EFFECT OF A LIFESTYLE PROGRAM ON HOLIDAY STRESS, CORTISOL, AND BODY WEIGHT

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Cortisol overexposure is well-known in the scientific literature to increase appetite and
promote fat storage in the abdominal area. The holidays are often cited as a stressful time of the year (Thanksgiving to New Year’s Day) ñ and a time during which many people
gain weight. Our hypothesis was that a comprehensive lifestyle program would attenuate stress and weight gain in this group of “stress-eaters.”

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EFFECT OF A LIFESTYLE PROGRAM ON HOLIDAY STRESS, CORTISOL, AND BODY WEIGHT

  1. 1. Effect of a Lifestyle Program on Holiday Stress, Cortisol & Body Weight S. Talbott, A. Christopulos, & E. Richards Treehouse Athletic Club & SupplementWatch, Inc. Salt Lake City, Utah
  2. 2. Conflict of Interest Statement SupplementWatch, Inc. - none TreeHouse Athletic Club - none Shawn Talbott - author, The Cortisol Connection & supplement industry consultant
  3. 3. BACKGROUND • The literature strongly suggests that stress/cortisol exposure is associated with increased appetite, weight gain, and specifically with increased abdominal adiposity1-3 • The literature also suggests that weight gain is significant4-6 and weight loss difficult7-9 during the 6-week holiday period • Anecdotal reports and subjective assessment of holiday weight gain may be high 1. Epel ES, et al. Psychoneuroendocrinology 2001;26:37-49. 2. McLean JA, Barr SI, Prior JC. Am J Clin Nutr 2001;73:7-12. 3. Bjorntorp P, Rosmond R. Nutrition 2000;16(10):924-36. 4.Yanovski JA, et al. NEJM 2000; 342:861-7. 5.Thompson C, et al. J Affect Disord 1988;14:257-64. 6.Rosenthal NE, et al. Ann NY Acad Sci 1987;499:216-30. 7.Boutelle KN et al. Health Psychol 1999;18:364-8. 8.Silverstein LJ et al. J Am Dietetic Assoc 1996;96:Suppl.A:30 9.Baker RC et al. Health Psychol 1998;17:367-70.
  4. 4. Elevated Cortisol, Obesity & Metabolic Syndrome • High cortisol secretion is associated with abdominal fat • Abdominal fat is most highly associated with illness and death from: • cardiovascular disease, diabetes, and metabolic syndrome, including hypertension, hyperlipidemia, hyperinsulinemia, & insulin resistance Abdominal Obesity Stress-related cortisol 24 P<0.05 0.5 P<0.05 22.5 0.34 23 ±3.7 0.4 ±0.5 21.5 cm 22 ±4.1 nmol/L 0.3 20.6 0.15 21 ±2.2 0.2 ±0.6 0.04 20 0.1 ±0.3 19 0 <10 11-20 >21 <10 11-20 >21 Years in work Peeke PM, Chrousos GP. Ann NY Acad Sci 1995;771:665-76. / Bjorntorp P, Rosmond R. Nutrition 2000;16(10):924-36. / Rosmond, et al. Obes Res 2000;8:445-450.
  5. 5. Elevated Cortisol and Appetite • Women with high cortisol response (compared to low responders): • consumed more calories • ate significantly more sweet foods • had more negative moods • High dietary restraint is associated with high urinary cortisol excretion • Dietary Restraint = Consciously trying to limit food intake to achieve or maintain a desired body weight 1. Epel ES, et al. Psychoneuroendocrinology 2001;26:37-49. 2. McLean JA, Barr SI, Prior JC. Am J Clin Nutr 2001;73:7-12.
  6. 6. PURPOSE • We conducted an 8-week lifestyle program to evaluate effects on measures of stress/mood, cortisol, body weight, and body composition • Subjects were self-identified as “high stress” with historical holiday weight gain • Program was conducted from week prior to Thanksgiving to week after New Year’s Day – (against our better judgment!)
  7. 7. METHODS • Fifty subjects started the program (42 women and 8 men) and 46 completed the program (40 women and 6 men). Baseline Age (y) BW (kg) BF (%) Waist (cm) BMI Characteristics N = 46 44 + 7 78.5 + 16.3 32.4% + 6.9% 86.7 + 11.2 28.8 + 4.8 • Participants met weekly for group educational seminars – Stress management - yoga, guided imagery, deep breathing, etc. – Exercise - customized by CPT - 5d/wk (3 aerobic/2 strength) – Nutrition - based on RMR for no more than 500 kcal/d deficit – Supplementation - multivitamin/mineral, green tea, 5-HTP, theanine, citrus flavonoids… – Evaluation - identification of stressful events and interventions
  8. 8. The Cortisol Connection Diet Lean Protein Fruits & Veggies Added Fat Concentrated Carbs Metabolic Controllers
  9. 9. METHODS • Before and after the 8-week program, we measured: – Body weight – Body fat percentage (BIA via RJL system) – Waist circumference – Profile of Mood States – Salivary cortisol (Salimetrics, State College, PA) • Paired Student’s t-tests were used to assess differences between pre/post measures. Statistical significance was accepted at P < 0.05. Data are expressed as mean + SD.
  10. 10. RESULTS Global Mood State & Salivary Cortisol Global Mood State (POMS) Salivary Cortisol (ug/dL) -18.7% -19.7% Both, p < 0.05 compared to pre value
  11. 11. RESULTS Profile of Mood States (POMS) +29% -41% -40% -41% -19% -14%
  12. 12. RESULTS Body Weight & Waist Circumference Body Weight (kg) Waist Circumference (cm) -0.6kg -1.3cm p = 0.03 p = 0.01
  13. 13. RESULTS Body Composition Fat Mass & Lean Mass (kg) Body Fat (%) +1.3kg -5.0% p < 0.05 -1.9kg
  14. 14. CONCLUSIONS • Cortisol/stress exposure has been associated with increased appetite, obesity, and abdominal adiposity. • Control of cortisol/stress would be expected to reduce appetite and enhance weight loss (metabolic effect) - and perhaps to improve compliance with the 8-wk diet and exercise regimen (behavioral effect). • Results of this 8-week weight loss program suggest that a comprehensive stress management, exercise, nutrition, and supplementation regimen (SENSE) delivers positive changes in mood, cortisol, body weight, body fat, and waist circumference - even during the “high-stress” holiday period - and that weight gain during this time of year is not “inevitable”
  15. 15. GOOD HEALTH!

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