Stress and pain diminish quality of life for millions of Americans and cost billions in healthcare expenses and lost wages.

Surveys suggest most Americans feel they’re experiencing unhealthy levels of stress, and nearly 80% of adults say they’ve endured more stress in the past 5 years.Aboutone-thirdofadultssurveyed reported physical and mental complications from too much stress (APA 2013). Meanwhile, 1 in 3 Americans suffers from chronic pain—most commonly back pain and osteoarthritis—more than the number affected by heart disease, cancer and diabetes combined (IOM 2011). For many people, chronic stress and pain occur together.

What can diet do about a problem this large? As tempting as “comfort foods” may be, they are full of fat and sugar and counterproductive for dealing with stress and pain. Fortunately, researchers are finding that a few key nutrition habits may reduce the effects of stress and pain on the body.

Fighting Stress With Food

A little stress in our lives is beneficial (Aschbachar et al. 2013). However, feeling too much stress too often or for too long is clearly harmful. Stress tells the body to unleash its “fight-or-flight” response, prompting the release of stress hormones—including cortisol, noradrenaline and adrenaline—to prepare for a physical feat. The thing is, while this response worked well for our hunter-gatherer ancestors who really did have to fight or flee, it does not work well for modern-day emotional or psychological stress. Repeatedly triggering the stress response takes a toll in the form of high blood pressure, impaired relationships, anxiety, depression, addiction, obesity, and other conditions such as chronic pain.

Several strategies for alleviating stress have been well studied and documented. They include making a concerted effort to minimize stressors, engaging in meditation and physical activity, and nurturing strong social relationships. Unfortunately, too many people turn to a detrimental coping method—eating—which leaves them feeling lazy and sluggish, depressed about their bodies and disappointed in themselves. This outcome contributes to weight gain and an increased risk of obesity. Stressed-out people recognize what’s happening but still have a hard time breaking the cycle (APA 2013).

While it is generally a bad idea to eat for psychological reasons, there are beneficial ways to use food to manage or prevent complications from stress. An area of emerging interest and promise is applying healthful nutritional strategies not only to help beat stress but also to stay healthy in spite of chronic stress.

Promoting Our Happiness Hormones

Chronic stress can reduce levels of serotonin, the body’s “feel-good” hormone. Serotonin is thought to be a key moderator of mood, appetite, sleep and memory. Some foods that may increase serotonin contain high levels of tryptophan, an amino acid needed to produce this “happiness hormone.”

Incorporating tryptophan-rich foods into a daily nutrition strategy is often advised as a way of raising serotonin levels and countering stress and depression. Additionally, vitamin D may enable the body to convert tryptophan to serotonin more effectively (Fox 2015). Other amino acids—like tyrosine, methionine and phenylalanine—also serve as precursors to important neurotransmitters (dopamine and gamma-aminobutyric acid, or GABA) that influence mental health. How well these amino acids can cross the blood-brain barrier to impact mental health is variable and an area of active investigation.

Nutritional strategies may also be aimed at decreasing the intensity or effects of stress-induced conditions like high blood pressure, anxiety, depression and insomnia. For example, potassium-rich foods can assist in lowering blood pressure. Some herbal substances, such as chamomile (Amsterdam et al. 2009), may lessen anxiety and depression, and there is some evidence that foods like tart cherries may improve sleep quality through production of melatonin (Howatson 2012).

Nutrition and Chronic-Pain Response

People who feel chronic stress are more susceptible to developing pain. This may be due at least in part to the body’s inability to regulate inflammation when stress keeps cortisol levels chronically elevated. The inflammation contributes to pain and other harmful effects such as an increased risk of cardiovascular disease. Consuming foods that fight inflammation is one way to help blunt the pain response.

Omega-3 fatty acids are among the most studied and best-known nutrients with potent anti-inflammatory effects (Calder 2013). Incorporating these powerful agents into a regular meal plan can lessen the burden of stress and pain, helping to preserve good health. Options range from including omega-3-rich fatty fish like tuna and salmon into a weekly meal plan to adding omega-3-rich foods to common meals (for example, tossing chopped nuts or avocado into a salad). The sidebar “Foods That May Help to Fight Pain” suggests more nutrients and foods that may assist with managing pain.

Nutrition Is Medicine

Ultimately, nutrition plays a substantial role managing chronic stress and pain, though the precise mechanisms and requirements for attaining this benefit are still under active scientific investigation. While scientists unravel the details, thinking of nutrition as medicine may improve the outlook of people who endure chronic stress and pain, while also enhancing their overall health.

Stress-Fighting Foods

The following foods may not make the stress go away, but they may reduce the negative health effects that are highly associated with chronic stress, including depression, anxiety, insomnia and cardiovascular disease.

  • Turkey, shrimp, dairy, soy and pumpkinseeds contain high amounts of the amino acid tryptophan, which is associated with a boost in the “happiness hormone” serotonin, which in turn may lessen depression and anxiety.
  • Broccoli, Brussels sprouts and asparagus are loaded with folic acid, a vitamin associated with serotonin production.
  • Dairy products, sunshine and other sources of vitamin D may boost serotonin levels through an increase in the enzyme that converts tryptophan to serotonin.
  • Oatmeal and other complex carbohydrates can stimulate the brain to produce serotonin. Carbohydrates that are absorbed more slowly help to ensure a steadier supply of serotonin.
  • Oranges, grapefruits, red and green peppers, and many other fruits and vegetables are rich in vitamin C, which can aid in lowering blood levels of stress hormones like cortisol and adrenaline and ease the subjective feeling of being stressed.
  • Crunchy veggies like carrots and celery sticks don’t possess any special nutritional content for fighting stress per se, but the crunchy sensation that comes from eating them provides mechanical stress relief.
Foods That May Help Fight Pain

The active compounds found in these foods have been credited with helping to reduce pain, sometimes to the same extent as commonly prescribed nonste- roidal anti-inflammatory medications. Some of the studies—on humans and animals—into the role of these foods in pain management are promising, but the research is in its infancy.

  • Red grapes, peanuts and cranberries all contain resveratrol, identified as a biologic that may fight pain. Most of the research has been on animal models, but the nutrient shows promise. Red wine also contains resveratrol, but using alcohol to reduce pain is generally not recommended.
  • Ginger has been found effective as an anti-inflammatory medication for pain manage-ment in people with osteoarthritis and rheumatoid arthritis (Ribel-Madsen et al. 2012).
  • Hot peppers contain capsaicin, which is knownto blunt the pain response (Leong et al. 2013). But beware—these chilis arehot! Capsaicin may be more practical in topical creams or ointments.
  • Green tea and pomegranates are loaded with potent antioxidants with decreased inflammation and pain relief (Leong et al. 2013).
  • Tumeric is a widely used spice–expecially common in South Asian dishes such as curry–that has been associated with anti-inflammatory effects owing to its active ingredient curcumin, which reduces the activity of inflammatory enzymes in the body (Kuptniratsaikul et al. 2009).Take the Quizwww.ideafit.com/ifjquiz or mail the quiz on page 82.antioxidants associated with decreased inflammation and pain relief (Leong et al. 2013).
  • Turmeric is a widely used spice—especially common in South Asian dishes such as curry—that has been associated with anti-inflammatory effects owing to its active ingredient curcumin, which reduces the activity of inflammatory enzymes in the body (Kuptniratsaikul et al. 2009).
The Stress Response

Stress triggers a series of reactions in the human body:

  • When the brain detects stress, it secretes a substance called corticotropin-releasing hormone from the hypothalamus, a part of the brain responsible for linking the nervoussystem with the endocrine system.
  • This signal tells the pituitary gland, a pea-sized part of the brain just below the hypothalamus, to release adrenocorticotropic hormone (ACTH).
  • ACTH travels to the adrenal glands, which release the “stress hormones”—cortisol, noradrenaline and adrenaline.
  • Stress hormones cause heart rate, breathing and blood pressure to rise. The hormones also help to increase blood flow to the large muscle groups, dilate the pupils to increase vision and release stored glucose into the bloodstream.

During acute stress, these hormones assist the body in mounting the critical fight-or-flight response. The larger problem for most people is chronic stress, which can keep cortisol levels elevated and cause considerable harm to the body, including disruption of serotonin balance and chronic inflammation, which contributes to chronic pain.


References

Amsterdam, J.D., et al. 2009. A randomized, double-blind, placebo-controlled trial of oral matricaria recutita (chamomile) extract therapy of generalized anxiety disorder. Journal of Clinical Psychopharmacology, 29 (4), 378-82.
APA (American Psychological Association). 2013. Stress in America. Accessed Jan. 2, 2015. www.stressinamerica.org.
Aschbachar, K., et al. 2013. Good stress, bad stress and oxidative stress: Insights from anticipatory cortisol reactivity. Psychoneuroendocrinology, 38 (9), 1898-1708.
Calder, P.C. 2013. Omega-3 polyunsaturated fatty acids and inflammatory processes: Nutrition or pharmacology? British Journal of Clinical Pharmacology, 75 (3), 645-62.
Fox, J.C. 2015. Research suggests vitamin D could affect brain function. Boston Globe. Accessed Jan. 5, 2015. www.bostonglobe.com/lifestyle/health-wellness/2015/01/05/research-suggests-vitamin-could-affect-brain-function/kdJThHsLlEpVRrdaesCSOK/story.html.
Howatson, G., et al. 2012. Effect of tart cherry juice (Prunus cerasus) on melatonin levels and enhanced sleep quality. European Journal of Nutrition, 51 (8), 909-916.
IOM (Institute of Medicine). 2011. Relieving pain in America: A blueprint for transforming prevention, care, education, and research. Accessed Jan. 2, 2015. www.icm.edu/Reports/2011/Relieving-Pain-in-America-A-Blueprint-for-Transforming-Prevention-Care-Education-Research.aspx.
Kuptniratsaikul, V., et al. 2009. Efficacy and safety of Curcuma domestica extracts in patients with knee osteoarthritis. Journal of Alternative and Complementary Medicine, 15 (8), 891-97.
Leong, D.J., et al. 2013. Nutraceuticals: Potential for chondroprotection and molecular targeting of osteoarthritis. International Journal of Molecular Sciences, 14 (11), 23063-85.
Ribel-Madsen, S., et al. 2012. A synoviocyte model for osteoarthritis and rheumatoid arthritis: Response to ibuprofen, betamethasone, and ginger extract–a cross sectional in vitro study. Arthritis. doi: 10.1155/2012/505842, epub 2012 Dec. 31.

Natalie Digate Muth, MD, MPH, RD

Natalie Digate Muth, MD, MPH, RD

"Natalie Digate Muth, MD, MPH, RDN, FAAP, is a board-certified pediatrician and obesity medicine physician, registered dietitian and health coach. She practices general pediatrics with a focus on healthy family routines, nutrition, physical activity and behavior change in North County, San Diego. She also serves as the senior advisor for healthcare solutions at the American Council on Exercise. Natalie is the author of five books and is committed to helping every child and family thrive. She is a strong advocate for systems and communities that support prevention and wellness across the lifespan, beginning at 9 months of age."

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