THENEGATIVEHEALTHEFFECTSOFSTRESSANDHORMONALBALANCE

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The Negative Health Effects of Stress and the Importance of Hormonal Balance
Jessika Berryessa
DFM 655: Nutrition Education and Communication
12/13/16

Introduction

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Hormonal imbalance is caused by many factors, such as stress. Stress is a culprit

of hormonal imbalance and college students are notorious for dealing with stress on a
daily basis. According to Anxiety and Depression Association of America (ADAA),
anxiety disorders are one of the most common mental health problems on college
campuses (2016). Anxiety disorders are chronic reactions to stress and can interfere
with peoples daily lives. In a survey with over 2,000 undergraduate college student
participants from 40 random four-year college universities, mtvU and the Jed Foundation
and the Associated Press (2009) found, in a day-to-day basis, 85% of students felt stress
(p. 1). They also found, 55% of students experienced sleep disturbances and 45% of
students either ate too much or did not eat enough (p.2). Students are under constant
stress; school work, financially and worrying about finding a job after graduation, etc.
(mtvU and the Jed Foundation and the AP, 2009, p.1-2).
According to Head and Kelly (2009), a prolonged exposure to stress can cause the
fight or flight response to occur regularly. The fight or flight response raises blood
pressure, blood sugar and heart rate. Also, blood can move away from the
gastrointestinal system, causing digestive issues. Head and Kelly (2009) explain during a
stressful situation, the hypothalamus is trigged to release corticotrophin-releasing factor,
which then sends a signal to the pituitary gland to release adrenocorticotropic hormone
(ACTH). ACTH activates the adrenal glands to release cortisol. These stress hormones
cause the fight or flight response, which raises your blood pressure, blood sugar and heart
rate (p. 1-2). Normally, a fight or flight response occurs only in a true life-threatening
situation. According to Green (2015) this is not always the case; these days a true lifethreatening situation, such as waking up in a burning building and a non-life threatening
situation such as preparing for and taking a test produce similar physiological responses.
He contends in present time, our stress responses are constantly activated (April 15).
Today in a true or non-threatening situation, the fight or flight response is triggered and
our system will work to pump blood into our muscles, which increases our heart rate,
blood pressure and blood sugar (Green, June 22, 2015). In order to escape or confront
the threat, our muscles need energy to act on it. Unfortunately, when this happens blood
will be diverted from other systems, such as the digestive, reproductive and immune
system to the muscles because those systems are not needed to act on an immediate threat
(Green, April 15, 2015). Therefore stress can lead to many conditions and diseases such
as cardiovascular disease, immune deficiencies and reproductive disorders. Stress may
also lead to bad eating habits, which can lead to an increase of stress hormones and
disturb the circadian cycle of cortisol release, which then causes irregular sleep patterns
(Head and Kelly, 2009, p.2).
When our body is stressed, it leads to hormonal imbalances, which is acceptable
temporarily when faced with a threat. Nowadays, people are under stress constantly, but
not usually due to a true threat. Students are especially vulnerable to be in stressful
situations. For example, if a student receives an F on their test, their body may recognize
that as a threat and indicates failure, which may lead them to feel there is no hope for a
future. This reaction to a stressful situation produces similar effects of the fight or flight
response, raising high blood pressure, blood sugar and heart rate. This can cause
digestive issues, immune deficiencies, cardiovascular disease, reproductive disorders and
sleep disturbances, ect. These conditions are caused by a constant increase of stress
hormones. Students are at risk for these disorders and conditions because most students

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are exposed to these stresses on a daily basis. Students are also prone to stress-related
behaviors such as a lack of sleep and eating too much or too little and eating unhealthy
foods. These stress-related behaviors cause a rise in stress hormones such as cortisol and
catecholamine causing a hormonal imbalance. Balancing hormones can lessen stress and
decrease risks of some conditions and diseases. According to Head and Kelly (2009),
supplementing with adaptogens, cortisol modulators, anxiolytic/Sedative botanicals and
plant extracts, neurotransmitters and vitamins support the adrenalstreat acute anxiety,
and support restful sleep(p.1). Educating students about supplementation to reduce
stress by balancing hormones may help to increase quality of life and prevent conditions,
diseases and habits related to stress.
The learning theory that best fits dietetic college students is Health Belief Model
(HBM). College students in general are knowledgeable and educated and unless you find
solid evidence with a valid explanation, you may not convince them of your cause.
Dietetic students already know stress is not good for our health, meaning they have
perceived susceptibility to the threat of stress. However, they may not feel scared about
the effects of stress on the body and therefore may not care to reduce their stress. By
educating them on physiological stress in the body and how this causes certain conditions
and diseases when constantly being stressed in the way students are, this allows them to
perceive susceptibility to the threat of developing stress-related conditions. Now that the
students understand the threat, they may feel they want to take action to reduce stress.
This is the point where the students themselves come up with their own ideas to reduce
stress, which also allows them to develop self-efficacy by realizing they have the
information to reduce stress from my presentation as well as previous knowledge. I also
allow them to perceive the benefits of reducing stress by first giving them examples of
different botanicals and nutrients and then explaining how these work to reduce stress.
When the students perceive stress as a threat and are not only provided information on
how to reduce stress, but also realize they already know how to do it on their own, this
can allow the students to feel a desire and a confidence to change.
My education style is developmental. My audience is dietetic college students,
who have background knowledge in anatomy and physiology and who are interested in
ways to manage stress. I wanted them to develop a knowledge and understanding of how
the endocrine system works in times of stress and all the factors contributing to a
hormonal imbalance leading to diseases. I first talk about the definition of hormones and
then I introduce them to more complex information through a video about how the
endocrine system works in times of stress. During the video, I wanted them to think
critically about why stress is harmful to our health. After the video, I explained why
stress could cause health problems. To test their knowledge from the video and the
information given to them about stress and its negative health effects, I wanted them to
talk with other students and write about ways to balance hormones to reduce stress. This
way they can think comprehensively and critically about everything they just had learned
and think about what they could do in order to relief stress. Also, by having them write
down their own thoughts, this allowed them to broaden their prospective and realize there
are more ways than just one to reduce stress.
Lesson Plan
Balancing Hormones to Reduce Stress
Duration: 13-15 minutes

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Target Group: Dietetic College Students

Overall Goal: To increase knowledge of physiological stress in the body and develop an
understanding of the importance to balance hormones to reduce stress. Also, to become
familiar with ideas promoting hormonal balance in order to reduce stress.
Major Concepts:
Hormones: Definition
Physiological stress in the body: What happens in our body when we are stressed
Hormonal imbalance: How stress can lead to hormonal imbalance, how it can have a
negative impact on our health and talk about the importance of hormonal balance
Different ways to balance hormones to manage stress: Talk about botanicals and
nutrients and their role in reducing stress
Icebreaker or Attention Grabber: (2 minutes)
Tell the dietetic students this presentation pertains to them and may help them out
Let them know my presentation will be about balancing hormones to reduce stress
(they can feel like they can manage their stress from the root of the problem)
Objectives and Learning Domains: Generalizations and Learning Experiences
1. The students will analyze the video shown to determine why reoccurring stress can be
bad for their health
Domain: Cognitive domain- analysis
Generalization: Continuous stress may have a negative impact on your health
Learning Experiences: (3 minutes)
Provide a video and explanation covering the following concepts
Physiological stress in the body:
o They need to understand there are many hormones (CRH, ACTH, cortisol,
norepinephrine, epinephrine) released during stress. Although, in major
stress, cortisol is released and produces the fight or flight response, which
increases blood pressure, blood sugar and heart rate. The fight or flight
response also shuts down other systems such as digestive, reproductive
and the immune system. When we are faced with a threat, which our body
identifies a threat, such as a test or an oral presentation, this may happen.
Since students can feel this stress often, we can develop different
conditions, such as immune deficiencies, digestive, and reproductive
problems, as well as cardiovascular disease.
Hormonal imbalance:
o From what was just mentioned, understanding how hormonal imbalance
occurs from chronic stress and how this can negatively affect our health
2. Students place their hand over their heart to feel if there is a noticeably fast heart rate.
Domain: Psychomotor domain- set
Generalization: A fast heart rate may indicate stress.
Learning Experiences: After the video, I talk about how in times of the fight or flight
response our heart rate increases. I asked the students to place their hand over their heart
and if their heart is beating noticeably fast it could indicate stress.
3. The students will contribute in a discussion about the different ways hormonal balance
can be promoted.
Domain: Affective domain- responding

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Generalization: Discussing different ways hormonal balance can be promoted may help
students receive various amounts of information they may not have thought about on
their own.
Learning Experiences: Before talking about the botanicals and nutrients used to balance
hormones, I wanted them to take a minute to talk amongst each other and based on what
they just learned about, write down all the ways they think hormonal balance could be
achieved. There is more than one way, not just what I had listed for them.
Teaching Aids and Materials:
PowerPoint-laptop and screen
Handout- students can follow along with their handout from my presentation. They also
had to think and list different ways to reduce stress from the information that was just
given about stress. I also listed botanicals and nutrients to balance hormones for extra
information if they were interested.
Summary: When faced with a threat, our body increases stress hormones and it affects
our blood pressure, heart rate, blood sugar to rise, blood can be shunted away from our
digestive system and immune and reproductive system can be slowed down. Students
have constant pressure to do well in school; assignments, tests and projects are perceived
as a threat in our body. When we have a persistent increase of stress hormones, we can
develop different conditions and diseases and this is why stress can be bad for our health.
It is important to know what happens physiologically in our body when we are stressed to
better understand how we can treat stress. Certain botanicals and nutrients can help to
balance hormones to relief stress.
Evaluation: The questions I asked for my pre-test were to evaluate their background
knowledge on the fight or flight response and stress hormones. To prepare for my
presentation, I wanted to know if they knew the basics of stress hormones and the
physiological response that occurs from a threat (fight or flight response). I also wanted
to know if they had an idea of what the fight or flight response is and if they could list
one stress hormone for competency of my topic. Most people knew something about the
fight or flight response and most people could list 1-3 stress hormones. Also, I asked
how stressed out they are from school. On a scale from 1-10, 10 being extremely stressed
from school, students stress was a 7.87 out of 10. I also asked if they were interested in
reducing stress to get an idea if they may use the information that was given in my
presentation and most people were extremely interested. The post-test survey tested the
students knowledge of vital points from my presentation. I unfortunately only received
12 responses. I wanted to know if they understood where hormones are produced and
synthesized. Most students thought it was the endocrine system, which is correct, but
some of them thought it was the sympathetic system. I understand how they could get
confused because the same chemicals can come from both the endocrine and sympathetic
system, but these chemicals act as neurotransmitters in the sympathetic system and
hormones in the endocrine system. Everyone understood the fight or flight response
occurs in times of stress and hormonal imbalance can happen from long-term stress. For
my last post-test question, I gave them a freebie because I wanted to remind them why
stress is bad for our health and how stress can lead to hormonal imbalance and different
conditions and diseases. For the freebie, they could either choose the correct answer or I
dont know. All the students listed one botanical or nutrient they already knew about or
learned from my presentation. Also, most of the students felt it was extremely important

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to balance hormones and all of them said they would incorporate botanicals and nutrients
into their diet to reduce stress.
Assignment: An in-class assignment was given to all students. They talked in groups or
individually to list different ways to balance hormones. The list was based on the
information they were given about how hormonal imbalance occurs from stress and how
it affects our health.
Conclusion
As a dietetic student and talking to many people in my major, I know first hand
how stressed out we are. My proof is shown in my pre-test where I asked the dietetic
students from 1-10 how stressed out they are from school, averaging at 7.87 out of 10
with 10 being extremely stressed. I also asked them how interested they are in reducing
stress, with 20 people indicating they are extremely interested and three people signifying
they are very interested. Research also shows students are stressed. As stated in my
introduction, anxiety disorders are very common among students (ADAA, 2016, p.1).
Also, according to a survey conducted by mtvU and the Jed Foundation and the
Associated Press (2009), many college students feel stress. These students also had
stress-related behavior symptoms of unhealthy eating habits as well as sleep disruptions.
They continued to state students worried about many other things besides school such as
work, finances and the stress of acquiring a job after graduation (pgs. 1-2). I learned from
my pre-test not everyone could name three stress hormones, but most people at least
stated cortisol to be a stress hormone. Most people also knew that the fight or flight
response was triggered by stress, but not much more than that. I thought it was important
during my presentation to teach the students the basics about the physiology of stress so
they can truly understand why stress can hinder our health. This way they can learn
about stress hormones, the physiological stress in our body and when it can occur. This is
important to know because many people believe the fight or flight response only occurs
in extremely stressful situations, but nowadays people such as students are under constant
stress. Students can be chronically stressed while in school; assignments, tests,
presentations, etc. can trigger a similar response to the fight or flight response in our
bodies depending on how serious students perceive these tasks. Most people are going to
school to have a better future and they will put a lot of pressure on themselves to do well
for the idea school is needed to have a better life. This can create anxiety in the body
when preparing for a presentation, test or paper because of the association between doing
well in these tasks and obtaining their ideal future.
I realized after going through the post-test that I should have elaborated on the
differences between the endocrine system and the sympathetic system. Some students
thought the sympathetic system produced and synthesized hormones instead of the
endocrine system. Due to time, I relied on the video to explain the differences, which I
thought the video did a good job of doing. However, I could have gone over that part in
order for the students to clearly understand the differences between the two systems. The
post-test also indicated the students understood when the fight or flight response occurred
and that chronic stress is bad for our health. Therefore I was effective in explaining that
in my presentation.
As previously stated, most students are stressed, but they may not be relieving
their stress. I decided to use the Health Belief Model (HBM) in order to facilitate change
in the students to act on relieving stress. Since dietetics is a science major, showing

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scientific information may be a more effective approach. I did this by educating students
on the physiological stress by showing them an easy to understand, fun video on stress.
This video and my explanation after the video tested their cognitive domain and had the
students analyze the video to determine why stress is bad for our health. After the video, I
further explained why stress has a negative impact on our health based on the physiology
of stress from the video. Also, I was trying to connect with students on a deeper level to
explain how these negative health effects from stress may be happening to them. For
example, in the video and information I stated, when our body is faced with a threat,
digestive, reproductive and immune systems can shut down. This is caused by the
increase of hormones and neurotransmitters in the body in order to pump more blood into
the parts of our body that can act on the threat, such as our muscles. For the psychomotor
domain- set, I had the students place their hand over their heart to see if their heart rate
was significantly fast, which can indicate stress. In order for the students to perceive the
severity of stress, I explained if this happens frequently, our hormones can become out of
balance and we can develop certain conditions and diseases. Although most students may
already have a perceived susceptibility to the bad health effects stress causes, I explained
that a similar reaction to the fight or flight response can happen to students when we are
under constant pressure to do well in school. For the affective domain- responding, I had
them talk to people and come up with ways to reduce stress so that they can realize they
already know many ways to relief stress. When students realize they already know ways
to reduce stress, this can build up confidence and increase their self-efficacy to facilitate
their own change to reduce stress. I stated my own way to reduce stress which was
through nutrients and botanicals and explained the benefits of using these substances to
balance hormones in order to relief stress.
I used a developmental style of education because based on my pre-test, they
needed more of a background of the physiology of stress and the fight or flight response.
Therefore I wanted to develop their knowledge of stress in the body to allow them to
understand how bad stress is for our health. Educating the students about that may lead
to a desire to lessen stress. I started them off with the basics of hormonal balance to
decrease stress by showing them a video of the physiology of stress and elaborating on.
Then I explained how the physiology of stress could lead to negative health effects.
Based on the information just given to them, I had them talk to people to get ideas of how
to manage stress to test their knowledge of what they recently and previously have
learned about.
I thought my presentation went well; except my hands motions were too
distracting. If I had more time, I could have elaborated more about the differences
between the endocrine system and sympathetic system. Most students did recognize after
my presentation that balancing hormones are important to reduce stress. Also, being a
dietetic student and having dietetic students as a target audience helped to have an
understanding of the severity of stress they have with school and responsibilities outside
of school. During the presentation, I believe the video helped students pay more attention
because they could visually see what stress looks like from the video and it was a fun,
easy video to follow. Another instructor could use my lesson, but if there was more time,
my lesson could be more useful. By expanding on the differences between the endocrine
system and sympathetic system and incorporating a longer more interactive activity to
apply the knowledge they just had learned, my lesson plan can be more effective.

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References
Anxiety and Depression Association of America (ADAA) (2016). Facts. Retrieved from
https://www.adaa.org/finding-help/helping-others/college-students/facts
H Green. (2015, April 15). Sympathetic Nervous System: Crash Course A&P #14.
Retrieved from https://www.youtube.com/watch?v=0IDgBlCHVsA
H Green. (2015, June 22). Endocrine System, part 1 - Glands & Hormones: Crash
Course A&P #23. Retrieved from https://www.youtube.com/watch?v=eWH H9je2
zG4
Gropper, S. and Smith, J. (2013). Advanced Nutrition and Human Metabolism. Belmont,
California: Wadsworth and Cengage Learning.
Head, K. and Kelly, G. (2009). Nutrients and Botanicals for Treatment of Stress,
Adrenal Fatigue, Neurotransmitter Imbalance, Anxiety, and Restless Sleep.
Retrieved from: https://www.spectracell.com/media/uploaded/2/0e2016801_266
fullpaper2009altmedrevnutrientsforthetreatmentofstressfatigueandinsomnia.pdf
mtvU and the Jed Foundation and the Associated Press (2009). AP 2009
Economy, College Stress and Mental Health Poll. Retrieved from
http://cdn.halfofus.com/wp-content/uploads/2013/10/mtvU-AP-2009-EconomyCollege-Stress-and-Mental-Health-Poll-Executive-Summary-May-2009.pdf