Don’t Worry, Be Healthy  

There is a consistent and growing body of literature indicating relaxation and the steps we take to reduce stress are good for us

By: Dr. David L. Katz*

As our aircraft curled around the Cape of Good Hope, crossed the fabled Table Mountain and started to descend, I remembered reading somewhere that Cape Town is arguably the most beautiful city in the world. I couldn’t have agreed more.
My wife and I enjoyed a rare breakfast this morning, sitting in Adirondack chairs atop a wind-swept hill overlooking two ponds, rippling reeds, and beyond – the sparkling sea. I’m confident the therapeutic value of that brief idyll more than compensated for indulging in a croissant from our picnic basket. And science is on my side!

There is a consistent and growing body of literature indicating relaxation – and the steps we take to reduce stress – are good for us. I recently participated in the work of a colleague, Dr. Ather Ali, who reviewed effects of mind-body practices on blood pressure for his master’s thesis in public health at Yale. His review of 12 prior studies found support for a blood-pressure lowering effect of a variety of relaxation techniques – yoga in particular – rivaling that of medication.
While the science is evolving, intuition sprints ahead. It simply makes sense that perennial stress is a toxic exposure, and its amelioration – advantageous.
Biologically, our stress response is not designed to be switched on constantly. Like most if not all aspects of human physiology, stress has a functional basis, In this case the one known as the “fight or flight” response. This programming converts the perception of a threat into a surge in hormones called catecholamines, such as adrenaline and noradrenaline, which power up our muscles, heart, lungs, and vision.
Unfortunately, physiologic adaptations evolve over large expanses of time, and don’t account for sudden changes in the environment. The system that helped us deal with stalking predators and the club-wielding denizens of a neighboring clan is what we’ve got to deal with challenges like income tax forms, utility bills, voicemail, spam, and work- and family-related demands. Not to mention, other stressed-out – sometimes downright nasty – people trying to cope with the same things!
The constant, minor stresses of daily life activate our flight-or-fight system, raising levels of adrenaline and noradrenaline. By itself, this is a potential cause of high blood pressure, as these hormones act directly on blood vessels. Additionally, since hormones operate in an elaborate system of checks and balances, raised levels of catecholamines disturb the entire system.
Levels of cortisol, known to many as the ‘stress’ hormone, rise, increasing the risk of dangerous abdominal fat accumulation, and elevated cholesterol. Cortisol interferes with the actions of insulin, so insulin levels tend to rise, which can increase the risk of insulin resistance – and over time, diabetes.
The trouble in chronicling the health hazards attached to stress is the sense of helplessness it can impose; it’s nearly impossible to elude stress. The good news? We don’t have to. We just have to manage it.
The mind-body techniques, such as meditation, biofeedback, visualization, and yoga that appear to offer health benefits such as blood pressure reduction in the face of stress are not methods to avoid the stresses of daily life. Rather they are methods for processing those stressful exposures to minimize their physical damage. It’s possible to recognize stress and react to it in ways that dissipate it before a harmful hormonal cascade results.
To date, stress reduction methods remain at the periphery of medicine, consigned largely to “alternative” medicine practitioners, and the institutions that welcome them. But with growing appreciation for the cumulative damages of chronic stress, advancing insight into the underlying mechanisms, and increasing evidence that stress reduction methods offer measurable health benefits, this is sure to change.
But don’t wait! If stress is a factor in your life and an influence on your health, be sure you have some means to dissipate it. For me, it’s a daily workout and the periodic escape such as the outdoor picnic breakfast with my wife. For others, it’s a daily dose of meditation or yoga. For a nice overview of mind-body techniques of potential benefit to you, visit http://nccam.nih.gov/health/backgrounds/mindbody.htm. Confer with your health care provider about local resources. While our work suggested yoga may offer particular benefits, the overall message at present is that stress management – by whatever means best suits your disposition – is of likely importance. Whatever you do, don’t stress out about your choice!
Just choose something. In other words – don’t worry, be healthy.

* David L. Katz, MD, MPH, FACPM, FACP; Director, Prevention Research Center, Yale University School of Medicine and medical contributor for ABC News. He may be reached at www.davidkatzmd.com.)