Chronic stress may be doing far more than affecting South Africans’ mental health – it could be contributing to the country’s growing burden of obesity, diabetes, and other metabolic disorders, many of which are major risk factors for cardiovascular disease (CVD).
While stress is often viewed as an unavoidable part of modern life, mounting scientific evidence suggests that prolonged psychological stress triggers biological changes that increase the likelihood of developing obesity, type 2 diabetes, and CVD.
Prof Naidoo, CEO of the Heart and Stroke Foundation SA, reminds us that day-to-day stressors have a cumulative effect. They alter the immune system while disrupting eating, exercise, and vegetative signs like sleeping patterns. Ultimately, she says, the cardiovascular system has reduced capacity in the face of cumulative stressors.
This makes the stress-metabolism connection particularly relevant during Heart Awareness Month this September. Gallup’s 2026 State of the Global Workplace report shows 36% of South African employees experience stress, while the 2025 Profmed Stress Index highlights financial uncertainty and workplace pressure as primary stressors.
The Two-Way Relationship Between Stress and Metabolism
“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 remains in a prolonged state of alertness, producing elevated levels of cortisol. Over time, this contributes to increased blood glucose levels, insulin resistance, and the accumulation of harmful visceral fat around abdominal organs.
Research shows that prolonged stress-response activation disrupts glucose metabolism and reduces insulin sensitivity. However, the relationship goes both ways: emotional stress increases disease likelihood, while metabolic disorders alter stress-response systems, compounding vulnerability.
Prof Naidoo notes that chronic stress impacts health in subtle ways, such as excessive eating during stressful episodes leading to weight gain—a driver for type 2 diabetes. Overweight and obesity, in turn, drive raised blood pressure and hypertension.
A Growing Health Crisis
The concern is acute in South Africa, where metabolic disorders are escalating. According to the International Diabetes Federation, approximately 2.3 million South African adults live with diabetes—a 7.2% prevalence rate, ranking fourth highest in Africa. Furthermore, about one in two South African adults lives with excess weight or obesity.
Jennings highlights that while many focus on diet and exercise, stress management is often the missing piece. Additionally, Prof Naidoo points to the gut-brain connection, where research shows that dietary choices directly influence mental health and well-being.
Why Is This Important?
Understanding this link is critical because metabolic disorders directly increase the risk of life-threatening conditions like heart disease and stroke. Workplace stress is strongly linked to metabolic syndrome—a cluster of conditions including high blood pressure, elevated blood sugar, excess abdominal fat, and abnormal cholesterol. Addressing stress isn’t a luxury; it is an essential public health and workplace prevention tool.
Small Changes Can Make a Big Difference
Jennings notes that this connection is not inevitable. Regular physical activity, sufficient sleep, a balanced diet, avoiding smoking, moderating alcohol, and practicing mindfulness help regulate stress responses. Prof Naidoo encourages anyone facing unmanageable stress to seek healthcare practitioners trained in stress management and mental health conditions.
