cortisol:Layout 1 5/22/07 7:53 PM Page 1 d HEALTH / STRESS/ WEIGHT LOSS 2n on THE ABCs OF CORTISOL CONTROL ... “Proper diet and regular exercise are still important pieces of the weight-loss puzzle, TA Editi IT’S A HEALTH REVOLUTION! but they are not the only considerations. We also need to consider the brain (sleep, L stress, mood) and hormone levels (cortisol and testosterone) for the most complete B O approach to truly effective weight loss….The missing pieces of the puzzle for most T people are stress control and hormone control….”— from the book T really oss So – how can you lower your The Cortisol ht L g SS / Wei stress levels, lose weight, keep it off & FITNE and protect your health? T ALTH h Connection HE — 00 e 0 The first edition ofThe Cortisol Connection signaled a revolution 9 01 HEA in our understanding of the effects of stress hormones like cortisol, AC: and explained the relationship between chronic stress, high levels C S BI of cortisol and the breakdown of the body’s health reserves. In o his carefully designed SENSEProgram (Chapter 9),Dr. Shawn Talbott presented simple guidelines for reducing stress, lowering r ▲ explains howcortisol, the cortisol levels, improving long-term health and reaching and main- t major stress hormone, taining desired weight. SHAWN TALBOTT, PH.D., i WHY STRESS contributes to weight gain, s Research in the last five years has shown that there is more, FACSM,is trained in depression, osteoporosis and sports medicine, health o and this new edition contains 25 percent new material, including management and nutri- MAKES YOU FAT hypertension l ➺ new biochemistry research, an updated stress self-test and tional biochemistry. He oversees educational a wei ght-reduction plan efforts related to exer- C ▲ includesnew research on the AND RUINS YOUR ➺ two new chapters about the relationships between cortisol cise, nutrition and die- connections between cortisol and testosterone and cortisol and HSD, the body’s fat-storage tary supplements in his o and HSD (the body’s fat-storage capacity as President of enzyme, that show the big part they play in stress response SupplementWatch, Inc. n HEALTH — AND enzyme), and cortisol and and weight gain He is a Fellow of both testosterone ➺ refinements of the SENSE program based on controlled studies the American College n of Sports Medicine WHAT YOU CAN with patients who have usedit for over 5 years e (ACSM) and the American ▲ describesthe author’s Institute of Stress. He Dr. Talbott has long maintained that lowering cortisol is as impor- c effective (yet easy-to-follow) maintains an active DO ABOUT IT tant to health and longevity as lowering cholesterol. This book nutrition counseling and t SENSE cortisol-reduction explains why. With the information in this book, you can start lifestyle research center, N i plan: Stress management— NOWto reduce stress, lower cortisol levels, avoid weight gain t(FhYe IF),untueraer YSoault ILnasktiet uCtiety. DESIG o Exercise—Nutrition— and take more control of your health. He lives in Draper, Utah. HIC n AP Supplementation—Evaluation R G R A ISBN-10: 0-89793-492-X US $15.95 TM T ISBN-13: 978-0-89793-492-3 Distributed to the trade DI N by Publishers Group West RIA B Y SHAWN TALBOTT, PH.D., FACSM B For more information on GN SI Banodo kcso mfomr huenaitlyth, family Hwuwnwt.ehru Hntoeursheo ubsoeo.kcso mvisit VER DE FOREWORD BY William Kraemer, Ph.D. O C Karp front:Layout 1 7/31/08 2:59 PM Page ii The Cortisol Connection (cid:129) (cid:129) (cid:129) (cid:129) (cid:129) (cid:129) (cid:129) (cid:129) (cid:129) (cid:129) (cid:129) (cid:129) (cid:129) (cid:129) (cid:129) Testimonials from SENSE Program Users (all names have been changed to protect privacy) “I started SENSE during a very stressful time for me—and I ex- pected to gain weight as usual because of the stress.… But SENSE was so simple to follow that it actually made things easier to han- dle (instead of harder to follow, as is the case with many other diets I have tried).… The program has taught me so much about nutrition and metabolism and how important it is to do several small things at one time to control weight.” — Sandy “M y results have been terrific, with a loss of 8 percent body fat and almost twenty pounds. But the best part is that the balance in the plan between exercise and diet and supplements is something I can continue to follow forever.” — Dennise “ Dr. Talbott’s SENSE program has helped me to lose more than fifty-f ive pounds of body weight and at least six inches off my waist.… Before starting on SENSE, my stress level was through the roof, I had just bought a bigger belt and I was starting to eye the 46-inch–waist pants (up from my then size 44 and my usual 38).… I can’t say enough about how beneficial the program was for me. Aside from the loss of weight and inches, I feel a whole lot better. My mood is up and my stress is way down from where it was at the start of the program.” — Mitch Testimonials (cont’d.) “B y using Dr. Talbott’s ‘Helping-Hand’ approach to eating, I was never hungry, I had no cravings, and I never felt like I was on a ‘diet’ of any kind. By following this program, I have made a com- plete 180-degree turn with my eating habits—and these changes have benefited my family as well as me.” — Stephanie “ I was diagnosed with diabetes a few months before trying SENSE, and my main interest was finding something that would help me control my diabetes. The fact that the program focused partly on controlling blood sugar made it seem like a good thing to try—but I never expected all the wonderful benefits in how I look and feel. By following SENSE, I lost more than five inches off my waist and have gone from a size 22 to a size 16.” — Laura (cid:129) (cid:129) (cid:129) (cid:129) (cid:129) (cid:129) (cid:129) (cid:129) (cid:129) (cid:129) (cid:129) (cid:129) (cid:129) (cid:129) (cid:129) Ordering Trade bookstores in the U.S. and Canada please contact: Publishers Group West 1700 Fourth Street, Berkeley CA 94710 Phone: (800) 788-3123 Fax: (510) 528-3444 Hunter House books are available at bulk discounts for textbook course adoptions, to qualifying community, health-care, and government organizations, and for special promotions and fund-raising. For details please contact: Special Sales Department Hunter House Inc., PO Box 2914, Alameda CA 94501-0914 Phone: (510) 865-5282 Fax: (510) 865-4295 E-mail: [email protected] Individuals can order our books from most bookstores, by calling (800) 266-5592, or from our website at www.hunterhouse.com WHY STRESS MAKES YOU FAT AND RUINS YOUR HEALTH — AND WHAT YOU CAN DO ABOUT IT (cid:129) (cid:129) (cid:129) (cid:129) (cid:129) (cid:129) (cid:129) (cid:129) (cid:129) (cid:129) (cid:129) (cid:129) Shawn Talbott, PH.D. Foreword by William J. Kraemer, Ph.D. SECOND EDITION Copyright © 2007, 2002 by Shawn Talbott All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying and recording, or introduced into any information storage and retrieval system without the written permission of the copyright owner and the publisher of this book. Brief quotations may be used in reviews prepared for inclusion in a magazine, newspaper, or for broadcast. For further information please contact: Hunter House Inc., Publishers PO Box 2914 Alameda CA 94501-0914 Library of Congress Cataloging-in-Publication Data Talbott, Shawn M. The cortisol connection : why stress makes you fat and ruins your health - and what you can do about it / Shawn Talbott. — 2nd ed. p. cm. Includes bibliographical references and index. ISBN-13: 978-0-89793-492-3 (pbk.) ISBN-10: 0-89793-492-X (pbk.) 1. Stress management. 2. Stress (Physiology) 3. Hydrocortisone— Physiological effect. 4. Health. 5. Obesity. I. Title. RA785.T35 2007 155.9'042—dc22 2007015592 Project Credits Cover Design Brian Dittmar Graphic Design Book Production John McKercher Developmental and Copy Editor Kelley Blewster Proofreader John David Marion Indexer Nancy D. Peterson Acquisitions Editor Jeanne Brondino Editor Alexandra Mummery Senior Marketing Associate Reina Santana Rights Coordinator Candace Groskreutz Customer Service Manager Christina Sverdrup Order Fulfillment Washul Lakdhon Administrator Theresa Nelson Computer Support Peter Eichelberger Publisher Kiran S. Rana Printed and Bound by Bang Printing, Brainerd, Minnesota Manufactured in the United States of America 9 8 7 6 5 4 3 2 1 Second Edition 07 08 09 10 11 Contents Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix Acknowledgments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Are You a Type C? Gauging Your Exposure to Stress . . . . . 6 1 Stress and Your Health: The Type C Personality. . . . . . . . 10 Are You Happy?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 The “Normal” Stress Response . . . . . . . . . . . . . . . . . . . . . 14 What Is Stress?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Humans Are Not Zebras . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Stress, Cortisol, and Metabolism . . . . . . . . . . . . . . . . . . . . 20 Stress and Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Cortisol: Too Much or Too Little? . . . . . . . . . . . . . . . . . . . . 23 Counteracting the Effects of Chronic Stress. . . . . . . . . . . . 25 Why Supplements?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 2 The Science of Stress. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Stressed Versus Stressed Out: What’s the Difference?. . . 30 Stages of Stress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Acute Versus Chronic Stress. . . . . . . . . . . . . . . . . . . . . . . . 33 Individual Responses to Stress. . . . . . . . . . . . . . . . . . . . . . 35 Is There a “Weaker Sex” When It Comes to Stress?. . . . . . 37 Summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 3 All About Cortisol, the Master Stress Hormone. . . . . . . . 39 The Endocrine System . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 The Adrenal Glands. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 What Is Cortisol?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 What Does Cortisol Do? . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 The Good, the Bad, and the Ugly of Cortisol Metabolism. . 43 The Catabolic Effects of Chronically Elevated Cortisol. . . . 47 v vi THE CORTISOL CONNECTION Cortisol Is Only One Piece of the Puzzle. . . . . . . . . . . . . . . 48 Summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 4 HSD: The Body’s “Fat Storage” Enzyme. . . . . . . . . . . . . . 51 What Is HSD and What Does It Have to Do with Cortisol? . 51 The Effects of HSD on Obesity and Diabetes. . . . . . . . . . . 54 The Pharmaceutical Rush to Block HSD. . . . . . . . . . . . . . . 59 Controlling HSD Activity Naturally. . . . . . . . . . . . . . . . . . . . 61 Summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64 5 Testosterone: Cortisol’s Alter Ego. . . . . . . . . . . . . . . . . . . 65 What Is Testosterone? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65 Not Just for Men. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 Maintaining Balance: The Cortisol-to-Testosterone Ratio. . 69 Testosterone and Aging: Menopause and Andropause. . . 70 Testosterone and Weight Gain . . . . . . . . . . . . . . . . . . . . . . 71 Maintaining Testosterone Levels Naturally. . . . . . . . . . . . . 75 Summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 6 The Relationship Between Stress and Disease . . . . . . . . . 79 Metabolic Consequences of Elevated Stress Levels . . . . . 80 How Stress Makes Us Fat: Cortisol, Diabetes, and Obesity 82 Cortisol and Syndrome X. . . . . . . . . . . . . . . . . . . . . . . . . . . 94 Cortisol, Fatigue, and Insomnia. . . . . . . . . . . . . . . . . . . . . . 97 Cortisol and Sex Drive. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101 Cortisol, Suppressed Immune Function, and Cancer. . . . . 104 Cortisol and Cardiovascular Disease. . . . . . . . . . . . . . . . . . 110 Your Brain on Cortisol: Anxiety, Depression, and Alzheimer’s Disease . . . . . . . . . . . . . . . . . . . . . . . 113 Cortisol and Your Gut . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120 Cortisol, Connective Tissue, Osteoporosis, and Arthritis. . 122 Cortisol and Aging. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126 Summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128 7 Counteracting the Effects of Chronic Stress . . . . . . . . . . . 130 Adrenal Stress Testing Kits . . . . . . . . . . . . . . . . . . . . . . . . . 131 Controlling the Stress Response: The SENSE Lifestyle Program. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132 Contents vii Stress Management and Avoidance (or Where Did Our Vacations Go?). . . . . . . . . . . . . . . . 134 Exercise. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144 Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147 Supplements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154 Guidelines for Choosing and Using Dietary Supplements . 157 Choosing Supplements. . . . . . . . . . . . . . . . . . . . . . . . . . . . 158 Using Supplements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 162 8 Dietary Supplements for Stress Adaptation . . . . . . . . . . . 164 Supplements Versus Prescription Drugs . . . . . . . . . . . . . . 164 Supplements to Avoid. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168 Vitamins and Minerals for Stress Adaptation . . . . . . . . . . . 178 Cortisol-Control Supplements. . . . . . . . . . . . . . . . . . . . . . . 192 HSD-Balancing Supplements . . . . . . . . . . . . . . . . . . . . . . . 208 Testosterone-Control Supplements . . . . . . . . . . . . . . . . . . 210 Adaptogens (General Antistress Supplements) . . . . . . . . . 218 Relaxation and Calming Supplements . . . . . . . . . . . . . . . . 227 9 Putting It All Together: The SENSE Lifestyle Program. . . 242 Be the Balloon: The “3S” Approach to Managing Metabolic Adaptation . . . . . . . . . . . . . . . . . . . . . . . . . 243 Stress Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 246 Exercise. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 249 Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 260 Supplementation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 274 Evaluation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 278 Concluding Words. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279 Appendix: Putting the SENSE Lifestyle Program to the Test. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 281 Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 283 References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 286 Resources. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 313 Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 316 Important Note The material in this book is intended to provide a review of information regarding the effects of stress and cortisol levels on health. Every effort has been made to provide accurate and dependable information. The contents of this book have been compiled through professional research and in consul- tation with medical professionals. However, health-care pro- fessionals have differing opinions, and advances in medical and scientific research are made very quickly, so some of the information may become outdated. Therefore, the publisher, authors, and editors, as well as the professionals quoted in the book, cannot be held respon- sible for any error, omission, or dated material. The authors and publisher assume no responsibility for any outcome of applying the information in this book in a program of self- care or under the care of a licensed practitioner. If you have questions concerning your nutrition or diet, or about the ap- plication of the information described in this book, consult a qualified health-care professional.