LIFESTYLE NEWS - Chronic stress may be contributing to South Africa’s growing burden of obesity, type 2 diabetes and other metabolic disorders - conditions that are also major risk factors for cardiovascular disease.
While stress is often regarded as an unavoidable part of modern life, growing scientific evidence suggests that prolonged psychological stress can trigger biological changes associated with metabolic and cardiovascular problems.
Prof Naidoo, CEO of the Heart and Stroke Foundation SA, says the effects of everyday stressors can accumulate over time, affecting not only the immune system but also eating habits, physical activity and sleep.
Ultimately, she says, the cardiovascular system’s capacity can be affected by this cumulative burden of stress.
The connection is particularly relevant during Heart Awareness Month this September, when attention turns to the factors that can influence long-term heart health.
How stress affects metabolism
Many people understand that stress can affect mood and sleep, but its potential impact on metabolism is less widely recognised.
“Most people understand that stress can affect their mood and sleep, but few realise that chronic stress can also disrupt the body’s metabolism,” says Nicole Jennings, spokesperson for Pharma Dynamics.
When stress becomes chronic, the body can remain in a prolonged state of alertness, with elevated levels of cortisol - often referred to as the stress hormone.
Over time, this can contribute to changes such as increased blood glucose levels, reduced insulin sensitivity and the accumulation of visceral fat around the abdominal organs in some people.
Research indicates that prolonged activation of the body's stress response may interfere with glucose metabolism, reduce insulin sensitivity and encourage fat storage - all factors associated with metabolic disease.
But the relationship can work both ways.
Long-term emotional or work-related stress may increase the likelihood of developing metabolic conditions, while metabolic disorders can also affect the body's stress-response systems, potentially making people more vulnerable to the effects of stress.
Prof Naidoo says the impact of chronic stress is not always immediately obvious.
For example, stressful periods may lead some people to eat excessively, contributing to weight gain and potentially increasing the risk of type 2 diabetes. Overweight and obesity are also associated with increased blood pressure and hypertension.
South Africa's metabolic health challenge
The concern comes as metabolic conditions continue to pose a significant health challenge in South Africa.
According to the International Diabetes Federation, approximately 2.3 million South African adults are living with diabetes, representing an estimated prevalence of 7.2% among adults. South Africa has the fourth-highest number of adults living with diabetes in Africa.
Obesity and excess weight are also major public health concerns, with approximately one in two South African adults living with excess weight or obesity. These conditions are associated with an increased risk of diabetes, heart disease and other metabolic disorders.
“Many people focus on diet and exercise when discussing metabolic health, and rightly so,” Jennings says. “However, stress management is often the missing piece of the puzzle.”
She adds that a person may be eating relatively well, but living under constant stress can still have consequences for their overall health.
Prof Naidoo also points to growing interest in the gut-brain connection, with research examining how diet and the gut microbiome may influence mental health and wellbeing.
Workplace stress is also a health issue
The potential connection between stress and metabolic health is particularly relevant in the workplace.
Studies have linked workplace stress with an increased risk of metabolic syndrome – a group of conditions that includes high blood pressure, elevated blood sugar, excess abdominal fat and abnormal cholesterol levels.
When these factors occur together, they can increase the risk of cardiovascular disease and stroke.
For South Africans facing financial pressures, job insecurity, rising living costs and demanding workloads, workplace wellness initiatives could therefore play a role in supporting both mental and physical wellbeing.
Gallup’s 2026 State of the Global Workplace report found that 36% of South African employees reported experiencing stress, while the 2025 Profmed Stress Index identified financial uncertainty and workplace pressure among significant sources of stress for South African professionals.
Small changes can support better health
The relationship between stress and metabolic health does not mean that chronic disease is inevitable.
Jennings says regular physical activity, adequate sleep, a balanced diet, avoiding smoking, moderating alcohol consumption, mindfulness practices and strong social support networks can all help support the body's stress response and overall metabolic health.
She encourages South Africans to view stress management as part of a broader approach to protecting both mental and physical health.
“Managing stress isn't a luxury - it's an important part of preventing chronic disease,” she says. “By recognising the impact stress has on the body and taking proactive steps to address it, individuals can improve both their mental wellbeing and long-term metabolic health.”
Prof Naidoo encourages people experiencing unmanageable stress to seek professional help. Healthcare practitioners with training in stress management and mental health can provide appropriate support and guidance.
The message is clear: looking after your mental wellbeing can form an important part of looking after your heart and overall physical health too.
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