging with moderate stressors can build stress resilience
• Shifting mindset from feeling threatened to viewing stress as a challenge and opportunity 
  • Using self-​​compassion, distancing, and comforting statements to recover more quickly

Finding Personalized Stress Shields

• People need to find strength statements or “stress shields” that resonate with them and feel believable

  • Chapter 3 of “The Telomere Effect” by Dr. Elissa Epel provides a list of options
  • Example: “Be the lion instead of the gazelle” — both experience high stress, but the lion has a challenge response while the gazelle has a threat response
  • Finding the right stress shield can help shift mindset and promote a healthier response to stress
    Stress and Eating

• Stress response can lead to different eating patterns

  • Some people eat less when stressed (high sympathetic response)
  • Others tend to overeat or binge eat when stressed (more common pattern)
• Stress can drive cravings and insulin resistance 
  • Repeated bouts of stress can lead to weight gain, particularly in the abdominal area
  • Chronic stress can lead to storing abdominal fat for quick energy mobilization

Opioid System and Eating

• Opioid system within our body can release substances that make us feel less pain and sedated 
  • Activated by things like sex and food
• Relationship between stress, eating, and the opioid system 
  • Stress can exacerbate compulsive eating tendencies
  • People with obesity may have a different reward response during stress
  • Insulin resistance can play a role in the reward center’s response to stress
• Developmental path to obesity 
  • Tendency towards a bigger reward response and hunger during stress
  • Becomes a way of coping and leads to obesity
  • Not all obese people have a dysregulated stress response

Interventions and Medications

• Naltrexone and Wellbutrin combination 
  • Used for binge eating
  • Dampens compulsive eating tendencies
• Semaglutide analogues
  • Effective in blocking hunger, especially in type 2 diabetics
  • Gaining popularity for weight loss

• Improved nutrition is essential for solving obesity as a public health problem

  • Regardless of medications, diet plays a crucial role in weight management
    Discussion on Obesity, Sugar, and Compulsive Eating

• Drug companies pushing drugs for BMI, but not addressing root causes

• Dr. Robert Lustig at UCSF focuses on sugar and processed food as major contributors to obesity
• Diet overrides effects of drugs, making it a losing battle against big food and big pharma

Mindful Eating and Breaking Compulsive Eating Cycle

• Mindful eating helps with self-​​regulation, checking in with hunger, and increasing body awareness
• Interoceptive awareness is critical for people with compulsive eating
• Positive stress pathway (e.g., high-​​intensity interval training) helps with cravings

Strategies for Managing Binge Eating and Cravings

• Top-​​down mindful check-​​in: label emotions and hunger levels before eating
• Surf the urge: watch cravings pass without consuming
• Create safe environments at home and work without sugary temptations

Sugary Drinks and Health

• Sugary drinks, including soda and energy drinks, are harmful calories
• Liquid sugar goes to the brain quickly, making it more addictive
• Removing sugary drinks from environments can lead to weight loss and health improvements

Addressing Sugary Drink Consumption

• Focus on alternatives like black coffee, yerba mate tea, or water
• Limit consumption of diet sodas and energy drinks

• Recognize the hedonic cycle of sugar and caffeine: feel good response followed by withdrawal and craving
  The Impact of Stress and Nutrition on Pregnant Women

• Pregnant women with excess weight are vulnerable to excessive weight gain during pregnancy

  • Not healthy for the mother or the offspring
• Study conducted on pregnant women with mindful eating and stress reduction training 
  • Took ten years to complete
  • Results showed that the training did not stop excess weight gain during pregnancy
  • However, the training had other positive effects on the women and their babies

Positive Effects of Mindful Eating and Stress Reduction Training

• Improved insulin sensitivity during pregnancy 
  • Twice as many women in the control group had impaired glucose tolerance
  • Half as many women in the mindfulness group had impaired glucose tolerance
• Babies born to mothers in the mindfulness group had: 
  • Less obesity
  • Fewer illnesses in their first year of life
  • Healthier stress responses
• Long-​​term mental health benefits for mothers in the mindfulness group 
  • Improved mental health eight years after the intervention
  • Results likely due to the mindfulness training during pregnancy and the social support from being in a group

The Power of Rebellion in Changing Behavior

• Younger generations may respond better to anti-​​establishment messaging 
  • Example: Anti-​​smoking campaigns showing rich men profiting from others’ health problems
• Activating a sense of rebellion can lead to better health choices 
  • Rebelling against big food and big pharma systems that work against individual health

Dissonance and Mindful Eating

• Dissonance method used to reduce eating disorders and reward drive 
  • Showing people how the food industry manipulates and designs addictive foods
• Mindful eating exercises can help people realize the true taste of processed foods 
  • Example: Eating a Twinkie slowly and mindfully often leads to disappointment
  • Encourages eating slowly and savoring small amounts of rewarding food

Mindfulness Intervention for Pregnant Women

Body Scan and Cravings

• Body scan: focusing on the body from head to toe, breathing into each part, releasing tension
• Significantly reduced cravings in a study
• Refocusing on the body takes away stress, anxiety, and self-​​referential thoughts

Interoception and Exteroception

• Interoception: sensory innervation of internal organs and skin, including proprioception (sense of limb position and body in relation to gravity)
• Exteroception: paying attention to and focusing on things beyond the confines of the skin
• Body scan shifts focus more towards interoception, potentially breaking the link between interoception and exteroception in cravings

Long-​​term Outcomes of Mindfulness Interventions

• Few long-​​term studies on stress interventions
• Meditation studies show slower biological aging, dampened inflammatory pathways, and longer telomeres in long-​​term meditators
• Short-​​term meditation studies show boosts in telomerase activity, an enzyme that protects cell aging and rebuilds telomeres

Deepak Chopra’s One-​​Week Transcendental Meditation Retreat

• Participants focused on yoga, meditation, and reflective exercises for about 8 hours a day
• Control group walked around the resort and listened to health talks
• Both groups felt great after the week, but meditation group had lower depression levels 10 months later
• People with early adversity benefited the most from the meditation condition
• Meditation involved focused attention on a word and awareness of the body

Meditation Retreats

• Range from half-​​day to two-​​week retreats

• Silent meditation retreats are recommended for getting to know the mind and achieving a quantum shift in stress levels
  Meditation and Managing Daily Stress

• Meditation can be helpful for managing daily stress

  • Short daily practices are most effective
  • Online classes can help develop meditation skills
• Breathing exercises, being in nature, and metacognition can also help reduce stress
• Meditation and plant medicine experiences can complement each other

Psychedelics and Brain Rewiring

• Psychedelic journeys are thought to be the time when changes occur 
  • However, the actual rewiring of the brain takes place in the window after the psychedelic journey
  • This can last for weeks or even months
• Similar to meditation, repeated short practices or longer retreats can induce brain plasticity

Mitochondrial Health and Mood

• Study on young mothers with typical children or children with autism 
  • Caregiving moms had significantly lower mitochondrial activity 
    • Less energy production, feeling more exhausted
  • Those with better mitochondrial enzymes had more positive emotions in the evening
• Daily mood was correlated with mitochondrial levels on the same day 
  • Suggests that mitochondria are sensitive to thoughts and feelings on a daily basis

Radical Acceptance and Chronic Stress

• Radical acceptance can help with chronic stress 
  • Accepting that some situations cannot be changed
  • Reduces the mental real estate taken up by unwanted situations
• Practice of radical acceptance can help loosen the grip on unwanted situations 
  • Allows for better well-​​being and focus on what can be controlled

Best Practices for Mitigating Non-​​Negotiable Stressors

• Daily mindfulness practice can help
• Recognizing and accepting situations that cannot be changed 
  • Focus on living well within those situations

• Caregivers who focused less on wishing things were different had better health trajectories

  • Less depression, heart disease, and early death
    Engagement, Focus, and Well-being

• Negative mind-​​wandering state predicts unhappiness and shorter telomeres

• Caregivers often experience more suffering due to wishing things were different
• Metaphor: pulling a rope attached to a brick wall 
  • Represents trying to solve unsolvable problems
  • Dropping the rope frees up energy for other things

Tendency to Pull on Brick Walls

• Limbic system has no sense of time 
  • Engages fight or flight responses
  • Reactivates childhood neural circuits in adult relationships
• Repetition compulsion: placing oneself in traumatic circumstances to rewrite the story 
  • Theory in modern trauma and neuroscience-​​informed trauma therapies

Uncertainty and Control

• Intolerance of uncertainty predicts pandemic anxiety, PTSD, depression, and distress
• Comfortable with uncertainty is a rare resilience factor
• Practices to help feel ease with uncertain future: 
  • Mindful check-​​ins
  • Reframing uncertainty as the beauty of the mystery of life
  • Adopting a receptive mode and being curious about what arises

Stress Management and Thriving

• Mindset matters in shaping physiology
• Two approaches to stress management: 
  • Forward center of mass: smashing into challenges and going through them
  • Receptive mode: leaning back and being aware
• Balancing both approaches can be valuable 
  • Forward center of mass offers opportunity for agency but is energetically demanding
  • Receptive mode is less energetically demanding but offers less opportunity for agency

• Knowing when to work and when to let go is crucial for managing stress and thriving
  Ford Mass Idea: Muscling and Releasing Stress

• Importance of letting go to mitigate stress in the right situations

• Waves of life: small waves, big waves, tidal waves
• Control in our direction, but always hit by the next wave
• Skillful surfing or navigating through life

Narrative and Stress

• Creating a coherent narrative is critical for making sense, finding meaning, and having a social identity
• Stress is about how we interpret and respond to events
• Narrative of purpose is important for rising above animal instincts

Breath Work and Stress Resilience

• Positive physiological stress: short-​​term bursts of stress to promote resilience
• Wim HOF method: extreme breathing and cold exposure
• Study at UCSF comparing low arousal relaxation methods, mindfulness slow breathing, positive stress exercise, and Wim HOF method
• Regardless of method, participants experienced reduced stress, anxiety, and depression
• Wim HOF method selectively boosted feelings of positivity

Physiological Reactivity and Different Interventions

• Examining stress response system, sympathetic nervous system, and parasympathetic response system
• Different profiles from different interventions, impacting nervous system and brain in unique ways
• Future research: looking at mitochondrial enzymes, telomerase, and gene expression patterns

Importance of Creative and Brave Research

• Combining personal journey and scientific rigor
• Open-​​mindedness to various outcomes and hypotheses
• Addressing different types of stressors and extracting critical elements from various practices

• Providing tools for mental and physical health in a larger context
  Dr. Alyssa Epple’s Work on Stress, Aging, and Metabolism

• Gratitude for Dr. Epple’s important work and rigorous studies

• Exploring the untapped power of rejuvenation within our bodies
• Need for non-​​pharmacological methods to reduce inflammation and stress
• Promoting healthy, resilient states through the nervous system

Dr. Epple’s Books and Resources

• Books: The Telomere Effect and The Stress Prescription
• Provides actionable tools for mitigating stress
• Discusses certainty and control in life