Modern research has demonstrated conclusively that one of the greatest risks for developing the major diseases of our time – diabetes, heart disease, cancer, infections, and arthritis – is allostatic load and abnormal stress-hormone levels.  It is my job as a physician to not only help people recover from illness, but to do everything possible to optimize well-being and reduce the likelihood of chronic disease. In my 35 years of practice at the Moss Center for Integrative Medicine, I have helped a number of my patients lower their stress levels and improve their overall health – these are the 4 key lifestyle changes I typically recommend:

1. Eat a healthy diet

 My clinical experience has taught me that food can have a great impact on the ability to adapt to stressful circumstances. Increasing cortisol production and the stress response through the consumption of bad fats, food allergens, and high-glycemic-index carbohydrates leads to greater vulnerability to the inevitable stress that accompanies our lives.

 With the breakthroughs in epigenetics (as described in Chapter 9 of The Adaptation Diet), we know even more about the importance of diet on cortisol and health. Empowering every person to learn to enhance adaptation and preserve a healthy genome through the use of good nutrition and bioactive foods is the ultimate goal of my book. I have presented compelling research about the impact that environmental toxins, including heavy metals and chemicals (POPs), have on the genome and the risk for chronic disease. Though there is little public awareness and almost no government oversight of the epigenetic effects of these toxins, it is possible with the information in this book for every person to make appropriate choices to reduce their toxic load, improve adaptation, and increase the chances for a robustly healthy life and healthier children.

To maintain adaptation and high-level wellness, proper food choices and dietary supplements need to be supported by good self-care. After all, it is estimated that up to 75 percent of medical visits have a stress-related component. Relaxation and adequate rest, meditation techniques, exercise and outdoor time, intimacy and laughter, time with friends and family, a rich spiritual life, healthy expression of emotions and needs, and health-promoting attitudes and behaviors are all part of adaptation and longevity. A detailed discussion of all these areas is beyond the scope of my book – however, all of these areas are critical to maintain adaptation.

2. Get some exercise

Exercise is another important component of adaptation. When I ask my patients what they do to decrease their stress, most reply that they work out at a gym or do other forms of aerobic exercise, the more intense the better. There certainly is benefit from aerobic exercise, including improved insulin sensitivity and blood-sugar levels, higher HDL cholesterol, lower total cholesterol, better weight management, and improved blood pressure. However, from the perspective of regulating cortisol, this is not always a great solution. In fact, the response to aerobic exercise or weight lifting is a temporary increase in cortisol, which is needed to reduce the inflammation triggered by the workout. This is why so many people who already might be marginal in their adrenal reserve do badly with this type of exercise.

 If you feel that the result of an aerobic workout does relax you and doesn’t trigger excess fatigue, then stick with it. However, for many people, walking at a brisk pace (three separate ten-minute walks a day has been shown to have tremendous benefit if time does not permit longer walks), low-intensity cycling, or swimming are better cortisol regulators. Better yet are yoga, tai chi, or qigong techniques. These exercises directly improve cortisol function through breathing techniques, slow movement, qi generation, and a feeling of slowing down and grounding. Including one of these ancient arts with a meditation technique that can be done at home is a powerful approach to adaptation.

3. Practice optimism

Beyond diet and exercise, changing the way you manage stress and how you think about stressful situations can have a dramatic adaptive impact. One example of the effect of attitudes on life experience is the quality of optimism. Optimists live longer, stay healthier, and are generally happier. Though optimism is considered a trait that one either possesses or doesn’t, it is possible for anyone to adopt the qualities of optimists. Optimists take responsibility for their actions but not for what they can’t control. Having a positive view of life events, optimists feel in control of their lives and expect success and happiness to be theirs. They feel they have the ability to fix what is wrong, deal more directly with stress, and eventually overcome difficult situations.

4. Keep your composure

Another key attitude is feeling in control of one’s life. Even more than other factors, maintaining a sense of control in a stressful situation can reduce allostatic load and help regain adaptation. The attitude that one can affect the course and destiny of one’s life has been shown to improve healthy aging. A belief that difficult situations can be effectively managed reduces feelings of helplessness and hopelessness, leading to lower cortisol levels and improving resistance to many chronic diseases. Control means that you are not at the mercy of circumstances that you can’t impact. At the very least, you can control your reaction to a situation.

Simple changes in attitudes like these can go a long way toward adaptation and health. For some of my patients, adopting proper dietary practices was not possible because of underlying issues, such as feeling out of control or being pessimistic. However, eating better brings about less depression and anxiety and empowers people to make the needed changes to maintain health. It is a classic chicken-and-egg phenomenon: poor control of cortisol leads to mental states that prevent some people from making the right choices to improve cortisol regulation, leading to continued allostatic load.

Next-steps: How YOU can manage your stress levels

 I have presented a very simple way of breaking out of this dilemma. If the first step can be taken by doing the initial elimination and detoxification diet (detailed in The Adaptation Diet), then in the majority of people there will be an immediate reduction in allostatic load and better cortisol management. This often leads to an improved mental state and a greater chance to make the long-term changes of the Adaptation Diet (controlling cortisol, reducing fatigue, losing weight, increasing longevity, etc.).

 Through measurement of salivary cortisol in many of my patients, I have been able to track improvement in their allostatic load from the Adaptation Diet. However, I don’t think the average person needs to do cortisol testing to know when they are better adapted. As soon as the aches and pains reduce, digestive symptoms disappear, energy improves, and the mood stabilizes, you can be assured that biochemical adaptation is occurring. And as an extra bonus, losing weight generally follows improved adaptation. Reducing stress and cortisol through the Adaptation Diet is a step in maintaining health and aging well. Combining this with other effective self-care approaches is the answer to adaptation and health.