Stress Awareness Month: highlighting the connection between stress and the gut
Stress Awareness
Throughout life, we face many challenges that can lead to feelings of overwhelm, worry and mental tension, which together can be referred to as ‘stress’ (World Health Organization (WHO)., 2023). Stress is a natural response to difficult situations and can occur in waves throughout the life cycle. In the UK, more than 72% of people report feeling stressed more than once a month, with 86% of 18–24-year-olds and 83% of 25–34-year-olds experiencing more stress than any other age group (Statista., 2024). Experiencing prolonged periods of stress can cause a significant strain on a person’s health and well-being, and therefore it is critical that stress is addressed before this impact occurs.
Is there a relationship between stress and the gut microbiome?
When it comes to mental-wellbeing, there is a well-established relationship between the brain and the gut, referred to as the ‘gut-brain axis’, where bacteria in the gut have evolved to communicate effectively with the host along this pathway. Research has shown that aspects of our mental well-being are tied to our gut health and our gut microbes can influence mood and cognitive function.
Stress can directly impact the gut and the microbes residing there. During periods of stress, the autonomic and circulatory systems can carry signals to the gut indicating distress and cause a shift in the composition of gut bacteria (Madison and Kiecolt-Glaser., 2019). Importantly, stress and changes in mood also impact nutrition, which is a key factor influencing gut microbiome composition. Low mood and stress often lead to a drive to consume highly processed foods with lower nutrient profiles and influence how much or how little we eat. Together, stress and dietary changes can have a big impact on the composition of gut microbes in the gut, which when sustained long-term, as in the case of chronic stress, can lead to dysbiosis whereby beneficial bacteria are unable to thrive (Madison and Kiecolt-Glaser., 2019). This, in turn, can alter lead to disorders of the gut-brain axis, such as those characterised by gastrointestinal disturbances, thus having a further negative impact on health (Foster et al., 2017; Madison and Kiecolt-Glaser., 2019).
Gut health and stress management
Because stress can have a significant impact on gut health, and because there is a bidirectional relationship between the gut and the brain, there are a number of lifestyle-related recommendations that you can make to support your patients.
1. Recommend biotics
Probiotics and prebiotics can support the abundance of beneficial bacteria in the gut and promote a favourable gut microbiome balance. Research shows that probiotics and prebiotics can increase the production of microbiota-derived metabolites, such as short chain fatty acids (SCFAs). SCFAs have been shown to reduce the circulation of pro-inflammatory cytokines and corticosterones associated with stress in stress-induced mice (Suganya and Koo., 2020). In humans, increasing the abundance of bacterial species with stress-protective properties to protect the host from the physiological effects of stress (Ansari et al., 2023).
2. Suggest meditation
Meditation is considered ‘exercise for the brain’ and is a proven technique for supporting mental wellbeing (Moral., 2017). Evidence shows that meditation can have a moderate impact on anxiety and feelings of low mood, and therefore should be considered alongside other strategies to promote mental wellness (Goyal et al., 2014).
3. Encourage regular exercise
Exercise has been shown to promote the release of neurotransmitters, such as dopamine and serotonin, which are associated with feelings of calmness and happiness (Pujari., 2024). These neurotransmitters have mood-regulating benefits, therefore participation in regular exercise could promote mental wellness and reduce feelings of stress, worry and anxiety (Pujari., 2024).
4. Where appropriate, recommend the inclusion of fermented foods
Fermented foods, such as live cultured yoghurt, sauerkraut, kimchi and kombucha, contain live probiotic bacteria and have been shown to impact the gut microbiome when included in the diet both short and long-term (Leeuwendaal et al., 2022). Many of these foods are now widely available in supermarkets. Encourage your patients to sample these foods to find what they enjoy and feel could become a part of their everyday diet.
The Takeaway
It’s normal to experience stress from time to time, however, chronic stress can be detrimental to health and negatively impact gut health due to the close relationship between the gut and the brain.
References
Ansari, F., Neshat, M., Pourjafar, H., Jafari, S.M., Samakkhah, S.A. and Mirzakhani, E. (2023). The role of probiotics and prebiotics in modulating of the gut-brain axis. Frontiers in Nutrition, [online] 10. Available at: https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2023.1173660/full.
Foster, J.A., Rinaman, L. and Cryan, J.F. (2017). Stress & the gut-brain axis: Regulation by the microbiome. Neurobiology of Stress, [online] 7(7), pp.124–136. Available at:https://www.sciencedirect.com/science/article/pii/S2352289516300509.
Goyal, M., Singh, S., Sibinga, E.M.S., Gould, N.F., Rowland-Seymour, A., Sharma, R., Berger, Z., Sleicher, D., Maron, D.D., Shihab, H.M., Ranasinghe, P.D., Linn, S., Saha, S., Bass, E.B. and Haythornthwaite, J.A. (2014). Meditation Programs for Psychological Stress and Well-being. JAMA Internal Medicine, [online] 174(3), p.357. Available at: https://pubmed.ncbi.nlm.nih.gov/24395196/.
Kato-Kataoka, A., Nishida, K., Takada, M., Kawai, M., Kikuchi-Hayakawa, H., Suda, K., Ishikawa, H., Gondo, Y., Shimizu, K., Matsuki, T., Kushiro, A., Hoshi, R., Watanabe, O., Igarashi, T., Miyazaki, K., Kuwano, Y. and Rokutan, K. (2016). Fermented Milk Containing Lactobacillus casei Strain Shirota Preserves the Diversity of the Gut Microbiota and Relieves Abdominal Dysfunction in Healthy Medical Students Exposed to Academic Stress. Applied and Environmental Microbiology, [online] 82(12), pp.3649–3658. Available at:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4959178/.
Leeuwendaal, N.K., Stanton, C., O’Toole, P.W. and Beresford, T.P. (2022).Fermented Foods, Health and the Gut Microbiome. Nutrients, [online] 14(7), p.1527. Available at: https://pubmed.ncbi.nlm.nih.gov/35406140/.
Ma, T., Jin, H., Kwok, L.-Y., Sun, Z., Liong, M.-T. and Zhang, H. (2021). Probiotic consumption relieved human stress and anxiety symptoms possibly via modulating the neuroactive potential of the gut microbiota. Neurobiology of Stress, [online] 14, p.100294. Available at: https://www.sciencedirect.com/science/article/pii/S2352289521000023.
Madison, A. and Kiecolt-Glaser, J.K. (2019). Stress, depression, diet, and the gut microbiota: human–bacteria interactions at the core of psychoneuroimmunology and nutrition. Current Opinion in Behavioral Sciences, [online] 28(3), pp.105–110. Available at:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213601/.
Moral, A. (2017). Guided meditation: A regimen for mental health - proquest. [online] www.proquest.com. Available at: https://www.proquest.com/openview/ab91b3055b517eba66868a414ad91b9f/1?pq-origsite=gscholar&cbl=2032134.
Pujari, V. (2024). Moving to Improve Mental Health - The Role of Exercise in Cognitive Function: A Narrative Review. Journal of Pharmacy and Bioallied Sciences, [online] 16(Suppl 1), p.S26. Available at: https://journals.lww.com/jpbs/fulltext/2024/16001/moving_to_improve_mental_health___the_role_of.9.aspx.
Statista (2024). UK: share of people who felt stressed monthly by age | Statista. [online] Statista. Available at:https://www.statista.com/statistics/1469914/share-of-people-in-the-uk-who-felt-stressed-monthly-by-age/.
Suganya, K. and Koo, B.-S. (2020). Gut–Brain Axis: Role of Gut Microbiota on Neurological Disorders and How Probiotics/Prebiotics Beneficially Modulate Microbial and Immune Pathways to Improve Brain Functions. International Journal of Molecular Sciences, [online] 21(20), p.7551. Available at: https://www.mdpi.com/1422-0067/21/20/7551/htm.
World Health Organization (2023). Stress. [online] World Health Organization. Available at:https://www.who.int/news-room/questions-and-answers/item/stress.
Zhang, N., Zhang, Y., Li, M., Wang, W., Liu, Z., Xi, C., Huang, X., Liu, J., Huang, J., Tian, D., Mu, J., Liao, X. and Zhai, S. (2020). Efficacy of probiotics on stress in healthy volunteers: A systematic review and meta‐analysis based on randomized controlled trials. Brain and Behavior, [online] 10(9). Available at: https://onlinelibrary.wiley.com/doi/full/10.1002/brb3.1699.