Effect of a Lifestyle Program onHoliday Stress, Cortisol & Body Weight

S. Talbott, A. Christopulos, & E. Richards

Treehouse Athletic Club & SupplementWatch, Inc.

Salt Lake City, Utah

Conflict of Interest Statement

SupplementWatch, Inc. - none

TreeHouse Athletic Club - none

Shawn Talbott - author, The Cortisol Connection &supplement industry consultant

BACKGROUND

• The literature strongly suggests that stress/cortisol exposureis associated with increased appetite, weight gain, andspecifically 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 holidayweight 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.

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

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.

Years in work

Abdominal Obesity Stress-related cortisol

<10 <1011-20 >21 11-20 >2119

20

22

24

23

21

0

0.1

0.3

0.5

0.4

0.220.6

±2.2

21.5

±4.1

22.5

±3.7

P<0.05

0.04

±0.3

0.15

±0.6

0.34

±0.5

P<0.05

nmol/Lcm

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 intaketo 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.

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!)

METHODS• Fifty subjects started the program (42 women and 8 men) and

46 completed the program (40 women and 6 men).

• 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

28.8 + 4.8

BMI

86.7 + 11.232.4% + 6.9%78.5 + 16.344 + 7N = 46

Waist (cm)BF (%)BW (kg)Age (y)BaselineCharacteristics

The Cortisol Connection Diet

Fruits & Veggies

Concentrated Carbs

Lean Protein

Added Fat

Metabolic Controllers

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 differencesbetween pre/post measures. Statistical significance was

accepted at P < 0.05. Data are expressed as mean + SD.

RESULTSGlobal Mood State & Salivary Cortisol

-19.7%

Both, p < 0.05 compared to pre value

-18.7%

Global Mood State (POMS) Salivary Cortisol (ug/dL)

-19%

-41%

-14%

+29%

-40% -41%

RESULTSProfile of Mood States (POMS)

RESULTSBody Weight & Waist Circumference

-1.3cmp = 0.01

-0.6kgp = 0.03

Body Weight (kg) Waist Circumference (cm)

RESULTSBody Composition

+1.3kg

Fat Mass & Lean Mass (kg) Body Fat (%)

-1.9kg

-5.0%p < 0.05

CONCLUSIONS• Cortisol/stress exposure has been associated with

increased appetite, obesity, and abdominal adiposity.

• Control of cortisol/stress would be expected to reduceappetite and enhance weight loss (metabolic effect) - andperhaps to improve compliance with the 8-wk diet andexercise regimen (behavioral effect).

• Results of this 8-week weight loss program suggest that acomprehensive stress management, exercise, nutrition,and supplementation regimen (SENSE) delivers positivechanges in mood, cortisol, body weight, body fat, andwaist circumference - even during the “high-stress”holiday period - and that weight gain during this time ofyear is not “inevitable”

GOOD

HEALTH!