April 3, 2023 • 2hr 1min

Dr. Elissa Epel: Control Stress for Healthy Eating, Metabolism & Aging

Huberman Lab

In this episode, Dr. Andrew Huberman interviews Dr. Elissa Epel, a professor of psychiatry at UCSF and expert on stress, aging, and metabolism. They discuss Dr. Epel's research on how stress impacts various aspects of health and aging, as well as evidence-based tools for managing stress and improving wellbeing. Key topics include the nuances of different types of stress responses, the links between stress and eating behavior, how meditation and mindfulness practices affect biology, and emerging research on "positive stress" interventions like breathwork.

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Key Takeaways

Stress is not inherently bad - some stress is necessary and beneficial for optimal aging and health. Underexposure to stress can lead to more rapid aging than ideal amounts of stress.
Our thoughts are the most common form of stress. Overthinking and rumination propagate internal stress even when external stressors are not present.
Short bouts of stress, when managed well, can be beneficial by mobilizing energy stores and potentially raising our threshold for reacting to future stressors.
The "challenge response" to stress involves viewing stressors as opportunities for growth rather than threats. This leads to better physiological outcomes like increased cardiac output and oxygenation to the brain.
Stress and eating are closely linked for many people. Stress can drive compulsive eating and cravings, particularly for high-fat, high-sugar "comfort foods".
Mindfulness practices like body scans can help reduce food cravings and break cycles of stress-induced overeating.
Long-term meditation practice is associated with slower biological aging, including longer telomeres and dampened inflammatory gene expression.
Radical acceptance of chronic, uncontrollable stressors can help reduce their negative impacts. Trying to "pull on a brick wall" only depletes our energy.
Both "leaning in" to challenges and learning to "let go" are important stress management skills. We need a balance of both approaches.
Brief daily practices like breathwork, nature exposure, and mindful check-ins can help reduce stress arousal and build resilience over time.

Introduction

In this episode, Dr. Andrew Huberman interviews Dr. Elissa Epel, a professor of psychiatry at UCSF and expert on stress, aging, and metabolism. They discuss Dr. Epel's research on how stress impacts various aspects of health and aging, as well as evidence-based tools for managing stress and improving wellbeing. Key topics include the nuances of different types of stress responses, the links between stress and eating behavior, how meditation and mindfulness practices affect biology, and emerging research on "positive stress" interventions like breathwork.

Topics Discussed

Understanding Different Types of Stress (6:18)

Dr. Epel explains that stress is not inherently bad, but rather refers to any time we feel overwhelmed or that demands exceed our resources. She distinguishes between:

Acute vs. chronic stress - Short-term stress followed by recovery vs. ongoing stressful situations
Good vs. bad stress - Some stress is necessary and beneficial
Stressors vs. stress responses - External events vs. our internal reactions

Our thoughts are the most common form of stress in modern life. Overthinking and rumination propagate internal stress even when external stressors are not present.

Tools for Managing Overthinking and Rumination (12:50)

Dr. Epel suggests three categories of strategies for managing stress-inducing thought patterns:

Top-down cognitive strategies - Changing beliefs and mindsets
Body-based approaches - Using the body to change the mind (e.g. breathwork, exercise)
Environmental shifts - Changing our surroundings to reduce stress triggers

She emphasizes the importance of awareness and catching ourselves when we get stuck in unproductive thinking loops.

Acute, Moderate and Chronic Stress (15:37)

Dr. Epel outlines different durations and intensities of stress:

Acute stress - Minutes to hours, followed by recovery
Moderate stress - Days to months to cope with an event
Chronic stress - Ongoing situations lasting years that we can't change

She notes the importance of daily restoration practices to offset the impacts of chronic stressors we can't eliminate.

Stress Benefits, Aging & Cognition (21:23)

Dr. Epel discusses research showing that some stress exposure is beneficial for optimal aging and cognitive health. Complete absence of stress is associated with worse outcomes than moderate stress. She gives an example of a study where elderly people who tutored at-risk youth showed hippocampal growth, highlighting how purposeful challenge can be beneficial at any age.

The Stress Challenge Response (32:19)

Dr. Epel explains the difference between a threat response and a challenge response to stress:

Threat response - Feeling survival is at risk, high cortisol, vasoconstriction
Challenge response - Viewing stress as opportunity, increased cardiac output and oxygenation

The challenge response is associated with better problem-solving, less inflammation, and potentially slower cellular aging. She notes we can train ourselves to shift towards more of a challenge response.

Stress, Overeating, Craving & the Opioid System (37:40)

Dr. Epel discusses her research on stress-induced eating:

About 50% of people with obesity show compulsive eating tendencies exacerbated by stress
Stress drives cravings for high-fat, high-sugar "comfort foods"
Repeated bouts of stress eating lead to increased abdominal fat storage
The opioid system is involved in the rewarding aspects of stress eating

Tools for Breaking Overeating Cycles (48:55)

Dr. Epel outlines evidence-based approaches for reducing stress-induced overeating:

Mindful eating practices - Checking in with hunger levels, slowing down, increasing body awareness
Riding out cravings - Learning to "surf the urge" without acting on it
Changing food environments - Removing tempting foods from home/work
Brief supportive interventions - Even short periods of motivational support can help

Soda and Sugary Drinks (54:44)

Dr. Epel discusses efforts to reduce sugary drink consumption, noting:

Liquid sugar is particularly harmful as it's rapidly absorbed
Removing soda from workplaces led to weight loss in heavy drinkers
Even diet sodas may perpetuate cravings and overeating

Meditation, Aging and Neuroplasticity (1:17:28)

Dr. Epel reviews research on the long-term impacts of meditation practice:

Long-term meditators show signs of slower biological aging (e.g. longer telomeres)
Even short-term meditation interventions can boost telomerase activity
A week-long meditation retreat led to dramatic changes in gene expression
Benefits of meditation were particularly strong for those with early life adversity

Chronic Stress and Radical Acceptance (1:29:49)

For dealing with chronic, uncontrollable stressors, Dr. Epel emphasizes the importance of radical acceptance:

Recognizing what we can't change and "putting down the baggage"
Letting go of wishing things were different
Focusing energy on what we can control
Using metaphors like "dropping the rope" attached to an immovable brick wall

Stress Management and "Skillful Surfing" (1:45:25)

Dr. Epel uses the metaphor of surfing waves to describe skillful stress management:

We need to "muscle through" some waves and let go for others
Between waves, we can ease up and change direction
Recognizing when we have control and when we don't is key
Both "leaning in" and "letting go" approaches are valuable

Breathwork, Wim Hof Method, and Cellular Aging (1:52:49)

Dr. Epel discusses her ongoing research on the Wim Hof method:

Comparing low arousal relaxation to "positive stress" interventions like intense breathwork
Both approaches reduced anxiety and depression after 3 weeks
The Wim Hof method selectively boosted positive emotions over time
Examining impacts on mitochondrial enzymes, telomerase, and gene expression

Conclusion

This wide-ranging discussion highlights the complexity of stress and its impacts on health. While chronic, uncontrolled stress is harmful, some stress exposure appears necessary for optimal aging and resilience. A variety of evidence-based tools can help manage stress, from cognitive reframing to body-based practices like breathwork and meditation. Dr. Epel's research points to the potential for brief daily practices to shift our stress responses over time, potentially slowing biological aging processes. Her work on "positive stress" interventions like the Wim Hof method opens up exciting new avenues for leveraging controlled stress exposure to improve health outcomes.