The Stress Prescription (Against Aging!)

This is Dr. Elissa Epel, whose work has for the past 20 years specialized in the effect of stress on aging. She’s led groundbreaking research on cortisol, telomeres, and telomerase, all in the context of aging, especially in women, as well as the relationship between stress and weight gain. She was elected member of the National Academy of Medicine for her work on stress pathways, and has been recognized as a key “Influencer in Aging” by the Alliance for Aging Research.

Indeed, she’s also been named in the top 0.1% of researchers globally, in terms of publication impact.

What’s that about stress and aging?

In her words,

❝Women with the highest levels of perceived stress have telomeres shorter on average by the equivalent of at least one decade of additional aging compared to low stress women❞

Source: Accelerated telomere shortening in response to life stress

We say “in her words”, as she is the top-listed author on this paper—an honour reserved for the lead researcher of any given study/paper.

However, we’d be remiss not to note that the second-listed author is Nobel Prize Laureate Dr. Elizabeth Blackburn. What a team! Maybe we’ll do a spotlight feature on Dr. Blackburn’s work one of these days, but for now, back to Dr. Epel…

What does she want us to do about it?

She has the following advice for us:

Let go of what we can’t control

This one is simple enough, and can be as simple as learning how to set anxiety aside, and taking up the practice of radical acceptance of what we cannot control.

Be challenged, not afraid

This is about eustress, and being the lion, not the gazelle. Dr. Epel uses the example of how when lions are hunting gazelles, both are stressed, but both are feeling the physiological effects of that stress in terms of the augmentation to their immediate abilities, but only one of them is suffering by it.

We’ll let her explain how to leverage this:

TED ideas | Here’s how you can handle stress like a lion, not a gazelle | Dr. Elissa Epel

Build resilience through controlled discomfort

Don’t worry, you don’t have to get chased by lions. A cold shower will do it! This is about making use of hormesis, the body’s ability to build resilience to stressors by small doses of controlled cortisol release—as for example when one undergoes thermal shock, which sounds drastic, but for most people, a cold shower (or even an ice bath) is safe enough.

You can read more about this here:

A Cold Shower A Day Keeps The Doctor Away

Connect with nature

You don’t have to hug a tree, but you do have get to a natural (or at least, natural-seeming) environment once in a while. Simply put, we did not evolve to be in the urban or even suburban settings where most of us spend most of our time. Getting to be around greenery with at least some kind of regularity is hugely beneficial. It doesn’t have to be a national park; a nice garden or local park can suffice, and potted plants at home are better than nothing. Even spending time in virtual reality “nature” is an option:

Effect of Virtual Reality on Stress Reduction and Change of Physiological Parameters Including Heart Rate Variability in People With High Stress: An Open Randomized Crossover Trial

(you can see an example there, of the kind of scenery this study used)

Breathe deeply, and rest deeply

Mindful breathing, and good quality sleep, are very strongly evidence-based approaches to reduce stress, for example:

• No-Frills, Evidence-Based Mindfulness
• The 6 Dimensions of Sleep (And Why They Matter)

Practice gratitude to build optimism

Optimism has a huge positive impact on health outcomes, even when other factors (including socioeconomic factors, pre-existing conditions, and general reasons for one person to be more optimistic than another) are controlled for.

Read: Optimism and Cause-Specific Mortality: A Prospective Cohort Study

There are various ways to increase optimism, and practising gratitude is one of them—but that doesn’t necessarily mean abandoning realism, either:

How To Practise (Non-Toxic) Positivity

There are other ways too, though, and Dr. Epel discusses some with her friend and colleague, Dr. Elizabeth Blackburn, here:

TED ideas | Could your thoughts make you age faster? And can we reverse that? | Dr. Elizabeth Blackburn & Dr. Elissa Epel

Want to learn more from Dr. Epel?

We reviewed one of her books, The Telomere Effect, previously. It’s about what we can do to lengthen our telomeres (a key factor in health aging; effectively, being biologically younger). You also might enjoy her newer book, The Stress Prescription, as well as her blog.

Enjoy!

This is Dr. Robynne Chutkan. She’s an integrative gastroenterologist, and founder of the Digestive Center for Wellness, in Washington DC, which for the past 20 years has been dedicated to uncovering the root causes of gastrointestinal disorders, while the therapeutic side of things has been focused on microbial optimization, nutritional therapy, mind-body techniques, and lifestyle changes.

In other words, maximal health for minimal medicalization.

So… What does she want us to know?

Live dirty

While attentive handwashing is important to avoid the spread of communicable diseases*, excessive cleanliness in general can result in an immune system that has no idea how to deal with pathogens when exposure does finally occur.

*See also: The Truth About Handwashing

This goes doubly for babies: especially those who were born by c-section and thus missed out on getting colonized by vaginal bacteria, and especially those who are not breast-fed, and thus miss out on nutrients given in breast milk that are made solely for the benefit of certain symbiotic bacteria (humans can’t even digest those particular nutrients, we literally evolved to produce some nutrients solely for the bacteria).

See also: Breast Milk’s Benefits That Are (So Far) Not Replicable

However, it still goes for the rest of us who are not babies, too. We could, Dr. Chutkan tells us, stand to wash less in general, and definitely ease up on antibacterial soaps and so forth.

See also: Should You Shower Daily?

Take antibiotics only if absolutely necessary (and avoid taking them by proxy)

Dr. Chutkan describes antibiotics as the single biggest threat to our microbiome, not just because of overprescription, but also the antibiotics that are used in animal agriculture and thus enter the food chain (and thus, enter us, if we eat animal products).

Still, while the antibiotics meat/dairy-enjoyers will get from food are better avoided, antibiotics actually taken directly are even worse, and are absolutely a “scorched earth” tactic against whatever they’re being prescribed for.

See also: Antibiotics? Think Thrice ← which also brings up “Four Ways Antibiotics Can Kill You”; seriously, the risks of antibiotics are not to be underestimated, including the risks associated only with them working exactly as intended—let alone if something goes wrong.

Probiotics won’t save you

While like any gastroenterologist (or really, almost any person in general), she notes that probiotics can give a boost to health. However, she wants us to know about two shortcomings that are little-discussed:

1) Your body has a collection of microbiomes each with their own needs, and while it is possible to take “generally good” bacteria in probiotics and assume they’ll do good, taking Lactobacillus sp. will do nothing for a shortage of Bifidobacteria sp, and even taking the correct genus can have similar shortcomings if a different species of that genus is needed, e.g. taking L. acidophilus will do nothing for a shortage of L. reuteri.

It’d be like a person with a vitamin D deficiency taking vitamin B12 supplements and wondering why they’re not getting better.

2) Probiotics are often wasted if not taken mindfully of their recipient environment. For example, most gut bacteria only live for about 20 minutes in the gut. They’re usually inactive in the supplement form, they’re activated in the presence of heat and moisture and appropriate pH etc, and then the clock is ticking for them to thrive or die.

This means that if you take a supplement offering two billion strains of good gut bacteria, and you take it on an empty stomach, then congratulations, 20 minutes later, they’re mostly dead, because they had nothing to eat. Or if you take it after drinking a soda, congratulations, they’re mostly dead because not only were they starved, but also their competing “bad” microbes weren’t starved and changed the environment to make it worse for the “good” ones.

For this reason, taking probiotics with (or immediately after) plenty of fiber is best.

This is all accentuated if you’re recovering from using antibiotics, by the way.

Imagine: a nuclear war devastates the population of the Earth. Some astronauts manage to safely return, finding a mostly-dead world covered in nuclear winter. Is the addition of a few astronauts going to quickly repopulate the world? No, of course not. They are few, the death toll is many, and the environment is very hostile to life. A hundred years later, the population will be pretty much the same—a few straggling survivors.

It’s the same after taking antibiotics, just, generations pass in minutes instead of decades. You can’t wipe out almost everything beneficial in the gut, create a hostile environment there, throw in a couple of probiotic gummies, and expect the population to bounce back.

That said, although “probiotics will not save you”, they can help provided you give them a nice soft bed of fiber to land on, some is better than none, and guessing at what strains are needed is better than giving nothing.

See also: How Much Difference Do Probiotic Supplements Make, Really?

What she recommends

So to recap, we’ve had:

• Wash less, and/or with less harsh chemicals
• Avoid antibiotics like the plague, unless you literally have The Plague, for which the treatment is indeed antibiotics
• Avoid antibiotic-contaminated foods, which in the US is pretty much all animal products unless it’s, for example, your own back-yard hens whom you did not give antibiotics. Do not fall for greenwashing aesthetics in the packaging of “happy cows” and their beef, milk, etc, “happy hens” and their meat, eggs, etc… If it doesn’t explicitly claim to be free from the use of antibiotics, then antibiotics were almost certainly used.
  • Dr. Chutkan herself is not even vegan, by the way, but very much wants us to be able to make informed choices about this, and does recommend at least a “plants-forward” diet, for the avoiding-antibiotics reason and for the plenty-of-fiber reason, amongst others.
• Consider probiotics, but don’t expect them to work miracles by themselves; you’ve got to help them to help you.
  • Dr. Chutkan also recommends getting microbiome tests done if you think something might be amiss, and then you can supplement with probiotics in a more targetted fashion instead of guessing at what species is needed where.

She also recommends, of course, a good gut-healthy diet in general, especially “leafy green things that were recently alive; not powders”, beans, and nuts, while avoiding gut-unhealthy things such as sugars-without-fiber, alcohol, or some gut-harmful additives (such as most artificial sweeteners, although stevia is a gut-healthy exception, and sucralose is ok in moderation).

For more on gut-healthy eating, check out:

Make Friends With Your Gut (You Can Thank Us Later)

Want to know more from Dr. Chutkan?

We recently reviewed an excellent book of hers:

The Anti-Viral Gut: Tackling Pathogens From The Inside Out – by Dr. Robynne Chutkan

Enjoy!