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Fight or Flight? Prolonged Stress Takes A Toll on Public Health

Consumers are looking for new solutions to adapt to modern stressors.

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By: Sean Moloughney

A once-in-a-generation pandemic, droughts, heatwaves, and wildfires, the war in Ukraine and fear of nuclear disaster, inflation and economic volatility, political extremism and terroristic threats are all enough to stress the most zen of us.

According to Gallup’s 2022 Global Emotions Report, in 2021, “negative emotions—the aggregate of the stress, sadness, anger, worry and physical pain that people feel every day—reached a new record in the history of Gallup’s tracking.”

In fact, 2021 was the most stressful year in recent history, with a new record-high 41% of adults worldwide saying they experienced a lot of stress the previous day. A one-point increase from the previous year followed a five-point jump between 2019 and 2020.

While still present, the stigma around mental health is receding, fortunately, thanks in part to younger people. According to the International Food Information Council (IFIC) 2022 Food & Health Survey, Gen Z consumers in the U.S. are the only generation who put emotional/mental health among the top three health benefits they seek from their diet. They’re also more likely than Gen X or Boomers to seek out options like therapy, mindfulness, or meditation for stress reduction.

Most Americans (56%) report feeling “very” (22%) or “somewhat” (34%) stressed over the past six months, according to the IFIC survey. Younger generations are more likely to say they’re “very stressed”—with 33% of Gen Z, 29% of Millennials, and 25% of Gen X, compared to 10% of Boomers.

The top areas where Americans have made changes to reduce or manage stress include sleep (41%), exercise (40%), mental health (30%), and diet/nutrition (30%). Among those who adjusted their diet/nutrition, the most common changes were trying to eat healthier (54%), focusing on healthy behaviors instead of weight loss (38%), and following a specific eating pattern or diet (37%).

“The stress of modern life takes a toll on everyone it touches, contributing to anxiety, health problems, poor relationships, and lost productivity at work,” said Steve Fink, vice president of marketing at PLT Health Solutions. “Fifty-five percent of Americans are stressed during the day. This is 20% higher than the world average of 35% (according to Gallup). According to the Center for Workplace Mental Health, work-related stress results in $190 billion in healthcare costs yearly. This represents between 5% and 8% of the total national healthcare spending.”

Understanding Stress & General Adaptation

Known as “the father of stress research,” Hans Selye (1907-1982), director of the Institute of Experimental Medicine and Surgery at the University of Montreal, Canada, pioneered the modern biological understanding of stress in 1936, known as the General Adaptation Syndrome (GAS), which is the pattern of physical changes the body goes through after being exposed to stress.

Selye described physiological responses in three stages: alarm, resistance, and exhaustion. “In the alarm phase we see a rise in blood pressure, slight change in blood chemistry, blood sugar elevation, and other responses designed for the fight or flight response,” explained Bill Chioffi, chief strategy and innovation officer at Nammex. “The other phases involve responses that are essentially adaptations designed to resist the stressor, but can lead to disease such as diabetes, cardiovascular disease, and other ‘chronic’ illnesses. Most of us experiencing daily, prolonged stress would fall into the resistance stage, characterized by irritability and poor concentration and, if passing into the exhaustion stage, sleep disturbances, depression, and fatigue.”

Stress can have a positive effect in the alarm phase, noted Chioffi, as “extra reserves for energy are released and thinking becomes clearer. Think of how an endorphin rush feels after or during exercise, or how the extreme cold of a ‘plunge’ invigorates you, then has a calming effect.”

Prolonged stress, however, “impacts circulation, digestion, and endocrine function, producing elevated levels of inflammatory compounds as seen in the resistance and exhaustion phases,” Chioffi said. “This coupled with lack of exercise and improper diet can lead to some brain fog, and since insomnia and fatigue are signs of the exhaustion phase, this adds to the lack of focus.”

Stress can be looked at through many lenses, according to Jeremy Appleton, ND, director of medical and scientific affairs, PLT Health Solutions, who noted Selye’s work has “contributed greatly to our present understanding of the hypothalamic-pituitary-adrenal axis, and how the effects of stress manifest on a hormonal, cellular, or metabolic level.”

From the beneficial stress of exercise to the damaging stress of severe injury or toxic exposure, “the human body has evolved multiple mechanisms to help maintain balance of its systems and function,” said Appleton. “Every body system can be involved. From the standpoint of cells and pathways, it can quickly become overwhelming to look at the many individual cell types and molecular mechanisms involved; there are hundreds, if not thousands. Which cellular pathways are activated in response to stress depends on the nature of the stressor.”

Occasional feelings of anxiety are a natural response to stressful situations and are usually brief and relatively mild, noted David Winston, RH(AHG), founder and president, Herbalist & Alchemist. “Anxiety on a more constant basis may be experienced in a number of ways such as constant worry, irritability, insomnia, headaches, and social anxiety. Physically, anxiety can impact our bodies in the form of elevated blood pressure and increased production of the stress hormone cortisol. Chronically elevated cortisol levels are linked to obesity, metabolic syndrome, insomnia, hypertension, PCOS, BPH, immune dysfunction, neuro- and gut inflammation, and increased risk of cancer, heart disease, diabetes, and atherosclerosis.”

Stress is known to impact memory, concentration, and the ability to learn new information, Winston added. “Elevated cortisol levels are associated with increased neuro-inflammation which is linked to depression, anxiety, brain fog, and Alzheimer’s disease. Given how stressful all of our lives have been these past few years, it’s no wonder stress support products are among our biggest sellers.”

Modern challenges also include, Winston noted, work-life balance and a lack of supportive relationships and sense of community. “We live in a very individualistic, isolated, and conflicted society where balance and harmony are simply not a major part of our culture. Finding healthy ways to reduce and manage stress is vital.”

Prolonged, chronic stress can have devastating physical and mental consequences, said Sébastien Bornet, vice president of global sales and marketing at Horphag Research. “Stress can lead to sleep disruption and chronic fatigue, areas with damaging short-term and long-term effects. Beyond feeling chronic fatigue, prolonged sleep disruption can lead to increased risk of hypertension and diabetes. Various studies suggest that high levels of cortisol from long-term stress can also increase blood cholesterol, blood sugar, and blood pressure. Like any chronic health issue, stress should be taken seriously and managed.”

Prolonged stress can have a profound effect on brain function, especially concentration, Bornet added. “Various studies have found chronic stress may lead to accelerated cognitive decline.”

Stress is a health issue that is often dismissed and not discussed enough, he noted. “There is a growing conversation on mental health—really driven by younger generations—that has us on a path to normalize talking about stress and mental health impact more openly. That can lead to more active condition management.”

Stress Management: Holistic & Personal

Ultimately, chronic stress can “wreak havoc on both your mental and physical health,” said Maggie McNamara, marketing director, Gencor. “It wears down your body’s natural defenses, leaving you exhausted and exposed to illness. Chronic stress and stress hormones can bring on mental and physical diseases and affect every part of our body.”

For the most part, she added, the damaging effects of stress are somewhat modifiable. “Some immediate changes to diet, like eating whole foods, drinking less caffeine or other stimulants, and decreasing alcohol can help. You also can dial down your reactivity to stress by doing deep-breathing exercises, progressive muscle relaxation, meditation, yoga, or aerobic exercise, which will help calm your body’s response to stress.” 

Effectively managing stress involves more than just taking a prescription medication or supplements. “It’s sometimes hard to think of how to help ourselves when we’re stressed, but there are many things we can do,” said Winston. “Exercise, mindful meditation, yoga, tai chi, deep breathing exercises, prayer, forest bathing, spending time in nature, psychotherapy,  reducing intake of stimulants, unplugging from computers, cell phones, and television, getting adequate, good quality sleep, avoiding blue light in the evenings, and healthy relationships are the foundation of a more balanced life.”

In addition, “a healthy diet rich in magnesium, calcium, B vitamins, and vitamin C is a good start,” he said. “There are also herbs and supplements that can help such as probiotics, B complex vitamins, and magnesium, as well as herbal formulas made with adaptogens, anxiolytics, and nervines to elevate mood, keep anxiety at bay, and promote restful sleep.”

According to Chioffi, stress management includes “prioritizing your own wellbeing and making time to exercise, rest, eat well, and get outside to enjoy nature. No person or pill is going to do that for you.”

Which stress management solutions are most beneficial depends on the individual, he added, “but focusing on practices that involve mindfulness, breathing, and connecting to nature seem to have the most lasting effects on the widest range of people. I personally find practicing kindness—being friendly, generous, and considerate—seems to disarm what could be stressful interactions.”

For better and worse, stress is a common part of life, said Bryan See, vice president of PhytoGaia. “Stress management is essential for overall wellbeing. We must have access to effective stress relievers that can calm our bodies and minds. Everyone responds differently to different stress management techniques. It is crucial to try different things and see what works best for you. Guided imagery, meditation, progressive muscle relaxation, breathing awareness, going on a walk, and art are efficient short-term approaches.”

A healthy, balanced diet, such as the Mediterranean, DASH, and plant-based diets, can also help to lessen the long-term effects of chronic stress, said See.

Product & Ingredient Solutions

The market for stress-reducing products and ingredients is “skyrocketing,” noted Fink at PLT Health Solutions. “It is most certainly related to the pandemic and is being led, interestingly, by Gen Z and Millennials, which means we may be in the midst of a new, enduring trend in the supplements business. We have had significant growth in our Zembrin Sceletium tortuosum ingredient over the last two years and our Rhodiolife Rhodiola rosea adaptogen ingredient saw significant growth as well.”

Fink noted an interesting development in the adoption of these ingredients in products outside of cognitive health. “We are seeing companies that want to provide cognitive support in sports nutrition and weight management products as well.”

Zembrin is a unique, naturally occurring selection of Sceletium tortuosum [syn. Mesembryanthemum tortuosum] a South African plant with a centuries-long history of use. Zembrin has demonstrated clinical efficacy for physical and emotional stress and enhanced mental focus, without undesirable psychoactive effects and risks associated with other ingredients, Fink noted. Zembrin users report that it promotes feelings of calm focus and alert serenity.

“In the U.S., Zembrin has been marketed to nutraceutical and functional food and beverage producers interested in incorporating the innovative, evidence-based ingredient in products that experientially support stress relief, enhanced mood, and improved cognitive function,” Fink said. “It has a significant body of scientific study developed to understand how it works.”

Herbs that help people cope with stress are in high demand, a trend that began soon after COVID-19 was declared a pandemic, said Winston. “We’re seeing heightened consumer understanding that adaptogens play a role in helping their bodies cope with stress.” Among the company’s top sellers right now are adaptogenic formulas, including Calm Adapt, a formula that includes adaptogens (ashwagandha, reishi, schisandra) with nervines (oat and linden flower).

“Ashwagandha is an adaptogen, anti-inflammatory, anxiolytic, immune amphoteric, and mild analgesic,” said Winston. “Reishi is a mild adaptogen, nervine, immune amphoteric, cardiotonic, and anti-inflammatory agent used for anxiety, bad dreams, insomnia, and stress-induced conditions. Schisandra is unique in that while it is calming, it gives a person a clear, focused mind. It also has anti-inflammatory, hepatoprotective, anti-asthmatic, and immune amphoteric effects. Fresh oat and linden flower are two of my favorite nervines that help to re-establish a healthy emotional foundation.”

Ashwagandha has been growing in popularity over the last decade, due to its recognition for reducing the negative effects of chronic stress on both physical and mental health, noted John Quilter, global vice president of ProActive Health at Kerry. “Kerry’s Sensoril ashwagandha has been shown to help the body cope with everyday stress, helping to improve cognitive health by supporting sleep, focus, and mood.”

Although ashwagandha has a long history of use as a natural remedy, with increasing focus on the impact of daily stressors on health, “it’s becoming widely known as a modern solution for managing stress,” he added. “Ashwagandha falls under the adaptogen category—adaptogens are natural substances that help the body adapt to stress. Sensoril ashwagandha is suitable for a variety of functional foods, beverages, and supplements that can aid in stress reduction.”

Nammex, which specializes in mushroom ingredients, is seeing an increase in demand for all of it products, Chioffi said, but especially Lion’s mane (Hericium erinaceus), cordyceps (Cordyceps militaris), and red reishi (Ganoderma lingzhi).

“All of these have been used traditionally to support immune function, nourish the digestive system, and promote overall wellness, and today’s consumers have caught on to the benefits of mushrooms,” he noted. “It is clear that people are wanting extra support from adaptogens, the class of herbal medicines that help us through the General Adaptation Syndrome by providing nutritionally dense and phytochemically diverse support. I have always been a fan of these non-specific agents of positive change and incorporate them into my diet as much as possible. Coupled with other adaptogenic plants such as Rhodiola (Rhodiola rosea), many consumers are finding out what our ancestors realized centuries ago and rediscovering the benefits of these powerful allies.”

At Gencor, the company’s patented saffron extract Affron is supported by eight published human clinical trials demonstrating benefits for stress, sleep, and mood, said McNamara.

“It has multiple mechanisms of action to provide these benefits including balancing the neurotransmitters serotonin, dopamine, and noradrenaline, facilitating neuroplasticity, softening the signal from the stress center of the brain, and supporting melatonin production at night.”

The company’s CALMaluma consists of a Caralluma fimbriata extract (CFE), derived from a cactus-like plant. Five human clinical studies show it reduces stress, frustration, and improves mood, McNamara said. “It also increases relaxation and supports a balancing of cortisol. It has a unique benefit of helping balance neurotransmitters while also having an impact on the HPA-axis (the critical pathway involved in the body’s stress response).”

Maypro offers a unique proprietary, upcycled ingredient, ETAS, derived from the tough lower portion of asparagus stalks (Asparagus officinalis). This enzyme-processed asparagus stem extract has the unique ability to increase the production of heat shock protein 70 (HSP70), which normally is produced by the body in response to the stress of exposure to excess heat. ETAS has been shown to be effective in reducing fatigue and feelings of unhappiness (dysphoria) caused by stress at a dose of 150 mg per day, according to the company.

Pycnogenol is a potent antioxidant shown in decades of research to boost blood circulation and help consumers meet their cognitive health goals, whether that is improved memory, concentration, mood, or attention, noted Bornet.

“Pycnogenol helps endothelial cells produce more nitric oxide (NO) which has multiple beneficial effects on brain function,” he noted. “Initially, NO increases blood flow, which improves oxygenation and the transport of nutrients to brain cells. The active metabolites of Pycnogenol build up inside the endothelial blood cells and there is good evidence showing that they pass the blood-brain barrier. NO regulates neuronal functions and thus contributes to processing signals inside the brain. In addition, NO helps modulate key neurotransmitters such as dopamine, serotonin, and norepinephrine.”

A 2015 study on Baby Boomers (aged 55-70), published in the Journal of Neurosurgical Sciences, found Pycnogenol can positively impact mood, as participants reported feeling less anxiety, a stronger sense of content, as well as increased sleep quality. Another study found Pycnogenol to help improve overall cognitive function in the workplace, including improved mood, decreased anxiety, heightened mental performance, and sustained attention in people aged between 35 and 55.

The body needs more nutrients when under stress, according to Ariati Aris, scientific affairs specialist at PhytoGaia. “This creates free radicals and oxidative stress. These free radicals can be suppressed by vitamin E, which also reduces stress and enhances overall health. Growing evidence suggests that tocotrienols can help maintain cognitive function during aging.”

The effects of tocotrienols on brain health, neuroprotection, and cognitive improvement are well documented in scientific literature and human trials, Aris added. “They are important for protecting the brain and promoting healthy cognitive function.” PhytoGaia produces a synergistic, natural, full-spectrum palm tocotrienol/tocopherol complex under the brand name TocoGaia, which is naturally extracted from sustainably sourced palm fruit through a unique, clean technology.

McNamara noted that a holistic approach to stress is optimal for everyone. “Especially, when it comes to supplementation, tackling various areas of health to mitigate the effects of stress in our lives are ideal. For example, taking a dietary supplement that includes a clinically tested ingredient for stress, addresses mood, plus has an ingredient that is effective and tested for sleep is going to be most advantageous.”

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