ZOE Science & Nutrition - The secret to coping with stress - how to protect your brain and body, and feel calmer now | Prof Carmine Pariante
Episode Date: September 3, 2026Growing up, many of us were taught to just stay calm and carry on - as if stress was all in the mind, with no real effect on the body. But chronic stress can change your brain, raise your risk of hear...t disease, and even shorten your life. In this episode, we ask: what happens when a stress response built to last minutes never switches off? Today, Professor Carmine Pariante, one of the world's leading researchers on stress, helps us understand what’s happening in your body during a stressful moment and why chronic stress disrupts sleep, appetite, and energy levels. Carmine also explains how worried you should be about cortisol, and whether "cortisol face" and "cortisol belly" are backed by evidence. By the end, you’ll understand why stress can be so powerful, when it becomes harmful, and have some evidence-based ways to manage it. Next time you reach for wine, your phone, or something sweet after a hard day, ask yourself: is this helping you cope, or helping you avoid how you feel? 🌱 Try our science-backed and tasty wholefood supplement Daily30 🌿Let your gut microbes snack on the ZOE Gut Health Bar Build healthy habits. Download the ZOE app today and start your trial for just £2.30 for your first week. 👉 Join ZOE Follow ZOE on Instagram. Timecodes 00:00 Intro 01:10 Should you be aiming for zero stress? 06:13 Inside your fight-or-flight response 11:19 Can stress actually cause a heart attack? 13:15 Why your stress response won't switch off 15:33 Why stress eating isn't a willpower problem 17:15 Why emotional stress feels physical 21:00 The earliest sign of chronic stress 22:05 There's no such thing as "it's all in your head" 25:15 Stress causes the same inflammation as a cold 29:54 The blunt truth about chronic stress 31:07 How stress clogs your arteries 32:55 Why chronic stress can steal your joy 35:10 What a brain scan reveals about chronic stress 37:07 Is "cortisol face" actually real? 38:49 Does the viral cortisol cocktail actually work? 41:20 Why control is the key to coping with stress 42:46 How singing for one hour lowered cortisol 45:15 Why exercise is such powerful stress relief 47:57 Foods with the strongest evidence against stress 49:45 Why alcohol doesn't actually relieve stress 50:58 Is your phone making your stress worse? 54:04 The first thing to do when stress overwhelms you 56:06 Why modern life never switches your stress off 📚Books by our ZOE Scientists The Food For Life Cookbook Every Body Should Know This by Dr Federica Amati The Appetite Reset by Dr Federica Amati Food For Life by Prof. Tim Spector Ferment by Prof. Tim Spector Good Mood Food (preorder) by Prof. Tim Spector Free resources from ZOE The Smart Snacking Guide: How to feed your gut, fuel your day, and snack without guilt The Hormone Harmony Guide: Tuning Your Body’s Internal Orchestra Eating for Better Brain Health: Your brain-gut blueprint How to eat in 2026 - Discover ZOE’s 8 nutrition principles for long-term health Live Healthier: Top 10 Tips From ZOE Science & Nutrition Gut Guide - For a Healthier Microbiome in Weeks Better Breakfast Guide Mentioned in today's episode Effect of anti-inflammatory treatment on depressive symptom severity, The American Journal of Psychiatry (2025) Implementing a group singing intervention for depression, Frontiers in Medicine (2024) The Relationship between Diet and the Occurrence of Depressive Symptoms, Nutrients (2023) Have feedback or a topic you'd like us to cover? Let us know here. Episode transcripts are available here.
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Welcome to Zoe Science and Nutrition, where world-leading scientists explain how their research can improve your health.
The wind cuts across an ancient tundra.
Somewhere in the distance, a predator creeps ever nearer.
An ancient human freezes, heart hammering, muscles tightening, senses sharpening.
In the next few seconds, that surge of stress could mean the difference between life and death.
Hundreds of thousands of years later, the predator of.
has changed. Now it's an overflowing inbox, a mortgage payment, a sleepless night, a meeting
you're already late for. Not life and death, and yet the feeling can be the same as hearing
that saber-tooth tiger's footsteps coming nearer. This powerful stress response kept us safe for
thousands of years. Now it's making millions of us sick and even shortening our lives. Why does
stress grip us so powerfully? Why does our body react to modern pressures as if we're still fighting for
survival. What can we do to prevent this? In this episode, we're joined by Professor Carmina Parianty,
one of the world's leading researchers on stress and how it affects inflammation in our brain.
Together we'll explore what happens inside the brain and body when stress strikes, why cortisol
has become the internet's favourite hormone, and where the social media posts about cortisol,
face and belly have any basis in science. We'll also tackle some of the biggest questions surrounding
stress today? What does the latest research tell us about how it can affect us? Can it really make you
feel tired and depressed, contribute to heart disease and chronic pain, even increase the risk of
dementia? And perhaps most importantly, if stress is woven so deeply into modern life, what can we
actually do about it? Carmina, is stress always a bad thing? No. Can enough mental stress
damage my physical health? Yes.
Is cortisol
or something we should always be trying to lower?
No.
Are there any evidence-based ways to reduce your stress levels?
Yes.
Are stress and anxiety the same thing?
No.
Can stress increase the levels of inflammation
throughout your body?
Yes.
And finally, what's one thing that most people get wrong about stress?
Guilt.
they feel guilt about it
rather than
understanding that it's coming from outside
I love that we're talking about stress
because I think that everyone listening to this podcast
knows what feeling stressed
feels like and honestly
I feel like I've been stressed
since the day nine years ago when I decided
to start Zoe with my co-founder
I'm not surprised
so I definitely feel like I live with this
and in the modern age it feels like stress
is coming at us from
every corner
Now, I was brought up in England to believe that you should just stay calm and carry on.
And that since stress was in the mind, it wasn't real.
It couldn't cause any physical symptoms.
And basically, if you could just ignore it, then that was the best thing to do.
And you're already starting to smile.
And I'm also smiling a little because over the last few years, I've been starting to reassess, you know, this upbringing that I had.
However, there is a lot of conflicting advice about stress from online influencers, and most of them
have something that they want to sell.
We know what it means to experience stress, but I realize, as I'm saying this, I have no
idea what it actually is.
Stress is every situation where the challenge that we're facing is bigger, or this is perceived
as bigger than our ability to cope with it, to deal with it.
Once you interpret this way, then you know there's always a mismatch, and it's a personalized
mismatch between how you are at the moment in your life on the day and what's happening
around you.
Stress is not the same for everybody.
And of course, we know this.
There are aspects of stress that most of us will consider intolerable, and I'm thinking
about, for example, being in a war zone or being a soldier, or...
Even if you choose to actively participate in a situation that would be life-threatening or very stressful.
And then, of course, there are a situation that most people will find it not stressful, you know, perhaps even relaxing.
And then everything in the middle, like from talking to podcasts today, talking to the public, having to give a speech or wedding, having a difficult job performance, all of that will always be about.
how you as a person perceive that task on that day, because it also changed from day to day,
and it changed from how prepared you are, it changed based on what is your kind of background,
mental health and well-being at that particular moment. It's a very kind of personal,
but also kind of moment-by-moment definition, if you like.
What you're saying is stress is when the problem that I feel that I'm dealing with right now
is bigger than I'm convinced that I can deal with?
Yes.
And often it is bigger than you can deal with it.
Sometimes it's bigger than you think you can deal with it.
Although times it is really bigger than what you can do about it.
So let's take an example.
I mean, you mentioned a war zone, but I maybe want to go back into my mental model of this,
which is like our ancestors being chased by a lion.
Can you explain a little bit about what's happening in my brain as that lion is starting to come towards me?
I mean, by the time the lines comes towards you, probably your brain almost kind of goes into
automatic functioning and is your body taking over.
Your sympathetic nervous system gets activated.
So this is a kind of direct system that originates from the brain and makes your heart
bit faster, brings more blood to your muscles, kind of prepares you for the immediate run or fight.
It also activate the immune system.
These are the cells that we use in our daily life to fight infections.
And of course, you want to be able to fight infection to have an immune system that is primed to fight
because we are going to be injured.
And it's a lion in front of us.
Even if we run away, we're going to have injured by running in a field.
And if you get caught, of course, it will be the injuries of the fight.
So immune system gets activated.
A few minutes after that, cortisol kicks in.
Cortisol is a hormone, so it's not directly produced by, if you like, the brain or the central nervous system,
but it's downstream to the activation of the brain.
And it's produced by a small organ, which is called the adrenal gland,
which actually sits on top of our kidney, left and right.
Cortisol goes straight into the bloodstream, produce more glucose, so more sugar in the blood.
That's the basis of energy, which will really need it.
It kind of also helps shutting down blood flowing organs that we really don't need.
So, you know, we don't need blood in the stomach because digestion is not a priority when we have to fight our life.
And in the brain, cortisol kind of help focus on the task ahead.
So typically it kind of narrow the focus of our attention so that you almost become unaware of things that are not really important,
except, of course, the lion or what you need to do to fight or run.
This is more or less what happens.
Now, as much as a lot of the predator models, we need to remember that these are models of acute stress.
All of us will encounter acute stress.
I mean, very unlucky, we encounter severe acute stress, you know, being in a car crash or being
assaulted and being exposed to violence.
And a lot of us will have intermediate acute stress.
But the problem with today's society is much more about chronic stress.
So the question is how a body that was really created for stress that would only last 15, 20 minutes, half an hour.
So at the time you either fight the lion or run away from the lion, how does that body, the stress reaction, deal with the fact that today's stressors are mostly psychosocial and continuous rather than acute and disappearing after 20 minutes.
I have this vision in my mind now, all these things being switched on in my body,
at the point that I see this lion in the distance coming towards me.
I'm really interested to follow up now.
Actually, on what you're saying about how that might be the same or different in my modern life.
I feel, though, that I get very anxious if I know I'm going to be late for a meeting,
for example, right, which feels like that's completely different from a lion.
But I definitely think, oh, I'm feeling stressed, I'm going to be late.
is that a completely different set of things that are going on inside my body?
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That trial helped us develop the formula we have today.
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No, it's just quantitatively different.
And you have an increase in pro-inflammatory signal, so your inflammation in the blood,
so your immune system activation goes up even if you're doing an exam, for example.
Your cortisol goes up if you're late and you're really worried about it, and your heart
will be, you know, beating faster if you're anticipating a difficult meeting with your boss.
So this mechanism operate.
The magnitude of the intensity, of course, is much higher when we are feeling.
facing a real life threat in a situation versus a mildly challenging or just kind of worrying concern.
There's a range to this as well. It's not like it's either on or off. You can have all of
those things you described like at different levels of intensity. Yes, absolutely. And this is why
people have, for example, stroke or other acute medical kind of complication under-condition
or really intense stress. But they don't have.
it, luckily, you know, if they're late for a meeting.
Because the level of activation, for example, of the sympathetic nervous system, which is the
system that increase your heart bit so they get faster, but also increase your blood pressure
so you can get more blood to the brain because that's where you need the blood because
you're, again, you have to decide what to do in front of the lion.
But all of that may only increase a little if we're worried about being late and increase really
exponentially a lot if we are facing a life-threatening situation.
In a situation where I've seen a lot of stress, there's all of these things
have been switched on in my body.
In fact, some of that is also to like my heart beats faster and more blood pressure.
Is that related to this idea that you could have a heart attack if you're under too much
stress?
Absolutely.
This is both in terms of chronic activation of the stress systems, which increase your risk
of cardiovascular problem, really across a variety of mechanism.
because unfortunately, having a chronic activation of your stress system
is not the same as having the acute activation that we're having in the jungle.
Because in the jungle, our ancestor would face a predator
for a few minutes, 20 minutes, half an hour, maybe not even every day.
But for us, it's different, right?
So it's the stresses of the daily life, the pressure of work,
the social isolation, the difficulty we have with a relationship
that stays with us every day.
So it's continuous.
So I think you're saying that there's a big difference between,
probably what our ancestors experienced, which is very high level of stress, but for the short
period of time. And I think you've mentioned compliance here, this idea of chronic stress.
Could you help us to understand what that means?
A lot of the conditions that we are now facing today and we're perceiving us stressful are
of situations that stays with us for weeks or months or years. It could be a work pressure.
It could be relationship difficulties. It could be feeling lonely. A lot of the problems,
they were facing as a society, they tend to be there for a long time.
And so at that point, it's very difficult to switch the biological stress response off,
because the challenge is always there. While with a lion, once the lion is gone, or if you're
dead, we don't need the stress system anymore. And so, Carmina, what's happening in those
sort of long-term situations? So, like, I've got a horrible boss, and my relationship is difficult,
and I'm worried if the company is going to go bankrupt,
etc., etc.
Is that a completely different set of reactions
that's going on in my body
from the one you described with the lion?
It's the same, but it stays on longer.
So your sympathetic nervous system
that is supposed to kind of make your heart beating faster
and your broad pressure go up for 20 minutes
or half an hour until you deal with the problem,
actually increase your blood pressure
for days and weeks and months in a row.
And, you know, the baseline stays on.
on because the baseline stays on, then when there's an acute thing happening on top of it,
you're starting already from an activated baseline, so it goes up faster and higher.
And it's the same with cortisol.
So your cortisol gets constantly activated.
And so the system is just more responsive.
And so when you're facing a small stress in the context of the ongoing stress,
then your cortisol goes up more and goes up.
higher. And cortisol, you know, in the short term helps because you want to have more sugar in
your blood so that you can, again, have the energy to run. But in the long term, that means your
risk of diabetes or metabolic disorders, your risk of weight gain, your cardiovascular problem,
all of that goes up because it's something that your body is doing not for half an hour,
it's doing it for weeks and months in a row. So this raised level of cortisol, it's not just that
it makes me feel maybe more focused and feel stress, but actually is going to increase my risk
of serious disease like diabetes, but also risk of weight gain?
Yes, weight gain, together especially with inflammatory component, because inflammation does the
same. So inflammation also increased our risk of metabolic dysfunction. It cannot potentiate
the negative effect of cortisol. One of the other thing the cortisol does is that activates
mechanisms or reward so that increase eating as a way of coping with stress.
So some of the negative consequences of the stress are the unhelpful way that we cope with them.
That's really interesting.
So you're saying that our modern environment is having the same reaction to me as I'm designed
to have against like this scary lion.
It's not quite as high, but it's just on for months.
And part of that system is like increasing my inflammation.
It's increasing this cortisol.
You're saying that that actually is likely to lead me to put on weights, it's likely to make
me eat more.
That's slightly crazy.
It is, but it's, you know, in the environment, of course, facilitate that high fat food
and high sugar food, they have kind of a rapid anti-stress effect.
They can't reduce cortisol because they kind of give you a feeling of reward.
Food obviously is available to everybody, I guess, alcohol, smoking.
comes immediately after in terms of availability.
And then, of course, some people use drug of addiction.
I mean, these are the negative one.
You can add, I guess, social media, scrolling,
and everything that takes the pressure away from you,
even if for like a minute or an hour,
it will be in a highly stressful situation,
it would be a welcome relief.
It's not like I know my cortisol is high, right?
So you're saying that, like, in my biology,
it's sort of saying, oh, if you get that, it's going to reduce, I'm going to feel better.
So I'm sort of learning these behaviors.
We now know in our modern world that eating lots of sugar is not going to be good for us.
But similarly, alcohol, which I think for many of us, we do think, like at the end of a really stressful day, I'd love to have a drink.
I definitely can often feel like I would really like a glass of wine.
There's a physical relationship to do with the level of pressure that I felt earlier in this raised stress in this raised quarter.
as all. Yes, and there's also the mental aspect. I mean, of course, all these strategies
we used to cope with stress. I'm really struck that you said that there's not a complete
difference between sort of physical and sort of emotional or social threats. Is there really genuinely
my body is going to respond in the same way to a really high intensity, like emotional situation
as it were to really high-intensity situation with like physical threat?
It does.
It's only really a matter of quantity and for how long it stays on all of these mechanisms.
We have one way of coping with stressful situation, which is usually a way that allow us to,
as I said, either run away or kill.
And unfortunately, modern society, we can, hopefully, we cannot run away from the stressors
and most of the time we cannot kill the stressor metaphorically or physically.
Why is it that you're saying it's today that we live with this chronic long-term stress?
Why wouldn't our ancestors have just been chronically stressed all the time?
There's really a lot to unpack here.
So first of all, our ancestor had different expectations on their life,
on what is their well-being, if you like, to use a term that probably would not have used to understand.
Probably not a lot of wellness influences back in the Savannah.
Absolutely.
So they would have had different expectation.
They would know exactly how often they would have been able to eat.
And they would know that a lion was always behind the corner.
They would have developed strategy to deal with it.
Also, they would have developed, I guess, acceptance of what the world around there was.
And, you know, this is not dissimilar to a lot of things that have changed over the last 100 years.
There have been plenty of discussion how our attitude toward death, for example, is change in society.
How, you know, 100 years ago, for example, you know, with infant mortality being much higher,
and of course, illness and medical care being much less developed than today,
it was unfortunately a common experience to lose someone in your family, to lose maybe a child,
and there was a different relationship with bereavement and the loss of someone.
I'm just giving you one of, I guess, hundreds of examples of how society has changed even recently.
So we are in a situation now that, if you like, is the worst of possible combination
where we have high expectation that life should be perfect
and everything should go well,
but we have less, if you like, spiritual or kind of philosophical frames
to make sense of what's happening to us.
And we are a society that is more difficult to live with
in terms of, you know, more fragmented.
We don't have a village where we trust, you know,
people who have been living with for our life.
So I think it's a weird combination of a much better quality of life
and a much worse kind of way of dealing with the difficulties that are still here.
I'd love to talk about what happens to us today now that we are living in this long-term stress
and particularly how it affects our health.
So imagine someone is experiencing this like,
low-level, long-term stress.
What symptoms might they notice and what might be going on inside them, perhaps that they're
not even going to be aware of?
We're all different in terms of some people tend to express stress in more in a physical
way, and some people tend to be more mindful of their emotional well-being and reaction.
I think that the minimum of, yeah, I would imagine someone who's going through a really
difficult time. The middle thing would be disrupted sleep, so inability to fall asleep,
maybe ruminating before going to bed about what's happening or waking up earlier in the morning,
again, with the kind of waking up with this concerns. Appetate change. A lot of people
when they're under stress, they stop eating or they eat less, they lose weight, other people eat
more. And sometimes it's like a curvy shift. So I know it, not as a scientist, but a
as a stressed person, that if I'm a little bit stressed, I eat more, but if I'm really stressed,
then I stop eating.
So each of us will have this kind of a curve.
You know, some people only have one style or the other.
So those are both potentially responses to the same underlying stress.
Absolutely.
You know, whatever in a way, whatever works for you or for me at that particular time.
But this is a real physical reaction.
This isn't just all in my mind, a bit the way I was brought up.
Like there's some real physical things that are happening inside me as a result of the stress responses that you were talking about.
Yes, because there's no mind and body and brain separation.
You know, it's all one single entity, if you like, communicating.
And so the high level of cortisol stimulates the brain and may, for example, increase hunger as a way of coping with stress.
The food will have a reward effect.
So the pleasant experience of the sugary or fat will make.
give our brain a feeling of kind of pleasure, which will then relax us, and therefore,
you know, the body relax after that. So it's a continuous communication between mind, body,
and brain. And so you were saying that if I start living with this long-term stress,
like I start to get these physical effects, and that might be disrupted sleep, appetite change.
Is there anything else? Yeah, well, you know, high blood pressure. And stomach pain,
you know, the famous stress gastritis, probably with indigestion or reflux or gastric acidity,
and this again is driven, it's largely driven by actually cortisol effect on the internal layers
of the stomach that the cortisol increased the kind of acidity. And that's why in very acute
situation, people may have, you know, when they're going at severe stress, they may have an acute
gastritis. They may need to kind of go and see a doctor just with that. So these are all kind of
consequence of stress. The inflammation goes up, although we don't feel it as much. However, we do
feel it a little bit because probably the high level of inflammation during stress is what drives
the feeling of fatigue and lack of energy. I can't feel my inflammation directly, but I might feel
like this fatigue, this tiredness, is lack of energy, and that is actually how my brain is
aware that my inflammation is higher. Yes, because you need to remember talking about ancestors
again. So when we have an infection, any type of infection, one of the response of our body
to the high level of inflammation is to shut down. So to kind of reduce our physical activity.
Think about how you felt last time you had flu, you know, those unlucky you had COVID,
how bad it was physically, how tired we felt. And this is because the brain is programmed to
respond to the high level of inflammation by shutting down kind of what we've got.
called the reward system, so the activity that make you sick things that you like, because
really you need to sit down and wait, and absolutely your body keeps all the energy to fight
the infection.
And possibly, from an evolutionary point of view, there's also a principle of kind of social isolation,
a natural social isolation, so we stop moving, we just want to kind of be in bed, we don't
want to social interact as a way of protecting our peers from the infection.
So that's another issue like ancestral mechanism similar to the stress, that it works also in daily life.
And so when we are stressed, the inflammation goes up and the brain perceived that almost like if there is an infection going on.
And so it signaled the body to feeling really tired and stop doing stuff.
Really interesting.
So my stress can trigger inflammation that is the same as if I actually had got a cold or flu.
Absolutely.
Absolutely.
I mean, if you measure it, you see the same levels.
Not as high as having, you know, COVID or sepsis or like a real severe infection, but
definitely as high as having a cold.
So I could measure that.
What would you measure in someone's blood?
We do that every day.
We take the blood.
You can measure what we call cytokines.
So these are chemicals produced by the immune cells, the white cells that are security in our blood.
They kind of send it in the blood to communicate with other immune cells.
there are lymphonols, in our spleen, and they go up.
There's one that we study a lot, it's called Intulogun6.
And it goes up with depression, it goes up with stress, it goes up acutely, with an exam,
but it goes up chronically in people who are, for example, as I said, have major depression.
I think that's amazing.
As I said, I was definitely brought up in this idea that your brain and your body are separate,
keep calm, carry on.
And so the idea that you could feel stress and there would actually be a chemical you could measure in your blood that's changed that is physically affecting you.
You know, there's a pretty big hole in this idea that these are completely separate.
Yes.
And in fact, I would argue that if you completely dissociate from the emotional content, if you like, of your life, the risk is that your body keeps feeling stressed and feel the effect of stress.
However, you're not even aware of it because you're kind of dissociated from the emotional component.
And so he's like, okay, I'm not going to be feeling sad.
I'm not going to be feeling worried about it because it's all in my brain.
But your body will continue to feel sad.
So these are sort of like the short-term impacts.
How serious can this be for our long-term health?
Very serious.
I mean, chronic stress that is so embedded in their life that eventually brings
clinical anxiety, clinical depression,
so, you know, with mental illnesses, for example, to die younger.
because of the ongoing physical effect of the biological changes that happens, the body and in the brain
with high level of stress. As I said, sometimes it's also some of the mechanisms that we use for stress.
So, you know, the change in our eating behavior, the use or abuse of alcohol or smoking or substances.
So it's really true. Like if I'm highly stressed over long term, I'm just going to die earlier.
You're going to die early. Are you going to have a miserable life?
and probably the people living with you will have a miserable life too.
Well, lots of people living with me might say they're having a miserable life,
so that might be true.
You know, stress is an emotional cost.
Stress is a physical cost in the body, but it's an emotional cost as well,
in the way we behave and the way we communicate with other people around us,
including the people that are closer to us.
And so you've mentioned already the fact that if I'm under the stress for a long time,
that will lead likely to weight gain.
We know that obviously that's really bad for your head.
health, you talked about high blood pressure. What about other diseases? And I definitely think that
the sort of heart attacks are the thing that I have, I think all the way back to before I was born,
right? Somehow the 1960s sort of madman, everyone was like, you're going to drop dead of a heart
attack because of your stress. Like, is that not true? No, no, it's true. Because, and again,
these are all the same mechanism kind of focusing on one single, you know, potential kind of
negative episode because the increase in food intake or the high level of cortisol, the stimulation
of more glucose will also increase your lipid in the blood that will increase accumulation
of cholesterol.
And so your blood vessels start to kind of becoming smaller and smaller and smaller, especially
the one in the heart.
The inflammation activate the response of cells they are circulating in the blood.
they make it stickier, so they stick to the blood walls, and a calculation happens,
basically like an accumulation of cells that block the flow of blood in the heart,
and you have a heart attack.
So all of these mechanisms operate in giving all of this different, if you like, negative effect.
Of course, we all come with different predisposition, maybe genetically or, you know,
based on how we, the kind of life we had as a child, or, you know,
the type of nutrition or physical activity or other lifestyle that we have.
Some people may suffer more in the stomach.
Some people may have a heart attack.
Some people may develop diabetes, but they're all downstream negative effect of stress.
And I know that you conduct a lot of research into inflammation and sort of mental health conditions.
And you've already touched on sort of fatigue and lack of energy.
But what is happening in the brain, if anything, as a result?
and does that affect like my mood or anything like that?
Yeah, so we now kind of know that high level of inflammation is present during depression.
It's also present during anxiety and other mental disorders.
But it's certainly important in the kind of the creation or at least some of the symptoms of depression.
The inflammation typically affect the reward system.
I keep going back to the reward system because this area of the brain that allow us to feel pleasure.
And if we don't feel pleasure anymore because this part of the brain got shut down and it
got shut down by the high level of inflammation, then of course, we'll, you know, our life
will become dull and will feel sad and unable to ever feel kind of normal again.
I think one of the things that often personally struggle with is being able to experience a lot
of happiness and I definitely have quite a lot of pressure in my life, but I never thought
about it being related to that. It sounds like you're saying that stress might lead to impact on
my brain that affects my ability to be happy and experience joy, because that's not so obvious.
I can understand the anxiety, but I'm surprised to hear that it would also affect maybe
then being able to even feel these positive emotions. These are all kind of downstream.
if you like, negative effect of something that in the short term is helpful.
So again, if we're going back to the idea that you have an infection,
you really want your brain to concentrate on fighting the infection.
So you just don't want to be seeking pleasure or pleasurable activities.
You don't want to go out.
This again, last hours, days, or, you know, you die because of the infection.
A lot of our ancestors would have done, you know, maybe even until 100 years ago
when the antibiotics were discovered.
Now we have this mechanism that are operating weeks, months, because they're chronic,
and one of the downstream effect of this is certainly the fact that inflammation
reduced the ability of our brain to respond to reward, so to respond to pleasure.
And we know it because if we give the studies that we have not been conducting
in using anti-inflammatory strategies, so literally medication that have been developed for inflammation,
for pain or for autoimmune disorders or inflammatory disorder like arthritis,
use this medication in people with depression.
And we can see that one of the things that lift is this ability to experience pleasure
and the brain areas that respond to pleasure get to work again, if you like.
You can actually sort of scan someone's brain.
And if you reduce the inflammation that comes from the stress,
like parts of their brain are suddenly sort of switching off.
that before was sort of dark and switched off.
Yeah.
That's crazy.
Yeah.
Well, you know, it's kind of trying to understand how we can help people with depression.
I think it's incredibly interesting this link between stress and inflammation and inflammation
and mood and this idea that there's a continuum.
So it's not like you're either clinically depressed or not.
You could have some of that.
I'm also partly think I'm struck because we meet so many other scientists talking about other
things in our modern life that contribute to inflammation.
You know, on this show we talk a lot about phyllis.
food, for example. And so presumably, if I'm eating a modern Western diet and I have some
level of inflammation, if I'm then stressed on top, does that mean my inflammation is therefore
going to go even higher? Well, we know that, for example, part of the inflammation in people
with major depression or other mental disorder is driven by an increase in weight because
the fat tissues is actively producing inflammation.
putting in the blood. Your inflammation makes the body more metabolically responsive. The stress
maybe increase your food intake, which then in the context of increased inflammation will kind
of create more problems from a metabolic point of view, you know, but your body will be more sensitive
to developing cholesterol, a high level of fats in the blood, a high level of sugar, and at the same
time the deposition of fat, increased inflammation. So it's all, unfortunately, they're all kind of
negative cycles kind of potentating each other. Think of a friend or colleague who powers through
deadlines and life challenges on coffee, adrenaline and too little sleep. Perhaps they feel awful
once the pressure lifts. Why not send them this episode? He can help explain when a useful survival
response starts becoming a threat to health, an actionable advice to help balance what to do. I'm sure
they'll thank you.
Let's talk about cortisol a little bit longer because you've mentioned it a lot through
this discussion and I've been struck by that because cortisol has become a bit of an online
buzzword recently, but I've now got one of the world experts.
I'd like to ask you.
So there's a lot of people talking about cortisol face and cortisol belly.
Is there any truth to that?
Can cortisol be causing you to lay down fat in these?
places. As you were saying, cortisol does increase food intake as a way of coping mechanism with
stress. People that have very high level of cortisol, but not because of stress, because of endocline
dysfunction, also tend to put on weight. And unfortunately, we see, for example, who people who take
steroids, which is really they're just kind of a cortisol, exogenous cortisol, the kind of
medication of the mimic cortisol. However, instead of all of that, I think what I don't
like, if you like, of the, or the buzz about cortisol is that somehow it's something that we can
measure or interpret or modify or, I mean, yes, cortisol is important in stress response.
However, you know, is that something that we can manipulate beyond just kind of try to have a kind
of less stressful life? And certainly doesn't help to measure it. And there's nothing, you know,
pharmacologically you can do to reduce.
it unless you take medications that are quite toxic.
So I just think stress is not about measuring your cortisol.
Coping with stress is not about measuring your cortisol.
Coping with stress is about improving the aspect of your life that you can control to make
you more able to deal with stress.
I would love to go to that, but first, I have a specific question that the research team
said, I have to ask.
So apparently, also online, there's a lot of noise about a cortisol cocked
tail that can allegedly reduce your cortisol levels.
So they've told you you're going to get cortisol face and cortisol belly.
And I just love to tell you what's in it.
So you can tell us all whether it's going to work.
Apparently it's orange juice, coconut water, salt, and potassium or magnesium powders.
Is this going to fix my cortisol?
To me, it doesn't ring any bell.
Because I cannot link any of this compound or things in the cocktail to anything
that particularly would affect cortisol.
this all level. So for those of you who've been taking your cortisol cocktail, we recommend you
stop. I'd love to talk about, you know, what we can do? But can I even start maybe with like
my aim? Should I be aiming to have no stress in my life? It's impossible. It may be actually
that that's the reason why we feel so stressed is because we are expectations that we should have a
stress-free life. And and so it's a continuous disappointment.
when we are stressed or when we feel stressed, hence the guilt, you know, because maybe we're doing
something wrong because we should not be feeling stress. So this is completely the wrong way around
or looking at it. The correct way is like life is difficult. Stress will be behind the corner
every moment and I need to learn how to cope with it. Avoiding it will only make it worse.
So don't try and avoid it.
Life is difficult.
Let's learn how to cope with it.
So could you talk to us now about whether there are any evidence-based things we can do
to handle this stress that inevitably comes our way?
Plenty of strategies.
The first thing to remember is that stress is particularly bad,
or is perceived as particularly bad when it is what we call uncontrollable stress.
or something on which we feel, we don't have any control.
If I come to this podcast because I want to do it and I really enjoyed the idea,
this would be a rewarding experience for me.
If someone obliged me to come to a podcast that I hate, because I hate to be talking in front of a microphone,
this would be highly stressful.
And if I cannot say no to that request, it would feel even more stressful.
So the first question we need to ask to ourselves is how much control do I have on the situation that makes me feel really stressed?
And sometimes control is about choices.
That's the most important strategy of having control on what you feel of stressful.
But you need to start by doing an analysis of the situation.
What can you control?
And maybe you cannot change your job, but you can.
maybe work less, or you can use better the hours that you're not working so that you're kind
of compensating your quality of life.
It's a balance.
So if you cannot reduce, objectively reduce stress level, maybe you can increase the positive
aspect in your life.
And so focus more on the positive aspect, gives more time and more attention to the positive
things in your life.
Things like spending quality time with family, friends, your hobbies, your passion,
We tend to think of the pleasurable side of life as the weak one, as in I don't need that.
You know, I want to become a very famous professor that I don't need to spend time reading books or, you know, or walking in the woods.
But these are essential activity for our well-being.
Whatever it is that is important for you, traveling, you know, walking, they generally do reduce level of stress.
And we recently did some work using singing groups for mother that were suffering from postnatal depression.
And we measured literally from before the singing session, one hour singing session, to the end of the singing session, a reduction in cortisol and inflammation.
And this is just one thing that we have been doing.
There are hundreds of other studies like this.
The same is for walking in the green areas, dedicate time to culture, art, creativity, but also,
you know, spending time with friends,
having a social network, social support.
And, you know, just next to it is the spiritual element,
which, again, it doesn't mean that you have to have a religion
or have to have a religious group or a spiritual, official spiritual, if you like, attitude.
However, things that will feed your soul, if you like, or feed your mind
will really help you with the stress.
I'm really interested that the first thing that you've gone to is not some sort of meditation,
but you've gone straight to both having some control over work and some time with friends and family.
That's because you feel these are the biggest things you can do to really...
Yes, and of course, the more personal lifestyle choices that will help you.
I mean, physical exercise, whatever helps you maintain a kind of physical activity and a healthy,
your body would benefit from movement, from physical fatigue.
Could you tell us a bit more about that?
Because I think from my own experience,
I started doing the gym about a decade ago.
And it was driven by like a physical issue.
I was having some pain.
And then I think supported by the things I was learning sort of through Zoe
about how good it was for my long-term health
to be doing exercise and resistance training, things like that.
But interestingly, I now think about it as being an essential part of sort of managing my mental health.
And, you know, my job is quite stressful.
Like, I think lots of people listening to this.
And I've started to think about, like, doing that exercise regularly through the week as something that helps me cope mentally.
But I have no idea if there's anything real in that or it's just sort of.
There is.
There is.
And, you know, again, there's so, in this context.
complex mind, body, brain.
Exercise does so many things because you can measure inflammation in the blood,
and actually we know that physical exercise is anti-inflammatory.
Recent research showing that the muscles actually doing exercise produce chemicals
that are against inflammation.
But also, exercise gives a feeling of reward and satisfaction with yourself,
because of course if there is one thing that you can get better,
art is exercise, whatever it's going to be, because you learn the skills, the technique,
your body gets more used to it, whatever it is. There are so many elements that are positive
about having a like a regular rewarding physical activity, both from a body point of view and from a
mental point of view. And I do a lot of physical exercise and certainly help me with coping
with stress a lot. So the exercise really does have an effect on stress. It does. You need to,
enjoy it or at the beginning where you don't enjoy it, push it until you start enjoying it.
It doesn't come with the first time you go to the gym. I'm sure you had the same,
exactly the same. Honestly, it took me years to start to enjoy it. And as I said for years,
oh, I don't get any pleasure out of it. It's actually not true anymore. Like, I do actually
get pleasure from it now. I did not grow up doing lots of exercise at all. So it's normal
that it might take quite a while. Yes. It's different to where, you know, in, in, in, in,
in some kind of team playing something when we were kids,
so we're always used to it.
I think for people like, I guess, you and me as well,
that we're not very sporty children.
It does time.
It does require time.
But I'm now at my fittest level.
I've never been as fittest now, and I'm 60.
Well, you don't look 60, so it's definitely working well.
When we talk about exercise, what do you need to do?
Do you need to be lifting weights or going for a,
run to be doing like this exercise is going to help with your stress?
I think the most important thing is doing something that you really like,
that increase your heart rate a little bit so that you feel, you need to feel tired after
it. You need to feel fatigue while you're doing it. You know, you need to push it yourself a little
bit. Could a long walk, for example? Yes, long walk also works. It's always beneficial because
you tend to focus on the repetitiveness of the stepping and there's a little bit of kind of creates
a little bit of meditation even if you don't want to do it.
What about diet and how it can affect stress? And if I'd said that to you 10 years ago,
I'd been like, that's mad to think that diet could have any impact on stress. But I've
definitely been reassessing that myself. What does the science say?
I'll never forget the moment that everything shifted for me. I was at a public talk on
nutrition. Listen to a speaker explained that my gut had trillions of microbes in it and that these
bugs shaped every aspect of my health. That speaker was Professor Tim Specter, one of the world's
top 100 scientists who became my co-founder here at Zoe. Nine years later, Zoe runs the world's
largest gut health research study. And the conclusion is simple. Gut health is health. How you feel
your long-term health and your digestion are all shaped by the state of your gut. As a listener to
this show, you know how important it is to feed your good gut bugs. But I suspect that like me,
you have a busy schedule, and often you feel you haven't given them all the different plants they crave.
And that's exactly why we created Daily 30.
It's a gut health supplement packed with over 30 plants that you sprinkle onto any meal.
It tastes great, adds a satisfying crunch, and gives your gut the diversity it craves.
Finally, a healthy, happy that's easy to stick to.
I should know, I take it every day.
And because we're Zoe, we don't just guess.
We test.
We put our original Daily 30 formula through a randomized controlled trial, the gold standard of testing.
The results blew us away and proved it supports your digestive.
digestion, energy and gut health. That trial helped us develop the formula we have today. Today,
Daily 30 is a non-negotiable daily habit for me. So don't put your health off for the future.
Go to zoe.com slash daily 30 and try it today. The best evidence is on things like fish,
rich diets and after that, a little bit less evidence, but promising, if you like evidence,
fruit and vegetables. And these are coming from largely,
studies at a population level
of cultural group that have a diet
that is particularly rich in fish
or vegetable or fruit or both
or kind of combination
they tend to have overall as a population
lower level of depression or lower level
of mental disorders.
It is possible that you need
a lot if you like to actually
have a therapeutic effect or a preventative
effect. So we're talking about kind of
eating fish twice a week
or having lots of fruit and vegetables
every day. I think
Again, even just having some kind of control in avoiding the bad food, not in a way that it kind
of deprives us of the pleasure of chocolate, but at least having a feeling of control that
we can actually, we can decrease the sugar intake, we can decrease the fat intake.
You know, feeling of control is always good for our mental health, partly because it has
a really positive effect.
One thing you haven't really mentioned that I would definitely like to ask about is alcohol,
because I am sure there are a lot of people listening to this podcast who say, you know, I know what I do.
I've had a really tough day.
I get home, maybe I've finally got the kids to bed and have that wonderful noise when you take the cork out of a bottle of wine,
and you're going to pour a glass of wine and you're going to drink it.
And I feel like my stress just falls straight after this alcoholic drink.
Does alcohol reduce my stress?
I guess is the first question in the short term?
No.
I mean, it reduced literally for.
like the 10 minutes, half an hour that you're drinking, and you're under the effect.
I would argue that actually if you feel that is actually reducing your stress a lot while
you're drinking, you're probably drinking too much.
It's ennumbing it and then usually gets worse after.
I mean, partly alcohol increased cortisol.
People with alcohol problem, they have sky high level of cortisol.
They increase inflammation terribly.
So people with alcohol dependence and alcohol abuse, they have high level cortisol and high,
high level of inflammation.
So physiologically, it does everything that you don't want to do because it activates stress
response.
I still think it's nice to have a glass of wine or I'll share a bottle of wine, you know,
with friends at the end of a difficult day.
But I think that if you start, if you're using it to numb yourself, then A is only going to
be very temporarily and B is going to get worse the day after.
These are all dysfunctional coping mechanisms.
or they become dysfunction at some point.
We all enjoy, you know, social media or spending time, you know, scrolling or spending time
on the internet, it could be pleasurable, interesting, and then it becomes numbing because
we are so entrenched into, you know, the moment.
Well, I love that you've talked about phones because I did want to ask because it feels
like there's this growing evidence that they might actually be harmful for us.
a lot of people take out the phone almost as a sort of way to de-stress,
but is it in fact making us more stressed?
It depends what we're doing it.
I suspect most of us, that includes me.
We're doing it because at the moment we don't want to think
of what is worrying us or we don't want to feel the emotion that we are feeling.
Am I saying that people should not have 10 minutes of kind of relief by looking on a mobile phone?
Of course not, the same way that people could have the glass of wine.
if it's becoming, you know, being drunk every night or not interacting with your family or
with your friends because you're constantly on your phone, that you need to ask yourself,
what am I avoiding in my mind by putting all my attention, you know, on the glass or on the
phone or whatever it is. The principle of wanted to use all of these strategies, whatever works
for us, to number our emotions, are the same across all of this. So we need to try to understand
how are we using it and we're using it in a healthy way, this acceptable, are we using in an unhealthy way?
Whatever it is that we're using.
So these aren't fundamentally going to help with my stress, whereas then you're talking about these other things, like time with my friends and family, actually trying to understand my stress and see if I can have more control over it.
You know, exercise, these things can actually reduce my stress genuinely and therefore lead to a sort of long-term improvement in how I feel and my health.
Exactly, because these things are doing it without numbing us.
So they are strategies that help us to cope with stress while being present to our stress,
while the negative coping strategies, if you like, are the ones that numbing the stress,
but they're not helping us finding a solution or finding a way of dealing with it.
When I'm stressed, I find it really hard to sleep, but then being tired, I think makes me feel more stressed.
and it's a sort of vicious cycle.
How much should I worry about this?
And is there anything I can do?
So I think most of the time, a kind of compassionate waiting,
accepting this is a difficult time,
accepting that there will be some difficult night for sleeping,
and try to minimize things that are disrupting us,
you know, again, screen time,
try to go to bed always at the same time, not too late,
reading maybe or whatever we feel that is distracting,
reading a book,
or whatever help us kind of relaxing, that's probably the best strategy.
Once it becomes a problem that you cannot work or, you know, it goes beyond just the discomfort
or not sleeping, then that's when you need to ask professional advice or help.
And of course, there are more kind of more specific psychological intervention.
You can do it.
I'm not saying that people should take medication for sleeping problem.
And certainly when they do, they usually recommend it only for like a, you know, a week.
Or so, just to go through the acute phase.
Final question.
If someone listening to this podcast right now is feeling really stressed,
what's the first thing that you would recommend that they do?
Talk about it to a close person, a friend, a relative, partner.
Don't keep it inside.
Talk about it.
Start with that.
Kami, I really enjoyed that.
I would like to do a little summary.
I mean, the first thing that springs my mind, actually,
is this thing about alcohol, that it actually increases my cortisol.
And so it doesn't actually reduce my stress.
It just sort of numbs me to it.
Yes.
I think the big thing I took away, though, is, you know, stress is natural.
Don't feel guilty about it.
Life is difficult.
So you're going to have stress in your life.
And therefore, you're going to cope better with it just by knowing that.
But we also have to recognize that having long,
term stress is bad for us because it increased this cortisol encourages us to eat high fat and high
sugar food more than we need. It encourages us to drink alcohol and smoking, all these sorts of things.
It is this very deep system within us. And so you describe brilliantly like what happens if I saw
a tiger in the distance, but it's the same thing. Maybe if I'm running late for my meeting,
this sympathetic nervous system is being turned on. My heart beats fast and my blood pressure goes up.
You know, my blood goes to muscles, all of this stuff about like being ready to fight or flee,
which obviously makes no sense for a meeting, but it's all being switched on.
My immune system is being turned on, and this is turning on my inflammation to get ready
because it thinks I'm going to get injured.
And it kicks in this cortisol, which you described as being like this really key drug that's having a big impact on me.
And also does some funny things like, you know, switches off the blood flow to my stomach,
which helps to explain also why, you know, so many people feel like these gut problems,
related to their anxiety.
This is all completely natural and we shouldn't feel worried that we get this short, sharp
stress from time to time.
The problem is that in our modern life, we tend to live with chronic stress.
It doesn't get switched off properly and it just sort of stays turned on.
That is a problem.
Over months and years.
And what you describe is it disrupts our sleep.
You know, it causes appetite, changes in stomach pains.
It increases our inflammation, which is a really big.
big problem, that leads to fatigue and low energy, it increases our cortisol as that increases
how much we eat.
So we put on weight.
It leads to a risk of diabetes, heart disease, but ultimately all of this together means
we're going to die younger.
So that's a pretty serious physical risk.
But interestingly, there's a real mental side to this as well, not just the fatigue, but
you said you can end up feeling more sadness and an inability to feel pleasure.
So, like, it's not just a long-term thing.
It's like really going to affect how we feel.
But the good news is it's not like there's nothing we can do about stress.
You said, spend time with your friends and family, understand what the stress is that's causing this deep ongoing thing.
And even just thinking about it, you may feel like I have more control, maybe not to remove all of that stress, but to think about what else you're doing in your life.
You know, maybe you've got to keep the job, but you can just change a bit the rest of what you're doing to feel like you have more control over it.
exercise is genuinely anti-inflammatory.
So try and add exercise into your life.
It doesn't have to be like lifting weights or running.
Actually, if you can do like a long walk that you feel tired about afterwards, that could really
be reducing your cortisol and reducing this stress.
Even better, like it's getting you out into nature, which you're describing as really
beneficial for this.
Be aware of dysfunctional behaviours that are numbing this.
And so you talk quite a bit about the phone, for example.
It's not really reducing your stress.
It's sort of numbing you from the underlying issue.
So it's not triggering these positive sort of biological systems that are sort of reducing the cortisol, you know, like the alcohol.
And then maybe the final thing that I took away is try to accept that life can be difficult.
You know, that maybe the biggest difference between us living in 2026 and our ancestors is our ancestors just assumed that life would be difficult.
and therefore actually they didn't have chronic stress because they're just like, well, this is normal,
whereas we feel everything should be easy and perfect and therefore constantly stressed because life isn't
matching that, but this isn't real. And if we can come to terms with the fact that life can be
difficult, weirdly, we might feel more relaxed. Absolutely. It's the principle of acceptance,
accepting the difficulties that we will encounter. It's just part of life.
