What, Me Worried?! A Metrics of Stress Case Study


Last week a client of mine came in whose numbers were seemingly inexplicably up.  I hadn’t seen him for quite a while and since he is usually 6-7% body fat it, he was quite dismayed by the numbers which had popped up to 12%.  He said he’d been eating the same and exercising as always and couldn’t understand how he could be up.  So I asked him what had been going on since I’d last seen him and he told me he was finalizing his divorce.  This on top of his day gig of running a billion-dollar private equity firm.  I gently suggested that his numbers may be attributable to stress.  “What?!” he snapped.  “I’m NOT STRESSED!”  Umm, okay, if you say so…”

I explained to him that with skinfold calipers, we can get inflated numbers because when we’re stressed the adrenals are overworked.  The adrenals maintain fluid balance so when they’re doing overtime we end up with some edema.  Of course, if stress is chronic, elevated cortisol also contributes to accumulation of body fat as well.

Some people handle their stress very well but may not be aware of how it’s affecting them physiologically.  This is where metrics can be invaluable for showing a client where he/she’s at and can be the factor in motivating them to change their behavior.

Kathy's Chart

My client Kathy is an excellent example of how important metrics can be.  If we take a look at her body composition chart you’ll see she made great progress but not without a few blips along the way.  This is real life.  But what’s so fantastic about Kathy is that she tracked all her food and exercise, and she wore a FitBit all day.  Since she was following everything to the letter most of the time, if one variable was out of whack, we were able to isolate it as the culprit.

So on Kathy’s chart we can see she was doing fine until Week 5 when her menstrual cycle showed up.  This is pretty common and will affect body composition due to water retention from increased inflammation.  It’s interesting to note that this was not a factor for the rest of her chart.  This isn’t surprising since one of the benefits of getting blood sugars under control is reduced inflammation, which in turn will reduce premenstrual symptoms.  We also see blips in weeks 21-24 due to overtraining, which is a subject we’ll address in another entry.

Of more interest for our discussion of psychological stress, however, are Weeks 11-15.   Kathy had done amazingly well, plummeting from 29% to almost 12% body fat.  Until the month of April killed us and she popped up as high as 17%.  Why?  Well, a job opportunity came up that Kathy really wanted.  She really, really, really wanted this gig.  And in April the interview process started.  A lot of people don’t believe me when I say stress may be the cause of elevated “body fat” numbers—whether from actual body fat or water retention.  But in this case, we had some amazing data because Kathy was wearing a FitBit the whole time.  So I asked her for some random screen captures of her heart rate during those weeks.


You can see that April 7 is our baseline day before she found out about this job opportunity.  Her heart rate throughout the day never really peaks past 100 until her evening exercise class where she topped out in the 130’s.  The second week her heart rate (not counting the evening exercise elevation) spikes past 100 twice and BPM’s are closer to 100 throughout the day.  The third week—and she’s in the thick of the interview process by now—heart rate spikes past 100 4 times and a little higher between spikes as well.  The fourth screenshot she surpasses 100 BPM 5 times and heartrate is considerably elevated between spikes.  And the fifth screen shot is the day of the final interview.  Her heart rate is almost 150 while NOT exercising!

Baseline Heart rate under 100 except during exercise in the evening.
Kathy just found out about job opportunity. Heart rate starting to peak past 100 during the day.
Job interview process has started. Heart rate spiking past 100 at more points.
Well into the interview process.
Final interview. Heart rate is almost 150 during the actual interview!

This story, at least, has a happy ending.  Kathy got the job and she made a full body composition recovery two weeks after.  I was thrilled that she had the metrics for the month because they show:

  • That even GOOD stress (she really wanted that job!) can still affect the body adversely. Over-stimulation of the sympathetic nervous system still taxes the adrenals.  Sometimes clients say they are stress-free because it’s not negative stress as we’ve just seen, eustress—good stuff—still has a physiological effect.


  • Over stimulation of the sympathetic nervous system (stress) really does affect you physically! And skinfold calipers, though old school, are a great way to observe the adverse effects stress can have on your body composition.  Wild fluctuations in body comp can indicate fluid imbalance due to adrenal and lymphatic overload.

Just telling my clients that stress will make them fat or, in the short term, appear so is often too abstract for them to prompt behavioral changes.  They’ve heard stress does these things to the body—“yeah, yeah, yeah.”  But metrics make all of this tangible.  With a few simple tools—a heart rate monitor and caliper measurements–you can observe the effects of sympathetic nervous system overdrive on the body.  Simple metrics can be a great motivator to make big lifestyle changes.

Story with a happy ending: Kathy at her new job!


Adrenals, Schmenals! Part 1

For years, my acupuncturist would take my pulse and say, “What’s going on with your adrenals?  You shouldn’t get up so early and run around the basketball court for an hour and a half at 6 AM.”  To which she would add, “That’s okay, my adrenals are shot, too.”  Yeah, yeah, yeah, adrenals, schmenals.  Stress can be a very abstract concept.

Some clients handle their stress quite well.  They’re accustomed to dealing with a certain level and that becomes their new norm.  But they may not realize that it’s affecting their physiology, regardless.  So you can tell the client that they’re stressed and they may even admit it, but what exactly does being “stressed” mean in terms of how it’s affecting your body?  This is where hormone testing (along with caliper testing) can be helpful in convincing the client to change their behavior.

The numbers don’t lie.  And in my case (above), they weren’t pretty either.

Cortisol, if you haven’t heard, is a stress hormone produced by the adrenal glands.  It wasn’t until I saw my own results, that I realized how high my cortisol levels were—ahem…OFF THE CHARTS!!!  And guess when it was the highest?  At 6 AM when I was on the basketball court.  I started sleeping in from there on out and moved my workouts to midday and the afternoon.  Prior to testing, I only had a vague notion of how under sleeping and overtraining were affecting my health.  It wasn’t until I saw just how bad it was (OFF THE CHARTS!) and that it was a real, tangible, measurable thing that I changed my behavior.  I lost 8 pounds of water immediately.

If you have a sneaking suspicion that you may be pushing too hard on all cylinders and would like to know where you stand, you might just want to give stress hormone testing a whirl.  Having some solid numbers on which to base decisions can sometimes move you faster towards better health.

The Russians Used Pencil: Measuring Body Composition Part 2

Skinfold calipers: sometimes Old School really is better.

The Lowly Caliper Measures More than Body Comp

Last week, we looked at the shortcomings of methods for measuring body fat.   I’ve always leaned on calipers but in recent years I’ve started to like them for the very reason they are criticized.  Detractors will say that because when you measure with calipers, you are measuring everything under the skin.  Yes, fat, but this also includes water.  Critics will say this means that calipers aren’t accurate.  Not for measuring body fat, perhaps.  But the fact that they measure water under the skin makes them an invaluable tool.

Why?  Any stressor—lack of sleep, alcohol, high blood sugar, psychological stress, toxins, lack of sunlight, antigens, overtraining—will tax the adrenals, causing inflammation.  Since the adrenals are responsible for water balance, any sudden, significant increase in a skinfold measurement can likely be attributed to the adrenals working overtime.  Calipers actually help me pinpoint which foods and lifestyle factors cause inflammation in a client.  So the very thing that’s always been cited as the major shortcoming of the calipers actually make them a more informative tool than the other measurement methods.  Blood and cortisol tests would be too cost prohibitive to run on a weekly basis.  With calipers, though, I’ve been able to determine food intolerances and training thresholds conveniently and cost effectively from week to week.

While some love to poo poo the fact that calipers don’t give an accurate fat measurement because they don’t account for edema, water retention from inflammation is often more of an aesthetic issue than actual body fat is!  Get rid of the bloat and clients are already happier with their appearance.  And, of course, chronic inflammation leads to metabolic disorders, elevated cortisol, and increased body fat.  So even if the calipers are not measuring precisely only body fat all the time, they can provide invaluable clues as to what is causing inflammation.