Stronger, Sharper, Healthier: The Power of Good Stress
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Welcome to the WebMD Health Discovered Podcast. I'm Dr. Neha Partak, WebMD's Chief Physician Editor for Health and Lifestyle Medicine. For many of us, the stress in our lives feels like the enemy, something we want to dodge at all costs.

But what if we've been thinking about stress all wrong? In this episode, we're taking a fresh look at stress through a new lens. The surprising idea that certain types of stress are not only helpful, but absolutely essential for living longer, healthier, and happier. From boosting our cells' ability to repair everyday damage to revving up our internal cleanup processes, our bodies are equipped with

remarkable defense systems that come alive under just the right amount of pressure. So today, we'll explore how modern life often deprives us of the beneficial stressors, like bursts of physical activity or challenges that push us just slightly out

outside of our comfort zones and why chronic never-ending stress is a completely different beast. We'll explore how simple tweaks to our daily routines can spark these good stress pathways, leaving us more resilient

energized, and better prepared to handle life's ups and downs. If you've ever felt overwhelmed by stress, but recognize that some stress is actually really important for our health, you won't want to miss this conversation. First, let me introduce my guest, Dr. Sharon Berquist.

Dr. Perquist is a board-certified internal medicine physician, research scientist, lifestyle medicine pioneer, and author of the book, The Stress Paradox, Why You Need Stress to Live Longer, Healthier, and Happier.

Welcome to the WebMD Health Discovered podcast, Dr. Berquist. I'm delighted to be here. So before we dive into the science, I'd love to hear about your own health discovery and what inspired you to write The Stress Paradox. What was the turning point in your journey or your career that made you rethink your approach to stress?

So I've been practicing internal medicine now for 25 years. And the overarching question that my patients have is, how do I stay healthy? How do I not depend on medications? And how can I age well so that I can be around for my grandchildren and grandparents?

Even though those are seemingly simple questions in the modern world that we live in that's nudging us towards becoming sick, it's actually a very hard thing to figure out how do we do this in a practical way. And that triggered for me an absolute obsession of how can we reimagine and rethink health care.

so that what we do for our patients puts them on this path of disease prevention, of aging well, and less reliance on the healthcare system as well as medications.

That led me down a journey of not only implementing different things in my practice, but also led me down a path of research into understanding the pathways that build health, not just contribute to disease, but actually build health.

and designing lifestyle programs that help people accomplish their goals, looking at biomarkers that catch disease at earlier stages. So that's been the inspiration, and it's been an incredible journey with incredible outcomes in my patients and in my personal life.

As you're talking, what resonates with me is that most of us think about health as something that is the opposite of having stress in our lives. So I would love to sort of have you kind of unpack that in terms of thinking about stress as something harmful and you're kind of challenging that conventional wisdom and thinking about stress as potentially good health.

Stress versus bad stress. So can you help us understand the difference? Yeah. And stress as a medical concept was discovered around 90 years ago. And even though there's so much we've learned since then, the predominant association is with how it was originally discovered, which is as a threat and an alarm system.

And that's how we understand stress. We think of it as fight or flight and that, you know, modern day, we think we're running from a saber-toothed tiger, but we're not. And a lot of the research around stress has been on understanding the harms of chronic stress. But there are different stress responses in our body. Besides the alarm system triggered by our autonomic nervous system, we also have a stress response system at the level of our cells.

And it's happening at a different timescale rather than the split second. Over hours to days and even over a lifetime through epigenetic changes, the stress, even though it was brief, is creating long-lasting changes in our body.

purpose of these cellular stress responses is not to harm us. It's actually to help us adapt to our environment, to become stronger so that the next time we encounter stress, we're better able to handle it. So I think what's

what we need to do is understand stress in a broader way. Yes, certainly chronic stress, the kind that we're exposed to every day can harm. That is unquestionable. But we also have to understand that there are certain types of stress, which are called hormetic stress. This is from the term hormesis is from a Greek word to excite.

These beneficial stressors help us adapt and we need these types of good stressors to help us become stronger. And the paradox really is that we need them to build resilience to the types of stress that we're working so hard to avoid and control.

control in our lives. So let's sort of unpack each of those pieces. Tell us about how good stress, what's the science behind it helping us live longer? When we activate these cellular stress responses, what we're doing is we're activating our body's natural ability to heal. And

Our body can heal itself, but we're not giving it the right stimulus to do the job it's there to do. When we undergo brief stressors, these hormetic stressors, what we're doing at the level of our cells is what I call the four R's.

We are resisting damage. We are repairing damage. We're recycling damaged components through cellular renewal process, and we're recharging ourselves. We're creating more energy in our body. And the reason that's important is if we ask the question of what leads to disease, what leads to the aging process?

It's changes that are happening at the level of our cells and molecules. It's inflammation. It's oxidative stress. It's impairment in our mitochondria that create energy. It's damage to our DNA. So on any given day, there are 10,000 injuries to our DNA, which is incredible, right? That's seven a minute.

And our body is in the background constantly trying to repair. Stress is the way we activate these defenses so that we can stay in balance. Right now, when we don't activate these healing responses, we're out of balance. We're getting the damage from our environment, but we're not really neutralizing or countering it with the capability we all have.

to become stronger and healthier, right? So this is the most powerful medicine we have at our disposal. And it's there hidden in plain sight.

How does this apply to mental and emotional stress as well? If you go back to what leads to our mood getting impaired. So if our cells don't function well, it also impacts our cells. For example, if we do emotional challenging tasks often,

One of the things that we do is release this growth factor called brain-derived neurotrophic factor. And it's strengthening the connection in our cells, and it's also increasing the number of good cells. And that is one way that we're improving the networks in our brain. And that translates not only in how we make better decisions and creativity, but it also improves our mood. And

And one of the beautiful things about good stress, these hormetic stressors,

is this phenomenon of cross-adaptation. We can use any one of the stressors and you can build resilience in really a cross-adaptive way, meaning you can use a physical stress to build emotional resilience and become happier, kind of have a brighter mood, more creative, and vice versa. And that's really a key thing because sometimes people feel stuck that the only

The only way that they can manage stress is by meditation, by mindfulness. And some people have a really busy mind and that doesn't always work. But knowing that you can, for example, do a high intensity interval training that also ramps up this brain-derived neurotrophic factor. So does intermittent fasting.

You can use these other ways to build resilience in the brain, build that neuroplasticity, and that can help your mood. It can help you manage stress. So I think it really comes down to what leads to the imbalance that creates the mood state that you're in and how can you get to the root of it.

Can you talk a little bit about some of the ways that our modern systems negatively impact our ability to handle stress and maintain good health? Yeah. So one of the key things here to differentiate is what makes stress good?

And what makes stress bad? So the stress that we associate as harmful is chronic, continuous stress. So situations that make us feel stuck, things like contentious relationships, a work situation that leads to financial hardship or some insecurity, things of that sort.

What makes stress good is our bodies are designed for brief, intermittent types of stress. And that goes back to how our ancestors were exposed to stress in their natural environment. So for over 2 million years, the natural stressors that our ancestors faced were these brief, acute episodes of stress.

And our physiology has come to depend on these for our growth and our healing. In our modern world, really in the last two centuries, a little bit more, there's been radical changes in our culture. And it's introduced a lot of comfort. And some of that has been incredibly beneficial, right? The leading cause of death is no longer starvation because we have refrigeration.

We have incredible techniques to deal with infections, which were, again, a leading cause of that. So some of the progress has been very welcome. It's advanced our living experience dramatically. But with that, we have removed some of these natural stressors, things that

were every day for our ancestors, like plant chemicals, intervals of high intensity exercise, thermal stress from heat and cold, right? Our ancestors didn't have air conditioning and heating. Because of refrigeration, we now eat all throughout the day. Our ancestors really by default had to have periods of fasting and they were forced to be challenged to explore new territory. Like

Humankind has been the most incredibly successful species on Earth, and we wouldn't have done that if we weren't always pushing at what's beyond the horizon. How can I explore and push where I'm living? Right. We expanded across Earth. And as we have become more comfortable, we have removed the need for exposure to these types of stress areas.

And that is actually making us more vulnerable to mental and physical illnesses that we're seeing today. And the simple idea behind that is a concept called bioplasticity. So it's essentially the biological equivalent of use it or lose it.

If we experience the stimulus of stress, we adapt to it. And if we remove that stimulus, which is what we're doing in our modern world, we lose it. We lose those capabilities. We become vulnerable.

So again, we need some amount of stress. And the key is differentiating the harmful stress that is draining us, it's exhausting, it's depleting us, it's leading to burnout versus the healthy kind of stress, this good stress, which is energizing, exhilarating, empowering, and health promoting. You mentioned plant chemicals and exposure to plant chemicals making us stronger or being less

one type of good stress. Can you dig a little bit into that piece?

Yeah, this is where understanding our connection to plants and our food environment has changed and is just radically different from what we think. So plants have chemicals called phytochemicals. And for a long time, we've thought that consuming phytochemicals is how we get antioxidants. And that's part of the story, but the story is actually a little more complicated than that.

Plants make the phytochemicals in response to stress in their environment. Things like drought, UV light, insects, us as humans trying to eat them. And the phytochemicals make the plant stress resistant. Their microbiome actually makes those phytochemicals.

When we as humans consume those plants, they activate our stress responses. So the same way they make the plant stress-resistant in its environment, those same phytochemicals are making us stress-resistant.

For example, if we consume sulforaphane, which is a plant chemical in broccoli and cruciferous vegetables and kale, what's happening is it activates a master regulator called NRF2. That master regulator ramps up our antioxidant defenses, our ability to metabolize different toxins in our environment. If we consume compounds that have resveratrol, for example, grapes, pistachios, dark chocolate,

resveratrol activates another one of our cellular stress responses called the sirtuin response or sirtuins. And they help improve our mitochondria. They trigger mitochondrial biogenesis, which is making more mitochondria. It is increasing our energy ability. And when we have more mitochondrial energy, we experience more energy. So the plant's response to stress builds our defense against stress.

which is kind of a radical way of thinking about why we need plants and how much disease fighting ability we're getting from plants. And right now in America, only one out of 10 people is getting the recommended fruits and vegetables. So in the book, I go through 10

Phytochemicals that we know activate are healing stress responses and some of the foods, there are charts with foods that contain these phytochemicals. But a really simple way to think about this is just get more fruits and vegetables, beans,

lentils, nuts, seeds, spices. If you're doing that, you are well on your way to leveraging the power of food. Since we're on the topic of food, let's move on to intermittent fasting as another sort of stressor. Because of our modern conveniences, we don't necessarily need to eat in this pattern. But what are the benefits with regard to good stress for incorporating intermittent fasting? And what are your best advice in doing that?

Intermittent fasting can be many things, and I want to be clear on what I'm meaning by it because there's so many different ways to do it. And what I'm advocating for is what is called a circadian fast. It's eating in 12 hours or less, so fasting 12 hours or more.

and doing it in a way that mirrors what our circadian biology is designed for, which is digesting food mostly earlier in the day and having less in the evening. And truly, this is normal eating. What we're doing today, which is consuming our calories over 15 hours, and we're getting over 45% of our calories at dinner or later. And

And the problem is our bodies are trying to unwind in the evening. Our insulin levels are lower. Our ability to metabolize the same food is less in the evening. So we're going to get a larger spike of glucose, a larger spike of insulin and more.

We need our insulin levels to go down overnight because that is what activates all these healing responses that we're talking about. The housekeeping functions that take damaged components out of our cells, the repair mechanisms that are making our DNA repaired from all the daily damage.

If we don't give our bodies enough time, which is the 12 or more hours, and the food pattern where our insulin level can get low enough to trigger these responses, we aren't doing the maintenance and repair that we need. So we're, again, out of balance. We're incurring daily damage.

we're not using our body's natural ability to heal it. I'd love to move on then to movement. So you mentioned high intensity movement as one of your good stressors. So talk to us a little bit about that.

If we go back to ancestral life, whether you were old or young, male or female, invariably you had to have periods where you had to do some level of vigorous activity, whether you were escaping from a predator, trying to hunt, it was just a part of life. And those intervals of intensity give us a unique benefit that we don't get from steady state, kind of a moderate intensity exercise.

What it does is it sends a very strong stimulus, a stress stimulus, and it triggers adaptations that make us, again, stronger, increase our capacity. In the case of exercise, it's one of the most powerful ways to improve our mitochondrial health, which is right now the center point of

all the metabolic disease that we're seeing in this country, when we get that strong stimulus, our body rapidly depletes energy with high intensity. And that rapid energy depletion is the signal to our body that we need to create more efficient energy. We increase our mitochondria and our body has a special form of autophagy called mitophagy.

where we're turning over damaged mitochondria and recycling so that we're creating healthier mitochondria. So we're not only renewing energy, we're also removing all the free radical emissions that are happening from the damaged mitochondria in our body. We're creating clean energy in our body. And if you look at studies that have compared continuous moderate exercise, so let's say you go for a brisk walk

versus people who get some intensity in that workout. For example, if you walk in intervals, so instead of steady state, you go really fast for a few minutes, and then you back off and walk slow, then really fast. So like, let's say every three minutes, you change the interval. By doing that, you build greater aerobic fitness. And that's

That is compared to people who are doing moderate intensity. So our body needs that little extra stimulus if we want to get the maximum health-promoting effect that our bodies are capable of. So in terms of practically speaking, how do you do that in your day-to-day life?

How do you incorporate these bits of bursts of activity? What I do is if I'm going up a flight of stairs, I'm just going to run up that flight of stairs. Similar if I'm going to get my car out of a parking deck at work, I'm going to just go really fast up that flight of stairs.

And so I think it's, you know, just little bits where you can get it to get that intensity. And all of these stressors are just little things you can be incorporating throughout your day. You know, it's just as simple as adding a plant food.

So just wanted to move on then to what you mentioned with regards to our exposure to various temperatures, so heat and cold. And I know that there's a lot of confusion. There's been a lot of media attention recently. Should you do cold baths? Should you not? What does this mean? What are the health benefits? So talk us through again, what do you mean by exposure to hot and cold and what are some of the benefits?

of those short-term exposures. Yeah, so a lot of media attention makes these seem like biohacks, that these are things that people obsessed with fitness or longevity should be doing. And what I want people to really understand is that these are everyday things that we all need. This is how we activate our body's ability to heal. So this is not just for biohackers, it's for all of us.

but it doesn't have to be extreme and it doesn't have to be expensive. So you don't have to have a cold plunge. You can just do 30 seconds of a cold shower. You don't have to have a sauna. You can do a hot bath at around 102 to 104 degrees. And

What the temperature is doing is, again, the common thread here is stress. It stresses your body. It activates this alarm reaction because our body wants to stay at 98.7 degrees Fahrenheit. That's how our enzymes work optimally. And when our core temperature either goes up or high, depending on cold or hot, our body is just going to kick in a stress response that gets our core body temperature back up.

In that process, we, of course, secrete a lot of stress hormones that we are familiar with, like norepinephrine, dopamine. But at a cellular level, we're doing exactly what these other stressors do. We're repairing DNA, reducing inflammation. We are activating heat shock proteins that are repairing the proteins in our body. So it's very health-promoting.

And temperature is one of the most underutilized everyday lifestyle practices we can all do. We can just turn down the thermostat to 60 degrees. And there are studies showing that just by doing that for the study did it for six hours in shorts and t-shirt for 10 days. That in itself increased metabolism. It increased the amount of brown fat, which is a special kind of fat that burns energy instead of storing energy.

I think that this is really interesting, this whole concept of biohacking or feeling like once you sort of decide that you're going to use a couple of these techniques, getting very compulsive maybe potentially about trying to follow some of these techniques. So tell us a little bit about what you're thinking about with regard to right amount, right dose, right type. How do you sort of think about that?

this as a lifestyle approach versus I'm going to do this as a hack. So getting at the right dose, this kind of Goldilocks dose that we're talking about, the hormetic zone that activates our healing responses but doesn't become chronic stress, right? So even a good stress can become harmful if it's too much.

The way you can feel your way to this zone is by pushing just a little bit past your comfort zone, but not to the point where you feel unsafe or overwhelmed. And that is going to be different for every person, right? So in the book, I have protocols that just create a framework so that every person can individualize these stressors in their life.

And it's going to be not only different person to person, but within the same person, it's going to be different day to day depending on our recovery. So that's kind of an overarching just past your comfort zone. You just have to be willing to get uncomfortable. If you want this inescapable, it's an inescapable part of the growth that I think we all seek.

And that we all have this ability to ramp up our human potential to live better lives if we just push past that comfort zone. So let's say we've followed these protocols. We're pushing past our comfort zone. Talk to us a little bit about recovery then. What should we be thinking about with regards to allowing ourselves to be in this recovery zone as well? Yeah, and I'm so glad you asked that because...

The key is not just to stress. You don't get all the benefits if you don't have adequate recovery. So it's during the stress that our bodies activate these healing defenses. We become more efficient. We ramp up our repair processes. It's in the recovery that we remodel and reconfigure our bodies to get to that healthier state.

Stress without the recovery can accumulate. It can become chronic stress. So think of it like a yin and yang, like peanut butter and jelly. They have to go hand in hand.

And the recovery is going to be different depending on the type of stress. And I go through this in great detail in the protocol. But if, for example, the stress is intermittent fasting or time-restricted eating, the recovery is going to be nutrient-dense meals with adequate protein, adequate fiber, and vitamins and minerals. If the

Stress is, for example, a really mentally taxing thing that you are working on. The recovery is going to be doing things like not like a deep rest, which are different than just zoning out and watching TV because you don't want a busy mind. You want to give your body the best chance of building neuroplasticity. So you either want to be out in nature or to do these forms of deep rest. So it depends.

Depends on the stress, but the point that you bring up, which is so important, is that it's mild to moderate stress for a short duration followed by recovery. Stress, recovery, repeat. Stress, recovery, repeat. That is the blueprint for us becoming our strongest, healthier, healthiest, and happiest self.

So talk to the listener who is really intrigued by what you've taught us today and wants to get started in incorporating this into their day-to-day life and maybe feeling a little bit overwhelmed.

Where should they start? And how do you envision someone incorporating good stress into their day-to-day routines? Yeah, I think the idea of adding stress in our lives right now just seems so counterintuitive that I think it's natural to have some level of resistance or skepticism about it. But I think...

I think the thing that anybody struggling with stress should just know is that we weren't made for stress. It's just that the type of stress that we're exposed to is the kind that we weren't designed for. And that's why it's leading to harm. So we don't have to fear stress and we certainly don't have to stress about being stressed. I think that's the key. It's a mindset shift.

And I want everyone to really start thinking about this as a mindset. So much of what we're told is what to avoid. Our environment is harming us. We have to get rid of the processed food. We have to stop being sedentary. It's all about avoidance and fear and all these pollutants and toxins. And yes, there's merit to that. But I want people to switch towards a mindset of abundance, of growth.

And the path to get to that is through stress. Can you talk to us a little bit more about from a cellular level to the level of our physiology, how these good stressors change?

change and shift our body and the benefits that these changes provide. And so one way to think about what we're doing with good stress is to think of our body and our cells as a savings account. When we're exposed to all these environmental harms that are happening every day, damaging our protein in our DNA, what we're doing is we're making withdrawals out of our health savings account.

When we choose good stress, these forms of hormetic stress that are brief and intermittent, what we're doing is we are making deposits into that account. I think

I think that what we want to do is build our account, right? We want to build resilience. And that's ultimately the goal so that we can prevent disease and slow the aging process. So beautifully said. I've been talking about this with a lot of other moms in my community where we really want to build this bank.

for a time when in the future we might have to contend with an illness or a big stressor. And so the more we have in our bank, I love your analogy, the better able we'll be able to manage any kind of future stressor. Right. And that's what resilience is.

resilience is building your defenses. It's using stress to fortify your body in a way where down the road, if you get an unexpected illness, your ability to fight it is greater. For example, we know that if we use mental stress to build our cognitive reserve, our risk of dementia is lower by about 45%. So

So yes, we need to make these small investments throughout our life. And good stress is one of the most powerful ways to do it.

And that builds our resilience because there's so much that's unavoidable and unpredictable in our future. Can you say your mantra one more time so that we can take that home with us? And then I'd like to give you just the final few minutes of our time together for just a few more practical tips, strategies that you might want to share with our audience. So the mantra is stress, recover, repeat. Stress, recover.

recover, repeat. What we know from the science of good stress from hormesis is that every time you expose yourself to one stress and then give yourself time to recover, there's a ceiling effect of how much it can increase your human potential. And it's about 20 to 25%. So going for really intense, big doses of stress aren't going to make you stronger, right? It just teeters into chronic stress.

But when we do these repeatedly, stress, recover, repeat, over time, we can increase our human potential 60 to 90%, right? Think about that. We can almost double our human potential. And that's why this is so powerful. That's why we need a mindset of growth, empowerment, of activating our energy.

innate ability to fight disease, age better, live a better life, and live a life with more joy.

Today, we discussed the stress paradox. We learned that while long-term, unrelenting pressures can harm our bodies and minds, short bursts of the right kind of stress can be a powerful tool for building health. It's all about finding those small, controlled ways to push just a little bit beyond our comfort zone.

Whether it's a quick interval workout or giving our guts the chance to rest with an overnight fast or turning the shower dial briefly to cold, the key is to pair any good stressor with intentional recovery so we give our cells a chance to feel the stress and

and then a chance to repair and adapt. Rather than fearing stress, we can embrace the body's natural resilience. Tapping into a new mantra that I'm really interested in repeating over and over, stress, recover, repeat for better energy, stronger defenses, and a brighter mindset.

So don't be afraid to step a bit outside your comfort zone. To find out more information about Dr. Berkwist, visit drsharonberkwist.com. Well,

We'll have that information in our show notes. Thank you so much for listening. Please take a moment to follow, rate, and review this podcast on your favorite listening platform. If you'd like to send me an email about topics you're interested in or questions for future guests, please send me a note at webmdpodcasts at webmd.net. This is Dr. Neha Bhattak for the WebMD Health Discovered Podcast. ♪