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Feelings linked to stress are a “warning to take stock and think about how to take care of yourself”

Everyday Health’s conversation with longtime Ohio State researcher Janice Kiecolt-Glaser

The Q and A below with Janice Kiecolt-Glaser, director of the Institute for Behavioral Medicine Research at The Ohio State University, is published here with permission from Everyday Health. Kiecolt-Glaser is a member of the Wellness Advisory Board of 12 national experts in behavioral medicine, neuroendocrinology, mind-body studies, psychology and sociology who are participating in Everyday Health’s United States of Stress special report. 

Kiecolt-Glaser is an elected member of the National Academy of Sciences Institute of Medicine and has authored more than 200 articles, chapters and books on subjects related to psychoneuroimmunology. Her research has shown that chronic stress can slow wound healing, enhance susceptibility to infectious illness, boost allergy symptoms and reactivate latent viruses. 

What are you working on now?

One segment of my current research focuses on the ways in which stress and depression alter metabolic responses to meals. An initial study showed that women who had experienced more recent stressors burned fewer calories after a fast-food type meal, and also had both lower fat oxidation and higher insulin levels compared with women with fewer stressors. Burning fewer calories leads to weight gain. People with lower fat oxidation are also more likely to gain weight by storing fat than those with higher fat oxidation, so their risk for obesity is increased. Higher levels of insulin foster fat storage. These adverse changes would all promote obesity.

This study also showed that depression substantially augments triglyceride responses to high saturated fat meals in ways that promote heart disease. Depression has well-established effects on heart disease morbidity and mortality, and these meal-related changes highlighted a previously unrecognized depression-sensitive pathway.

During stressful times, many people turn to calorie-dense, high-fat “comfort” food. While the influence of acute or chronic stress and depression on food choice is well-established, this novel data suggests that stress and depression affect metabolic responses to these meals.

A longitudinal study in my lab is now addressing how these metabolic responses affect coronary artery calcification — which can lead to increased risk of atherosclerosis, coronary heart disease and other conditions — as well as weight change in breast cancer survivors.

Another segment of my current research focuses on how physical fitness affects inflammation, a robust and reliable predictor of all-cause mortality in older adults. Chronic inflammation signals a heightened risk for disability and mortality even in the absence of clinical disease. Although inflammation rises with age, active individuals have lower levels of inflammation than those who are more sedentary. Indeed, when fitness is assessed objectively by maximal exercise testing, poorer physical fitness is clearly associated with higher inflammation.

An immune challenge provides a useful paradigm for studying an individual's ability to limit the daily inflammatory responses that occur in response to infection or tissue injury. For this reason, another of my studies uses a typhoid vaccine as a peripheral immune stimulus to assess the magnitude and kinetics of a transient inflammatory response and associated behavioral changes that are associated with heightened inflammation — depressive symptoms, fatigue, cognitive problems, and increased pain sensitivity.

My colleagues and I are addressing a novel question: Does poorer physical fitness heighten the magnitude and duration of inflammatory responses to immune challenges, as well as magnify maladaptive behavioral responses?

This study will improve our understanding of how physical fitness influences inflammation along with adverse inflammation-associated behavioral changes, including negative mood, fatigue, increased pain sensitivity and cognitive deficits. This project will provide insight into the pathways through which regular exercise produces its substantial health benefits.

A newer study in married couples ages 40 and older addresses how the gut microbiota — the collection of microbes associated with the human digestive tract — and molecular markers of aging are related to the couple’s relationship and health. A recent publication from my lab showed that marital distress was associated with a “leaky gut,” in which the intestine’s lining becomes permeable, allowing bacteria to leak into the blood stream. The heightened inflammation that follows is the immune system’s response to the leaky gut.

In our lives, when we’re stressed, we are likely to sleep more poorly, make poor dietary choices, exercise less, drink and smoke more, and spend less time with friends and family, all of which fuel stress in turn. So the broad solution is better recognition of those early stress signals, to stop the train before it leaves the station.
Janice Kiecolt-Glaser

From your own research or that of others, what have you learned about stress that you didn’t know or that surprised you?

I have been increasingly impressed by the many ways that acute or chronic stress can affect our physiology. In the early years of our research in the 1980s, there was skepticism among many researchers and clinicians about the actual health relevance of stress. We initially showed that stress could impair the ability to develop and maintain protective antibody responses following vaccinations, with larger effects in older adults. Subsequently, we also showed that stress substantially slows wound healing, which has clear implications for surgery.

In the first part of this century, we began examining the effect of stress on inflammation and found that stress could, indeed, boost inflammation, both short-term and long-term.

Following the lovely work by Elissa Epel and Elizabeth Blackburn, we showed that caregiving stress — that is, the body’s response to the demands of caregiving for, say, a chronically ill family member — could shorten telomeres. Why does this matter? Blackburn, who won a Nobel Prize for her telomere research, described them as the protective caps at the end of the shoelaces we call chromosomes, which carry your genetic material. Telomeres wear down and shorten as we age, leaving chromosomes unprotected and our bodies susceptible to all kinds of diseases. Over the course of our lives, the rate of change of that telomere shortening depends in part on how well we take care of ourselves. And yes, that means exercising regularly, getting adequate sleep, eating healthfully and managing stress in our lives. Through telomeres we see that chronic stress measurably affects us on a cellular level, causing us to age.

Most recently I was amazed to find that stress alters metabolic responses to fast-food-type meals. In each case, the novel data increasingly pointed to the broad importance of chronic stress to health and well-being.

What stresses you out, and how do you manage the stressors in your life?

Losing my husband to Alzheimer’s has been extremely difficult. Strong friendships, exercise, mindfulness meditation and joy in my work all help me to manage stress.

We all need to be better informed about stress. In a sentence, what should we know to increase our stress IQ?

Think about stress as feeling overloaded, out of control, unable to cope; those kinds of feelings are a red flag, a warning to take stock and think about how to take care of yourself. The issue is that we often have blinders on precisely when we experience those kinds of feelings, and we ignore the danger signals.

What’s the one recommendation you would make to help people 1) lower their daily stress levels, and 2) function better in the midst of a stressful situation, incident, or moment?

There is no easy quick fix. The problem is that stress is a little like an avalanche: It starts at the top of the mountain when something breaks off (something stressful happens in our lives). Barreling down the mountain, it not only gains momentum, it also gains mass as it keeps destroying things in its path that become part of it, a monster feeding on itself.

In our lives, when we’re stressed, we are likely to sleep more poorly, make poor dietary choices, exercise less, drink and smoke more, and spend less time with friends and family, all of which fuel stress in turn. So the broad solution is better recognition of those early stress signals, to stop the train before it leaves the station.

Personally, I am finding that mindfulness meditation is very useful, but it is certainly not a quick or easy fix: It requires dedicated practice.

Why did you become involved in research related to stress?

It seemed like an interesting topic years ago. I was particularly intrigued by the research about how close personal relationships were such an important buffer against stress, a topic that still fascinates me today. Being socially isolated and lonely can literally be a killer.

Have you ever experienced a meltdown? If so, where and why?

No real meltdowns, but surely some very difficult times.