Search This Blog

Tuesday, February 25, 2014

Stress, Our Foe







     Last time we took a look at the acute stress response and how it can benefit us during life-threatening situations (man running from a bear): hormones are released which cause an increase in heart rate and blood pressure, stored glucose is activated to provide an energy source to the "exercising" muscles and so on.  Once the threat has passed,  the body will return to a state which makes us feel like we have just been pulled off of the ceiling, therefore we can continue on with the business of daily living.  Now let's look at what happens when we can't turn off the stress response and it moves from being acute to chronic (sustained).
 

     Close your eyes for a moment and imagine you are stuck in rush hour traffic and it is going to make you late for the big meeting, or you are about to take the most important certification exam and if passed, will earn you a job promotion.  How does your body react to these scenarios?  I bet if you think about times when you may have been faced with these same situations, your body responds the same way as if you are running for your life.  Why?  Because it cannot distinguish the difference between acute and chronic stress.  The effects of chronic stress on the body is such a broad topic that it is impossible to cover everything in one post.  Today, we are going to take a look at the how and why chronic stress is linked to Type 2 diabetes.  This will provide an example of how stress serves not as our friend, but rather as a foe.

     The work of Robert Sapolsky (PhD), Professor of Neurology and Neurosurgery at Stanford University, provides insight into the fascinating connection between stress and chronic disease (2010).  Dr. Sapolsky tells us that when we are faced with intermittent stressors every day (rush hour traffic, annoying co-worker, etc.) and allow this to affect us psychologically, then the stress response never shuts off (2010). So how is this linked to diabetes?  Let's take a look.  The foods that we eat (carbs, proteins, and fats) are broken down and the nutrients are absorbed to sustain life. Anything that is not immediately used is stored in fat cells and the liver for future energy needs.  We are going to focus on our primary energy source which is glucose.

    Foods such as pasta, bread, vegetables, cookies, and cakes are all contain carbohydrates which are broken down rapidly into simple sugars (glucose) which provide energy for cell metabolism and muscle activation.  The hormone insulin allows these sugars to move from the bloodstream into the cells to accomplish this task.  However, when the body is faced with stress, the brain sends signals to the pancreas to stop releasing insulin.  The reason why is that at a time when we are running from the bear, we do not need to store glucose, but rather need every bit that is released from the cells and liver to provide energy to our moving legs and arms.  When we are under chronic stress the same thing happens: the release of insulin is shut off.  Sapolsky notes that we face intermittent stressors throughout the day which turn on and off the stress response.  As a result, the body's metabolism is using and storing energy in a haphazard way because it thinks the bear is chasing us again (2010).  Our body prefers to be in a state of balance and if subjected to this roller coaster ride, eventually something is going to give.

     As we have seen previously, when the body is under stress it draws glucose from the liver and fat cells to provide extra energy for the muscles.  Once the threat is over, the brain says "Hey, you need to replace all that glucose you just used up so eat more carbs."  Our hunter-gather ancestors did this exactly and their bodies stored the glucose for future needs.  The one thing about them was that they were always on the move looking for their next meal and fending off threats.  They consistently met their metabolic needs in this way.  Remember, they faced more acute than chronic stress situations than we do today.
 
 
 

     Enter us, the chronically stressed, westernized society.  If you have not guessed it by now, our body is going to think we are constantly running from bears and use up the glucose stores.  What happens next: our brain tells us we need carbs to replace our energy stores.  We do this by eating refined foods such as white breads and pastas, and fast foods versus the whole foods (another discussion) that our ancestors consumed.  Under normal circumstances we store excess nutrients in the fat cells until needed.  Because our stress is chronic, we will have a tendency to overeat (and gain weight) to replace the "expended glucose" and here is where it becomes our foe.

    By nature, we are a more sedentary society and therefore our metabolism is not as efficient in the use of our energy stores.  Eventually, the fat cells become too full and cannot store anything else.  The brain tells these cells to resist insulin which in turn leads to excess glucose in the body known as hyperglycemia.  Sustained insulin resistance leading to hyperglycemia is known as Type 2 Diabetes.  This is a very preventable condition that requires providing the body with appropriate nutrition, exercise, and stress management/coping skills. Thus begins our journey on the road to wellness.  Until next time, be well.         Tim

References

Sapolsky, R. (2010). Stress and Your Body. Virginia: The Great Courses.

Friday, February 14, 2014

Stress, Our Friend


In the last post, I promised that I would provide a practical application to help you make sense out of the General Adaptation Syndrome. I'm going to begin with a little anatomy, and then tell the story about a man, a bear, and how stress can be our best friend.

Murray and Pizzorno, in their book The Encyclopedia of Natural Medicine, give us a little anatomy primer on what is responsible for the cascade of events known as the stress response. The authors tell us that an area in the brain known as the hypothalamus serves as the gateway between the nervous and the endocrine (hormonal) systems. When our bodies are subjected to stress the hypothalamus signals a gland known as the pituitary, to direct the adrenal glands (which sit on top of the kidneys) to release a hormone known as epinephrine (2012). Now let's see how this applies to the man and a bear.
 
 
 
 

Here we have a man by all accounts who is in deep, deep, trouble. So, how is his body going to help him get out of the precarious situation? This is where stress becomes our best friend. The man's brain recognizes that he is in a life-threatening situation and the hypothalamus is mobilized into action. The hypothalamus says to the pituitary gland "Oh, oh. You better tell the adrenals to let loose with some adrenaline otherwise this guy is going to be somebody's lunch!"
 
 
 
 

The pituitary gland then kicks the adrenals into action and epinephrine begins to flow into the bloodstream. His heart rate and force of contraction begin to increase and the blood is moved away from less vital organs such as the skin and the digestive system, and pushed up towards the heart and lungs (more vital to survival at this point). His breathing also begins to increase as a way of supplying more oxygen to the heart, brain, and "exercising" muscles (arms and legs).

Our friend here is only going to be able to keep up this pace so long before the muscles say "we need more help!" In order for muscles to move and function they need to be supplied with an energy source, and this is where the liver comes into play.  This vital organ stores excess glucose (sugar) until called for by the body. Glucose or simple sugar is the primary energy source used by working muscles.  During a stressful (bear-chasing) situation, the liver begins to flood the bloodstream with sugar that is quickly brought to the muscles by way of the increased heart rate and force of contraction.  The muscles are now happy because they can keep this man moving at a marathon pace to escape this predator.

Another byproduct of the stress response is that the digestive system is slowed down dramatically.  The process of digestion requires a tremendous amount of energy to complete its task.  However, during the flight response, the vital organs as I mentioned earlier borrow this energy from digestion in order to help the hunted escape the hunter.  I am sure you will agree with me that the man could care less at this point whether or not the hearty meal he ate about an hour ago gets properly digested. He will have plenty of time for that if he escapes the bear.

Not everyone in their lifetime will be chased by a wild animal. However, one may be faced with every day life- threatening situations. Over the years we have heard countless stories of a mother being able to lift a heavy object that has fallen on top of and trapped her child underneath, or a civilian having the strength to pull someone much bigger than himself from a burning car.   It is the stress reaction (our friend) that has enabled these heroic feats.  The heightened sense of awareness that allows us to quickly move out of the path of a speeding car is owed to the stress reaction.  In all of these cases the body responds in the same exact way as the man running away from the bear.

What has been described in today's post is known as the acute stress reaction which is very vital to our survival.  Take note of what happens to you the next time you walk around the corner and someone says "boo!" or suddenly have to slam on the brakes of your car in order to avoid an accident.  How does your body react?  Do you become more keenly aware of your surroundings?  Increased heart rate and breathing?  Let me know what you experience.  Oh, and here is one more activity that activates the acute stress response:
 
 
 
 

 
Exercise.     Until next time, stay happy, healthy, and avoid any angry bears.      Tim
 
 
Murray, M., and Pizzorno, J. (2012). The Encyclopedia of Natural Medicine (3rd ed.).  New York: Atria,  782. 
 
 
 
 
 
 
 

 

Wednesday, February 5, 2014

Stress: Friend or Foe?


     Today is the 16th anniversary of my fellow firefighter's death.  In the years following this incident I was left with what felt like a war-torn psyche.  PTSD is a disorder of the mind with distinct signs and symptoms. However, what is the biological significance of both acute and chronic stress on the body?  Our journey continues with an examination of this process through the work of noted endocrinologist, Hans Selye. 

     The remainder of this post will flow like a biology textbook, but it is necessary to summarize the scientific literature as it is described.  I promise to break all of this information down into lay terms in future posts (believe it or not this also relates to exercise).  I leave you with another video that will describe the effects of stress on the body.  Please leave any questions on this subject matter in the comments section of the blog post.

     Stress is an every day event in our lives, be it a physical or psychological event that creates both internal and external changes in the body (Gould, 2006, p. 218).  For example, a stressor can be trying to escape from a wild animal as did our ancestors, the end of a long term relationship, or fear of hospitalization.  Hans Selye defined this fight or flight as the General Adaptation Syndrome and separated it into three distinct phases: alarm, resistance, and exhaustion (ACHS, 2012, p. 223).

     The alarm phase begins when an individual is exposed to a stressor such as walking around a corner and someone scares you by saying “boo”.  Immediately, the brain directs the hypothalamus to activate the adrenal medulla to release the hormone adrenaline (epinephrine) which causes the following physiological responses: an increase in heart rate, diversion of blood from the less vital organs such as the skin and the digestive system to preserve the core (heart, lungs, and muscles), and respirations increase to provide additional oxygen to these same critical organs (ACHS, 2012, pp 221, 223, 225).  Additionally, the pituitary gland signals the adrenal cortex to increase cortisol production that causes the liver to release large amounts of stored glucose in order to boost energy levels (ACHS, 2012, p. 223).  The sum effect of these physiological responses prepares the body to respond to a perceived threat.  According to the ThinkQuest library, the alarm phase lasts only a few seconds which is the amount of time it takes for the release of adrenaline and its physical effects to manifest (2012).

     While the alarm phase prepares the initial response, it is in the resistance phase that the body continues to adapt to the stress and operate at peak performance (ACHS, 2012, p. 223).  As the glucose stores are depleted, the hormone cortisol converts protein to a secondary energy source.  Additionally, the hormone aldosterone will cause sodium reabsorption in order to maintain an elevated blood pressure.  ThinkQuest library notes that it is in the resistance phase where the body learns to adapt to a stressor and handle it better when faced with similar circumstances.  For example, the body will adapt to the cyclic pain of chronic disease (2012).

     Although resistance allows the body to adapt to a stressor, it is in the exhaustion phase where the fight ends.  This is the point of the physiological battle where the body has used up all of its reserve forces and can no longer keep pace.  Cortisol and aldosterone levels fall and lead to hypoglycemia and erratic blood pressure respectively (ACHS, 2012, p. 223).  In the end, a person no longer has the strength to fight the stressor and becomes tired and run down (Think Quest Library, 2012).

     All three phases of the General Adaptation Syndrome are part of a normal response to stress.  A healthy response can be the elation felt upon learning that one has become a new aunt or uncle.  This initial reaction will wear off and the body returns to a state of calm.  However, if one experiences a chronic negative stressor with a sustained resistance phase, the body becomes more susceptible to heart disease, diabetes, and cancer (ACHS, 2012, p. 223) with a suppression of the immune system response (Gould, 2006, p. 222).

 
 

References

American College of Healthcare Sciences. (2012). General Adaptation Syndrome (Stress): Fight or Flight. In Aroma 203 course e-textbook. Portland: American College of Healthcare Sciences.

Gould, B. (2006). Pathophysiology for the Health Professions (3rd ed.).  Philadelphia: Saunders-Elsevier.

General Adaptation Syndrome. (2012, February 27). Retrieved from the Oracle Education Foundation ThinkQuest library: http://library.thinkquest.org/C0123421/gas.htm
 
 
Copyright Disclaimer Under Section 107 of the Copyright Act 1976, allowance is made for fair use for purposes such as criticism, comment, news reporting, teaching, scholarship, and research. Fair use is a use permitted by copyright statute that might otherwise be infringing. Non-profit, educational or personal use tips the balance in favor of fair use