Stress Eating and the Healthy Eating Meditation Practice

by Baxter

Breakfast of Champions by Melina Meza

Recently I had the good fortune to present an all-day workshop on Yoga for Healthy Eating at the Yoga Journal Conference in San Francisco. The workshop was in many ways a distillation of all of the ideas and information we have presented here at YFHA over the last 2+ years. And as I prepared for the day, and while I was presenting the workshop, the stories my students and workshop attendees shared with me really brought home once again how powerful our daily modern stresses are in derailing our attempts at healthy eating.

As we have addressed here previously, the stress response, which usually is NOT to a true life-threatening emergency these days, causes an immediate impulse behavior that is essential in a true emergency, when you need to act, not mull over what to do. But because we are usually at the desk or behind the wheel and not actually fleeing or fighting and expending energy, the impulse tends to override our commitment and willpower to maintain healthy eating habits. So sometimes we grab a snack as our impulsive reaction.

On top of that, the stress reaction releases extra cortisol into our blood stream, which hangs around a lot longer than the fast acting adrenalin and CRH hormone. And cortisol tends to increase our appetite, even if it is nowhere near mealtime. So we have yet another urge to eat. And since the body releases energy-rich sugar molecules into our bloodstream in those first moments of our stress response - molecules that have been stored in the body for emergencies - we tend to be more likely to want to replace them by reaching for carbohydrates that are rich in similar sugar molecules when that post-event cortisol appetite strikes. So we make another unhealthy choice by going for the snack foods and sugar-rich soft drinks so readily available at work and at the store! What’s a determined yogi to do?

Nina has suggested that a regular stress-reduction asana practice—with an active portion (such as a few rounds of Sun Salutations to address held physical tension in the body), followed by several restorative poses or even a supported easy inversion—combined with meditation and breath awareness -- is a good option for beginning to deal with the overall stress in your life. And we have also talked about how the stress response causes that immediate impulsivity, which Kelly McGonigal, PhD says reduces your willpower in the moment of the stressful event. But she also notes that a regular meditation practice tends to build willpower, possibly offsetting the stress response impulsivity and getting you through those daily stressful bumps. According to one study, even 10 minutes a day starts to do the trick after you rack up as little as three hours of total meditation time over several weeks.

All of this made me think about the times when you return home from a stressful day, fatigued and not wanting to or having the energy to do your stress management practice. So I came up with a 20 minute practice to address the general effects of stress and to support our resolve and will power to eat more healthy, that just about anyone can do when you first get home.

Before I share this fairly simple practice, I want to reiterate our recommendations on what to do in the moment of the stress event. Consider any of the following:

• Get up and take a short, brisk walk.
• Try one of our short office yoga practices, which you can do at work or just about anywhere.
• Drink a big glass of water and sit quietly, observing your breath for five minutes before acting on the impulse to eat.
• If you really feel you need to eat something, be prepared with healthy whole-food snacks you bring to work each day, or have in your purse or backpack before you leave home for the day.

For the 20-minute practice, I’m proposing a two-part meditation. You can practice this when you get home or, honestly whenever it suits your schedule. But I suggest you do it every day (we’ve said before and I’ll say it again: your bad habits never change without work and practice!).

Part 1:  This is your Stress Reduction practice, a 10-minute simple, reclined meditation. Before practicing, set a timer so you don’t have to worry about what time it is, because that is not relaxing. For this practice, lie in Relaxation pose for 10 minutes, and simply focus on your easy, natural breath as it enters and exits your body. That’s it. Try to stay gently awake. You can use a blanket support under your spine and head, or just a pillow to lift the head slightly. The purpose of this first meditation is to trigger the Relaxation Response that Herbert Benson first described back in the 70’s.

Part 2: This is your Willpower Boosting practice, a 10-minute seated meditation practice. Come up from your reclining position and sit with or without support on the floor, or use a chair if you prefer. Set your timer again for 10 minutes. Now, establish a nice inner lift from your sitting bones up to the crown of your head. Then pick a simple word or phrase to use as your mental focus, and repeat it to yourself mentally on each exhalation. You might use the phrase “healthy eating” as your intention, or pick something that works better for you. When you notice that you’ve become distracted, immediately return to repeating your phrase. This second meditation is not about relaxing, but about staying focused and concentrated on your intention. That does not mean you might not still feel relaxed at the end, but that’s not the purpose. Remember, studies have shown that meditations like this not only make meditating easier over time, but also improve a wide range of self-control skills, which is what we are after!

So there you have it—the 20-minute, two-part Healthy Eating Meditation practice! Give it a go for the next month. And let us know what changes you notice. No time like the present to make the change you want to see in 2014!

How Yoga Affects Breathing

by Baxter

Jellies by Melina Meza

As I was reading an interview in my latest yogauonline.com newsletter with physician and yoga therapist Loren Fishman, MD and his collaborator Ellen Saltonstall called Can Yoga Preserve Freedom of Movement? (hell, yeah!), a short statement from Dr. Fishman about how physical movement and the breath are connected caught my eye:

“…something that is really very poorly recognized in the medical or the yoga literature: that moving your joints is one of the strongest stimuli to breathing properly and deeply. There are little movement receptors inside all of our joints, and they send signals that go directly and indirectly to the apneustic center, one of the centers in the brain that regulate breathing.”

You may remember that a while back Nina and I wrote a post Falling for Yoga Myths about some of the things that really do stimulate and regulate our breath, and that I also did a post How Breath Affects Your Nervous System detailing the relationship between the Autonomic Nervous System and the breath. Part of my purpose for writing these posts was to correct some common misconceptions about breathing that continue to exist in the yoga community. You may recall that I mentioned that the levels of carbon dioxide (NOT oxygen) in the blood stream are monitored by the deep brain structures, and it is the CO2 levels that have some of the greatest influence on changes in breathing moment by moment. In addition, the brain and the periphery of the body are also assessing the acid/base balance of the blood, or the pH.

But now, Dr. Fishman adds in a new twist to our understanding of breath! Turns out that the same nerve receptors we have talked about in relationship to balance, called proprioceptors, which are located in the muscles, tendons and joints, affect breathing, too. Not only do they tell the brain where you are in space, how fast you are moving and in which direction, but also the movement of joints, tendons and muscles stimulate part of the brainstem that regulates breath called the apneustic center. Located in the part of the brainstem called the pons, the apneustic center is involved in stimulating our inspiration or “in breath.” Movement—physical movement—stimulates increased depth of breathing, known technically as “hyperpnea.” In a serious, life-threatening situation in which the breathing was slowing and shallow, moving someone’s limbs could stimulate the breath back to healthier levels. Cold water and pain can have a similar effect on breathing.

This connection between bodily movement and improved depth of breathing is helpful news, especially when it comes to people who have been previously inactive, have become stiff, suffered a loss of vitality and notice that their breathing does not respond well to physical stresses such as an increase in work load for their body. By beginning to move the joints and limbs systematically, as we would do in a beginning level yoga class, we are (without even mentioning how to breath) going to stimulate an increase in the depth of breathing. I am sure many of you have had this experience: at the start of class, during an initial sitting meditation or centering practice, the breath and chest feel slightly tight and restricted, but when your attention is brought to the breath at the end of a balanced yoga asana practice, the breath seems to have greater freedom and depth with less effort. This body-to-brain connection of the proprioceptors and the pons of the brainstem are likely at work. Just one more reason to keep moving your body!

To read all kinds of nerdy details on the physiology of breathing, check out the article Regulation of Breathing.

Tension Headaches and Yoga

by Baxter

Let me start off today’s post by personally wishing you all a Happy New Year! We are seven days into 2014 already, and Nina and I are excited to continue our work here at Yoga for Healthy Aging in the coming year. Today’s post comes out of something a few friends mentioned the day after their NYE celebrations: a lot of them had hangover headaches! Surprise, surprise! But I just happen to be preparing a workshop on headaches for the upcoming Yoga Journal Conference in San Francisco in a few weeks, and when I reviewed what we have written on the topic, I was surprised to find that we had not specifically talked about the most common form of headache that people experience (fortunately not hangover headaches): tension or musculoskeletal tension headaches. Sure, we alluded to it on our pretty thorough discussion on Yoga and Migraines last year, but I thought it would be well worth a focused look at tension headaches today. So here we go!

Tension headaches are indeed the most common headaches people experience, although the exact causes are not yet entirely clear. According to the Mayo Clinic website:

“A tension headache is generally a diffuse, mild to moderate pain in your head that's often described as feeling like a tight band around your head.”

Very encouragingly, the site states, “managing a tension headache is often a balance between fostering healthy habits, finding effective nondrug treatments and using medications appropriately.” Why do I find this encouraging? I am always excited when modern western medicine discovers that lifestyle and non-drug therapies are the better first choice in addressing a health concern. Bravo!

It is important, before we discuss yoga options for tension headaches (TH) to be clear on what constitutes a tension headache, and how it is different from migraines, for instance. A tension headache typically has the following qualities and presentations:

• dull, aching head pain
• sensation of tightness or pressure across the forehead and sides and back of head (headband distribution)
• tenderness on the scalp, neck and shoulder muscle

I am sure some of you can identify with this and are likely massaging those areas right now! Modern western medicine splits tension headaches into two categories, those that are episodic and those that are chronic. Episodic tension headaches can last from 30 minutes to a week. The more frequent they are, the more likely they are to become classified as chronic. If your headaches occur 15 or more days a month for at least three months, you are bumped up to the chronic camp. Let’s hope that is not in the cards for you!

Tension headaches can be hard to distinguish from the less common migraine headaches, and can even occur in people who also suffer from migraines. The Mayo Clinic points out some helpful distinguishing features between the two:

“Unlike some forms of migraine, tension headache usually isn't associated with visual disturbances, nausea or vomiting. Although physical activity typically aggravates migraine pain, it doesn't make tension headache pain worse. An increased sensitivity to either light or sound can occur with a tension headache, but these aren't common symptoms.”

The fact that physical activity does not usually worsen tension headaches is helpful to know when you are considering whether or not to do an asana practice when you already have a headache. And it is a way to test out your particular headache to see if it is tension or migraine.

It is still not clear what the underlying cause is for these common headaches. Some specialists link them to muscle contractions anywhere above the shoulders that might be encouraged by emotions, tension or stress, even though research does not support muscle contraction as the cause. The most common theories suggest that people with tension headaches have a heightened sensitivity to pain and stress. And related to that, stress turns out to be the number one trigger of tension headaches. Statistically, according to one study, 90% of women and 70% of men experience tension headaches at some point in their lives, with the peak incidence in people in their 40s.

The gang at Mayo Clinic did disappoint me a bit. Following their initial statements about non-drug treatment, they launch into medication choices before discussing lifestyle and alternative therapies—you all came so close! But when they finally do get to the non-drug options, stress management and improved posture are two of the three main recommendations. We have discussed this in many other posts, so by now we all realize that yoga rocks for addressing these options. And yoga does get the nod as a possible preventive treatment option for tension headaches.

Nina did a nice job in her headache prevention posts Preventing Migraines (and Other Headaches), Part 1 and Part 2 in outlining good yoga options for migraines and tension headaches (see also Peaceful Poses for Stress, Anxiety, Neck Pain and Headache Prevention). In general, because tension headaches are not typically worsened by physical activity, an active asana practice could be appropriate for when you have a headache as well as for headache prevention. I cannot tell you how many times students have come into class complaining of a headache, only to state on departure that their headache was now gone. And since most of the classes I teach include some short vinyasa portions, either reclining or standing, such as Sun or Moon Salutations for a few rounds, as well as static poses, a short pranayama session and a 10-minute Savasana (Relaxation pose), I can conclude that a well-balanced yoga practice can be both preventative and prescriptive.

Here are some of my favorite specific approaches for treating and/or preventing tension headaches:

Releasing muscle tension in neck and head. Even though muscle contraction does not appear to be the main cause or clear cause of tension headaches, I’d still focus much of the yoga asana practice on the area at and above your shoulders to release any excessive muscle tightness. Our shoulder series Opening Tight Shoulders, along with Owl and Curious Dog neck movements (see Neck Muscle Strain and Spasm) would be excellent additions to a daily home practice.

Refining your asana choices. Monitoring the effect of certain groups of yoga poses to see if they aggravate or improve headache symptoms is always a good idea. The more you start to understand how your body interacts with the practice, the better your personal practice will develop to support lessening your chances of getting tension headaches.

Finding the best stress practices for you. In addition to the more active practices of yoga, experimenting with quieter options is also essential in preventing and treating tension. A weekly restorative class or home practice (see Mini Restorative Practice) or the periodic use of Supported Relaxation pose (see Savasana Variations) and a yoga nidra recording (see Yoga Nidra and Deep Physical Relaxation) will work nicely for many. Pranayama practices such as 1:2 ratio breathing (the inhalation is 1/2  the length of the exhalation) or gradual lengthening of both inhale and exhale equally are great beginning breath practices to try. Short sitting or reclining meditation practices for 5 to 10 minutes are also great stress reducers.

Resetting pain sensitivity. Just as regular stretching of the hamstrings in Standing Forward Bend (Uttanasana) tends to lower the intensity of the perceived stretch discomfort over time, a general yoga practice has the potential to lower the heightened pain sensitivity that some people may have. There is no study to presently prove that last assertion, but it seems reasonable to observe in your own situation if adding in a regular, reasonable home practice begins to change the frequency and intensity of your tension headaches.

Please let us know what you find out if 2014 is the year you ramp up your practice with the intention to improve your tension headaches!

Friday Q&A: Bronchitis and Yoga

Q: Every year I seem to get a couple of months of chronic bronchitis.  I have a regular gentle yoga practice, am 63, and am frustrated that when I get a winter cold it seems to settle into my lungs. I am wondering if you have any thoughts on what yoga to practice to strengthen and help heal my lungs.  I looked at your list of topics, but did not see anything that addressed this specific issue. Any thoughts would be appreciated.

A: I happen to be working on this post as I fly home from co-leading a yoga retreat in Mexico, which would have been all well and good except for the fact that I had a cold when I left over a week ago, and now I am still battling with a persistent, non-productive cough that feels like it is in my chest and not my throat. When I slip my doctor hat on, I can’t help but be suspicious that I may have gone from having a typical winter cold to possibly having an acute bronchitis. Bronchitis is an inflammation of the bronchial tree, that part of the lung architecture just down stream from your trachea, which is the biggest part of the tubes that allow air to move from the outside down into the deepest parts of the lungs, the alveoli, where our breathing gases get exchanged. Bronchitis, especially the acute kind, usually implies an infection of some sort, typically a virus or a bacteria, the latter for which antibiotics might be needed to eliminate.

Bronchial Tree

Since my cold showed up nine days ago, I have not felt much like doing a yoga practice! I had a low-grade fever for the first three days, and any mild physical activity left me feeling exhausted, so asana practice seemed like a potentially aggravating idea. Then, when the cough settled in to my chest, lying flat on my back led to more coughing, and deeper breathing also could trigger a coughing fit. So about the only thing I felt up for and that left me feeling a bit more rested afterwards was propping my chest and head up on a long body pillow, and doing yoga nidra practice with the sankalpa: My Immune system is robust! So my personal take-home message for acute bronchitis is that less is more, and that could be true for our reader if the “chronic bronchitis” has already set in for the winter.

Chronic bronchitis is a form of bronchitis that has been around for at least three months in the past two consecutive years and has the other following characteristics: daily cough that produces clear, white, yellow or green mucus, fatigue, slight fever and chills, and chest discomfort. Chronic bronchitis implies a constant irritation or inflammation of the lining of the bronchial tubes, and is often due to a history of cigarette smoking. Other factors can also lead to the chronic form of bronchitis, including air pollution as well as dust or toxic gases in the environment or workplace.

In addition to encouraging smokers to stop and those exposed to environmental factors to make smart changes, western medicine often recommends medications other than antibiotics, which are reserved for situations in which fever or change in color of mucus indicate an acute infection on top of the chronic symptoms. Instead, medicines that improve the symptoms might be recommended, like inhalers that help to dilate or open up the airways to allow easier breathing. And, depending on the overall severity of the symptoms, a very modified yoga practice might be necessary until the chronic bronchitis symptoms resolve for the season.

However, when our reader is in his or her nine months of relative respiratory good health, a combination of yoga practices might help prevent the severity and length of these seasonal bouts. All of the basic balanced yoga practices we have discussed for other conditions that lower the stress response will simultaneously improve immune function, so a regular, daily home asana, pranayama and meditation practice is a must. In particular, asanas that target stretching the tight musculature around the chest and ribs, like Cat/Cow, deep side bends like Gate latch Pose, and backbends like Bridge and Bow that open up the front chest could improve aspects of the overall respiratory system. Basic forward bends and twists will also help to address the entire three-dimensional area of the rib cage and lungs. 

Pranayama focus is also very important here. If there is any hint of asthma as part of the picture, please review my posts on that topic and visit Barbara Benagh’s website to read her insights on modified breath practices. I’d focus on two specific pranayama practices:

1. Improve overall lung capacity by very gradually working to lengthen your inhalation and exhalation. For example, if you find it easy now to do a two second inhalation and a two-second exhalation for a series of six breaths, begin to work towards four-second inhale and four-second exhale (4:4 breath). And when that gets easy, to for 6:6, and so on. Always work in a gentle way and avoid getting short of breath or shaky. If you do get short of breath or shaky, take a break, go down to a lower time ratio and proceed more gradually.
2. Increase muscular strength of the accessory muscles of breathing that are often called into action in breathing conditions like chronic bronchitis by practicing either Kapalabhati, Skull Brightening Breath, or Bastrika, the Bellows breath. By improving the strength and endurance of the accessory muscles of breathing such as the four layers of your superficial abdominal muscles (to mention only a few), you will be improving the stamina of your breathing musculature.  I’ll describe these techniques in a future post. But in the meantime, you can find good descriptions in Richard Rosen’s second book on pranayama, Pranayama Beyond the Fundamentals. And take your time with these techniques by initially doing only 15-30 seconds at a time. Take many days to gradually add more time to your practice.

With all the practices I am recommending here I am assuming that chronic bronchitis is the only health condition you are dealing with. If that is not the case, consult your teacher or a yoga therapist for a more personalized practice that is safe for you.

—Baxter