Dr. Elissa Epel: Control Stress for Healthy Eating, Metabolism & Aging | Huberman Lab Podcast
welcome to the huberman Lab podcast
where we discuss science and
science-based tools for everyday life
I'm Andrew huberman and I'm a professor
of neurobiology and Ophthalmology at
Stanford school of medicine today my
guest is Dr Alyssa eppel Dr eppel 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 eppel's laboratory focuses
on stress and the many impacts that it
has on our brain and body both negative
and positive for instance our laboratory
has shown that particular forms of
stress change our telomeres which are a
component of the genetic Machinery of
ourselves that impacts how quickly our
cells and therefore we age we also
discuss exciting work from Dr Apple'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
Apple's laboratory has explored
including Med 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 Apple'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 eppel's
laboratory as well as to learn more
about her books entitled the telomere
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 it is however
part of my desire and effort to bring
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livemomentous.com huberman and now for
my discussion with Dr Alyssa eppel Dr
eppel 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 I've 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 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
meanings 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 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 in life
if anything they are increasing and so
it really comes down to
not the stressors of what 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 well 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
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 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 experience stress and when I
do I have tools related to you know
breath work running exercise sleep
non-sleep deep rest I'm a 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 that but you could
just be stuck there all day in this kind
of threat mode or red mind State and
that's just a shame we don't need to
turn on that that stress response all
the time
it'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
this past year 46 of adults report
feeling overwhelmed by stress and then
you break it down you're like oh 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 why
don'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
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 solved 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 crunching 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's stressed
until he realizes that he's tensing his
shoulders 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 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 are
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 where where we're
working stress out of the body we're
metabolizing it we're burning it up and
we get relief changes are you know
amygdala activity and moves us to more
an experiential state where we're more
in our somatosensory cortex and then the
third 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 an environment
that we find calming it might even be
just be a corner of the house but
implanting what I call safety signals
where 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 pre-designated physical space
that represents 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 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 alleviating stress and
just enhancing mood
um this has 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've
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
transition from there into talking about
some of the work that you've been doing
on stress and stress related eating and
stress and how it 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 and all its
um beautiful and 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 it's not always related to our
minds 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 and we might
not be aware we might not 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 this 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 our
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 I know you have a study
that's actually explored the Wim Hof
method quite directly one of the few
studies 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 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 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 a 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
of 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
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 accelerates 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'd love to hear about the um lack of
inevitability around aging and stress I
I realize that there's a big landscape
of of discussion around aging and stress
for us to cover but since you brought it
up 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
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 well of course it
appears that toxic stress chronically
unmitigated stress that makes us feel
like we are at the world's Mercy or the
other people's Mercy will accelerate
aging
turns out that under exposure to stress
leads to more rapid aging than what you
describe as ideal
amounts of stress in other words that no
stress is not the answer
rather to have some stress is ideal if
you want to have so-called optimal aging
can you explain a little bit about the
mechanisms behind that maybe this is a
good opportunity also to tell us about
your telomere work
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
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 Challenge and risk and let me give
you an example one study took um
elderly people who retired and they you
know Society kind of labels them as
you're kind of done with your meaningful
work in life and
um your you know you are pretty much not
able to contribute to society I mean
there's so many negative stereotypes
that people then kind of embody and then
live
um in 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 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 these
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 is that hippocampal growth
mean for their well-being and their
cognitive function
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 gauged out the Salk
Institute did a study in the I think the
early 2000s where they took terminally
ill people and these people agreed to
have their bodies injected with a Dye
that would label new neurons and then
after they died their brains were
processed
um and they didn't die from the dye
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 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 of 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 but why not up to when you
die right absolutely yeah 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 and 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 neuroprogenerative 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 and proof musculoskeletal
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
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
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
into that we can two people can approach
the exact same stressor and one person
is having a pretty overreactive stress
response where they basically are
feeling their survival is threatened so
it's high cortisol High vasoconstriction
and 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
vasoconstriction the other person who's
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
there they didn't trigger all that
pro-inflammatory response and their
telomeres 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 challenge response so we could
call this kind of a
um
to to be really simplistic two types of
psychological stress response feeling
threatened like you're gonna 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 over 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
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are the sorts of things that
people I can do in order including me I
should say
um can do in order to 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 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 equally fascinating 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 situation 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 uh epigenetics We've inherited
maybe it's 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
the 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
threatened response to a kind of
challenge response
are there any data that dictate 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 so since a lot of our
listeners so 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're talking about
vasoconstriction 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
vasodilation more resources used and
more positive effects on the brain and
body yeah so what 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 be 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're you
know I list a bunch of options in
chapter three which is called be the
lion instead of the gazelle so the Blind
and gazelle are both you know high blood
pressure high stress and the Lion's
chasing the gazelle but the gazelles
having this total threat
vasoconstriction 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 lying 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 affect
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've 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's excited my body is doing just
what it should right now
so that reframing in Studies by Wendy
Mendez and others my my colleagues who
do these reappraisal research they have
basically trained 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 fentanyl
overdoses and we all know about the oxy
content epidemic and all these people
addicted to opioids and
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 reduce 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 sexo activates the endogenous
opioid system as far as a 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 gonna 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 but I can go a long period of
time without eating although I love to
eat 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 hyper focus
on the stressor the deadline whatever it
is in life that that needs tending too
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
either 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 would be the
opposite eating would be the opposite of
what your body's telling you to do I
should I'm just gonna forgive me for
interrupting uh for those of you hearing
sympathetic we're we're not talking
about sympathy we're talking about the
uh the sympathetic arm of the autonomic
nervous system which is the so-called
fight or flight 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 reactor 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 insulin
resistant State and what goes along with
that is tending to be overweight or have
obesity and so just by 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 binge
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 satiated so it's this
compulsive eating tendency that stress
brings you to and
so the so what it mean we measure this
is very easy to measure it means that
people feel like 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 percent but what
they also have is this tremendous kind
of uh diet what we call dietary friend
or control over their eating so they're
they're able to
to 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 Dr you're craving
the comfort food the high fat high sugar
high salt
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 intra-abdominal
area that's what we've seen we've seen
it cross-sectionally we've seen it in
rest studies in my studies and now we've
seen it in people and many stuff for
about 10 years I study this and the
question was is what's happening in
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 they're 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 just 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 people lean people and
people with obesity my colleague rajita
Sinha Yale it's basically found that
when you stress them out people with
obesity are having a different reward
response and they're having their 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 sir
because I can imagine these were people
that at one time were not obese who got
stressed
the opioid system
reacted in a particularly 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 and
that leads to insulin insensitivity
exactly I could also imagine that they
were insulin insensitive therefore they
need to eat more in order to feel come
of an increase in uh
satiety because we know this
um now 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 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 heterogeneous so I I think
it's the developmental path that you're
describing which is that
um there's a tendency toward having a
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 dysregulated 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 Naltrexone which it can block the
opioid receptor it's used to block the
opiated receptor in the context of
different types of addiction have people
tried to use Naltrexone in the context
of binge eating and does it help people
lose weight because
it presumably reduces some of the
rewarding properties of food
that's one of the very few drug
combinations that has been used for
binge eating so it was a combination of
Naltrexone and Wellbutrin and I'm not
sure at this moment how much
um that's favored for binge eating but
certainly the early trials showed that
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
semi-glue tied yeah
um uh analogs because they do seem very
effective in blocking hunger especially
in type 2 diabetics I don't know if
you're familiar with but right they're
sort of all the rage uh 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 semi-glue tied 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 particularly
for 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 I 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 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 as
the only cause of the Obesity epidemic
but it's certainly one of them at least
that's my belief according to the data
yes and Rob is the biggest proponent of
you know of helping people understand
the big problem and 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 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
our 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
in terreceptive 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 another is
the positive stress pathway looks
important for breaking the compulsive
eating cycle so high intensity to
interval training or you know maybe some
of these other ways that we've been been
talking about to increase the bodily
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 stressed 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
Naltrexone and Wellbutrin and some of
these prescription approaches because I
always say while I value certainly value
prescription drugs in certain contexts I
always feel like behaviors should come
first do's and don'ts
than nutrition then supplementation and
then if and only if it's still needed
prescription drugs but that's just my
bias based on my observations
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 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 hunger from one to
ten and figuring out is it am I really
hungrier as a boredom that helps people
and if you do that check-in 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
right the craving surf the herbs so if
we deal a lot with soda Drinkers and it
is addictive and there is nothing worse
than drinking sugar soda for our body so
we help people by help um having them
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
Etc 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 try that at UCSF
my colleagues and I um including Rob
lustig 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 Laura
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 so when
we took it out of the workplace
they actually had 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 in that little bit of
support helped them 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
super interesting I think that um
for most of us we think about sodas 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 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
non-water uh beverage consumption is
going to be either coffee
um usually black coffee or nowadays I
sometimes will throw some ketones in
there not because 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 podcasts and we're prepping for
podcasts 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 a
ketogenic diet that's um clear to me
based on my experience and the data as I
see them and understand them
um or yerba mate tea which is just a
caffeinated tea from 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 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 yerba mate soda it's gonna be
yerba mate
um or food and soda I'm gonna 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 work it's
harmful calories they're not empty yeah
I mean there are no amino acids in there
they're no essential fatty acids and
there aren't many carbohydrates that you
can really utilize for
um long-term bouts of mental or physical
work so so what 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 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 hedonic 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 wanna not because you want to feel
better 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 crap 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 I think is starting
to change and I think in the years to
come provided 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 podcasts
and I think also lobbying
uh lobbying our politicians really
getting them to understand
um just how pernicious this 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 a colleague talking
about how bringing junk food or soda to
work is like passive smoking you're like
you're bringing something and that's
going to pollute other people's health
and you shouldn't do it so that's that's
much more Edge energy and people will
fight them on that
um but the the basic reality is yeah
we're gonna 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'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 yes 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 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 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 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 though you
can we can tell people until you know
we're blue 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 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
a number of different aspects of of kind
of a big markets 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 Stice
who's 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 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 so 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 and
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
ad 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
darker milk chocolate dark yeah
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 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 it's out
there I'd like to just take a brief
moment and thank one of our podcast
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while we're talking about stress eating
obesity and
um here we've also broadened the
discussion to include different
Generations we're talking about teens
and adults 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 physiological changes that people
experience during pregnancy 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 event
is 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 men and women that
show that we can help them regulate
using somebody's mindful eating
strategies or 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 Offspring so we we did
this study it took us probably 10 years
total to you know get the Grant and
recruit groups of 10 women who are
pregnant in the same stage and give them
this training and mindful eating mindful
nutrition stress reduction and then my
colleague Nikki 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 just
keep are you know being shocked by how
impactful the stress reduction training
was it was just two months of their life
but but pregnancy is a very critical
period when these women were 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 had a
they got a blood test to see how well
their body was metabolizing food sugar
and so it's like a pre-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 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 eight years later we looked
at the mental health of the mom so right
after the intervention eight weeks later
everyone in our mindfulness stressor I
can do it felt great they felt less
depressed they had less stress and less
anxiety that's what you'd expect right I
mean they've 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 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 I don't plan on it and uh
you never know well um yeah hi
zero 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 so much so
that it's multi having a
multi-generational impact so how many
minutes a day
um how many days per week 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 on 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 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
mind body movement people like different
things there's Qigong
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 of check-ins 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 check-in 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 would
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 ourselves thinking negative
thoughts about ourselves 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 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 we
can perceive things in terms of extra
reception or basically paying attention
to and focusing on things beyond the
confines of our skin or interoception I
realize you know all this but for their
sake
um no one really understands
interoception go for it so in
interception essentially the sensory the
sensory innervation of the of the
internal organs of our own skin that
includes proprioception 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 heightened
sense of inter-reception or heightened
sense of extra reception so I could
think of one form of craving where for
instance the donut again donuts for me
is in front of me and I'm saying
thinking that I want that and so I'm
almost in complete extra reception but
I'm Tethered to it like my internal
world is Tethered to the donut it's
almost like the donut is in control of
me briefly
right and then I eat it
um but it's hijacked your prefrontal
cortex it's it's hijacked everything
yeah yeah and then if I do a body scan
so I'm putting myself in this experiment
and it's kind of uh a hypothetical
scenario I'm putting myself into this
experiment I do a body scan which
without question is
shifting me more towards interception
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 extra reception where our
interception is just exquisitely locked
to extra reception 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 Stanford who's now
the chair of neurosurgery at UPenn uh
School Medicine which is Casey Halpern I
mean they do they literally drill down
through the skull of people who have
binge eating 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 eat 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 somehow
breaking that interoceptive
extracceptive tether anyway I'm
speculating here but I'd love your
thoughts on on binge 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
scan 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
all intersective extra receptive
balancing 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
doing 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 it sounds like your laboratory has
been involved in doing a lot of studies
where you're examining people over a
very long period of time even their
children what can we learn about the
long-term outcomes of things like body
scans meditation and then we'll get into
breath work
there hasn'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 taken up
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 in these meditation
interventions we do the short-term ones
that inflammatory Pathways of gene
expression are dampened way down
and cross-sectionally other people like
Elizabeth hoji have found longer
telomeres in the meditators versus the
controls so we we haven't really found
telomere lengthening in our short-term
meditation studies but we do find boosts
in telomerase activity which is this
enzyme that protects our cell aging
slows our cell aging rebuilds the
telomeres
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 uh Retreat Center
where Deepak Chopra leads us one week
Transcendental Meditation Retreat so
people got a mantra and they were
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
resort 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 a week later
everyone felt fantastic after the week
right they weren't allowed to bring
their laptop and work and they 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're 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 oh what was the
meditation condition how long per day
yeah it well so they did they learned
transcendental primordial sound
meditation which is similar to TM where
you have a your 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 all 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 I recommend them I
think they're amazing ways to get to
know the mind and to really calm the
body in ways like a you know a Quantum
shift in our level of stress that we
don't get it's very hard to get in short
bounce
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 yes exercise and
sunlight and all the things I talk about
on the podcast but I'm certainly not
averse to uh doing a longer meditation
are all of these
um uh TMA 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-week 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 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 Retreats and so lots of classes can
do that and 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 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 it um an increased
focus on psychedelics so the 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 microdose and macro
dose 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 plants 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 then 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 rain takes place so when
people talk about integration afterwards
they're not just talking about the few
hours where they're you know parachuting
back down to to uh uh typical
Consciousness let's call it that but
that there's these long perhaps even
weeks or month-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
almond inducing uh this big time brain
plasticity all right well I'm now I'm
gonna have to do it and I'll report back
to everybody uh 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 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 Picard 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 and 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 telomeres epigenetics mitochondrial
health and then what explains those who
looked 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 bakar my
colleague who has been obsessed with
mitochondrial Health as a pathway to
understanding both stress address and
really health and disease he has
developed a way to measure mitochondrial
in 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
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 and 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
within their day at their mood and ask
well 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 from 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 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 our study
it looks 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 it in a state of chronic
stress and here I'm talking about the
kind of stress that you mentioned before
which is you know they're
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 there's a
theme in the self-help literature and
it's a
theme that now I think in the formal
psychology literature actually
um was talking to a dialectical
dialectical psychology expert recently I
think that's the the correct title
dialectical behavioral therapy correct
yeah that's a common great one yeah
you're correct I I was I was grasping
and um that's correct and they were I'm
talking about
um some of the misconceptions about
radical acceptance because I think a lot
of people hear the words radical
acceptance at least this 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 ironically
accept the fact that I'm not going to
deal with this right I'm gonna walk away
from it but what you're talking about is
chronic stress of the sort that really
the stress or 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 stressor
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 mechanisms
support groups it's always better to
have more social support than last of
course but are we
again talking about
a daily mindfulness practice or is it
daily mindfulness of a certain type 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 you 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
found from our caregivers we measure
where their mind is at night 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 and 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 a
caregiver or not this negative
mind-watering state of not being present
for your evening wishing things were
different instead of being engaged
predicts
more unhappiness it predicts
shorter telomeres
so 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 your
your 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 tinge 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's just
so concerned 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 tenancy 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 stated that
people do this in the reverse Direction
too meaning in time trying to control
the past
through current behaviors as well as try
and control the future
um so give me an example of that yeah
this is something I learned from a guest
we had on here Dr Paul Conti is a
psychiatrist to
um 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 limbic
system that engages these
fight-or-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 wouldn't
the human mind have separate circuits
for adult like romantic attachment
versus child parent attachment is all
sounding very Freudian And yet when you
look at the the neural 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 but
what he said was that the limbic system
and the stress system when it's
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 it
doesn't have to be childhood trauma you
think well that doesn't make any sense
it's like the most illogical thing in
the world like you get burned on the
stove or 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
exquisitely hard to to get away from it
so that this repetition compulsion is an
attempt to try and rewrite the story and
this is this is a theory not just a
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 Rogue
represents as you said it's sort of a
way of diverting resources towards
something that has no conclusion right
and in dropping the Rope you can divert
those resources towards other things
um so I was just curious again I wasn't
consulted with the design phase and I'm
assuming you weren't either but you know
what I wonder what what in US uh a
scientists I'm just kind of doing the
Duncan 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
knows with certainty what your plans are
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 one through ten scale how
much would that drive you crazy
tomorrow Saturday so I'm a little more
flexible on 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 it that would be a
six yeah six out of ten 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 measure 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 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 the latter 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'll 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 trying 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
this idea of okay stress can
give us early dementia stress can limit
our sleep stress can Empower 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 capture the top
uh Contour of the beautiful work of my
colleague Dr Alia Crum who's yes you
know love her work feeling this podcast
and is a huge fan of her work as well
and with that mindset matters because it
shapes physiology
for sure it uh her data point to that so
there are 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
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 the
stress mitigation 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 receptive mode and of more
of an awareness mode exactly and I think
that um since here we are at the table
to researchers who 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 because one
is less energetically demanding but of
course offers less opportunity for
agency or at least apparently so that's
the leaning back and then the the other
is certainly gives an opportunity for
agency but we know from 100 years or
more of psychology and psychiatric
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 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 in 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 Riptide we need to
go the direction of the tide but we can
have some control in our Direction and
it kind of goes back to
um our colleague Robert sapolski'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
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 paddle
what do you think is the value of
journaling and and placing one's own
narrative on stressful circumstances
especially these non-negotiable
circumstances again I'm fascinated by
these because I think it's a category of
stress that's not often talked about and
yet it's so prominent some people say
okay you know dealing with short-term
stress okay well my lab 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
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 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 I mean 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 are a few studies out
there but I can't I can't remember
exactly yeah definitely creating a
coherent 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
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 your 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
Laboratories studied breath work your
laboratory studying breath work and um
and I know that you've been
doing a study on the so-called Wim Hof
method
um which of I'll let you familiarize our
listeners to some of them are familiar
with the Wim Hof method others are not I
think a lot of people think of a whim in
terms of his role as the Iceman because
of cold exposure but of course he has um
breath work practices that mirror
um things like tumor breathing and other
things but maybe you could tell us a
little bit about what you're doing there
and what you're interested in
discovering I realize it's too early to
give us the results but hopefully
they'll come back and do that at another
time but
what is the study what motivated the
study and maybe I can convince you to
give us a little teaser of what you're
discovering so for um I I for many years
I mean I think my
um first paper when I was a graduate
student with Boost McEwen 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 uh
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 things 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 hit type
workout or taking the dogs for like a
really brisk walk or like burning up
that energy and my body is
um a very big effect size for me
personally everyone has their you know
different ways that they can see 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 Wim Hof at
a uh a meeting where we talked kind of
back to back 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
afterwards I was like what was that and
then he heard about telomeres 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 UCS staff
um with my colleagues Wendy Mendez and
Eric Prather it's been many years and
it's funded by the John W brick
Foundation which is very focused on what
are non-drugway ways that we can help
mental health
so it was a very good fit for all of us
to come together and design the study
and we have been basically comparing
low arousal relaxation methods
mindfulness slow breathing to positive
stress exercise and Wim Huff 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
hermetic 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 high
arousal or the low arousal the level of
stress anxiety and depression fell
dramatically in everyone so many paths
to changes in stress there are probably
very different physiological Pathways
and and we can talk about that more when
we 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 Hof 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 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
telomere 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 telomeres can
change very quickly and telomerase May
so we're going to look at mitochondrial
enzymes telomerase 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
essays where you can look at you know
seven thousand different uh proteins
like the Soma logic and so we'll get to
see well what's the pat you know did we
really change patterns of acute stress
with these different types of stress
resilience interventions and in terms of
the physiological reactivity there are
ways that we can
examine both the stress response system
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 in 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 Wim Hof
method I was positively uh delighted
because I uh
I 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 gleaned 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 necessarily asking questions alone
but
um raising hypotheses and being
comfortable for those hypothesis
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 journey into these different
practices I don't know what came first
the science of the practices but 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 Wim Hof it's really esoteric and
you know kind of crazy
um I'm certainly not saying that but you
say well what are the critical elements
from that that we might be able to
extract to understand this positive
eustress phenomena 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 we're 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
couldn't agree more and UCSF is 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
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 wonderful 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 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 know I speak on
behalf of many many people and I just
really want 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 Apple I hope
you enjoyed the conversation as much as
I did if you'd like to learn more about
Dr Apple's laboratory's work or if you'd
like to learn about her books such as
the telomere effect and the stress
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