Stress, diet and heart disease

By Chloe Steele, our Heart Health Club Nutritionist. 

Heart disease and disorders of the brain are among the leading causes of death in Australia, and recent research has started to find some intriguing links between the two. It has been observed that people suffering from anxiety, posttraumatic stress disorder, and major depressive disorder have an increased risk for heart disease and it has been suggested that the disorders may be involved in the development of one another 1,2.

Whilst there could be many reasons for the underlying link, one major contributor has been shown to be a hormone called cortisol which is produced when the body is under stress. If this is made for a long period of time, such as in times of chronic stress, it can increase cholesterol, fats and sugar in the blood and raise blood pressure, all of which can contribute to the development of heart disease 3,4.

In addition to increasing cortisol production, stress can activate the sympathetic nervous system, which in turn leads to the production of chemical messengers known as catecholamines. These are responsible for the fight or flight response, which is a vital reaction when we come under a perceived harmful event, attack, or threat to survival. However, the continued production of these neurotransmitters can be detrimental to our health as they can cause inflammation, metabolic abnormalities, blood vessel dysfunction and blood sugar dysregulation, all of which contribute to heart disease 5,6.

As well as influencing biological changes, stress has been shown to influence what we eat, making us crave energy dense, sweet, and fatty foods, which can contribute to weight gain and increase the risk of heart disease. This behaviour is especially pronounced in men 7.

Although biological and behavioural changes occur when under stress, these are not irreversible and there are a few steps that you can take to help ensure stress does not contribute to the development of heart disease.

Participate in activities proven to help relieve stress.

Stress relief is the first step to ensure that it is not contributing to your risk or exacerbating the advancement of heart disease. Yoga, meditation and seeking professional support when things are getting on top of you are all great ways that can help.

Engage mindful eating

Stress eating can be overcome and practicing mindful eating is a great way to break the cycle of bad food choices. To do this, you need to be able to differentiate between emotional and physical hunger. Stress driven hunger comes on suddenly, craves high energy foods, isn’t satisfied when you are full and triggers feelings of guilt or shame. Physical hunger is gradual, can be satisfied by a variety of foods, stops when you are full and does not induce negative emotions. If you notice that you are stress eating, then pause and reflect as to why you may be craving a certain food and give yourself the opportunity to make a different decision. Sometimes the craving will overcome your better judgement and in this instance it is important to understand that you are only human and not give yourself a hard time, as this can perpetuate the problem.

Avoid buying energy dense processed foods

If you tend to buy energy dense processed foods when you are doing your regular shop, then they are more accessible when a stress related craving hits. These foods bought at a supermarket also tend to come in bulk, which means they are more likely to be eaten all at once. As an alternative, fill your kitchen with fruits and vegetables, which you know contain the nutrients needed to protect the heart. If you know you head for the kitchen when you’re feeling stressed, having healthy snacks prepped and ready to grab will help avoid temptation.

Be kind to yourself

Stress is an inevitable part of life so it’s important to be kind to yourself. Try to embrace moments of calm, prioritise self-care and know that when life gets stressful that this too shall pass.

References:

  1. De Hert M, Correll CU, Bobes J, et al. Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World Psychiatry. 2011;10(1):52-77. doi:10.1002/j.2051-5545.2011.tb00014.x
  2. Correll CU, Solmi M, Veronese N, et al. Prevalence, incidence and mortality from cardiovascular disease in patients with pooled and specific severe mental illness: a large-scale meta-analysis of 3,211,768 patients and 113,383,368 controls. World Psychiatry. 2017;16(2):163-180. doi:10.1002/wps.20420
  3. Fraser R, Ingram MC, Anderson NH, Morrison C, Davies E, Connell JMC. Cortisol Effects on Body Mass, Blood Pressure, and Cholesterol in the General Population. Hypertension. 1999;33:1364-1369.
  4. Quinkler M, Stewart PM. Hypertension and the cortisol-cortisone shuttle. J Clin Endocrinol Metab. 2003;88(6):2384-2392. doi:10.1210/jc.2003-030138
  5. Kaaja RJ, Pöyhönen-Alho MK. Insulin resistance and sympathetic overactivity in women. J Hypertens. 2006;24(1):131-141. doi:10.1097/01.hjh.0000194121.19851.e5
  6. Sher LD, Geddie H, Olivier L, et al. Chronic stress and endothelial dysfunction: Mechanisms, experimental challenges, and the way ahead. Am J Physiol – Hear Circ Physiol. 2020;319(2):H488-H506. doi:10.1152/ajpheart.00244.2020
  7. Torres SJ, Nowson CA. Relationship between stress, eating behavior, and obesity. Nutrition. 2007;23(11-12):887-894. doi:10.1016/j.nut.2007.08.008