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Stress refers to a reaction given a particular stimulus. Stress is a common problem in most modern societies. Stress creates greater physiologic demands. Unhealthy eating patterns will only result in an increased level of stress, followed by further health problems if in the future if the issues are not resolved. Prolonged stress increases the metabolic needs of the body and causes many other changes. The increased metabolism can also cause an increase in the use and excretion of many nutrients. Although stress alters nutrient needs, if marginally deficient in a nutrient, stress can make that deficiency even worse. Copyright © 2014 Elsevier Inc. All rights reserved.
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Diet and Stress
Michael J. Gonzalez, DSc, NMD, PhD
Jorge R. Miranda-Massari, BS, BSPharm, RPh, PharmD
“Let food be your medicine and let medicine be your food.”
Stress in biological terms refers to the reaction of the body to the disturbance of the
equilibrium given particular stimuli. A stressor can vary in intensity, and people have
different levels of coping ability to respond well or fail to respond properly to an event
that has occurred in their life, whether physical or emotional. Physiologic systems
work in a complex and integrated manner. There are many factors of one’s daily life-
style that bring stress upon the body. Stress is a common problem in most modern
societies, in which there are economic pressures; political, religious, and other social
conflicts; overpopulation; contamination; and a food industry that provides main sta-
ple foods that are additional stressors (refined carbohydrates, excessive animal fats,
artificial colors, preservatives, and sweeteners). Unhealthy eating patterns will only
result in an increased level in stress, followed by further health problems in the near
future if the issues are not resolved. With a healthy eating plan accompanied with sci-
entific supplementation and a proper stress management program, one can overcome
stress, prolong one’s life span, and reduce the likelihood of stress-related illnesses.
The authors have nothing to disclose.
Nutrition Program, Department of Human Development, School of Public Health, University
of Puerto Rico, Medical Sciences Campus, GPO Box 365067, San Juan, PR 00936-5067, USA;
Department of Pharmacy Practice, School of Pharmacy, University of Puerto Rico, Medical
Sciences Campus, GPO Box 365067, San Juan, PR 00936-5067, USA
* Corresponding author.
E-mail address:
Diet Stress Nutrition Supplementation Vitamins Minerals
Nutrition, diet and stress.
Stress and nutritional insufficiency.
Nutrition for stress.
Psychiatr Clin N Am 37 (2014) 579–589
0193-953X/14/$ – see front matter Ó2014 Elsevier Inc. All rights reserved.
The US population in general as a whole is overstressed. It is well understood that
stress and perceived stress in adults contribute to a wide range of disorders including
hypertension and elevated plasma cortisol,
cardiac and cardiovascular disease,
flammatory bowel syndrome,
type 2 diabetes mellitus,
and a reduced quality of life
among those suffering with cancer.
Stress happens in 3 stages. The first is an initial state of alarm (fight or flight
response), which produces an increase of adrenaline. Living organisms can withstand
occasional extreme stress and still survive. The second stage is a short-term resis-
tance mechanism that the body sets up to cope with the problem. The final stage is
a state of exhaustion. The exhaustion stage occurs when the body has used up all
its available resources. If the situation is not taken care of, stress can produce long-
term damage to the body, including heart problems, high blood pressure, the immune
system problems (susceptibility to infections and allergies), skin problems (acne, itchy
rashes, psoriasis, and eczema), pain (neck, shoulder and back), diabetes, and
Stress affects the whole body is the following sections provide a brief description of
how stress affects different body systems.
Musculoskeletal System
When muscles are tense for prolonged periods of time, other reactions of the body
promote stress-related disorders. Tension headache and migraine headache have
been associated with chronic muscle tension in the area of the shoulders, neck,
and head.
Respiratory System
Stress can make breathing more difficult. For those with asthma or a chronic obstruc-
tive disease, getting enough oxygen can become difficult.
Repeated acute stress and persistent chronic stress can induce inflammation in the
vasculature, especially of the coronary arteries. This is one of the proposed mecha-
nisms associating stress to myocardial infarcts. It addition, it has been shown that
the way a person responds to stress can alter cholesterol levels.
Stress affects how the hypothalamus signals the pituitary gland and the autonomic
nervous system to secrete the stress hormones epinephrine and cortisol. The hypo-
thalamus stimulates the adrenal glands cortex to produce cortisol and the adrenal me-
dulla to produce epinephrine. This gives the body the energy to run from danger.
The Nervous System
Chronic stress can result in a long-term drain on the body. As the sympathetic nervous
system continues to trigger physical reactions, it causes a wear and tear on the body.
ANS Autonomic nervous system
DHA Docosahexaenoic acid
EPA Eicosapentaenoic acid
PMS Premenstrual syndrome
Gonzalez & Miranda-Massari
Excessive activation depletes the system of neurotransmitters, peptides, cofactors,
and other mediators and also alters receptor response.
Stress creates greater physiologic demands. More energy, oxygen, circulation, and
therefore more metabolic cofactors are needed (eg, vitamins and minerals). The irony
of stress is that people suffering stress need a more nutritionally dense diet but often
opt for comfort foods lacking in the necessary nutrients, consequently inducing a
situation of nutrient depletion that further compromises the metabolic systems. This
situation can be further complicated by the use of medications that often contribute
to nutrient depletion.
Stress can cause unhealthy eating habits. People who often endure stress have no
time to fit a balanced nutrition around their busy schedule. Moreover, stress makes the
body crave foods that are high in fats and sugars. This eating problem in time will inflict
a greater stress on the body, plus a nutritional insufficiency state that poses a threat to
one’s physical and mental health. Stress can have the effect of making people skip or
forget to eat their meals. Also people under stress use coffee or other stimulants to
assist them and help them cope. The problem with coffee is that it contains caffeine,
which, if taken in large quantities, can have negative adverse effects on the body. One
problem is that the person is using coffee to stay awake when rest is obviously
needed. Caffeine also has an impact on the hormones in the body. Adrenaline and
cortisol are increased under the influence of caffeine. The neurotransmitter dopamine
is also increased, all with possible negative adverse effects. The increased amount of
cortisol produced by stress gives the person a strong urge to eat foods that are high in
carbohydrates, sugars, and fats. This eating pattern will result in excess fat being
stored. When someone is stressed and does not eat the right amount of food or the
correct amount of nutrients, he or she will start to encounter inconsistencies in their
blood sugar and other metabolic reactions. These inconsistencies lead to problems
such as tiredness, lapses of concentration, and mood swings. If stress is not dealt
with properly, the body will suffer in the long run problems that are much more serious,
such as diabetes.
The High-Fat Diet and the Stress Response
Kitraki and colleagues
published a study in 2004 using Wister rats, investigating the
effects of a diet high in polyunsaturated fat (corn oil) corresponding with a deceased
consumption of carbohydrates and reduced intake of protein over 7 days on both en-
ergy consumption and a subsequent stress reaction to a short stressor (swimming).
Comparing levels of stress hormones in the high-fat/low-protein/low-carbohydrate
diet rats and normally fed rats, they found that the levels of corticosterone in both
sets of rats were not different during the application of the stressor. Additionally, corti-
costerone concentrations appeared to not be affected by the different diets. However,
further analysis of the blood showed elevated levels of glucocorticoid receptors within
the hypothalamic area of the rats fed a normal diet, while lower glucocorticoid recep-
tors levels were found in the rats fed the high-fat/low protein/low-carbohydrate diet.
The results highlight how quickly an improper diet with high fat intake and lacking in
other nutrients can adversely impact the balance of stress hormones as evidenced
by lower glucocorticoid receptors in the hypothalamus known to mediate the effects
of cortisol.
Diet and Stress 581
Omega-3 and Perceived Stress
Bradbury, Myers, and Oliver (2004) did a study to determine if perceived levels of
stress can be lowered through consumption of the omega-3 fatty acid docosahexae-
noic acid (DHA).
Participants scoring high on a scale of perceived stress were
randomly assigned to either a group taking fish oil supplements containing DHA or
a group (placebo group) taking supplements of olive oil for 6-weeks. For the analysis,
both the fish oil group and the olive oil placebo group were compared with each other
as well as against a larger control population. Following the 6-week trial, results
showed that perceived stress levels were significantly lower among both the fish oil
and olive oil groups. When comparing perceived stress levels between the fish oil
group and the larger population, the fish oil group had significantly lower perceived
stress. Further analysis showed that there were no significant differences in perceived
stress levels between the fish oil and olive oil groups, and no significant difference in
perceived stress levels between the olive oil and the control groups. At the end, only
the fish oil group showed significant reductions in perceived stress compared with the
control sample, consistent with the conclusion that omega-3 attenuates perceived
Diet, Stress, and Inflammation
Inflammation is a biomarker of stress. Ha
¨nsel, Hong, Ca
´mara, and von Ka
demonstrated that situations such as work-related stress, stress associated with living
in poor socioeconomic conditions, stressful events suffered in childhood, and stress
associated with caring for another all contribute to chronic stress and influence the
function of the immune system. Furthermore, Ha
¨nsel and colleagues
how chronic stress impacts the HPA axis and the autonomic nervous system (ANS),
resulting in increased levels of inflammation. Galland
did research exploring the
impact of nutrition and patterns of food consumption on immunologic indicators of
inflammation (eg, interleukin-6, tumor necrosis factor alpha, and C-reactive protein).
showed healthier, anti-inflammatory influences with food consumption pat-
terns that result in a greater monounsaturated fat to saturated fat ratio, a greater
omega-3 to omega-6 ratio, and greater levels of vegetable, fruit, whole grain, and
legume consumption.
Bakker and colleagues
did research to see if dietary changes could reduce mod-
erate levels of chronic inflammation in individuals identified as being overweight. They
provided men who were overweight with a mix of nutrients known to deliver anti-
inflammatory effects (vitamin C, omega-3, and extracts derived from green tea and
tomatoes) for 5 weeks. Measures were taken of blood plasma, fat tissue, and meta-
bolic enzymes. At the end of the 5 weeks, there were no changes in measures of
inflammation (C-reactive protein). Yet, there were small changes indicating some
attenuation of inflammation in fatty tissues as indicated by improved performance of
endothelial tissue and oxidation of fatty acids in the liver. The outcome indicates
that adopting a diet high in anti-inflammatory and antioxidant properties may have
beneficial impacts on inflammation and oxidative stress. It is possible that the nutri-
ents provided were not given in enough quantities to have a more profound effect
on inflammatory parameters.
Vitamins and Stress
As mentioned earlier, supplementation with vitamins may reduce stress and improve
overall mood. The benefit of vitamin supplementation in reducing stress and improving
mood and mental performance was shown by Kennedy and colleagues
in a sample
Gonzalez & Miranda-Massari
of working men between the ages of 30 and 55. These men were required to fill out
questionnaires measuring their mood state and perceived stress, and assessing their
overall health. Cognitive functioning, mood change, and fatigue were also assessed
during a battery of cognitive tests. The men where then randomly assigned to an
experimental or control group. For 30 days, the men in the experimental group
received dietary supplements of vitamins and minerals. During the last day of the trial,
all men were asked to walk on a treadmill as they were engaged in a test of cognitive
function. Analysis showed that the men who received supplements of vitamins and
minerals exhibited improved cognitive performance, lower rated stress, and improved
mental functioning.
Another study conducted by Mishra and colleagues
further demonstrates how
insufficient amounts of vitamins, specifically B vitamins, can contribute to distressed
mood. They assessed the impact of vitamin levels (vitamins B6, B12, niacin, and
folate) taken as a child and taken as an adult on women’s psychological state during
adulthood. Using a standardized questionnaire to assess levels of psychological
distress and a memory recall session to assess patterns of food consumption and
vitamin intake during childhood, they collected food intake information from a sample
of women. They found that only deficient levels of vitamin B12 taken at their current
adult age had an association with higher reporting of psychological distress. With
respect to diet, improper nutritional balance, insufficient vitamin intake, and excess
consumption of fat have been shown to exacerbate the stress response and create
unhealthy balances of stress hormones. The dietary patterns shown to create posi-
tive protective effects against stress and inflammation are consistent with the Med-
iterranean diet, consisting of increased levels of vegetables, fruit, whole grain, nuts,
seeds, beans, eggs, and higher levels of fiber along with lower levels of red meats.
Stress reduction is also aided by supplementation with vitamins and minerals
including magnesium, calcium, manganese, B vitamins, and vitamins C and E. Addi-
tional stress protection was shown with the intake of omega-3 fatty acids, particularly
DHA from fish oil, and increasing the ratio of monounsaturated fats (omega-9) to
saturated fats.
“Don’t be foolish enough to dig your own grave with a fork and spoon.”
It cannot be overstated that emotional stress affects all aspects of nutrition. A wide
variety of foods needs to be consumed in order to remain healthy. This is because
there is not 1 food available that contains all the necessary nutrients that are required
for optimal health. Therefore a selection of healthy foods is needed. Nutrients needed
include minerals, vitamins, proteins, and fatty acids. Consuming the required nutrients
(typically between 40 and 60 nutrients) per day is essential to a healthy, well-protected
body. Sadly, most physicians have no background in nutrition. Sugar is one of the
foods we should eliminate. Sugar itself contains no required vital nutrients. Sugar
may produce a burst of energy for a short period of time only. When this high runs
out, the person will suffer a crash.
One of the main problems with on-going stress is the depletion of nutrients. The
stress response is fight or flight; either action requires lots of energy. Stress utilizes
many nutrients for energy production, even if one sits in front of a computer screen
all day.
B vitamins are essential for coping with stress, as they are used in most metabolic
enzymes. Substances like sugar, alcohol, and caffeine will drain these resources and
Diet and Stress 583
affect the functionality of the body and the brain. When under stress, the body uses
reserve B vitamins.
Foods can help relieve stress in several ways. Comfort foods, like a bowl of warm
oatmeal can boost levels of serotonin, a calming brain chemical. Other foods can
cut levels of cortisol and adrenaline, stress hormones that take a toll on the body
over time. And a healthy diet can counter the impact of stress, by revving up the im-
mune system and lowering blood pressure. One of the best ways to reduce high blood
pressure is to get enough potassium, and half an avocado has more potassium than a
medium-sized banana. Guacamole, made from avocado, just might be a healthy alter-
native when stress has one craving a high-fat food.
Carbohydrates prompt the brain to make more serotonin. For a steady supply of this
feel-good chemical, it is best to eat complex carbohydrates, which are digested more
slowly and have a lower glycemic index. Good choices include whole grain breakfast
cereals, breads, and pastas, as well as old-fashioned oatmeal. Complex carbohy-
drates can also help one feel balanced by stabilizing blood sugar levels. Carbohy-
drates at bedtime can speed the release of serotonin and help one sleep better.
Because heavy meals before bed can trigger heartburn, stick to something light,
such as fruit and low-fat yogurt. Another bedtime stress buster is a glass of warm
milk. Research shows that calcium eases anxiety and mood swings linked to premen-
strual syndrome (PMS). The authors recommend organic, skim, or low-fat milk.
Oranges provide vitamin C. Studies have demonstrated that this vitamin can curb
levels of stress hormones while strengthening the immune system. In a study of people
with high blood pressure, high cortisol levels (a stress hormone) returned to normal
quicker when people took vitamin C.
Crunchy raw vegetables can help ease stress in a purely mechanical way. Munching
celery or carrot sticks helps release a clenched jaw and may ward off tension. Spinach
and all green leafy vegetables are a good source of magnesium. Insufficient magne-
sium may trigger headaches and fatigue, compounding the effects of stress. Cooked
organic soybeans or a filet of salmon can also provide magnesium.
Omega-3 fatty acids, found in fish such as salmon and tuna, can prevent increases
in stress hormones and may help protect against heart disease, mood disorders like
depression, and PMS. For a steady supply of feel-good omega-3s, aim to eat 3 oun-
ces of fatty fish at least twice a week.
Pistachios, as well as other nuts and seeds, are good sources of healthy fats. Eating
a handful of pistachios, walnuts, or almonds may help lower cholesterol, ease inflam-
mation, reduce the risk of diabetes, and help protect against the effects of stress.
Almonds are full of helpful vitamins: vitamin E to increase the immune system, plus
B vitamins, which may make one more resilient during bouts of stress such as depres-
sion. Snack on a quarter of a cup every day.
Drinking black or green tea may help one recover from stressful events more quickly.
One study compared people who drank 4 cups of tea daily for 6 weeks with people who
drank another beverage. The tea drinkers reported feeling calmer and had lower levels
of the stress hormone cortisol after stressful situations. When it comes to stress, the
caffeine (in coffee) can boost stress hormones and raise blood pressure.
Caffeine can be responsible for inducing the first stage of stress (alarm stage).
Caffeine is also responsible for making people hyperactive and nervous. Because of
this, the person’s sleeping pattern can be affected significantly by caffeine. If one
has trouble controlling stress and always feels tired, one should look at his or her
diet to see if there are any nutrient deficiencies or insufficiency. When the body is under
stress, it has been proven that the body uses up its resources until they are finished.
Following a diet plan will strengthen the body against stress and other illnesses.
Gonzalez & Miranda-Massari
The following are the main nutrients that the body will use up
1. B vitamins. These help the body cope with stress (build metabolism) and control the
whole nervous system
2. Proteins. Assist in growth and tissue repair
3. Vitamin A. Essential for normal vision
4. Vitamin C. Protection of the immune system (eg, antioxidants and diabetes protec-
tion), lowers the amount of cortisol in the body
5. Magnesium. Needed for a variety of tasks such as muscle relaxation, fatty acid for-
mation, making new cells, and heartbeat regulation
There are many herbal supplements that claim to fight stress. One of the best stud-
ied is St. John’s Wort, which has shown benefits for people with mild-to-moderate
depression. This herb also appears to reduce symptoms of anxiety and PMS. Valerian
root is another herb that has a calming effect. Health care providers should be told
about any supplements a patient is taking, especially herbs, so they can check on
any possible interactions with any medication.
Tip # 1 Eat a Variety of Different Color Foods
The colors and their intensity are a guide to the variety of phytochemical (pigments)
and their concentrations.
The color blue/purple on fruits and vegetables reveals the presence of natural plant
phytochemicals called anthocyanins, which act as powerful antioxidants, protecting
cells from damage. In general terms, the darker the color means the higher the phyto-
chemical concentration. Anthocyanins have been shown to have a role in the support
of healthy blood pressure, the prevention of blood clot formations, the improvement of
memory function, and in lowering the risk of cancer.
Blue/purple on fruits and vegetables also shows that they contain flavonoids that
support blood vessels, help prevent short term memory loss, and even prevent urinary
infections by precluding bacteria from sticking in the epithelium of the urinary tract.
Green fruits and vegetables reveal chlorophyll content. Another phytochemical
found in green colored food is lutein, which is important for eye health.Lutein works
with zeaxanthin (found in corn, red peppers, and grapes) to reduce the risk of cata-
racts and macular degeneration.
Other nutrients present in green food include the indoles in broccoli, cabbage, and
other cruciferous vegetables, which may help protect against some types of cancer.
Many green plant foods are also rich in isothiocyanates, which stimulate enzymes in
the liver that assist the body in removing potentially carcinogenic compounds. Greens
(especially dark leaves) are also rich sources of folate, vitamin K, potassium, some
carotenoids, and omega-3 fatty acids.
Red fruits and vegetables reveal lycopene and anthocyanins. Lycopene is a power-
ful antioxidant that is found in plants such as tomatoes, watermelon, and pink grape-
fruit. Anthocyanin is found in fruits such as strawberries, raspberries, and red grapes
and has powerful antioxidant activity. Lycopene is believed to reduce risk of myocar-
dial infarcts and certain types of cancer, especially prostate.
Orange/yellow fruits and vegetables reveal carotenoids. Beta-cryptoxanthin, beta-
carotene, and alpha-carotene are all orange-friendly carotenoids that can be con-
verted in the body to vitamin A. Vitamin A is important for vision and immune function,
Diet and Stress 585
as well as skin health. There are scientific reports on carotenoid-rich foods helping to
reduce the risk of cardiovascular disease and some cancer.
In conclusion, many phytonutrients are essential in helping the body fight oxidation
and degenerative diseases.
Tip #2 Eat Antioxidant-Containing Foods
Most phytochemicals are known to have antioxidant activity. Free radicals are oxygen
molecules with an aberrant electron. Metabolically speaking, this unbalanced electron
configuration causes damage to the following: cell membranes, DNA, RNA, and mito-
chondria. Free radicals are a hazard to the body’s integrity at the cellular and tissue
level. They have been associated with the development of cancer and heart disease,
and other diseases as well. Antioxidants destroy free radicals. The 4 major antioxi-
dants are: carotenes (precursors to vitamin A) vitamin C, vitamin E, and the mineral,
selenium. Antioxidants are found mostly in fruits and vegetables.
Tip # 3 Choose Organic Foods (Whenever Possible)
In simplest terms, currently available foods are full of chemicals: synthetic fertilizers,
pesticides, herbicides, and fungicides. Organic foods will largely reduce the burden
of contaminants.
Tip #4 Drink Filtered Water
In general, people are usually dehydrated. People do not drink enough water! Many
beverages (eg, coffee, tea, sodas) act as diuretics, meaning they increase the loss
of water through urination, thus promoting dehydration. Various studies show that
the water supply is not as clean as it should be. City drinking water may contain sizable
traces of antibiotics, hormones, and chemicals.
It is in the best interest to install a high-end water filter system to be used for all
drinking water (and cooking). Remember to replace the filter once a year (or as often
as needed). One should also know that there is no federal regulation on bottled water.
Most bottled water is ordinary tap water, sitting in plastic containers on pallets, stored
in warehouses months before store delivery. It might be best to carry one’s own
filtered water in a suitable water bottle.
The importance of being hydrated cannot be overemphasized. Water helps flush out
metabolites, waste products, and toxins for elimination. Dehydration will compromise
this process. How much water is enough per day?
The authors suggest the best indication of being hydrated is producing near-clear
urine (since dark urine may be a sign of dehydration).
Tip # 5 Eat Herbs and Spices
Use fresh spices and herbs to cook and in salads. Prepare a backyard garden with
herb plants that may include rosemary, thyme, sage, cilantro, oregano, garlic, and
many others. These spices and herbs are not only added for taste, they have health
benefits (essential oils of herbs enhance the immune system and may have antimicro-
bial and other beneficial properties). The leaves, stems, and roots of these plants
contain phytochemicals such as bio-flavonoids and antioxidants. There are several
mushrooms (shitake, maitake and reishi) that are known to enhance the immune sys-
tem as well.
Tip # 6 Consume Free Range Meats and Poultry and Wild Caught Fish
Free range means that the cattle are allowed to eat as they roam around the pasture
for their entire lives. Nonfree range refers to those animals that are raised on factory
Gonzalez & Miranda-Massari
farms, live in overcrowded conditions and fed corn and other grains. Once again, corn
is not a food source and is not found in their normal diet. The problem is that it may
contain synthetic fertilizers, herbicides, fungicides, or pesticides. Also, living in such
close quarters gives rise to infections; hence more antibiotics are used even prophy-
lactically. Hormones and steroids are also given to increase yield. As for the consump-
tion of beef, chicken, mutton, pork, and salmon, the best way to go is organic.
Tip # 7 Eat Fiber
Fiber (roughage) is found in fruits, vegetables, grains, and legumes (eg, peas, beans,
and lentils). These are complex carbohydrates that are not digestible. Fiber sweeps
out both the small and large intestine, carrying fat molecules (which is why fiber is
said to lower cholesterol) and toxins. The World Health Organization suggests that
each person consume 30 to 40 g of fiber a day. One should try to consume a good
amount of fruits and vegetables each day.
Tip #8 Consume Omega 3s
Omega 3 and omega 6 oils are essential fatty acids. This means that one’s body
cannot produce them, and hence they must be obtained from the diet.
People have an imbalance of fatty acids in their diet; it is overloaded with omega 6s
(vegetable oils) and severely lacking in omega 3. The standard American diet, which is
high in omega 6 oils, tends to favor inflammation. Sources of omega 3s include cold-
water fish (eg, salmon, cod, and tuna), flax seed oil, and walnuts. Omega 3 fats act as
anti-inflammatory agents. They are also essential for brain cells and the retina. DHA
comprises about 97% of all the omega-3 fatty acids in the human brain and 93% of
those in the retina. Low concentrations of eicosapentaenoic acid (EPA) and DHA
have been shown to result in an increased risk of death from all causes and accelerate
cognitive decline.
There is evidence that omega 3 oils may also help to prevent
and combat cancer. If one chooses salmon, the authors recommend buying wild
Alaska salmon or Norwegian salmon, not farm-bred salmon. The latter is known to
have a high polychlorinated biphenyl content (a known carcinogen).
Tip # 9 Take a Multivitamin and Mineral Formula with a High Content of B-Complex
B-complex vitamins are known to act as a stress fighter vitamin, because many of the
B vitamins are used to assist metabolic processes for energy production (fight or flight).
The impact that stress can have on one’s health is serious and can cause problems to
every major system of the body. With the right nutrition, one can reduce the impact
that stress has on the body and effectively repair any damage that has been done.
Proper nutrition prepares the body for any stress. When the body becomes stressed,
it craves foods that are high in fats and sugars. These are the foods that need to be
avoided, as they only provide someone with a small burst of energy, which will result
in a long period of fatigue. On the other hand, a high-fiber diet rich in fresh fruits, veg-
etables, nuts, and whole grains provides greater appetite satisfaction over a longer
period than processed, high-fat, and high-sugar snacks. But even more important,
when one replaces junk foods with fresh, high-fiber plant foods, one is more likely
to consume greater amounts of vitamins A, B6, and C, and the B vitamins niacin,
thiamin, riboflavin, and folate. One will also have a higher intake of magnesium, iron,
selenium, zinc, phosphorus, and calcium. These nutrients are all vital to a healthy
metabolism and provide significant stress protection.
Diet and Stress 587
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Diet and Stress 589
... Although a healthy diet is often advised to alleviate stress and stress-related pathologies [37,38], scientific and experimental evidence directly supporting such recommendations is remarkably tenuous. That is, some studies have reported high calorie diets, rich in sugars and fat, enhance stress reactivity, across species. ...
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There is increasing academic and clinical interest in understanding the nature of the relation between diet and response to stress exposure as a risk factor for mental illness. Cross-species evidence shows that conditions of chronic and acute stress increase the intake of, and preference for, caloric-dense palatable foods, a phenomenon thought to be explained by the mitigating effects of comfort foods on the activity of the stress-response network. It is largely unknown whether and how real-world dietary intake of saturated fat and sugars impacts stress responsivity in humans. Therefore, here we examined whether real-world dietary intake of saturated fat and sugars predicted salivary cortisol reactivity following an acute physiological stressor. Multilevel modelling of four salivary cortisol measures collected up to 65 min after the stressor on 54 participants (18–49 years old) were analyzed using a quadratic growth curve model. Sugar intake significantly predicted a weaker cortisol response following the Cold Pressor Test (CPT) controlling for BMI and gender, revealing an inhibitory effect of caloric-dense diets on cortisol reactivity to stress. As the consumption of sugar rose individuals had lower post-stressor cortisol levels, a smaller rate of increase in cortisol 20 and 35 min after the CPT, a lower cortisol peak, and an overall weaker quadratic effect. These observations add to a growing body of evidence reporting suppressive effects of high-energy foods on stress-associated glucocorticoids reactivity and are consistent with the comfort food hypothesis, where people are seen as motivated to eat palatable foods to alleviate the detrimental repercussions of stressor exposure.
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The growing prevalence of food insecurity observed in the last years, has been favored by the COVID-19 pandemic, leading to mental health issues, such as stress. We aim to analyze the prevalence of household food insecurity before and during the COVID-19 pandemic and its association with perceived stress. We analyzed data from two population-based studies conducted in 2019 and 2020-2021 in the municipality of Criciúma, State of Santa Catarina, Southern Brazil. Food insecurity and perceived stress were assessed with the Brazilian Food Insecurity Scale and the Perceived Stress Scale. The covariables were sex, age, skin color, schooling level, income, job status, marital status, household crowding, overweight, and diet quality. Crude and adjusted associations between food insecurity and perceived stress were assessed using Poisson regression. A total of 1,683 adult individuals were assessed. Prevalence of food insecurity was 25.8% in 2019, decreasing to 21.6% in 2020. Prevalence of perceived stress was about 38% for both years. Before the pandemic, food insecurity increased the prevalence of perceived stress by 29% (PR = 1.29; 95%CI: 1.02; 1.63), but no association was found during COVID-19. We found a worrying prevalence of food insecurity before and after de pandemic, nonetheless food insecurity and perceived stress were associated only in 2019. An assessment of these aspects after COVID-19 is needed to ensure basic life rights for all.
Stress is an integral part of every person’s daily personal and work life, and one of the important factors affecting health and longevity. Excessive or prolonged stress, exceeding natural regulatory capabilities and adaptive resources of the body, leads to changes in homeostasis and a wide range of problems, including metabolic syndrome, obesity, mental disorders, cardiovascular disease, etc. Given that stress in this context acts as a risk factor for these conditions, and they can be combined in a patient, it can be seen as the basis for the development of polymorbidity. Polymorbidity, the combination of two or more diseases in a patient, is currently regarded as one of the most serious problems of modern medicine, requiring from the doctor in-depth knowledge in various interdisciplinary areas. Polymorbidity is associated with more frequent use of medical care, lower quality of life, and a higher risk of premature mortality. In this regard, understanding the pathophysiology of stress and knowing how to correct it early is an urgent medical challenge that needs to be solved. The present work gives a brief overview of the organization and (patho-)physiology of the human stress system, discusses the role of stress in the development of polymorbidity, in particular its cardiometabolic phenotype, using the example of the relationship between acute and chronic psychological stress and the development of cardiovascular disease, describes ways of stress management in the early stages, including the use of the combined drug phenobarbital and ethylbromizovalerianate with a multimodal spectrum of action.
Diet and nutrition play a fundamental role not only in human body composition and in physiology, but have also relevant effects on mood, mental well-being and cognitive performance. In particular, the preservation of mental well-being through a healthy lifestyle, including a well-balanced diet and, in case, through the intake of specific food supplements, is of particular relevance in the perspective of global human ageing, as the brain is affected significantly by a persistent presence of stress factors. Due to the increasing burden of mental and neurological disorders and to the universality of food as a modifiable risk factor, even limited improvements in nutritional habits may translate to a considerable rise of well-being and mental health in the global population. Moreover, the use of targeted, well-balanced food supplements aiming to support the mental health and well-being will probably represent a relevant tool in future decades, together with an increased awareness of the importance of nutrition, also considering the COVID-19 pandemic and the related stressful events and limitations we are still experiencing at global level. The aim of this review is to summarize the experimental and clinical data reported in the literature concerning the beneficial effects of a subset of micro- and macronutrients contained both in food and in supplements, namely magnesium, folic acid, docosahexaenoic acid, eicosapentaenoic acid, and alpha-tocopherol, on a series of disorders, including stress, anxiety, low sleep quality, and low cognitive performance.
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Purpose Mental health and obesity have a bilateral relationship with each other. No study has been done on the association between mental health and the ENRF9.3 index so far. Therefore, for the first time, the present study investigated the relationship between the ENRF9.3 index and mental health in overweight and obese women. Methods In the current cross-sectional study, 124 overweight and obese women were selected. Food intakes in the last year were collected with 147 items semi-quantitative food frequency questionnaire. Then, the ENRF9.3 index score was calculated for all individuals. Mental health was assessed with 21-item Depression Anxiety Stress Scales (DASS) questionnaire. Results In the present study, the total DASS score was marginally significant (P = 0.05), however, after the adjustment, it became insignificant (P > 0.05). After adjusting confounders stress also became significant (P = 0.04). No significant relationship was observed between depression and anxiety, even after adjustment (P > 0.05). Conclusion The present study showed that a nutritious diet is not associated with overall mental health score, among subgroups of the DASS total score. The relationship was seen only for the stress subgroup. Level of evidence Level III: Evidence obtained from cohort or case-control analytic studies.
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Specific nutrients or dietary patterns influence an individual’s psychological stress. As a major aspect of a healthy diet, the influence of dietary diversity on psychological stress remains uncertain. Within these contexts, we aimed to examine the association between the dietary diversity score and psychological stress, using prospective data from the China Health and Nutrition Survey (CHNS). We included 7434 adult participants, with complete dietary information, in the 2011 wave, and followed-up with perceived stress scale (PSS-14) in the 2015 wave. The dietary intake of foods was coded into 29 food groups, using the DQQ for China, and the dietary diversity scores were obtained, using DQQ, by calculating the number of food groups consumed during one 24-h dietary recall. The univariate analysis, and logistic regression model were used to examine the relationship between psychological stress and diet diversity. Approximately half of the participants (4204, 56.55%) perceived a higher level of stress (PSS-14 total score > 25). Dietary diversity was lower in the higher-stress group (p for trend <0.0001). Unconditional multivariate logistic regression demonstrated that participants with higher daily dietary diversity were less likely to experience higher-level psychological stress, compared with participants with lower daily dietary diversity (ORs range: 0.480–0.809). Dietary diversity was found to be inversely associated with psychological stress, in this prospective analysis of a national population. Further studies are required to figure out the mechanism and effectiveness of dietary diversity on psychological stress.
Background Food insecurity affects 13.7 million U.S. households and is linked to poor mental health. Families shield children from food insecurity by sacrificing their nutritional needs, suggesting parents and children experience food insecurity differentially. Objective To identify the associations of food insecurity and mental health outcomes in parents and children Data Sources PubMed, Embase, Web of Science, and PsycInfo Study Eligibility Criteria We included original research published in English from January 1990 – June 2020 that examined associations between food insecurity and mental health in children or parents/guardians in the U.S. Study Appraisal and Synthesis Methods Two reviewers screened studies for inclusion. Data extraction was completed by one reviewer and checked by a second. Bias and confounding were assessed using the Agency for Healthcare Research and Quality RTI Item Bank. Studies were synthesized qualitatively, grouped by mental health outcome, and patterns were assessed. Meta-analyses were not performed due to high variability between studies. Results We included 108 studies, assessing 250,553 parents and 203,822 children in total. Most studies showed a significant association between food insecurity and parental depression, anxiety, and stress, and between food insecurity and child depression, externalizing/internalizing behaviors, and hyperactivity. Limitations Most studies were cross-sectional and many were medium- or high-risk for bias or confounding. Conclusions and Implications of Key Findings Food insecurity is significantly associated with various mental health outcomes in both parents and children. The rising prevalence of food insecurity and mental health problems make it imperative that effective public health and policy interventions address both problems.
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COVID-19 created challenges at work with increased risks of multiple interrelated psychosocial stressors, surfacing as a comorbidity of COVID-19. The roles of many Occupational Safety and Health Practitioners (OSHPs) included helping to recognise, prevent and mitigate these risks, especially for essential and front-line workers. The rationale for this study was to investigate potential competency gaps amongst OSHPs on their lack of priority or inability to understand the scope of the negative synergistic effects of these stressors and provide support where and when appropriate. Drawing on the International Labour Office (ILO) SOLVE methodology, eight psychosocial stressors were identified and a seminar was developed to raise the awareness of the comorbidity of COVID-19 and psychosocial stressors with the target audience of OSHPs, who would potentially further disseminate this information to a broader workforce. The membership network of the Institution of Occupational Safety and Health (IOSH) was used to implement the intervention through organising Zoom-based seminars globally. Participants were followed-up with during the seminar and through a one-year post-seminar survey to determine retention of the presented material and to what extent it was put to use. An information sheet was designed and made available to participants for further dissemination. The information sheet can be used by all industries at all levels as a tool to raise awareness and to signpost participants on where to seek help if needed. Twenty-five seminars were held with 2483 participants. Feedback revealed that participants grasped the presented concepts as many of the questions raised during and after the session focused on the implementation of the presented measures. We concluded that, given the correct knowledge, OHSPs are an invaluable resource to lead workforce engagement in this area. Due to UK General Data Protection Regulations (GDPR), there were difficulties undertaking the follow-up survey. Those who could be contacted indicated that where they could influence an intervention, there were improvements in the workplace. It is recommended that participant data be controlled by the research team with qualitative data recorded. Further studies are needed to review both competencies and existing job descriptions of OSHPs and the challenges around expanding responsibilities to lead psychosocial interventions at work.
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Garlic products are used as sources of medicine in many ways in human beings in their day today life. As a result, researchers from various disciplines are now directing their efforts towards discovering the medicinal values of garlic on human health. The main interest of researchers in the medicinal values of garlic is its broad-spectrum therapeutic effect with minimal toxicity. Garlic extract has antimicrobial activity against many genera of bacteria, fungi and viruses. Garlic contains a higher concentration of sulfur compounds which are responsible for its medicinal effects. The chemical constituents of garlic have also been investigated for treatment of cardiovascular disease, cancer, diabetes, blood pressure, atherosclerosis and hyperlipidaemia and highly praised by several authors. Therefore, this paper is reviewed to inspire and impress the young researchers about the medicinal values of garlic.
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Inflammatory bowel disease (IBD) is the term used to describe two specific conditions: ulcerative colitis and Crohn's disease. It is thought that stress may play a role in the course of this disease, impacting the pattern of flare-ups and remission. In this article, Cheryl Jordan reviews the evidence for the impact of stress on the course of IBD. The findings of this article suggest that it is the perception of being under long-term stress that impact on the course of the disease, rather than stressful life events themselves. Additionally, certain styles of coping show links to poorer perceptions of health, wellbeing and greater disease concerns. Finally, areas for exploration are suggested for nurses working with this group of patients, with the aim of beginning discussions as the first step in encouraging adaptive coping.
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Cardiovascular disease related to atherosclerosis represents nowadays the largest cause of morbidity and mortality in developed countries. Due to inflammatory nature of atherosclerosis, several studies had been conducted in order to search for substances with anti-inflammatory activity on arterial walls, able to exert beneficial roles on health. Researches investigated the role of dietary carotenoids supplementation on cardiovascular disease, due to their free radicals scavenger properties and their skills in improving low-density lipoprotein cholesterol resistance to oxidation. Nevertheless, literature data are conflicting: although some studies found a positive relationship between carotenoids supplementation and cardiovascular risk reduction, others did not find any positive effects or even prooxidant actions. This paper aimed at defining the role of carotenoids supplementation on cardiovascular risk profile by reviewing literature data, paying attention to those carotenoids more present in our diet ( β -carotene, α -carotene, β -cryptoxanthin, lycopene, lutein, zeaxanthin, and astaxanthin).
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Lycopene is a phytochemical that belongs to a group of pigments known as carotenoids. It is red, lipophilic and naturally occurring in many fruits and vegetables, with tomatoes and tomato-based products containing the highest concentrations of bioavailable lycopene. Several epidemiological studies have linked increased lycopene consumption with decreased prostate cancer risk. These findings are supported by in vitro and in vivo experiments showing that lycopene not only enhances the antioxidant response of prostate cells, but that it is even able to inhibit proliferation, induce apoptosis and decrease the metastatic capacity of prostate cancer cells. However, there is still no clearly proven clinical evidence supporting the use of lycopene in the prevention or treatment of prostate cancer, due to the only limited number of published randomized clinical trials and the varying quality of existing studies. The scope of this article is to discuss the potential impact of lycopene on prostate cancer by giving an overview about its molecular mechanisms and clinical effects.
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Omega-3 long-chain polyunsaturated fatty acids (LC-PUFA), especially DHA (docosahexaenonic acid) are essential for brain development and physical health. Low blood Omega-3 LC-PUFA have been reported in children with ADHD and related behavior/learning difficulties, as have benefits from dietary supplementation. Little is known, however, about blood fatty acid status in the general child population. We therefore investigated this in relation to age-standardized measures of behavior and cognition in a representative sample of children from mainstream schools.493 schoolchildren aged 7-9 years from mainstream Oxfordshire schools, selected for below average reading performance in national assessments at age seven.Whole blood fatty acids were obtained via fingerstick samples. Reading and working memory were assessed using the British Ability Scales (II). Behaviour (ADHD-type symptoms) was rated using the revised Conners' rating scales (long parent and teacher versions). Associations were examined and adjusted for relevant demographic variables.DHA and eicosapentaenoic acid (EPA), accounted for only 1.9% and 0.55% respectively of total blood fatty acids, with DHA showing more individual variation. Controlling for sex and socio-economic status, lower DHA concentrations were associated with poorer reading ability (std. OLS coeff. = 0.09, p
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Background: Docosahexaenoic acid (DHA) is important for brain function, and its status is dependent on dietary intakes. Therefore, individuals who consume diets low in omega-3 (n-3) polyunsaturated fatty acids may cognitively benefit from DHA supplementation. Sex and apolipoprotein E genotype (APOE) affect cognition and may modulate the response to DHA supplementation. Objectives: We investigated whether a DHA supplement improves cognitive performance in healthy young adults and whether sex and APOE modulate the response. Design: Healthy adults (n = 176; age range: 18-45 y; nonsmoking and with a low intake of DHA) completed a 6-mo randomized, placebo-controlled, double-blind intervention in which they consumed 1.16 g DHA/d or a placebo. Cognitive performance was assessed by using a computerized cognitive test battery. For all tests, z scores were calculated and clustered into cognitive domains as follows: episodic and working memory, attention, reaction time (RT) of episodic and working memory, and attention and processing speed. ANCOVA was conducted with sex and APOE as independent variables. Results: RTs of episodic and working memory improved with DHA compared with placebo [mean difference (95% CI): -0.18 SD (-0.33, -0.03 SD) (P = 0.02) and -0.36 SD (-0.58, -0.14 SD) (P = 0.002), respectively]. Sex × treatment interactions occurred for episodic memory (P = 0.006) and the RT of working memory (P = 0.03). Compared with the placebo, DHA improved episodic memory in women [0.28 SD (0.08, 0.48 SD); P = 0.006] and RTs of working memory in men [-0.60 SD (-0.95, -0.25 SD); P = 0.001]. APOE did not affect cognitive function, but there were some indications of APOE × sex × treatment interactions. Conclusions: DHA supplementation improved memory and the RT of memory in healthy, young adults whose habitual diets were low in DHA. The response was modulated by sex. This trial was registered at the New Zealand Clinical Trials Registry ( as ACTRN12610000212055.
Background and aims Flavonoids are a group of polyphenol compounds, ubiquitously found in plants. Great emphasis has been given to their possible benefits for cardiovascular health. These beneficial effects may be mediated by a specific action on arterial walls. Arterial stiffness is a marker of vascular aging, increasingly used in the clinical setting and assessed by pulse wave velocity. It has shown to be a robust predictor of cardiovascular events and mortality. This review aims at providing a comprehensive evaluation of available intervention and observational studies examining the relationship between flavonoid consumption and arterial stiffness. Data synthesis A Medline® literature search was performed using the keywords “arterial stiffness” and “flavonoids”. As a result, 2 cross-sectional and 16 intervention studies assessing the relationship between flavonoids intake and arterial stiffness were retained. Four intervention trials reported a significant decrease of arterial stiffness after a flavonoid-based intervention, independently from blood pressure changes. The two observational studies reported significant associations between a higher flavonoid consumption and a lower arterial stiffness. In this review, isoflavones, anthocyanins and to a lesser extent cocoa flavan-3-ols appeared to be the more efficient to improve vascular function. Conclusions Despite their heterogeneity, preliminary data seem to support an improvement of the arterial stiffness related to flavonoid intake. However, further research on absorption and dose-response effects of the specific flavonoid subclasses on arterial structure is warranted.
The actions of nutrients and related compounds on age-related macular degeneration (AMD) are explained in this review. The findings from 80 studies published since 2003 on the association between diet and supplements in AMD were reviewed. Antioxidants and other nutrients with an effect on AMD susceptibility include carotenoids (lutein and zeaxanthin, β-carotene), vitamins (vitamin A, E, C, D, B), mineral supplements (zinc, copper, selenium), dietary fatty acids [monounsaturated fatty acids, polyunsaturated fatty acids (PUFA both omega-3 PUFA and omega-6 PUFA), saturated fatty acids and cholesterol], and dietary carbohydrates. The literature revealed that many of these antioxidants and nutrients exert a protective role by functioning synergistically. Specifically, the use of dietary supplements with targeted actions can provide minimal benefits on the onset or progression of AMD; however, this does not appear to be particularly beneficial in healthy people. Furthermore, some supplements or nutrients have demonstrated discordant effects on AMD in some studies. Since intake of dietary supplements, as well as exposure to damaging environmental factors, is largely dependent on population habits (including dietary practices) and geographical localization, an overall healthy diet appears to be the best strategy in reducing the risk of developing AMD. As of now, the precise mechanism of action of certain nutrients in AMD prevention remains unclear. Thus, future studies are required to examine the effects that nutrients have on AMD and to determine which factors are most strongly correlated with reducing the risk of AMD or preventing its progression.
The physiology of behavior means, in large part, the role of the nervous system in the control of behavior. Thus, this book begins with the fundamentals of neurophysiology, neurochemistry, neuropharmacology, and neuroanatomy. The second section of the book describes the physiology of perception and movement. The third section of the book deals with species-typical behaviors, which are of special importance to motivation. The fourth section of the book deals with the physiology of learning. The final section of the book describes the anatomy and physiology of human communication and of disorders of thought and mood. (PsycINFO Database Record (c) 2012 APA, all rights reserved)