Stress Less by Thea Singer - a Book Review

Since I'm writing this over Easter, I'll start with an egg-inspired question: do you like your science hard-boiled or soft-boiled? This book is definitely an 8 minuter: by no means hopelessly dry and tough but definitely not oozing with easily-swallowed and highly digestible protein.

Ah, proteins. There's a lot of talk of those in this book. And of hormones, enzymes, DNA, brain parts, cell structures and armies of lab rats.  If you did Human Biology in your later school years, or took a biochemistry paper, you'll be fine. If not, then you choose … find a quiet corner where you can concentrate on this fascinating stuff, or curl up with a novel for a relaxing read instead… really… you're in control, you choose…

…after all, a key message of Stress Less is that a sense of control is one of the keys to reducing our perceived level of stress. But I'm getting ahead of myself. After that slightly scary opening, I'd better tell you why I recommend this book!

Why read this book (if it's so scientific)?

Because it explains, accessibly, the latest science on ageing including the remarkable discovery that ageing processes within our cells apparently can be reversed.

Because it steps through:

• Diet
• Exercise
• Mind
• Social support
• Sleep

…and investigates the current state of knowledge about the impact of perceived stress on each, as well as interventions that appear to work better than others in addressing stress and in (possibly) slowing ageing processes.

Because it casts the interventions in a supportive manner.  One consistent theme was that it's no good if the interventions end up being one more way for you to beat yourself up and add to your stress!  Thus, for example, Singer reports on meditation techniques that don't make you feel a failure when chattering thoughts intrude.

Because each chapter contains a scientifically validated self test questionnaire which can make the book a more personal journey.

Because, unlike the last book I reviewed, it is an inclusive work. The author ranges widely and unapologetically, even in the face of science's tendency to want to narrow things. Singer undoubtedly respects the scientific method but she's prepared to draw her own conclusions on the best evidence available, rather than waiting for science to nail every last variable.  Thus, this book has a section on one of my favourite topics, optimism, triggered by the empirical observation that some women under huge stress are nevertheless resilient in terms of their cell ageing. You won't be surprised to hear that they are optimists.

Who is the author anyway?

Perhaps that wide-ranging approach isn't too surprising given that Thea Singer's online bio suggests she is something of a Renaissance woman. She has been a modern dancer, a pre-med student, a writing teacher at MIT, and a magazine publisher, too; she now spends much of her time writing about health and science.

One way the academic and writing influences translate into this book is that while she refuses to dumb down the complex stuff, she does make it intelligible through use of metaphors and similes. For example, Singer suggests we think of telomeres, the structures that cap the end of DNA strands, as being much like the plastic tips on shoelaces, where they do a similar job of stopping fraying.  She also peppers the book with cases studies to present the mindset of the stressed woman in an engaging way and to put a face to each chapter.

Singer has seemingly won the respect of the leading researchers at the forefront of the new science of stress as judged by her repeated access to many of them. I couldn't help noticing how many of these scientists were women, and, while Singer never makes any direct comment on this, I wondered if there was a bit of sly activism in her showcasing so many female scientific role models.  Or maybe there are simply many more women active in this branch of research…regardless, I did enjoy reading about so many smart women!

Blackburn and Epel

In particular, two prominent scientists Singer introduces us to are:

• Elizabeth Blackburn, born in Hobart, and inter alia a recent Nobel Prize winner in Physiology for her joint discovery with Carol Greider and Jack Szostak of telomerase, the enzyme that replenishes telomeres. Her recent research has been on the healthful effects of mindful meditation
• Elissa Epel, from California, the younger researcher who sought Blackburn's help with her study designed to explore whether telomeres' length could be used as a marker for chronic stress in humans. Epel, incidentally, wrote the book's foreword; she thinks the book should have been called Stress is the New Biological Clock but wryly concedes that Stress Less is probably more marketable...

Women and Chronic Stress

The target group chosen for Blackburn and Epel's groundbreaking 2004 study was mothers caring for chronically ill children. They were considered - rightly - a great example of people suffering chronic stress.  Compared to a low stress control group, these women, who all reported feeling under high levels of stress, were found to have significantly shorter telomeres (a sign of ageing) and lower levels of telomerase (the enzyme that can fix telomere length, if you recall).  What's more, the women who reported feeling the highest levels of stress for the longest duration had the shortest telomeres and lowest levels of telomerase.

This, then, was:

the first demonstration of a link that went from the macro (the psychosocial world where children whine and husbands see only in black and white) to the micro (the world inside our cells, tunnelling to our DNA)

From stress to ageing

Bob Sapolsky, one of the first scientists to comment on Blackburn and Epel's 2004 work traces a "speculative path of how chronic stress may do its dirty work."  In my own words, to give you a sense of the biochemistry you'll meet:

1. We perceive stress again and again, chronically
2. Stress hormones eg glucocotisoids are released again and again
3. These hormones increase oxidative stress (think: free radicals) on our white blood cells and the telomerase within them
4. The telomerase is no longer able to properly fix the telomeres capping our DNA strands
5. The telomeres thus get shorter and shorter and finally "fray", revealing open DNA strands
6. The cell becomes senescent, no longer able to divide but still able to spit poisons into surrounding tissues and thus age them too.

All downhill from here - not!

In a later study that ran for 12 months, Blackburn and Epel recruited older women caregivers, dealing with ailing partners. The results replicated the earlier 2004 project. However, this longitudinal study revealed something fascinating: over the year, some of the stressed women actually experienced a drop-off in their perceived stress levels (eg they obtained more help with caregiving) and what do you think happened?

Their telomeres lengthened and their telomerase increased.

In a nutshell, their biological ageing reversed.

The New Science of Stress

The idea that chronic stress is bad for us, and that it increases our susceptibility to diseases like diabetes, is not new.  And nor is it news that poor health can make us look and feel older than we are. What is new is knowing how stress in humans (rather than those long-suffering rats and fruitflies) actually wreaks havoc within us and also seeing the possibility that the havoc can be slowed and even reversed.

Actually, I should be careful not to oversimplify: the new science so far shows an association between individuals' perceived levels of psychosocial stress and ageing changes in their cells - Singer, surrounded by scientists, is very careful not to overclaim causality and refers, rather delightfully, to the "Talmudic world of science where every finding is ripe for further hair splitting".

It was Sir Isaac Newton who famously said,

If I have been able to see further than others, it is because I have stood on the shoulders of giants.

Similarly, the new science of stress has taken several long strides forward in the last few years, but it stands on the shoulders of the old science - and Singer goes into detail on both in the first two chapters. A tip: you can understand the new developments independently of the old, but you need the old science to make sense of some of the later material, so don't skip the first chapter!

Managing stress to slow the ageing process

I'll leave the last words to Singer. She writes that her approach to the Stress Less book has been driven by:

my own understanding of so many midlife women like me… We act… with definite intentions based on reliable, concrete information we've dug up ourselves. My intent is not to lay out an ironclad program for you to rigorously follow but rather to let you pick and choose your strategies for reducing stress. After all, lack of control and unpredictability induce stress. What all of us need, now more than ever, is to trust our own good minds to make our own wise choices.

P.S.

Galia read this book review and asked me what three things I would do differently as a result of reading this book. I'm only going to come up with two. Three would be too much like stress...

The first thing is that I am going to draw comfort and encouragement from the exercise chapter. The science says that too MUCH exercise (as in full-on overexercising) is as bad as never rolling off the couch. It's safer and healthier for my cells to keep it at the light-to-moderate level. For a while now, I've been power walking up our big hill at home, and jogging back down in a session that takes 30 minutes. Hey, that sounds about right, I shouldn't change it (but I do need to keep at it).

Second, and still looking for high impact, low effort insights, I'm going to follow some of the easy-to-implement dietary advice. Before breakfast, I will invest two seconds to take omega 3 and multivitamins to lengthen my telomeres.  And of an evening, I will download a fistful of the recommended nuts. Washed down with a glass of something (alcohol is not advised in the book, alas, but I don't care) they sound a perfect way to unwind from a stressful day...