ZOE Science & Nutrition - Beat stress with science: 4 key techniques for stress relief with Dr Rangan Chatterjee

Episode Date: February 8, 2024

Stress is a main factor contributing to ill health, and Dr. Rangan Chatterjee believes that it’s the number-one cause of the illnesses he treats. In today's episode of ZOE Science & Nutrition, Rangan sheds light on the causes of stress, ranging from sleep deprivation and overwhelming workloads to a lack of quality time with others. You’ll learn how “microdoses” of stress can reach a tipping point, why recognizing these doses is key, and which powerful strategies can help you cope. Are you ready to transform your relationship to stress? Dr. Rangan Chatterjee is regarded as one of the most influential medical doctors in the U.K. He wants to change how medicine is practiced for years to come, and his mission is to help 100 million people around the globe live better lives. He’s a professor of health communication and education at the University of Chester, and he hosts one of the most listened-to health podcasts in the U.K. and Europe — Feel Better, Live More has had over 200 million listens to date and is listened to and watched by over 8 million people every month.   🌱 Try our new plant based wholefood supplement - Daily 30 *Naturally high in copper which contributes to normal energy yielding metabolism and the normal function of the immune system Learn how your body responds to food 👉 zoe.com/podcast for 10% off Timecodes: 00:00 Introduction 01:24  Quickfire Questions 04:24  What is stress? 08:00 Our bodies respond to physical and emotional stress in a similar way 10:48 How much stress is bad for us? 16:17 How do micro stress doses affect us? 20:08 Modern life stress is different! 23:16 Stress is the number 1 cause of disease today 29:37 Do women and men perceive stress in the same way? 30:54 Breathing techniques for stress reduction 36:28 Movement and exercise for stress reduction 41:32 How to make new behaviors into habits 43:37 The impact of human touch 49:04 The power of journaling 52:54 Summary Mentioned in today’s episode:  The impact of daily gentle touch stimulation on maternal-infant physiological and behavioral regulation and resilience from Infant Mental Health Journal  Fogg Behavior Model from behaviourmodel.org The Stress Solution and Feel Better in 5 by Dr. Rangan Chatterjee Episode transcripts are available here. Have feedback or a topic you'd like us to cover? Let us know here

Welcome to ZOE Science and Nutrition, where world-leading scientists explain how their research can improve your health. Today, we confront an epidemic of the modern world that's silently creeping into our homes, our workplaces, and even our schools. You can't see it, you can't hear it, but it's there. We're talking about stress, chronic, relentless stress that damages our health and our happiness. In the US, over a quarter of adults experience stress so great that it limits their ability to function day to day. Globally, we're witnessing a surge in burnout

with stress-related illnesses skyrocketing. And stress doesn't just fray the nerves. It actually has a direct impact on our physical health. But it's not all bad news. There are ways of coping with stress and regaining control over your mental well-being. Here to share five practical, scientifically-backed strategies is Dr. Rangan Chatterjee. Rangan is a practicing medical doctor and a professor of health

communication and education at the University of Chester. He's a Sunday Times best-selling author and host of the globally successful Feel Better, Live More podcast. Rangan, thank you so much for joining me today. Jonathan, I'm really excited. It's taken a little while to tempt you down to the studio, and I'm very excited as well. Now, we have a tradition that we always start with a quick fire round of questions from our listeners. Wow. And there's very strict rules. You can say yes or no, or if you absolutely have to, you can give us a one sentence answer. Are you willing to give it a go? Okay.

I feel quite nervous, but let's go. It'll be fine. We normally find like the more number of academic credentials you have, the harder it gets. Okay. So as a doctor, it's going to be difficult, but I think you can manage it. All right. Starting at the beginning. Can stress truly damage our health yes do you see more stressed people in your clinic now than 10 years ago 100 yes can a single night of poor sleep drastically increased my stress levels.

Yes, but we shouldn't worry too much about one night's poor sleep. Is there scientific evidence that the power of human touch can reduce stress? Yes. Is there one stress-reducing technique that works for everybody? No. Okay, and finally, and you don't just have to say yes or no, you can have a sentence or two. What's the most common misconception about stress that you hear? I think the most common misconception about stress is that it's purely external. It's only to do with things in our environment like our workload or our email

inbox or our to-do list. And I think that stress needs to be looked at in a much broader way. So I think of it in terms of external, biological and internal. I grew up in a very English family. So for those listeners who are all around the world, I was brought up with a stiff upper lip. So for those, you know, listeners who are all around the world, you know, I was brought up with a stiff upper lip, you know, so things are tough. You definitely shouldn't show it. And above all, whatever you do, don't talk about your feelings. Like, you know, you can talk about almost anything, but like your feelings somehow are

like, definitely to put it in a box and like never discuss. And I remember my grandmother talking about living through World War II and how, you know, even if there were bombs falling, you know, you just have to sort of keep calm and carry on. So that was like definitely the environment in which I was brought up. And over the last, you know, five or so years, I've just become more and more interested in mental health, the value of sort of being in touch with my own feelings and dealing with them and actually, actually shock horror, maybe even talking about some of them. And I've also been discovering sort of through Zoe and through this podcast, actually, how there's sort of more and more credible science about mental health, how it's important, but we haven't talked specifically about stress at all on the podcast. This is going to be the first rung. And so I'm, I'm really looking forward to it. And I'd like to start at the very beginning with like a probably deceptively simple question.

What is stress? Stress is at its core, a response that we as humans generate when we feel under attack. When we feel there's danger there, we become stressed. The word stress has almost become common parlance now. You know, how are you doing? Yeah, I'm okay. I'm a little bit stressed, but I'm okay. Yeah, definitely. I think that's how I'm used to thinking. Yeah, we've normalized it. And therefore, what we've done as doctors is sometimes when we have said to patients that I think stress is playing a role here, what's often happened is that patients walk out the door thinking that, oh, the doctor's not taking me seriously. And I do appreciate that on some occasions, I think that has been the case.

But when we all understand the biological effects of stress, we understand that actually too much stress that goes on for too long a period of time without periods of recovery and relaxation have really damaging effects on our physical health, our mental health, and our emotional health. So what is the stress response? Well, let's imagine, I don't know, we were around 200,000 years ago, Jonathan, right? We're in our hunter-gatherer tribe. We're getting on with our day. The best

way to imagine stress is, let's say a predator of some sort. A lion. A lion. Okay. Let's say a lion. I can visit this lion in East Africa somewhere thinking I'm his lunch. Yeah. So a lion's approaching and you see that lion out of the corner of your eye. Yeah. Okay. So a threat has presented itself in your environment, right? So in an instant, your stress response system kicks into gear. And I think this is really important to understand. And what does that mean, my stress response? So a whole host of things happen in the body. I won't go through them all because it would probably take me three hours to list them all for you, but let's go through some of the common ones your blood sugar your blood glucose essentially starts to go up well why would it go up well it means that

more sugar is around there's more glucose to be available to your brain and the way your body does that is by making certain cells resistant to insulin right so your blood glucose goes up so that your brain gets more glucose all the energy i might need to figure out what increases energy right what else happens um your blood pressure goes up again why would your blood pressure go up well it can deliver more oxygen to your brain these are all good things when you literally are in danger your blood becomes more prone to clotting that's fantastic because if you were attacked and that line was to cut you instead of bleeding to death your blood's going to clot that's amazing so it's like it's like getting prepared for the fact i'm going to get eaten by

the line and it's already like changing what our bodies are incredibly clever right and another thing i think it's worth thinking about is that our amygdala, the emotional parts of our brain goes onto high alert. So we become hypervigilant for all the threats around us. Now let's think about that, Jonathan. That is a really good and clever response from your body when you really are in danger. The problem today in the 21st century for many of us is that our stress response systems are being activated to the state of our daily lives by our email inboxes, by our to-do lists,

by our three social media channels we're trying to stay up to date with, etc. So literally you're saying that the little thing beeps on my phone and my body like starts to clot my blood because I think I might get eaten by a lion like it's that it's really we know that our body responds to physical stress and emotional stress in a very similar way and that's why these days if your stress response system has been activated to the state of your daily life, which it is for so many of us, those short-term responses that are so helpful become harmful in the long term. So blood glucose going up helps you for 30 minutes to get away from danger. But if that's happening day in, day out to the state of your life, that makes you tired. You're going to put on weight, particularly around your belly. And ultimately, it's going to cause type 2 diabetes.

And a lot of people don't realize, Jonathan, that you can raise your blood sugar, you can get type 2 diabetes just from chronic stress alone. It's not just diet and exercise. I just want to make sure I've really heard that right, because I think it's probably be quite shocking for a lot of people. Because I think I was definitely brought up with this idea that your brain and your body are two completely separate things. But what you're saying is just that continued stress week in, month after month, year after year alone could lead to like really severe, you know, life-threatening diseases. Yeah. I had a patient once, Jonathan, about six or seven years ago, who was a renal registrar in a hospital in Manchester at the time.

And, you know, her diet wasn't amazing, but it was okay. And she, you know, would move her body reasonably regularly. She became pre-diabetic. And when we looked at everything in her life, when we sort of tried to understand what was going on, it was stress that was driving it. When we helped her dramatically reduce her stress levels over a period of months, and she managed to do that,

her HbA1cc her average blood sugar started to come down out of the pre-diabetic range and into the normal range i think 21st century living has become very stressful for so many of us and what i really want to do this conversation with jonathan is to make sure people understand that stress has real biological effects on your body. But then also to say, it's not as hard as you think it is to bring those levels down. You don't have to suddenly go off and live in a monastery and meditate all day, right? That would be great for your stress levels for most people, but that's not practical. So we will get to those practical strategies. But just to go back to that evolutionary response for a moment, blood glucose in the short term helps you, in the long term harms you. Blood

pressure going up because you think there's a lion there or because you're in a 30-minute spinning class in the gym, that's a great thing. You don't want your blood pressure going up, though, day in, day out. That's when it increases the risk of heart attacks or strokes. I'd like to share something exciting. Back in March 2022 we started this podcast to uncover how the latest research can help us live longer and healthier lives. We've spoken to leading scientists around the world doing amazing research and across hundreds of hours of conversations, they've revealed key insights that can help you to improve your health. If you don't have hundreds of hours to spare, no need to worry. At the request of many of you, our team has created a guide that contains 10 of

the most impactful discoveries from the podcast that you can apply to your life and you can get it for free. Simply go to zoe.com slash free guide or click the link in the show notes and do let me know what you think of it. Okay, back to the show. This comes up quite often actually in very different areas. I think about Sarah Berry talking often about what happens inside your body when you eat food. And she says, your blood sugar going up after a meal is a perfectly normal response, but it's sort of, it happens, then it comes back down. What's bad is like this very prolonged period, you know, with sort of modern food and modern eating,

where you're just doing this like meal after meal, and there's these big excursions. And is that something similar with stress where you're saying, is being stressed from time to time bad for you? Or is it only if it's sort of like over, it's almost like permanently? I think you raise a great point there, Jonathan. Stress is not all bad. We need stress to be the best version of ourselves. We need stress because it helps us perform better. But there is a dose response with stress. Let's say I was a bit nervous

to have this conversation with you, Jonathan, today, or I had to give a talk on stage and I was a little bit nervous. I was feeling a little bit stressed. Well, actually, we know the little bit of stress is going to help me perform better. I'm going to be able to pull little bits of information from parts of my brain and actually deliver better information to you than if I was maybe not stressed. But if those stress levels get up too high and I start to get, you know, really stressed, oh, I don't know what Jonathan's going to ask me. Am I going to know what to say? My brain can start to freeze, right? And then I no longer am performing better, I'm actually performing worse. And so this really

nice curve that I sort of put in my second book, The Stress Solution, where I sort of outline all the causes of stress. And it basically shows that a little bit helps us, a little bit more, you start to get diminishing returns. And then if it keeps going, it turns out to be downright harmful. And so let's think about the hippocampus in the brain, for example. It does many things, but it's usually associated with memory. So a little bit of stress helps us remember more things, but chronic stress, day in, day out, our stress loads starts to kill nerve cells in the hippocampus.

Doesn't sound good. It's not good. And we now know that chronic unrelenting stress is causative. It's one of the causative factors for dementia. Is that right? Yeah. So I don't say that to scare people. I'm not saying that's the only thing, right? That's clearly there's many things in our environment that increases the risk that we're going to get Alzheimer's when we're older. You know, poor diet, sleep deprivation, all kinds of things play a role. But so does chronic stress. So again, for people listening who've felt somehow that all this mental stuff doesn't have anything to do with your body, there's another example of like there's this real link between stress constantly on for months and years actually know, again, another really serious disease. People are skeptical. Let's imagine a everyday scenario where you can understand straight away

how emotional thoughts, psychological stress can impact your physiology. You know, you could be sitting in an exam hall and feeling the time pressure, feeling you don't know how to answer these questions and feel a real urge to go to the toilet, that is emotional stress translating to your physiology, right? It's a very simple way of demonstrating that. And, you know, just to go back to those short-term responses that are helpful in the short-term but harmful in the long-term, you know, we mentioned the amygdala there, the emotional part of our brain. Well, if there's a lion approaching, you want to be hypervigilant to everything all around you. If you are in a dark street in London on a Friday night or New York or LA and you are walking back by yourself to your car and you think someone is following you,

you want to be hypervigilant. That's an appropriate response. If though your stress response is being activated day in day out to the state of your life, your amygdala being on high alert is what we call anxiety. And so we know that anxiety rates are going through the roof these days. And again, there's many different causes, including the food that you eat and the impacts on the microbiome and the gut-brain axis, for sure. But we shouldn't underestimate just how powerful effects chronic stress has. And again, bringing it back to the last point you made, Jonathan, the key is not that we should never be stressed. That's unrealistic. It's not what we want. It's just that we should never be stressed that's unrealistic it's not what we want it's

just that we need to understand where stress lives in our life so that we can try and reduce it where possible and even if we can't reduce it we can bring into our lives some stress reduction strategies that are going to make a really big difference so if i um if i understand what you're saying i think you're saying like being stressed for something particular like like I'm going to go and do a race that I'm excited about, or I'm about to perform in a podcast and I want to make sure I'm going to do a good job because Rangan's here and I don't want to appear like a total amateur. That's all right if my stress level goes back down afterwards and like across the day, most of the time my stress is low and it's peaking.

That may even be good. But if somehow I'm stuck in this thing being on, this stress level being on like all the time, day after day, then I can end up with anxiety. I can end up with like these direct physical illnesses because somehow in this modern world, my responses are no longer just getting switched on with the lion and getting switched off when he leaves. It's almost like you've left the light on and it's just sort of permanently on. Yeah, exactly. And another helpful concept, Jonathan, I think is something I've been talking to my patients about for years and also the public.

And it's the concept of micro stress doses, or I abbreviate them to MSDs. A micro stress dose is a dose of stress that in isolation we can handle just fine. The problem is when those micro stress doses build up one after the other. You said at the beginning that people are, you're seeing a lot more stress even than 10 years ago. So what is causing stress today? Okay, there's two ways I'm answering that question. Let me first of all answer it through the lens of micro stress doses, right? These little hits of stress that in isolation we can handle just fine. The problem arises when they mount up. Because when they mount up, they get us closer and closer to what I call our personal stress

threshold. And it's going to be different. Yours is going to be different from mine. Mine's going to be different from my wife's. But here's the thing we have to understand. When we hit our personal stress threshold, that's when things start to go wrong. That's when our back goes into spasm, our neck goes. That's when we overreact to an email and send one back that we regret. That's when we have a row with an email and send one back that we regret. That's when we have a row with our partner. We always think it was the last thing that happened that was the problem. But in my experience, it very rarely is the last thing. It was simply the straw that broke the

camel's back. So what does that look like? Well, let's imagine a typical scenario that I see in many of my patients, right? They're super stressed with their job. So they don't want to go to bed on time because they want to have a bit of me time in the evening and chill out in front of Netflix, watching a box set, right? So they go to bed a bit late, let's say midnight. And the next morning, their alarm goes off at 6am. So this is how these micro stress doses or MSDs start to add up very quickly. You're lying in bed in a deep sleep. Your phone alarm goes off. That's micro stress dose number one, because it's jolted you out of your deep sleep. You look at the time and think, oh, I've got five more minutes.

You press snooze. You fall back asleep. Five minutes later, it wakes you up again. MSD number two. Then you pick up your smartphone. You quickly go to your email inbox and go, oh man, there's three work emails from yesterday. I didn't get on top of. I'm going to have to do that. Microstress dose number three. Then you go onto Twitter or Rex and see some of the negative headlines that are on there. Microstress dose

number four. Then you realize, wow, I should have got up from bed 20 minutes ago. So you haven't even got out of bed yet and you're already quite stressed. Yeah. And I would find with most of my patients that before they even left their house in the morning, they had been exposed to 10 or 15 microstress doses. And what does that mean? It means you are so much closer to your own personal stress threshold, which means it doesn't take much in the day to tip you over. And that has been one of the most useful concepts for my patients to help them understand stress, because there's two ways of looking at that. First of all, can we reduce how many of these micro stressors we're exposed to each morning, perhaps by not looking at our emails or our phone first thing,

perhaps by having a cup of coffee in silence or having a little workout or some meditation, whatever it might be. So you're not building up those MSDs in the morning. But also if you do have a stressful life and you've got young children, you're trying to get off to school and you're trying to get to work and all these kind of things just understand that in the day can you take regular pauses and do things that will you know let's say you're building up your stress load that then brings you away like a 15 minute walk at lunchtime without your phone cannot start to lower that stress load on your body what i'm intrigued by because you started this story talking about like 200 000 years ago like with the lion um i'm sort'm intrigued by, because you started this story talking about like 200,000 years ago, like with the lion.

I'm sort of intrigued by how our modern environment is different maybe from the environment in which we live. Because we talk a lot about that on the podcast to do with things like our food and your bacteria and things like this. I'm struck that a lot of the examples you described feel like things that didn't exist. Actually, even maybe like 200 years ago for anybody. Is that my chance? I would absolutely agree with that. I've looked quite carefully at this. And I think a very simple way of looking at this is, let's be really clear, let's not look at the past through rose-tinted lenses.

There was real life-threatening stress there. There was wild predators. There was danger. There was all kinds of things. You could starve to death, presumably. You could starve to death, exactly. But their stress was a real physical threat to their survival. And from what we can tell, their lives basically were mostly in the parasympathetic state, the relaxation state, and it was punctuated by brief moments of high stress, which they dealt with. Whereas in the modern world, it's almost been flipped.

Whereas we are constantly having our sympathetic nervous system, the stress part of our nervous system, constantly activated from the minute we wake up to the minute we go to sleep at night. And we're only occasionally really having that relaxation, having that rest and digest mode activated in our body. And if we think about what are some of those stresses in the modern world compared to our evolutionary ancestors, well, the list is endless. Light exposure at the wrong part of the day is a huge stressor on our bodies. Back then, it used to be light in the morning, gets you out, helps set your circadian rhythm. You're doing things in the day. You're working in the day, but when it's nighttime in

the evening, it's campfire time. You light a fire. It's now no longer the work of the day, it's storytelling, it's dance, singing. We know that from tribes that the evening, they sort of downshift into relaxation mode. And I really like that concept for us when we think about stress of campfire time. What do you do in the evening? Do you have your own version of campfire time? Or are you constantly on, still doing emails, still going on to social media, trying to win an argument with someone from the other side of the world who you don't know or whatever it might be? Or are you really taking a bit of time to connect? If you're lucky enough to live with friends or family or partners, how many times do we sit, let's say, in our kitchen

with our partner? So we're physically in the same space, but mentally, because we're both on our own devices, we're a million miles away, right? So yes, I agree with you. It's very different today. I think I would argue today, right? And I've been a doctor now for 22 years, right? I've seen tens of thousands of patients. I would argue based upon what I've seen that stress is the number one cause of illness that I see today.

That's extraordinary. I really do believe that. It's the number one cause of illness that I see today. That's extraordinary. I really do believe that. The Journal of the American Medical Association in 2013, there was an editorial letter where they proposed that 60 to 80% of what a medical doctor sees in any given day is in some way related to stress. And other researchers are sort of hypothesizing that it could be as much as 90% but I think if you look at the totality of the research I think we can safely say between 60% and 90% of what a medical doctor like me sees in any given day is in some way related to stress and Jonathan let's just think about the stress response right it can affect every organ system in the body. It can increase your risk of type 2 diabetes, heart disease, obesity, anxiety, depression. But what about two broad categories

of symptoms? One of them that you will have covered a lot on your podcast, gut problems and libido problems, right? I mentioned before that when you feel stress or when a human being feels stress, it activates all the processes that are necessary for survival, but it also switches off two very important functions. Digestion gets shut down because if your body thinks that you have to run away from a tiger, right, or you mentioned a lion, digesting your food efficiently and adequately is not a priority, right? Number two, libido. In over 20 years of seeing patients, the number of patients I'm now seeing who are having problems with their libido, their sex drive, basically, it's just coming through

the roof. And I'm seeing it in younger and younger ages. It's absolutely incredible. And there are many different causes of that. But I would say that stress is one of the biggest causes of low libido. Because if you're chronically feeling under stress, your body feels that it's in danger. So, you know, your body doesn't feel it needs to be able to chill out and procreate with your partner and this is a really serious issue that a lot of people i think don't recognize enough that's fascinating i have one follow-on question just listening to this because you you said that this is actually a lot worse even than 10 years ago not just 22 what do you think has changed like even in the last decades that means that the stress is

is higher because some of the things you're talking about are like modern life with we have an alarm clock and we go to the office or things this has been true for quite a long time so what is it that's shifted in the more recently i think there are a number of different things. My view on this, having studied this for a number of years now, is that we as humans are really resilient. We can actually handle a lot of stress. I think it's important to say that. What's happened, I think, over the last 10 years is we don't have daily time where we are allowing ourselves to recover from the stress that we accumulate. And I think one of the big causes of this is technology. Now, it's easy to blame technology for everything. And of course, there are loads of benefits of technology. But one of

the major downsides for me is that 20, 30 years ago, you could basically come home from your work and you were pretty much switched off for most people you'd have dinner maybe at home you might watch some television in the evening but you weren't able to stay engaged so this blurring of boundaries between home life and work life i think is a huge problem probably one of the biggest problems and i think all we need to do is go, well, I tell you what, what would happen if each evening we just paid a bit of attention to recovery, a bit of attention to say, I'm going to switch off now. I'm going to let things reset so I'm ready for tomorrow. It would help our sleep. It would help our stress levels. It would help the quality of our lives.

And it's not just me who is saying that stress is a massive problem. There's loads of research supporting that, Jonathan. The World Health Organization, I think back in 2018, put on their website that stress is the health epidemic of the 21st century. That's extraordinary. It is extraordinary, isn't it? So I'm really intrigued by this because my background is really data science. That's how I eventually got to Zoe and met Tim also with my co-founder George. So I'm quite familiar with the way that the algorithms behind a Instagram or a YouTube or something like this works.

And I think what's clear to me now in a way that definitely wasn't clear to me a decade ago is they basically hack the way that human beings work, that they are designed to take this attention. And I think the way you're describing this with stress is almost like capture that way that our body is set to worry about a lion with this thing that is going to

constantly trigger with notifications that are constantly going to go off and tell you that you need to look at this, this little sense that there's something exciting or possibly scary, right? You're going to roll in. And that is clearly very different, particularly with a phone, right? Even if maybe 15 years ago, quite a few people had this with a computer. The fact that now we take this around with us all the time, we can take it into your bedroom. We have to acknowledge that these phones are a huge source of distraction. And we have to realize that it's not our fault, right? It's not that we're fundamentally flawed, that we can't resist these things. They are designed to be irresistible. And so, you know, I'm currently deep in the latter stages of writing my sixth book.

And I have to, in the morning, when I protect some time for deep work, I have to put my phone either in another room or upstairs in my house when I'm writing downstairs, because otherwise I will get pulled into it. One of the questions that we had a lot from listeners was whether stress impacts women and men in the same way always. And I was just curious about what the science says about that. There is some research on that. I think men and women do perceive stress differently. And a huge part of stress is perception you know how we interpret things and look it's very hard to say that this is the case in every single individual but as a

broad rule we the research that i've seen suggests that women will internalize stress a lot more than men so men might talk about it you know they may rage about something bang their hands you know maybe want to go and work out that stress from their body in some way. Whereas it appears from the research that women tend to internalize it more and keep it within. Okay. So these are obviously broad averages, but you see this and you see this through your- That does seem to be a slight difference. That's really interesting. I'd love to talk about your strategies for actually coping with stress, because I know this is something that, as you said, you wrote a book on, you're really focused

on with your patients. And I think you also said, interestingly, at the beginning, that there isn't just one strategy that works for everybody. So someone's listening to this and they're like, yeah, I'm way over the top with stress. I'm now really anxious about all the way that that's going to impact my health. Can you give this listener something positive that they could actually do with like real evidence that can help? Yeah. So I think the first thing anyone looking for advice on stress needs to really acknowledge to themselves is how much stress is in their life, right? We need to just go, you know what? I've tried to put it to the side, but I do think that chronic stress is an issue. Fine. Then all you have to understand is that we all respond differently to stress

reduction practices. I'm going to mention a few practical things now. See if one of those resonates that you can bring into your life. Don't try and do all that will be too much so i think the most powerful thing anyone can do to lower stress is to understand the power of their breath okay right the way we breathe is information for our bodies there was some research done at ucla which showed that 80 of office workers when they look at their emails change the way that they breathe. That's amazing. Right. So what happens? We breathe a bit quicker, a bit more shallowly, and a bit more from our chest than our diaphragm. And what does that do?

Diaphragm is like where your guts are, is that? Exactly. And that sends a stress signal to the brain. It says to your brain, there is danger. It's not calm in my environment environment your brain then sends a message back down to encourage you to keep breathing in that manner so it's a feed-forward cycle but that means you can actually hack that now the word hack is overused but breathing really is a hack because if you slow your breath down intentionally and consciously you can start sending calm signals up to your brain rather than stress signals. And there's a lot of scientific evidence showing us that intentional breathing practices can lower our stress levels. My favorite one is what I call the 3-4-5 breath. And this is based

upon the scientific principle that anytime your out-breath is longer than your in-breath, you help to switch off the stress part of your nervous system and activate the relaxation part. This is literally going to change what's going on inside. In real time. So if you think about those micro stress doses, even if someone can't change that, but they're at 2pm, they're feeling frazzled, they've got a meeting, they're feeling reactive, even one minute of 3-4-5 breathing will start to lower their stress levels and make them more engaged and focused for the afternoon, right? So the 3-4-5 breath is you breathe in for a count of three, you hold for four, and you breathe out for five. So we know that with that longer out breath, you are changing your physiology. Now, the 3-4-5 breath

takes 12 seconds. Five of them take one minute. So I've been teaching this for years to students who are nervous before exams. I remember some of my patients who were teachers who would find the afternoons really stressful. They would do it in their staff room at lunchtime. High-flying business executives before meetings, and all of them have reported back to me, well, pretty much all of them, not everyone, because we all respond differently, that it makes a massive difference. And also, maybe related to some of your listeners, Jonathan, a lot of people feel that they are reacting to certain foods these days. And of course, there are intolerances, there are allergies.

But one thing I've also found with my patients is that sometimes people aren't actually reacting to the foods, they're reacting to the fats, that they're in a stressed state when eating foods. So if you do the 3-4-5 breath for one minute before lunch or before dinner or before breakfast, you will find that you're much more calm. Your rest and digest system is going to be working better. And you may just find that you're digesting food better. So the three, four, five breath is one breath that people can try, but there's another breath, right? Called the box breathing. Okay. That apparently the US Navy SEALs use before they go into combat. You look at it like a box. So you breathe in for four, you hold for four, you breathe out for four, and you hold for four again. Now, if some people find four too much, some of my patients do, I say, okay, go down to two. What you're trying to do is equalize everything. I think the key take home for people is there are a million breathwork

practices out there. We've just mentioned two. I would say for people, experiment with those two, experiment with some others if you don't like those two, find something that works for you, and you have something in your back pocket that you can take around with you everywhere in your life. You can do it first thing in the morning to really calm yourself and ground yourself like I do each morning, or you can do it when you're feeling stressed in the day. But in terms of stress reduction strategies, I think there's nothing more powerful than the breath. And what I love about it- And you have this built into your routine in the morning. So you think about this,

you just do this once. I do it as soon as I get out of bed. I one minute of that i literally get out of bed i sit on the side of my bed and i've conditioned myself now to do that before i do anything else and what i love about breathwork practices jonathan is that they're free and they're accessible there's loads of studies now on breathing you know that's been growing for the last few years i think professor and Andrew Huberman over the last couple of years has been testing a variety of different breaths. And he tested something called a physiological sigh, which is two inhales and then a long exhale compared to some forms of other breathing.

And from recollection, his research suggested that the physiological sigh might be the quickest and most effective way to calm our nervous system in real time now you said that there isn't just one thing that works for everybody so you've talked about breathing are there other things that people could yeah i mean look that we could do a whole hour on different strategies but to make it really practical breathwork is one of them i would say let's not neglect exercise right and i prefer the word movement really to exercise okay again think about it on an evolutionary level what is the stress response doing it's priming your body to

move in many ways to run but often we're getting stressed now by looking at our laptops on our email inboxes your body's getting primed to move but we're not moving we by looking at our laptops on our email inboxes. Your body's getting primed to move, but we're not moving. We're sat on our bums all day, right? And I think many cases of anxiety and chronic stress would be hugely alleviated by regular movement. In the moment, that could be, you know what, I'm feeling really, really stressed. I'm going to do one minute of jumping jacks or skipping. I will often do this between patients when I'm feeling my stress really stressed. I'm going to do one minute of jumping jacks or skipping. I will

often do this between patients when I'm feeling my stress load going. I find it's a very quick way of burning off that stress. What does the research show us? The research shows us that people who exercise regularly, they are more resilient to stress. And I think it's because exercise really works out your stress response system. By practicing that stress response in your body, you get better at it. There was some really interesting mice research done at Princeton in 2013, where they showed that mice who exercise vigorously had higher levels of the calming neurotransmitter GABA. And I think that starts to be replicated in human studies.

So it's really, really fascinating. Again, it doesn't mean you have to become a marathon runner, but just regular bits of movement. Hi, I love that you're listening to this. It means a lot to me and the whole team who put such a lot of hours into this podcast each week. We release this show for free without ads to help millions of people improve their health with cutting edge science. In return, all I ask is that you help us on this mission. If you know someone who'd benefit from listening to this episode, please send them a link to this show. And if you haven't already, hit follow wherever you're listening right now. Thank you and on with the show. And so that's interesting. I'd never thought about this. You know, I think people who listen to the podcast regularly know that

I do go to the gym regularly because I believe it's really important for my long-term health. And people who know me well will know that I get stressed quite a lot. There's a lot going on. I'm busy. And I have often felt, actually, that I go into the gym, I tell my trainer I'm feeling really stressed about whatever it is right now. And at the end of the session, I am less stressed. Partly I feel because I'm just like I'm tired. And you're saying there's real evidence in fact. I actually am reducing my, I'm not just helping my health, but I am actually reducing my stress by doing exercise.

You absolutely are. And as I know, as I say, exercise, regularly exercising makes you more resilient to stress, but it also helps you burn off and work off that stress. So I think that is really powerful. And does it have to be like intense exercise? Because I sometimes I'm thinking back also back to like COVID and just the extraordinary joy there was of going for a walk. You know, if you're in the UK, there was this period when you could just go out for a walk like once a day. And I do remember that it was amazing. And I definitely wasn't like, you know, it was not like hard exercise.

Is there... Look, again, this comes back to that overarching principle, which is we all respond differently to different therapeutic interventions, particularly when it comes to stress a 20 or 30 minute walk around your block will lower your stress levels right you will feel better working out vigorously with your trainer in the gym jonathan will also help you do that and presumably you have to not be using your phone while you're on i would say for sure because you really want to use it as a switch off.

Look, I'll go for a walk and listen to podcasts for sure, but I'll try my best to not look at the phone, keep it in my pocket or wherever it is, or my backpack and not get it out. I don't want to be checking emails whilst I'm, you know, having that stress reduction practice. And to make this super, super simple for people, this is something I recommend as a patience for years. It's what I do every year. I have a five minute strength workout every morning, Jonathan, and I've rarely missed a day in maybe three years. And it's got nothing to do with motivation. It's because I understand the principles of human behavior change. How do you turn new behaviors into long-term habits? In the morning, I'll do some sort of mindfulness, some breath work, maybe some meditation just for

a few minutes. And then I like a cup of coffee, right? So in my pajamas, I'm in my kitchen, I make my coffee in the cafeteria. I put all the water... French press, I think they call that in the States, don't they? Yeah. So I weigh the coffee out. I'm pretty particular with how I like it. I pour the water in and then I put a timer on for five minutes because that's how I like my coffee brewed. In those five minutes, I don't go on Instagram. I don't go on email. I basically in my pajamas, do a strength workout, either body weight or there's a kettlebell in my kitchen. I'll do something. And for those of you who aren't audio, Ranga's looking in very good shape. So clearly he's doing

something right. No, the point is, I think there are lots of rules of behavior change that we should follow. The two most important rules in my experience, as evidenced by the research as well, on number one, you've got to make something easy. And number two, you've got to stick it on to an existing habit. So why have you got to make it easy? A lot of this comes from Professor BJ Fogslab at Stanford, where he did a lot of research on this. He has shown that we overly rely on motivation, right? And there's something in the research called the motivation wave.

Motivation goes up and motivation comes down. Now, here's the thing, Jonathan. Often, people might hear what we say about exercise and go, right, I need to do one hour five times a week in the gym. The problem with that is if you can do it, great. But for many people, they can't manage that. And so, we will do something hard when our motivation is high. But when our motivation drops, as it always does, we'll only do that behavior if it's easy. That's why my workout is five minutes, right? Because I can never say I don't have five minutes. It's easy. I don't need to get changed. I'm literally

in my pajamas doing it. So I've ticked off box number one. I made easy number two is the best research shows us that where you put that behavior into your day will determine whether it becomes a long-term habit and the very best way to convert new behaviors into habits is to stick it onto an existing habit right making coffee each morning is a habit yeah i don't need a Google calendar notification to say, Rangan, remember to make your coffee. It's going to happen automatically. So by sticking on my workout there, it means I very rarely miss it. It's really clever. So you put it, attach it to this thing that you're going to do because you love your coffees. Of course, you're going to do that. But you could bring whatever is breathing or journaling, which is great for reducing stress or whatever activity

you want to bring in why don't you think about applying those two principles you don't have to do it just with a workout now i do want to make sure that we we mentioned human touch because you gave me this fascinating answer at the beginning um that there is real science that somehow human touch can affect stress could you tell us about that yeah this real science that somehow human touch can affect stress. Could you tell us about that? Yeah, this is something that I discovered through chatting with Professor Francis McGlone from John Moores University. He's probably one of the leading touch researchers on the planet. And his research has shown that we have a type of nerve fiber called CT afferent nerve fibers. And when we stimulate those nerve fibers, it sends a message deep into the limbic system within our brain, and it starts to lower levels

of the stress hormone cortisol. It's absolutely incredible. So when we think about human touch, we often think about, yeah, like if I touch my hands, I can feel that. That's touch. Is there anything more to it than that? And very broadly speaking if you zoom out there's two types of touch fiber there's fast touch fibers and they're slow ones so let's say this was a boiling hot cup of coffee yeah which it was about an hour ago but it's not at the. And let's say I touch it and it's too hot and I put it down. The first signal that I'm getting is the fast touch nerve fiber. It's simply telling me that there's something hot on my fingers. You've got to let go right away. Okay. But there's also a second nerve fiber, which is slower, which delivers the emotional

quality to touch. You've got kids like me. So another way of thinking about this is I remember when my daughter was little and if she would fall over and let's say hurt her knee, initially she'd just stop and rub her knee. But five or six seconds later, that's when she'd start crying. Do you recognize that with your kids? Yeah, absolutely.

It doesn't happen immediately because there's two nerve fibers. The first one is the fast one, which is just telling you something happened there. Then a few seconds later, it's the emotional quality to that touch, right? I just assumed it's because they were like really young, so they couldn't compute what's going on. But there are actually two signals.

There are two different nerve fibers. And Professor McGglone has actually done most of the research on this and what's really interesting is those ct afferent nerve fibers they're all over our body they're on our skin particularly on our forearm and our upper back okay and they have shown in his lab that they are optimally stimulated at five centimeters per second stroking rates. Now, nobody strokes another human being thinking about what speed am I doing it at, right? But what's really interesting in the laboratory, if you bring a human onto a wooden arm and you ask it to stroke it, they'll do it at all kinds

of depths and all kinds of rates. But when it's on another human arm, you automatically lock into that speed. It's what mothers intuitively do with their children and their babies. And he has shown that when the CT afric nerve fiber is stimulated, you start to lower levels of the stress hormone cortisol. Other research on touch has shown us that when it's safe affectionate touch and that's an important point that i must bring up it can not only lower cortisol it can lower our heart rate lower our blood pressure increase the amount of natural killer cells right that's a type of immune cell that helps us fight off bacteria and viruses all from stimulating human touch. Now, to be really clear, Jonathan, I'm not talking about unwanted touch. I know it's relative to the obvious, but I think I need to

just make that clear. This is about consensual. This is like somebody that you trust and feel safe with, whether that's a loved one or a friend or something like this. Professor McGlone hypothesized that this is a very important internal reward system for us. And he is hypothesizing that as touch is becoming eroded out of our lives, he's saying because

our internal reward system has not been adequately stimulated, we're looking for rewards in other places. So could one of the reasons why we have so much sugar or spend so much time on our phones or have these low-grade addictions be because we're not getting enough touch?

What you're saying is that whether or not that is true, there's something real and physical and leading scientists are understanding that, that there is this sort of direct link to physical touch and to things that sort of deepen our brain. Yeah, 100%. And what's the take home for people? Well, the take home is if you are someone who likes touch, but maybe feels that touch has been eroded out of your life, can you bring that in? I mean, anyone who's got a pet will know how good it feels to hug a pet. People can self-massage as well right if if let's

say someone's living by themselves if you don't have anyone in your life um where where you feel you can hug or have that safe affectionate touch with you could self-soothe you could self-massage you know with some cream or some oil if you just rub your legs or your forearms you will be activating those nerve fibers in your body so that's something you can do some people really like massage or things like reflexology well these things are also going to do those things for you so for that person by themselves if they've got the resources and if they enjoy it that could be something that will be very very beneficial for their health i would say the only other thing and there are you know many other things we could talk about with respect to stress i think journaling is something that we really

undervalue as a way of managing stress and can you explain for people who've yeah i know we're nearly out of time so let me try and keep it super simple journaling is simply the act of writing down your thoughts right there are millions of ways to do this but it is free it's accessible and we know from the scientific research all kinds of studies have been done on journaling it can help reduce anxiety improve sleep quality reduce rumination lower physical stress and lower emotional stress all kinds of research has been done on the power of journaling and that is just writing down basically you can either do it free form where for five minutes let's say first thing in the morning with a cup of tea you just write down anything that comes into your mind and often people will find that things that

they were worried about in their life that they didn't realize start to come out on paper, or you can do it in a more structured way. So I've been asking my patients for years to ask themselves certain questions. And the most successful questions I found with my patients, the ones that they really found useful, I put in something called a three-question journal, which I've just brought out because I think it's going to be really useful for people. But these are just three simple questions, for example, in the morning and in the evening that you can answer that will help lower your stress levels. So, you know, one of those questions could be, what do you deeply appreciate about your life?

Okay, it gets you out of rumination and thinking about all the bad things in your life and the news and you focus it on the good things like i'm grateful for the fact that i can afford to buy healthy food for my family i'm grateful for the fact that i have a job i'm grateful for the fact that it's winter and i can afford heating whatever it might be there's a lot of scientific research on gratitude and what it does for our physical and psychological well-being another question I love which is the second question that I answer each morning is what is the most important thing I can do today this is a lovely question to help you make decisions each day the more you do, the more you realize that actually

there's only ever one priority. And so this morning, for example, when I answered that question, and there's many things I could have put down, but I put down when I'm home later and my children come back from school, the most important thing I have to do today is make sure my laptop's down and I look them in the eye and I pay attention to what they're telling me. Now, it sounds so simple, but I promise, because I've seen people do this, when you do that every day, you start to focus your attention on what's important in life. And going back to the start of this conversation, Jonathan, why do so many of us feel so stressed? Because we're running around doing all these kinds of things that may seem important, but are not really the

truly important things that actually nourish us. So that's a couple of questions people can think about in the morning. A couple of questions I would really encourage people to do in the evening, which I have found transformative for me and my patients, and it really helps people make better choices in their life, just ask yourself two questions each evening. What did I do well today? What can I do differently tomorrow? Those questions, if you do them day in day out, they will lower your stress levels, they will help you create new healthy habits in a very compassionate and non-judgmental way. So that was my sort of quickfire way through journaling. I hope there was something practical in there for the audience.

And I think this has been very motivating. And I'm definitely going to take away the breathing. So I'm going to give that a shot because that I can see is manageable. And I am really interested by what you said about the human touch because I think that one of the things that I most enjoy through Zoe is the discovery of all this science that nobody knew about before.

And I think that's remarkable. And we're definitely going to follow up on that scientist that you mentioned, because I would love to learn more. Ranga, would it be all right if I did a quick summary of what we have covered and please correct me where I go wrong? So we started talking about what is stress and you had this brilliant metaphor of like, you know, 200,000 years ago and suddenly there's a lion and all these amazing things happen inside your body. You know, your blood pressure is going up. You're saying even my blood starts to sort of be able to clot differently. And so this is very like immediate and strong

physical response. And you said that actually, that's good. Like we're designed to have a stress response. It's a healthy thing for us to happen. And actually, you know, you should expect that to happen about, you know, coming onto a podcast, you want to do a good job, whatever, like this is a good thing, as long as it's not always on. But the problem is that in our modern world, many of us just basically having this stress response on and on and on throughout the day, throughout the month, you know, throughout years. And actually, that then starts to cause direct physical harm. And I think you mentioned diabetes, you mentioned heart disease, you know, you mentioned, um, dimension. I think you said, you know, your perspective is you think this could even be like the number one cause of ill health

because it also leads to other things like the way it affects your, your eating. So it's pretty scary. You then talked a little bit about sort of um your theory about sort of micro stress doses so this is like building up one after another and i think you gave me this example where you could like you could before you got out of bed already had about half a dozen stresses from like the alarm going off three times to checking your email to all the rest of it and therefore when you finally are conscious of being stressed and you shout at your wife or something, which I'm sure I would never do, actually, this is like the final, it's like the straw that breaks the camel's back on the back of everything else. And you also talked about the fact that you think that it's much worse in your practice, even than 10 years ago. And that although you can't prove it, you feel like technology is an important part of that. And the phones, they're always on, the way they're constantly pinging you,

the way that you, you know, there's always the next thing to scroll to, the next thing to listen to. So that's all quite scary. But the good news is you gave us a lot of things that we could do. And I think there were four. So first you talked about, you started with breathing. And I assume you started because you're particularly excited about that. And you talked about this three, four, five breath, which if I remember rightly is three seconds in,

hold for four seconds, out for five seconds. And then repeat. You said, I think five times is one minute. And there is going to be a direct impact, like measurable by scientists, reduction in your level of stress. Correct.

So that's magic. There was also the box breathing, but that intimidated me a bit because you said that was for Navy SEAL. So it's interesting that just mental... I'm going for the three, four, five. Sounds like karma. Movement and exercise.

So again, lots of evidence that if you do exercise you're effectively sort of burning off the stress you're going to lower that because stress is almost preparing you to run away from the line so by doing this exercise you're almost sort of following through but interestingly you said um you know even going for a walk for many people can lower that stress but don't bring your phone because then potentially you're just sort of like actually just canceling out that. Or trying to look at it at least.

At least, yes. You're allowed to listen to Rangan's podcast, but don't look at the phone while you're doing it. And I love the fact that you have this model where you're even doing this in your pajamas like while you're waiting five minutes for the coffee. Then you talked about human touch. And apparently there is a magic way to move your finger i think

you said five centimeters per second yeah like on i think you said like like your upper back and your lower arms in particular but but i don't want people to stress out and measure the rates at which they're stroking someone at five centimeters per second you will naturally do that like they'll you'll do it whatever feels natural is actually right. And there is real impact again, where there's these special nerves that will pick that up. And so, if there's something about touch with somebody that you feel safe with, I think that's really amazing. And then lastly, and briefly, I think you talked about journaling, writing down what's in your mind, reflecting, I think, at the end of each day about what you did can also really change your

stress yeah and we didn't mention nature nature lowers cortisol as well that's but so get as much nature as you can that also works and i would say johnny the one thing i didn't mention which is a great i think way to finish for people is this idea that if you're chronically stressed the way you see the world starts to change as well you focus in you don't take in the bigger perspective you become less compassionate less kind more divisive and we are living in a divisive world where people are at each other more and more yeah so i think there's a a real human case as well as a health case to lower our stress levels. I think it will also help us have a kinder and more compassionate and a world that's full of empathy.

It's a beautiful way to end. Rangan, thank you so much. Thanks for having me. It's been incredible to hear some of Rangan's strategies to reduce stress and regain our mental wellbeing. You can find many more insights from our podcast and download our free guide with our 10 most impactful tips by going to zoe.com slash podcast.

You can also learn more about how a Zoe membership can help you understand your own body better and how to change what you eat to best support your health. And as a podcast listener, you get 10% off of your membership. As always, I'm your host, Jonathan Wolfe. Zoe Science and Nutrition is produced by Yellow Hewins Martin, Richard Willen, and Tilly Fulford. See you next time.