In similar circumstances and at similar stages of life, women consistently report feeling more stress than men do. Some researchers attribute women's greater stress to the many roles they play — spouse, mother, housekeeper, employee, and caregiver. We do know that women's stress hormones and blood pressure, unlike those of men, tend to remain elevated at the end of the workday.

02-01-2003

Although stress is never listed among the top 10 causes of death in America, it's linked to many illnesses. And some of them, such as heart disease and stroke, can be deadly. Thus, our three resolutions for 2003 address ways of reducing stress. These resolutions won't solve all our troubles; nor are they the only ways to ease stress. But they may lessen the damage it can cause.


What is stress?

We often see stress as a force from the outside: for example, job loss or pressures, financial problems, or unexpected illness or death. But we experience stress inside, physically as well as emotionally. Stress manifests itself through physical sensations — including shortness of breath, heart palpitations, and muscle tension — as well as through emotions such as anger or anxiety. Together, they constitute the classic "fight-or-flight” response that helped our prehistoric ancestors survive in a dangerous world.

In a life-threatening emergency, stress hormones such as adrenaline and cortisol flood the bloodstream. They speed the heart rate, increase blood pressure, tense the muscles, raise blood sugar levels, and activate immune cells. These changes, also known as the stress response, mobilize the body's resources for fighting or fleeing. Once the threat has been addressed, the energy and tension normally subside, and the body relaxes.

But if the stress response is activated too often or left running too long, these emergency hormones and functions may actually turn against the body. This can cause or worsen many health problems, including heart disease, atherosclerosis, hypertension, suppressed immunity, autoimmune disorders, allergies, diabetes, colitis, chronic fatigue syndrome, irritable bowel syndrome, depression, and memory problems.


What causes it?

Many situations other than imminent physical danger can trigger a stress response. That's because our bodies have a hard time distinguishing between life-threatening dangers and more mundane sources of stress, such as a traffic jam, a marital spat, or a boss's displeasure.

Unfortunately, the impact of routine stress tends to build up, rather than subside, as the day goes on. The uncertainty of world events and fears of terrorism have added new stresses to our daily load.


Lighten the load

We can't be inoculated against the strains of daily life, but we can take steps to counter their effects. When we feel overwhelmed, we often neglect the proven strategies that help the most. Here's a reminder of three good ones.

1.   Eat a healthy diet and take a daily multivitamin

In stressful situations, cortisol helps the body stock up on energy by increasing hunger and storing food in the form of glycogen and fat. But chronically elevated cortisol can produce unhealthy weight gain. Rockefeller University neuroscientist Bruce McEwen explains in his book The End of Stress as We Know It that various studies have linked stress and excess cortisol to increased abdominal fat, which adds to our risk for heart disease and diabetes.

Accumulating abdominal fat is a red flag, especially in women, who usually carry their weight lower in the body. Eating fatty foods and snacks, a temptation when we're on stress overload, adds fuel to the fire because dietary fat boosts cortisol production.

Chronic excess cortisol production spurs the loss of mineral from bone, suppresses immune function, and may impair memory.

What to do. Eat a balanced diet with plenty of fruits and vegetables, choose whole grains more often than refined grains like white rice and white flour, and watch your fat intake. Make sure the fats you eat are healthy ones, such as those found in cold-water fish, canola and olive oils, and nuts. It's also important to avoid deficits in calcium, zinc, iron, magnesium, folic acid, and vitamins B6, B12, and D. These nutrients affect your energy, bones, heart, mental acuity, and mood. Taking a daily multivitamin is insurance that you'll get the basic vitamins and minerals you need.

2.   Exercise

The body releases adrenaline to prepare it for fight or flight, both of which are physical activities. So physical activity, in the form of exercise, is an excellent way to dissipate stress. Adrenaline constricts blood vessels (thus elevating blood pressure), boosts the heart rate, and speeds blood clotting. It also appears to increase the body's production of cholesterol. Under threat, the body benefits from these changes. But frequent or long-term elevations in adrenaline endanger the cardiovascular system.

What to do. Start with a walk. Research has shown that 30 minutes of brisk walking five to seven days of the week can lower a woman's risk for heart attack and stroke. It can also help counter weight gain, lower blood sugar levels, and activate genes that help clear fat and sugar from the bloodstream.

If you're already getting in 30 minutes of walking per day, try adding yoga, tai chi, or another form of relaxing physical activity to your weekly schedule. Or consider getting 60 minutes of walking or other exercise per day for additional health benefits and to reduce the risk of weight gain.


Selected resources

Self-Nurture: Learning to Care for Yourself as Effectively as You Care for Everyone Else, by Alice D. Domar, Ph.D., and Henry Dreher. Penguin USA, 2001 (paperback).

Stress Control: Techniques for Preventing and Easing Stress. A Special Health Report available from Harvard Health Publications, P.O. Box 421073, Palm Coast, FL 32142-1073. Online at www.health.harvard.edu/SHR.

The End of Stress As We Know It, by Bruce S. McEwen, Ph.D., with Elizabeth N. Lasley. Joseph Henry Press, 2002.

3.   Make time for yourself

Life will always have its stressful times, such as when several crises demand your attention all at once. On these occasions, it may be wise to opt out of nonessential obligations that add to your burdens. Maybe you needn't check your office e-mail over the weekend, do all the grocery shopping, serve on one more committee, or skip your lunch hour so often.

What to do. Once you find a few extra minutes for yourself, you can listen to music, call a friend, read a book, or practice relaxation. Strategies such as meditation and visualization evoke the relaxation response, a term coined by Harvard cardiologist Herbert Benson. It's characterized by decreased heart rate, blood pressure, and muscle tension. (For instructions on how to elicit the relaxation response, see HWHW, Sept. 2002, p. 7.)

If your time is short, try a "mini-relaxation,” one of several quick deep-breathing exercises (see below, "Got a minute to relax?”) described by Harvard psychologist Alice Domar in her book for women, Self-Nurture.


Got a minute to relax?

* Sit upright or lie on your back.

* Place your hand just beneath your navel so you can feel the rise and fall of your belly as you breathe deeply through your nose.

* As you inhale, count slowly, saying to yourself, "one, two, three, four.” Exhale slowly, counting back down from four to one.

* Do this for one minute or longer.