Nutrition Counseling, Stress and Cortisol

Debunking, reframing and gentle approaches

By: Molly List

What is stress? Is it a visitor we know of all too well? I invite you to think about your experience of this feeling or state of being. It’s often psychological, emotional, biological and social in nature. Our stress response often comes with three phases – alarm, resistance and exhaustion. And we often face a feeling of shock, make attempts to cope or adapt and wind up feeling overwhelmed or burnt out especially when we are facing it for a prolonged period of time. Did you know that there are different types of stress? Let’s take a look at what types there are and lay some ground work around defining stress.

Understanding stress

According to The American Institute of Stress, stress can be identified as either distress, stress that negatively causes discomfort and harm, or as eustress, a positive kind that often supports you in improving your performance. 

• Distress is one type of stress, often defined as “physical, mental or emotional strain or tension,” or, “a condition or feeling experiences where a person perceives that demands exceed their available personal or social resources.” When chronic (over an extended period), distress can impact our physiology in a way that perpetuates states like anxiety, depression, cognitive impairment and heart disease. 
• Eustress has positively been associated with replenishing our feelings of energy, can enhance our cardiovascular health, boost endurance, and sharpen cognitive function, supporting overall mental acuity and motivation. Does this shock you? 

Regardless of the type, there’s a unique interplay between our systems in mediating a stress response, involving our nervous, endocrine and immune systems.  And there are a variety of categories to stress based on the duration, source and response – acute (“fight or flight/flee”), chronic (over an extended period), environmental, psychological, traumatic, episodic, acute and lastly physiological (illness, injury, sleep deprivation, or nutritional deficiency-related). 

Two systems are at play and can become activated during a run in with stress – 

(1) sympathetic-adreno-medullar system (SAM) axis, or (2) hypothalamic-pituititary-adrenal system (HPA) axis. Both systems exist to support you in fighting a threat or fleeing a situation, essential, as you can see — 

• SAM axis activation causes a sudden increase in norepinephrine and epinephrine from our adrenals resulting in an increase in smooth and cardiac muscle tissues, meaning increased blood pressure, heart rate, skeletal muscle blood flow, sodium retention and the making of new glucose for energy occurs! As energy floods into the workings of these systems, gut motility often slows to conserve energy. 
• HPA axis response is slower than SAM axis, where the hypothalamus signals to your anterior pituitary gland then to the adrenal glands for hormones like cortisol to be secreted for circulation in and throughout the body. This axis is also signaled in response to our circadian rhythm, meaning cortisol levels are high in the morning and low at night. More to come on cortisol! 

Stress’ impact on the gut

Our sympathetic nervous system (“fight or flight/flee”), when triggered, slows gastric emptying and overall gut motility, as well as results in a reduced blood flow to the gut and prevents gastrointestinal secretions and nutrient absorption from being supported – not great, though when this system’s turned on, it can help our energy to be shuttled elsewhere, rather towards supporting us in fighting or fleeing.  

Stress-induced gut motility changes can look like diarrhea or constipation, stress impacting the mucosal layer of the GI (gastrointestinal) tract which can increase permeability of the lining increasing likelihood of inflammation or infection. Since the gut and brain talk to one another, there can be a dysregulation of the axis due to stress which can exacerbate GI disorders. 

Chronic stress can weaken the immune system increasing likelihood of complications like H.pylori gastric ulcers, bleeding and more. 

Laying groundwork on cortisol 

Cortisol is a glucocorticoid produced by the HPA axis, originating from the adrenal cortex (located on top of each kidney) and is controlled by the sympathetic nervous system. Did you know cortisol is made from cholesterol? Not only does it mediate our stress response but it also plays a role in regulating metabolism, our inflammatory response and immune function and can affect nearly every organ system – nervous, immune, cardiovascular, respiratory, reproductive, musculoskeletal, integumentary.

Cortisol is produced in response to illness, injury, trauma or psychological stimulus, supporting the body in accessing energy quickly to respond to a perceived threat. As already mentioned, cortisol follows a 24-hr cycle, typically peaking 30 minutes after waking and declining throughout the day, lowest levels usually during the early sleeping phase. 

How cortisol works to support waking up, or a fight/flee response – 

• Increases availability of blood glucose to the brain 
• Acts on the liver, muscle, adipose tissue and pancreas and increases the making of new glucose in the liver
• Muscle cells decrease the uptake of glucose since they have their own reserve of energy
• Increase protein and lipid breakdown
• Increases glucagon to pull out stored glucose from the body, and decreases insulin via working with the pancreas 

It’s amazing how our bodies were built to move through and to cope with stress. We might note that what can trigger stress can be a multitude of things — 

a tight work deadline, a difficult relationship, a traumatic event, news regarding the health of a loved one, not having anything prepared/planned out for dinner, poor air quality, navigating financial difficulties, and so much more. 

Chronic stress leads to our body’s system believing that we require a constant state of being prepared to fight or flee. More chronically being in a greater stressed state can impact our blood pressure, heart and blood sugar management, mental health and more long term. 

Some symptoms that relate to chronically elevated cortisol levels include increased fat deposition in the face, shoulder blades, and abdominal areas, muscle weakness, impaired glucose tolerance, hypertension, hair loss, trouble sleeping, impaired immune function, difficulty concentrating, bone density loss/osteoporosis and more. 

And then on the flip side, adrenal insufficiency, inadequate levels of cortisol, is often autoimmune related, and symptoms include fatigue, loss of weight, hypotension, hyperpigmentation of the skin. 

Overall, hyper- or hypo-cortisolism exists for many individuals, often related to tumor presence, autoimmune disease, or due to corticosteroid use for things like inflammatory disease management. 

Keep in mind what else could perpetuate chronic stress or elevated cortisol levels – stressing about stress or cortisol levels!  It can be supportive to start with, foundationally, some of what will be discussed below, before speaking with your healthcare provider about cortisol testing through blood, saliva or urine, and too, such discussions might be helpful to have with a trusted registered dietitian!

Let’s discuss the hype on “anti-” cortisol or “cortisol detox”-ing, and how to instead gently promote cortisol balance with talking nutritional strategies with a registered dietitian as well as things beyond nutrition. 

Nutritional Strategies for Cortisol Balance 

Forgeo Cortisol Detox Diets, Adrenal Resets 

Be leery of products and eating plans that promote “detox” as such products or plans are often not tested for safety or studied for effectiveness. Our bodies are naturally equipped to detox or remove toxins or impurities from the body – our liver, colon, sweat and kidneys are some places or sources for removal of these types of substances. A multitude of “resets” already occur within our body, and too we have a circadian rhythm that controls many aspects of our internal clock. Additionally be cautious of really restrictive or deprivational regimented eating or lifestyle plans as they can impact our ability to nourish yourself adequately, lead to nutrient deficiencies, and can negatively impact your relationship to food and your body. 

Gentle Nutrition for Stress Management and Cortisol Support 

Here are some simple yet effective ways to support stress WITHOUT stressing yourself out. 

1. Consistent and regular eating. 

Skipping meals or long periods of time without food can signal stress to the body, leading to a rise in cortisol to maintain blood sugar levels. 

• Where to start? Aim to eat within ~1 hour of waking, and space eating intervals to every 3-4 hours to support a steady supply of energy. Listen to your body’s hunger cues as well. Choose foods that satisfy you. Bring in convenience items to allow for time and energy to be spent on some not all aspects of meal and snack preparation. 

2. Thoughtful, balanced macro-nutrient intake.

Ensure a good balance of carbohydrates, proteins and fats at each meal, and the pairing at least two within snack times to help regulate blood sugar and provide sustained energy. 

• Carbohydrates – provide glucose, the brain’s primary fuel. Weave in complex carbohydrates or fiber containing carbohydrates for sustained energy release; grains, vegetables, fruits, legumes. 
• Proteins – help slow down absorption of carbohydrates, promoting greater satiety, stable blood sugar; meats, poultry, fish, eggs, dairy products, tofu, tempeh, lentils, beans, nuts, seeds. 
• Fats – essential for hormone production and overall cell function/structure, also contributing to satiety; avocados, nuts, nut butters, seeds, oils, fatty fish. 

3. Weave in nutrient-dense foods within food and beverage choices.

Certain vitamins and minerals support the body in stress response and adrenal health; greater depletion with stress. 

• Magnesium – known for sleep, calming effects with nervous system connection
  • sources: dark leafy greens, nuts, seeds, legumes, whole grains, dark chocolate 
• B vitamins (B5, B6, B12, folate) – crucial for energy production, neurotransmitter synthesis, increased depletion during stress. 
  • sources: grains, meats, eggs, dairy, leafy greens, legumes, nuts, seeds. 
• Vitamin C – antioxidant that supports adrenal function, immune health.
  • sources: citrus fruits, berries, bell peppers, broccoli, kiwi
• Omega-3 fatty acids – anti-inflammatory properties, supportive of brain health, beneficial in managing stress. 
  • sources: fatty fish, flaxseeds, chia seeds, walnuts. 

4. Hydration

Dehydration can be a physical stressor on the body, potentially impacting cortisol levels. 

• Start hydrating early and throughout the day; choose preferred beverages, caffeine-free; opt for adding in hydrating foods like fruits; consider electrolyte repletion; talk with your registered dietitian or health care provider on appropriateness of supplementation. 

5. Mindful eating practices 

Meal and snack times can be an opportunity to check in with yourself and support calm, where possible. How you eat plays a significant role in managing stress and supporting digestion too.

• Consider slowing down, paying attention, tuning in to hunger, fullness, and releasing judgment around food choices. It could start with taking 3 slow, deep breaths before eating! 

Beyond Nutrition 

1. Adequate sleep – chronic sleep deprivation impacts cortisol levels; aim for 7-9 hours a night; try to establish a consistent sleep schedule, bedtime routine. 
2. Stress management techniques – actively managing stress is crucial for lowering cortisol – meditation, deep breathing exercises, yoga, spending time in nature, engaging in enjoyable activities; ASK FOR or GET HELP, whether at home, work, with your nutrition, within your family or friend circle, therapist, or a trusted health care provider. 
3. Regular, joyful movement – engage in enjoyable activity – walking, dancing, gardening, gentle stretching. 
4. Social connection – nurture relationships with friends, family and find community; spend time with people who uplift you. 

I invite you to see that there is choice in how to view and address the stress you experience. I welcome you to choose intention over perfection. Balancing cortisol levels isn’t about strict rules or deprivation, it’s about meeting yourself where you are at and getting curious as to in what ways might you be able to support yourself in feeling more empowered and not overwhelmed in ways to find greater resiliency around stress management in your life. 

Resources; links to references below… 

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Explore Your Relationship with Food with a Registered Dietitian in Raleigh, NC

Thinking about food all the time isn’t a sign that you’re failing, it’s a signal that something deeper wants to be heard. Nutritional counseling in Raleigh, NC can offer you the space to explore that signal with compassion and care. At Nutritious Thoughts, we help clients unravel the “why” behind their food thoughts, reconnect with their bodies, and create relationships with food that feel sustainable, grounded, and peaceful.

• Contact us at (828) 333-0096 or email info@nutritious-thoughts.com
• Tell us more about yourself.
• Food thoughts aren’t a flaw—they’re a signal. Let’s listen with compassion.

Expanded Counseling Services at Nutritious Thoughts

At Nutritious Thoughts, nutritional counseling in Raleigh, NC is just one way we show up for our community. In addition to individual sessions, we also offer Community Wellness & Education programs that bring thoughtful, inclusive conversations about food and body trust into schools, treatment centers, and workplaces. These workshops and trainings offer space to reflect, unlearn, and reimagine your relationship with food in community. Whether virtual or in-person, our goal is always the same: to make compassionate, weight-inclusive support accessible where it’s needed most. Reach out if you’d like to learn more about how we can support your organization.