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Getting a little heavy? If you're past 40, the real cause of weight gain may be stress Tuesday, April 24, 2001 By Virginia Linn, Post-Gazette Staff Writer
Dr. Pamela Peeke isn't subtle when expressing her distain for dieting. "Dieting is the single most horrific thing. ... It's the most stressful experience men or women could self-induce."
The National Institutes of Health researcher offers another solution to controlling weight and promoting a healthier lifestyle: Learn to control your stress.
In her bestseller published last year, "Fight Fat After Forty," the internist targets what she calls "toxic stress" as the culprit in putting on "toxic weight" -- the kind of life-threatening fat that collects in the abdomen instead of the hips, turning what one of her patients described as an "hourglass figure into a shot glass."
While these sound like marketing buzzwords, the assistant clinical professor of medicine at the University of Maryland School of Medicine said there's strong science to back it up.
She will discuss her findings as part of her keynote speech to the Pennsylvania Dietetic Association on May 1. Her speech at the Sheraton Station Square is open to the public.
Peeke, a former NIH research fellow who works in the developmental endocrinology branch of the National Institute of Child Health and Human Development, said three things typically happen, particularly to women, when they enter their 40s.
First, they become more sedentary, which contributes to a lowered metabolism. Second, their sex hormones decline as they approach menopause. Estrogen promotes fat storage in the hips, thighs and buttocks -- primarily as a repository of fat for breast-feeding. As estrogen disappears, the fat storage site shifts to the abdomen, she says. Those with more fat in the belly vs. the hips face higher risk of cardiovascular disease, diabetes and cancer.
If a woman remains active, this shift shouldn't contribute to any significant or life-threatening disease, or major weight gain. But all too often, women are also dealing with chronic, unrelenting stress, which Peeke says produces a flood of cortisol from the adrenal gland. Prolonged cortisol secretion triggers the flow of insulin, a potent appetite stimulant and fat storage hormone that causes even more weight to settle in the waist.
The abnormally high cortisol in the bloodstream also triggers an unrelenting appetite for fat and carbohydrates, she says.
People display three distinct eating responses to stress. There are stress resilient individuals, stress overeaters and stress undereaters. The resilient person adapts to stress, perhaps with exercise or meditation. But both the overeater and undereater sees stress as uncontrollable, which keeps cortisol continually elevated. For these individuals, the goal is to become stress resilient.
In her book, Peeke outlines seven-day meal plans customized for each stress eater. Among her mantras: Toss out all those fat-free foods. They replace fat with sugar and tempt stress overeaters to overindulge.
And when you eat is just as important as what you eat. She emphasizes the importance of mid-morning and mid-afternoon snacks, smaller portions (what she calls "Woman Food") and avoiding refined and processed sugars and starches such as white bread, rice, pasta and potato. People instead should eat dark and fibered starches such as whole wheat bread, rice, pasta and sweet potato.
Even so, these "healthy" starches should be eaten primarily before 5 p.m. because the 40-something body metabolizes the sugars differently. So she's devised the "Over-40 Carb Clock" that is based on the glycemic index, a ranking system of carbohydrates based upon their effect on blood sugar, and therefore insulin. And try to finish dinner by 8 p.m. ("If you eat after 8, you gain a lot of weight.")
A centerpiece of her weight-management advice is teaching people to effectively navigate what she calls the CortiZone, the time from 3 p.m. through evening when cortisol and adrenaline levels decrease in the bloodstream and individuals are at greatest risk for stress eating. That's the time when "the vending machine is calling you," she says.
Plan ahead by having high quality/low-stress foods on hand, such as fruits and vegetables, low-fat yogurt or cottage cheese.
Since her book was published last year, Peeke has gone on to focus with other researchers on the impact of cortisol on certain diseases such as breast cancer. She'll discuss the progress in this area in her Pittsburgh speech.
Peeke, who is in her mid-40s, is a stress overeater. Any kind of licorice -- Good and Plenty, Twizzlers, etc. -- pushes her stress buttons. Once she recognized how stress was affecting her, especially during the CortiZone, she learned to bring it under control. "It's all about being aware."
She's turned to running as a stress reliever and plans to run the New York Marathon in the fall, taking with her a group of her patients, including breast cancer survivors, to participate.
Exercise and meditative practices such as massage or yoga have a big impact in reducing coritsol in the body. Recognizing the power of the mind over the body is crucial in keeping stress and weight gain in check, she says.
"This isn't hoochie coochie, woo woo, medicine anymore."
Dr. Pamela Peeke will speak from 9 to 10 a.m., May 1, as part of the Pennsylvania Dietetic Association annual meeting at Sheraton Station Square. Cost is $10 at the door.
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