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Stress Less; More Rest & Digest by Sophie Knapp, MScN

April 02, 2022

Stress Less; More Rest & Digest by Sophie Knapp, MScN
Ironically, as I take a seat to write about stress, the fight, flight, or freeze feels are bubbling up because it’s such a wide-reaching and important topic; it’s a bit overwhelming to tackle! However, chronic stress is a major issue in our modern times, and since April is National Stress Awareness Month, let’s take the opportunity to dive into how it robs you of vitality and what you can do to restore your life force.
 
What does stress look like in the body?
Our stress response is regulated by a series of organs & hormones that make up the hypothalamic-pituitary axis, commonly referred to as the HPA axis. It consists of the hypothalamus, a pea-sized gland located near the middle of the underside of your brain, the pituitary gland, which resides just below the hypothalamus, the adrenal glands that reside on top of your kidneys, hormones, & all the tissues those hormones target like muscles, immune cells, & fat cells just to name a few.
Depiction of the basic anatomy of the HPA axis.
The HPA axis is the connection between your nervous system and your hormone systems meaning its function affects your levels of cortisol, sex hormone, thyroid hormone, growth hormone, and more. These hormones are responsible for so many critical functions like making you feel energized & helping you build & maintain muscle & bone mass.
 
Stress is the trigger that activates the HPA axis, putting us in fight or flight mode. A bit of “eustress” or healthy stress on a daily basis is beneficial for us. The surge of norepinephrine stimulated by eustress creates a sense of euphoria & well-being while also generating feelings of motivation. Simultaneously, it mobilizes energy in the body, fueling us so that we can enthusiastically carry out our lives. A “regulated” or “healthy” HPA axis responds to stress by sending signals down the line of involved organs to release hormones that elicit these feelings. Now, this part is key: within 20 minutes of the source of stress disappearing, a healthy HPA axis shuts off, & that flood of hormones is dammed back up allowing us to re-enter rest & digest.
 
The sad news is that many of us are living with chronically elevated stress levels that cause our HPA axes to be indefinitely stuck in fight or flight mode meaning they never shut off. This is the distinction between eustress & unhealthy, chronic stress.
 
In many ways, constant fight or flight isn’t our fault. Mainstream western culture praises busyness. In our modern ways of living, many of us are in constant “go-mode,” embodying a nonstop sense of urgency to show up for life’s myriad demands ranging from our work-life obligations to those that come with running a household to just doing all the things you’re interested in doing! Because busyness is the norm, it can be really hard to “unstuck yourself” from fight or flight so that your body, mind, & soul can find some peace & relief in rest & digest mode.
 
Constant fight or flight & dis-ease:
Anxiety, depression, consistent fatigue coupled with the inability to sleep, unwanted weight gain (especially around the midsection), low libido, irritability, difficulty focusing, & poor digestion are just a few of the most common symptoms folks with HPA axis dysfunction complain of when they seek guidance from their healthcare practitioner(s).
 
As a nutritionist, when I see clients with chronically heightened stress, & it’s very common, I hone in on how it affects their digestion for a few reasons. Although all of the aforementioned symptoms could be related to dysfunction outside of the gut & deserve attention, stress first & foremost inhibits your ability to digest your food & absorb nutrients. This occurs because by & large, your body exists either in fight or flight or in rest & digest.
If you’re stuck in fight or flight, then you can’t rest & digest.
 
Without healthy digestion, the body struggles to break down food & absorb nutrients. Over time, this malabsorption can lead to nutrient deficiencies associated with common HPA axis dysfunction symptoms, & the consequences of this are exacerbated by the fact that being in a stressed state depletes the body of many nutrients like protein & magnesium. By focusing on correcting digestion, a majority of people’s symptoms usually resolve because their bodies are able to get the nutrients they need to carry out normal functions & heal.
 
Before getting into how to fix the dysfunction, let’s dive deeper into how impaired digestion can cause trouble.
The gut-brain connection:
You may have heard of the gut-brain connection, & perhaps you’ve heard of the nerve responsible for connecting the two, the vagus nerve. This massive nerve is deemed “The Great Wanderer” as it’s a neural giant that originates in your brain & wanders far & wide, down into the abdomen to innervate your entire gut! It’s in charge of telling your stomach, liver, gallbladder, pancreas, all 6 feet of your large intestine, & all 22 feet of your small intestine what to do. It’s responsible for communicating to your stomach that it should churn your food, that your pancreas needs to release its digestive juices & enzymes, & that your intestines need to contract to keep the food you eat movin’ & groovin’ at an optimal rate through your system.
Got a guess as to what the vagus nerve does when you’re in fight or flight?
The answer is, pretty much nothing.
 
The vagus nerve can only be active when you’re calm or in that rest & digest state. In other words, this is why when you’re stressed, you don’t digest because the vagus nerve is being inhibited from firing. When you don’t digest, a series of issues arise that ultimately lead to an inflammatory state in your gut & systemic tissues.
 
Let’s break that down. When stress hits, your vagus nerve shuts off, immediately affecting digestion in two ways: it can either stop all movement in the gut (constipation) or cause a huge, ongoing movement (diarrhea). Let’s start with what happens when constipation is the body’s reaction.
 
Going number two is your body’s main way of removing metabolic waste, making it one of your most important daily detox functions. Detox is how your body gets things that aren’t supposed to be in there out. If detoxification isn’t humming along at a fast enough rate, then the body has to activate the immune system to clean up the mess. The immune system is able to do its work by instigating an inflammatory process. Under acute circumstances, this inflammation is exactly what’s needed to clear out unwanted waste products, but when the trigger for immune activity doesn’t cease because the stress hasn’t ceased, it creates a state of ongoing, low-grade inflammation, a process that’s widely recognized as the basis for most all chronic diseases.
 
Additionally, constipation leads to imbalances in the microbiome. If your bowels aren’t being told to contract by the vagus nerve, then food can remain stagnant in the GI tract. Now, recall that it’s not just your digestive juices that break down your food, it’s also all your teeny tiny microbial friends that make up your microbiome & live all throughout your digestive tract helping you metabolize food too. Those microbes eat the food that you eat. It’s mutually beneficial for you & them. They’re nourished by your food, & you benefit from them helping you break foodstuffs down. In fact, the end products that are made from microbes eating our food (so really microbial poop) are essential for maintaining health!
 
However, too much of a good thing is a problem. Because food isn’t moving through your intestines, microbes have more time than usual to chow down, & when they’re left to feast like this, they’re able to replicate faster, allowing their populations to grow, often to the point of overgrowth.
 
More microbes don’t sound like a problem, right? These are your friends after all, but when you consider that there’s inflammation being triggered by the lack of detoxification via defecation, this overgrowth can really lead to trouble.
 
The inflammation causes issues with the integrity of your gut, which is another way of saying that your GI tract (mainly the small intestines) can become “leaky.” The cells that line your intestines are normally connected by proteins called tight junctions. Like a lineup of linked hands on a strong team in a game of Red Rover prevents members of the opposing team from breaking through, when digestion & the microbiome are healthy, tight junctions are like gorilla-gripped hands linking the cells that line your gut, keeping even the burliest of foodstuffs on the inside of your food tube from breaking through to the outside.
Cartoon of the line-up of cells that lines the GI tract. The left side shows heathy tight junctions that prevent food from exiting the intestines, & the right side shows how when tight junctions break down, foodstuffs, microbes, immune cells, & more are able to leak out into the body where they are taken up by lymph & blood vessels.
However, when digestion & the microbiome aren’t optimal, it’s common for these tight junctions to degrade, disconnecting the wall of cells that lines your gut. It’s like a Red Rover team just let go of each other’s hands, allowing all the members of the other team to run straight between them to the other side of their line-up.
 
When tight junctions break down like this, it’s termed leaky gut or intestinal permeability because without solid tight junctions, the contents of the intestines, undigested foodstuffs, microbes, enzymes, etc, are able to leak out of the gut & into parts of the body where they don’t belong. In order to clean up the leaked contents, the body has to utilize the immune system, which could lead to systemic inflammation.
 
Symptoms associated with a permeable gut include brain fog (difficulty concentrating, feeling like you’re in a haze, trouble with cognition & memory), joint pain, skin rashes, acne, depression, menstrual cycle disturbances, & more. These symptoms manifest as a result of a number of complications associated with leaky gut like inflammation, nutrient malabsorption, & hormone disruption.
 
If you’d like a deeper dive into the microbiome, check out this other post on my blog.

Don’t worry, there's tons you can do to relieve stress:

 
Eating changes to manage stress:
Chronic stress depletes the body of a number of nutrients. Intentionally increasing your intake of these nutrients via eating changes or supplementation during times of heightened stress can help prevent deficiencies.
 
Nutrients to increase during periods of heightened stress:
Protein:
If you’re a meat-eater, upping your protein is easier to achieve by adding a serving or two per day to your intake. If you’re a plant-based protein consumer, consider adding a simple protein shake that contains fat, fiber, & plant-derived protein powder to help increase your consumption. Aiming for 20-50grams of additional protein/day can help offset the added demand for protein that stress puts on the body. Increase your intake in proportion to your baseline daily consumption goal.
 
Magnesium:
Though nuts, dark chocolate, dark leafy greens, whole grains, & legumes are good providers of magnesium, it’s a challenge to achieve the necessary extra intake level. It’s worth considering supplementing this nutrient during stressful periods.
 
If you decide to take a magnesium supplement, be intentional about which form you take, & base it on your bowel patterns.
 
If you’re someone who tends toward constipation, magnesium citrate or oxide will help increase your magnesium intake and also help to stimulate bowel movements. Thinking back to how pooping every day helps you detox & prevent bacterial overgrowth & low-grade inflammation, getting a BM assist will help you out in that way too. If you’re someone who tends toward loose stool, then magnesium citrate & oxide will likely make food move through you too quickly, which can also lead to dysbiosis of the microbiomes & subsequent inflammation. You’ll want to seek out magnesium glycinate. Feel free to take your optimal form of magnesium liberally, supplementing the full daily value even if you’re also consuming food sources of it.
 
B vitamins:
When I think of Bs, I think of foliage! Aim to eat lots of fresh, whole vegetables & fruits of all colors & high-quality sources of meat & fish during stressful times to help replenish these essential nutrients. They’ll energize you & aid in your daily detox processes.
 
Supplements to manage stress:
There’s a huge selection of nutrient & herbal-based products that can help combat feelings of stress. I’ve listed my go-to’s here.
 
Nutrient-based supplements like L-theanine, GABA, & tryptophan along with any of tryptophan’s related nutrients including 5-HTP & melatonin can help ease stress & anxiety while connecting you to a sense of calm. Most folks find that they’re able to maintain an energized calm that keeps them at ease yet alert with L-theanine & GABA & therefore prefer to take them in the morning & afternoon. Nutrients like tryptophan, 5-HTP, & melatonin are better suited to be taken in the evening as they can really chill you out. For this reason, they’re fabulous sleep aids to help turn down the stress so you can get some much-needed shuteye.
 
Herbs can be wonderfully supporting friends in times of high stress too. Adaptogens like  reishi mushroom, ashwagandha, & eleuthero can be helpful during the day & into the evening. Plant extracts of hops, passionflower, lavender, skullcap, & saffron can be especially helpful in the evening for helping you drop into a sleepy state. A few more uplifting herbs that can help more during the daytime are St. John’s Wort & Mucuna.
 
I’m also a fan of a synergistic nutrient & herbal-based, stress-relieving product called Cortisol Manager from the brand Integrative Therapeutics. It’s a long-loved supplement by naturopaths for helping folks lower stress levels so they can get to bed. This is another great one to consider taking in the evening for restorative sleep.
 
Bear in mind that it’s contraindicated to take most of these herbs and nutrients if you’re on antidepressant medications. In experimenting with these herbs, you may find that some work better than others because they all have different mechanisms of action & affect folks differently based on their genetics. If you’re wanting to target your herbal remedies to your bio-individual needs, it’s strongly recommended to work with a healthcare professional, and it’s something I specialize in with my holistic nutrition practice, Knapp Nutrition LLC.
Reducing the amount of stress in your life is the long-term solution:
Though there are many ways to reactively manage stress, staying ahead of it is the best way to prevent it from wrecking your health. Think of increasing specific nutrients & taking supplements as a band-aid for short-term stress management that’s most effective when used in moderation. Getting in the habit of being on top of your stress level is the best long-term way to prevent stress from negatively affecting your well-being & quality of life.
 
My go-to lifestyle recommendations for relieving stress:
Top of the list is doing anything that stimulates the vagus nerve. Waking this nerve up automatically brings your body more into a rest & digest state.
 
Activities to stimulate the vagus nerve:
Deep breathing. Find a comfortable position. I recommend sitting in a chair with your feet flat on the ground with your spine aligned & your shoulders relaxed. Seal your lips & begin to inhale through your nose for a count of 4 followed by a long, smooth, even exhale out of your nose or mouth for a count of 6; then hold your breath with empty lungs for a count of 2. Repeat for 3-10 cycles of breath. If you’re new to deep breathing, work your way up to the breath-hold over the course of weeks or months. It can feel uncomfortable to hold empty, but teaching your body to remain calm while safely experiencing this discomfort helps you better respond to stressful situations over time.
 
Gratitude journaling or prayer. A big part of stress is related to feeling like we don’t have enough–not enough time, energy, or resources to do all the things we need to do. Taking the time to acknowledge all that we do have helps to push us away from feelings of scarcity & into an abundance mindset. When we see the world through this lens, our vagus nerve is able to stay active, and we’re more likely to feel like we can do everything we need to do in the time we have to do it.
 
Singing. Try turning off the TV or the news for a few minutes a day & pump up the jams that make you want to belt your heart out. It’ll help directly increase your vagal tone, thus stimulating a rest & digest state.
 
Gargling. Yep, it may sound weird, but it's so good! A saltwater gargle for 30 seconds in the morning and evening directly stimulates the vagus nerve & can help put you in a less stressed state for the day ahead & the night of sleep that later lies before you.
 
Pressure on the third eye. Your third eye is located right in the middle of your forehead. You hear it mentioned in yoga classes because of this pressure-related, calming phenomenon. To take a page out of the yogi’s book, the posture child’s pose with your forehead on the floor is a wonderful way to stimulate the vagus nerve. This pose is a bonus because it also brings your head below your heart, another way to stimulate the vagus nerve. If you’re not in a space where you can get down on the ground & form your body into a yoga pose, you can gently press your fingertips or the heel of your hand into your third eye for the same effect. Couple this with deep belly breathing, & you’re sure to feel at least a few of your worries melt away.
Other lifestyle changes you can make:
Embrace the pleasure of enjoying your food. Although it’s important to strive to eat nutrient-dense, healthy, whole foods on the regular, it’s equally important to satiate your cravings. Though restricting foods you love may seem necessary to maintain health, restricting too much only adds to your stress levels. If you really have a hankering for say, ice cream, it’s probably more beneficial to your health if you just allow yourself to indulge in your fave flave rather than suffer from the deprivation. Of course, enjoy less healthful foods like this in moderation, & when you do treat yourself, refrain from feeling guilty or shaming yourself for eating it. It’s totally ok to enjoy all foods, even if they’re “junk” foods. One bowl of ice cream isn’t going to be the difference between good health & bad or your dream bod & one that’s larger than you’d ideally like to have. This nutritionist enjoys the occasional bowl of coconut milk ice cream, & there’s no reason why you can’t too!
 
Allow yourself to say no more often. You know when you commit to doing something but then the time to do the thing arrives & you just don’t feel like doing it anymore? That could be your body telling you that it’s in need of rest. It’s ok to listen to your body in that moment & bail on the thing. There can be challenges that come with doing this, but if you’re able to communicate that you’re honoring your body’s needs & taking care of yourself, it’s pretty tough for those who love & care about you to be upset with you for canceling.
 
Make time for breaks. This applies on the micro & macro levels. On the micro-scale, it’s important to ensure you’re doing what you can to give yourself breaks from the stress of the day. Taking a handful of 5-15 minute stretch, walk, social, or snack breaks can be the difference between a pleasant day & an exhausting one. On the macro scale, it’s important to do what you can to prevent burnout. Maybe you can’t afford to take a luxury vacation multiple times or even once a year, but everybody is capable of scheduling in time for having absolutely nothing to do. On the simplest level, try to give yourself one weekend per quarter when you don’t do any work. No chores around the house, no overtime work, and no errands. Use this time to just be & allow for restoration to systems like the HPA axis.
 
Practice positive self-talk. The stories we tell ourselves in our heads greatly impact our outlook on the world around us, & there are many ways to go about rewriting your internal stories. The shift is usually slow, but your mind is like a muscle. The more you work it, the stronger it gets!
 
Cleaning up your social media consumption can be a good starting place to reformulate the sentences that endlessly run through your mind. Go through your feed, & with each account you follow, ask yourself if what they share adds to your happiness or to your stress. It’s up to you to remove all that doesn’t serve you.
 
Guided meditations model what positive self-talk sounds like while also providing repetition to help you remember that verbiage. In addition, the physical & mental stillness that naturally comes with meditation activates the vagus nerve–bonus!
 
Consider trying out cognitive behavioral therapy. CBT specialists are incredible at helping you uncover where your negative self-talk comes from, what it sounds like, & how to have more positive lines of thinking arise naturally.
 
Move your body! Movement is a great way to melt stress away. Yoga is a favorite of mine as it combines intentional deep breathing, meditation, movement, & direct vagal stimulation all into one activity. However, yoga isn’t for everyone. The important thing is to make time every day to move in a way that brings you joy which could look like going for a walk outside, dancing in your kitchen, playing with your kids, hitting the gym, you get the idea.
 
Make space for joy. Be intentional about scheduling time for socializing & doing the things you love in life. Socializing is essential for our mental health, as is laughing! Basically, just make sure you’re creating space for joy to manifest in your life through the folks & things in this world who make you happy. That may include scheduling in time for this sort of stuff as well as cleaning up mental cloudiness that interferes with your ability to tap into the goodness of the present moment.
 
Last, do what you can to get a solid night’s rest of 7-9 hours each night. There’s a long list of actions you can take to optimize your ability to fall & stay asleep all night, & it’s referred to as sleep hygiene. Sleep hygiene 101 includes: staying on a sleep/wake schedule (going to bed & waking up around the same time each day; plus or minus 2 hours is a good rule of thumb); avoid napping during the day, especially after noon; avoid eating within a couple hours of bedtime; ensure your sleeping environment is dark as this helps the body produce melatonin; avoid screens within one hour of bedtime; & most folks sleep better in a cooler room ~60F.
 
If you’re experiencing any of the symptoms mentioned in this blog post, it’s recommended to get in touch with a healthcare provider who can guide you through an optimal & safe path to resolving your ailments. I’m able to provide services to improve eating & lifestyle & test for digestion dysfunction, hormone dysregulation, & gut imbalances in my holistic nutrition practice: Knapp Nutrition LLC. I’ve tackled many cases like this and can serve as a resource to help you discern if stress management is all you need or if further intervention is warranted to resolve your symptoms.
 
Most of the interventions mentioned in this post can be implemented on your own & often at little or no monetary cost. It’s not always necessary to work with a specialized healthcare professional to resolve gut issues &/or manage your stress levels, but it’s always recommended to discuss any changes in exercise, eating, and lifestyle regimes with your primary care doctor & any other members of your healthcare team.
 
Not sure how to start managing your stress? Pick out just one recommendation mentioned in this post. Think of a ship that’s sailing across the Atlantic Ocean from Europe to the US. If it changes direction by just one degree, it can be the difference between it landing in Mexico or New York State! By adding just one stress relieving activity to your life, you could change the trajectory of your health to as significant of a degree as that ship’s.
 
Still feeling overwhelmed? Help’s always available through your healthcare team or by contacting a holistic practitioner like myself. Call or email me for a free 20-minute consult. Info available on my website: knappnutrition.com.
Image references in order of appearance:





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