From Mutation to Metabolism: A Broader View of Cancer Development

Erik Peper, PhD, BCB1 and Richard Harvey, PhD2

1 Biofeedback Health, Berkeley, CA and 2 Institute for Holistic Health, San Francisco State University

My aunt died of breast cancer and my mother was an identical twin. She and her sister resembled each other so closely that family members often couldn’t tell them apart. For the first 26 years of their lives, they both lived in Amsterdam. After they married, they moved to different cities. At the age of 82, my mother’s twin was diagnosed with breast cancer with metastasis to the brain and died that year. For my mother, this was one of the most devastating experiences of her life. It was as if half of her had died. Even with this loss, my mother never developed cancer and lived to the age of 95. The situation became even more complicated when my cousin (the daughter of my mother’s twin) also died of breast cancer at the age of 53, while my mother’s two daughters remained cancer-free. -Erik Peper, PhD. Reproduced by permission from Peper, Gorter and Faass (2026).     

Cancer, with a capital ‘C’ along with each of the many kinds of malignant cellular processes is often understood primarily in terms of a disease driven by genetic mutations. This blog begins with observations from twin studies along with ongoing and emerging research suggests that genetics may represent susceptibility rather than destiny. In the case of identical twins, the experience of developing different cancer outcomes illustrates the importance of environmental exposures, lifestyle choices, specific metabolism interactions, immune functions, and particular cellular physiology.

The blog examines prevalent hypotheses about cancer processes which acknowledge interactions and functions such as immune, metabolic and evolutionary pressures. In particular, the paper argues in favor of revisiting the Warburg effect and the role of mitochondrial dysfunction in cancer development. The Warburg metabolic theory proposes that impaired mitochondrial energy production may drive cells toward an ancient survival pathway characterized by increased glucose fermentation, loss of specialized cellular function, and uncontrolled or unregulated proliferation. This perspective does not reject the strong role of genetics in cancer processes but rather places DNA and RNA within a broader biological context influenced by metabolism, epigenetics, and the environment. Understanding cancer as a systemic metabolic disorder may expand prevention strategies and complement existing treatments by emphasizing lifestyle, environmental, and metabolic interventions.

Twin Studies: Genetics as Predisposition, Not Destiny

For decades, research on cancer causes and treatments has been dominated by the Somatic Mutation Theory (SMT), which proposes that cancers arise through the accumulation of DNA mutations (Weinberg, 2023; Huang et al., 2025). This SMT framework has guided the “War on Cancer” and has led to remarkable advances in targeted therapies, chemotherapy, immunotherapy, and radiation treatments. These strategies have saved countless lives, yet they primarily focus on eliminating malignant cells rather than understanding why normal cells become malignant in the first place. While a variety of mutation-focused approaches has yielded remarkable therapeutic successes, one could expect that genetically identical individuals would develop the same or similar cancers.

Decades of twin research suggests otherwise. In the landmark Nordic Twin Study of Cancer, Lichtenstein and colleagues (2000) analyzed nearly 45,000 pairs of monozygotic (identical) and dizygotic (fraternal) twins from Sweden, Denmark, and Finland. If one identical twin developed cancer, the co-twin’s probability of developing the same cancer was about 10% which is much lower than expected if inherited genes alone determined cancer risk. Heritable factors accounted for only a portion of susceptibility (approximately 27% for breast cancer, 35% for colorectal cancer, and 42% for prostate cancer). The remaining risk was attributed largely to environmental influences, lifestyle, aging, and biological processes that occur during life (Lichtenstein et al., 2000; Mucci et al., 2016; Harris et al., 2019).

Both specific cancer investigations along with epidemiological findings across many places, people, and types of cancers suggest that genes create a predisposition, but they do not inevitably determine whether cancer develops. Instead, the cellular environment, metabolic health, environmental exposures, and epigenetic regulation strongly influence whether that predisposition is expressed. Simplistically stated, Genetics loads the gun and lifestyle and environment pulls the trigger (Peper et al., 2026).

The success of cancer treatments based on current oncology theories means that the Somatic Mutation Theory (SMT) provides a partial explanation of cancer processes. Extending the SMT of carcinogenesis to include Warburg-like theories has led to increasing evidence which suggests that metabolic dysfunction, mitochondrial injury, chronic inflammation, immune dysregulation, and environmental exposures all contribute to carcinogenesis. A useful framing of cancer risk related to inherent or heritable factors in comparison to non-intrinsic or non-genetic factors has been described by others (Brennan & Davey-Smith, 2022; Karras et al., 2024; Rahman et al., 2018; Wu et al., 2018). 

For example, Wu et al., (2018) suggest that it is not possible to modify ‘random errors in DNA replication’ as an intrinsic risk factor, it is possible to partially modify endogenous risk factors related to inflammation or hormone production or fully mediate or modify directly and indirectly moderate non-genetic exogenous risk factors associated with toxic carcinogenic exposures that include exposures to some products from carcinogenic interactions with bacterial, viral, fungal and parasitic products, tobacco products, ultra-processed food and beverage products and chemicals (e.g., preservatives, pesticides, contaminants, dyes, non-nutritive chemicals such as sweeteners), industrial pollutant and chemical products (e.g. endocrine disrupting ‘forever’ chemicals such as in plastics), and lifestyle moderators such as lack of sleep, exercise, relaxation from mental ruminations and strain. A simplified model pathway would be: Risk of cancer is based on intrinsic genetic factors plus non-intrinsic endogenous and exogenous ‘epigenetic’ factors moderated by individual adaptive capacity to reduce endogenous or mitigate exogenous non-intrinsic factors.

Rather than competing explanations, mechanisms of cancerous disease processes may interact to determine whether genetically susceptible cells remain healthy or progress toward malignancy. These factors may explain that the overall cancer mortality has declined substantially over the past several decades and is predominantly due to the decreased tobacco use, earlier detection, and improvements in treatment. At the same time, the incidence of several cancers, including colorectal and breast cancer, has increased among younger adults (Siegel et al., 2025; American Cancer Society, 2024; Ugai et al., 2022; Lee, 2026). These trends suggest that additional biological and environmental factors deserve closer examination. Beyond regulating exposure to lifestyle factors such as tobacco products as a mediator of reduced cancer mortality, theories by Warburg and colleagues have pointed to metabolic regulation, including regulation of sugars, as a mediator in cancer mortality.

The Metabolic Origin: Revisiting the Warburg Effect

An alternative framework proposes that cancer is fundamentally a disorder of cellular metabolism. This concept dates back to Otto Warburg, who received the 1931 Nobel Prize in Physiology or Medicine for discovering that cancer cells exhibit a distinctive pattern of energy metabolism (Bononi et al., 2022; Otto, 2016; Nobel Prize Outreach, 2026). He showed that cancer cells rely predominantly on glucose fermentation, an anerobic process for making energy without oxygen (e.g. glucose splits into pyruvate and makes two adenosine triphosphate molecules) which is much less efficient than making energy through oxidative phosphorylation, even when oxygen is abundant in a cancer cell. The vast majority of cancerous cell growth depends on a less efficient glucose metabolism form of energy (Kim, 2017; Warburg, Negelein & Posener, 1924). The Warburg effect has been recognized as a hallmark of cancer for nearly a century (Seyfried & Chinopoulos, 2021).

Non-cancerous healthy cells mainly generate energy by producing ATP through oxidative phosphorylation within the mitochondria. Healthy cells are metabolically flexible and can generate energy from both glucose and free fatty acid oxidation (FAO). During periods of fasting, exercise, or carbohydrate restriction, triglycerides stored in adipose tissue are broken down into free fatty acids and glycerol (Eberle, 2013). The liver also converts free fatty acids into ketone bodies, which provide an efficient alternative fuel for the brain and many other tissues when glucose availability is reduced (Wakil & Abu-Elheiga, 2009; Edwards & Mohiuddin, 2023).

When mitochondrial respiration is chronically impaired by environmental toxins, oxidative stress, metabolic dysfunction, or other factors associated with carcinogenesis, cells may shift from efficient oxidative phosphorylation to a more primitive, glycolytic mode of energy production that can generate ATP in the absence of oxygen. Mitochondrial function can decline as people age when accumulation of reactive oxygen species which can directly harm mitochondrial DNA (Bondy, 2024; Cui et al., 2012; Madamanchi & Runge, 2007). In addition, mitochondrial function can also decline due to the indirect moderating effects of lifestyle choices (Caturano et al., 2025; Lemos et al., 2023; San-Millán, 2023).

As described by Miwa et al., (2022), when mitochondrial function declines, mitochondrial dysfunction can contribute to cellular senescence which is the hallmarks of aging. As a response healthy cells can progressively relinquishes their specialized role within the tissue and adopts characteristics of a more ancestral, less differentiated state (Zhang et al., 2025).

Zhang et al. (2025) suggests a few mechanisms which explain the shift of healthy cells away from specialized states towards a less differentiated state, such as shifts in the tricarboxylic acid cycle (TCA) which rely on healthy mitochondria to produce cofactors such as acetyl-CoA and positively charged Nicotinamide Adenine Dinucleotide (NAD+), along with drops in chromatin, inhibiting DNA and histone demthylases (locking chromatin in a hyper-methylated state, and an upregulation of glycolysis. Additionally, cells ‘sense’ when mitochondria have low energy production such as a high ratio of adenosine mono-phosphate or di-phosphate (AMP/ADP) to adenosine tri-phosphate (ATP), which then leads to the AMP-activated protein kinase (AMP-K) pathway (Mihaylova & Shaw, 2011). Finally, hypoxia-inducing factor (HIF) signaling is how cells ‘sense’ and adapt to changes in available oxygen, and HIF binds to DNA, activating specific genes (Huang et al., 2023). The Warburg theory suggests that when mitochondrial dysfunction directly or indirectly reduces oxidative phosphorylation, the cells shift energy production from the mitochondria to cytoplasmic glycolysis which is a hallmark of unicellular ‘ancestral’ organisms or more embryonic or stem-like cellular activity (Suomalainen, & Nunnari, 2024; Zong et al., 2024).

It is as if your cells suddenly forget they’re part of a team. Instead of working together like citizens in a well-organized society, they revert to their most primitive programming; the “me first” mentality of our single-celled ancestors. This is what happens in cancer where sophisticated multicellular cooperation gets hijacked by an ancient survival script buried deep in our biological software. Sonnenschein and Soto (1999) describe this process in their book The Society of Cells (1999), “the default state of cells is proliferation.” In other words, multiplication isn’t some aberrant behavior; it’s actually the factory setting when single cells began. Every cell carries this “go forth and multiply” command like prehistoric programming code.

In healthy tissue, cells have learned to override this ancient impulse. They’ve evolved sophisticated “stop” signals, quality control mechanisms, and cooperative protocols that keep the peace. Cancer occurs when these civilized controls break down, and cells revert to their evolutionary factory settings—endless growth, damn the consequences.

It’s as if your cells suddenly decide to ignore millions of years of evolutionary teamwork and go back to playing by the rules that worked when life was just lone microbes floating in primordial soup.

Under Survival Threat, Organisms Revert to Their Oldest Survival Mechanisms

The same regression process can be observed in human beings. When children experience overwhelming stress, they often revert to earlier developmental behaviors, such as becoming incontinent or seeking protection by hiding behind a parent. Similarly, when adults perceive an immediate threat to survival, the stress response is not always fight or flight. Instead, the body may enter a freeze response characterized by profound immobilization.

This freeze response represents an ancient survival strategy that is activated when the nervous system perceives extreme, life-threatening danger. In this state, heart rate slows, metabolism is reduced, and movement is inhibited through activation of the dorsal vagal complex which is the evolutionarily older branch of the vagus nerve according to polyvagal theory, (Porges, 2023). For reptiles and other primitive vertebrates, this physiological strategy can increase the likelihood of survival until the danger has passed.

Metabolic Theory in Context

A ‘metabolic perspective’ related to carcinogenicity, or related to reversion to more primitive types of behaviors, does not dismiss the importance of genetics. Rather, a metabolic perspective places genetic mutations within a broader biological framework in which metabolism, mitochondrial integrity, immune surveillance, environmental exposures, and epigenetic regulation interact to determine whether a cell remains healthy, or progresses toward malignancy. From this perspective, cancer represents more than the accumulation of genetic mutations. It reflects a regression to an ancient cellular survival program in which energy production and reproduction, rather than specialized function and cooperation with neighboring cells, becomes the overriding priority. Genetic mutations may therefore be viewed not only as the initiating a set of complex interactions that reflect causes of cancer but also as downstream consequences of chronic metabolic dysfunction and mitochondrial damage.

If cancer represents the activation of an evolutionarily ancient cellular survival program triggered by metabolic dysfunction, then interventions that improve metabolic health can reduce risk associated with carcinogenesis which complement conventional treatment. As Dang (2012) points out, “excessive caloric intake is associated with an increased risk for cancers, while caloric restriction is protective, perhaps through clearance of mitochondria or mitophagy, thereby reducing oxidative stress.”

One practical implication is for people to follow often repeated advice: decrease the availability of rapidly absorbed carbohydrates by minimizing the consumption of sugar-sweetened beverages, refined starches, and ultra-processed foods while emphasizing whole, nutrient-dense foods. Broadly stated, such dietary changes in sugar intake can improve metabolic resilience, reduce chronic inflammation, and create a physiological environment that is less favorable for the metabolic adaptations observed in many cancers. Although additional clinical research continues to provide evidence supporting the effectiveness of ‘lifestyle’ and epigenetic strategies across different cancer types, the metabolic perspective offers a compelling framework for prevention and adjunctive therapy.

The metabolic theory of cancer based upon the Warburg effect offers hope in treatment by reducing glucose availability may help slow the growth of some cancers. The process is described clearly by Professor Thomas Seyfried of Boston College (Seyfried et al., 2014; Seyfried et al., 2021). His metabolic theory remains an active area of research, however is not the current consensus view on cancer biology. Consider watching the compelling overview of this metabolic theory presented by Professor Thomas Seyfried’s in his YouTube lecture, Cancer as a Metabolic Disease,

What can you do to reduce cancer risk and support healing

The metabolic theory of cancer presented in this paper suggests behavioral and lifestyle strategies to reduce cancer risk and slow or prevent cancer growth. Simply stated, reduce excessive glucose availability which becomes the main energy source for cancer cells. Clinical improvement may be possible if cancer cells are put on a diet (Stetka, 2016). Changing diet is one component to optimize what you can do to reduce cancer risk, support our immune system to promote healing and optimize health although the outcome is not totally in our hands.  Implement the following environmental and lifestyle behaviors promote health and healing.

Reduce and eliminate ultra-processed foods, simple carbohydrates and sugar. These increase the risk of cancers by 20 to 50 percent. Sadly, many patients undergoing chemo and radiation therapy and have difficulty with swallowing, are recommended to drink oral caloric rich supplements (such as Ensure Plus or Boost Very High Calorie) that are specially formulated to provide dense calories and protein in a small volume. They contain between 15 to 22 grams of sugar (1 to 2 tablespoons of sugar) in an 8 ounce serving– the sugar which paradoxically encourages  cancer growth.

Reduce and eliminate exposure to endocrine disruptors. These are chemicals that can mimic, block, or interfere with the body’s hormones, due to higher estrogen levels (in milk and beef, for example) and pesticides (some of which act as estrogen mimics). This means eliminating as much as possible all plastics and eat mainly organic foods that do not contain herbicides or pesticides. If possible, eat organic foods.

Reduce air and water pollution that are known factors to cause cancers.  This means use air and water filters at home since more than 50% of drinking water in the United States contain cariogenic substances and air pollution from car or fires are harmful.

Increase physical activity.  Movement/exercise is important because that reduces lymphatic circulation and blood flow, impacting the immune system in the long term.

For detailed information and recommendations what you can use to reduce cancer risk and optimize health, see our book, Cancer Reconsidered-Why Environment, Lifestyle and Immunity Matter more than we thought.

Additional relevant blogs

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Edited with the help of ChatGPT


Will the stock market bubble collapse? Will human fertility decrease to zero?

“Those who cannot remember the past are condemned to repeat it.” – George Santayana (Santayana, 1905)

These two questions may seem totally unrelated, yet they are deeply connected if one takes a long historic view and hypothesizes that present-day trends will continue.

When I drive or commute, I very much enjoy listening to podcasts. They offer an in-depth, nuanced discussions that are missing from today’s soundbite culture. These deep-dive podcasts offer a vital antidote, providing the nuanced, extended discussions necessary for true cognitive synthesis. One of my favorite podcasts is The Diary of a CEO with Steven Bartlett. I found the recent episode, “Billionaire’s WARNING: I’m SELLING. The Crash Is Already Here!”, very eye opening.

The interview was with billionaire investor Jeremy Grantham, the co-founder and long-term investment strategist of GMO. He is also the chairman of the Grantham Foundation for the Preservation of the Environment, and co-author of “The Making of a Permabear: The Perils of Long-term Investing in a Short-term World.”

While economics and financial markets fall outside my primary line of research, I deeply appreciated his long-term perspective—an analysis I find to be entirely spot-on. The actual content offered a masterclass in pattern recognition, forcing me to sit back and critically analyze the macroeconomic shifts happening around us rather than just reacting to the daily noise of the market. He persuaded me that the present AI-driven financial bubble will burst; we simply do not know exactly when. I concur with him that it will occur sooner rather than later. Personally, I would not be surprised if it occurred within the next two years. We must simply be prepared to deal with more challenging times.

The scientific data is clear: human fertility—both male and female—has been decreasing each decade. This is starkly indicated by a 50% drop in male sperm counts and a rising number of couples struggling to conceive (Ravitsky & Kimmins, 2019Mann et al., 2020; Inam, 2025). The culprits as for the increase in cancer rates? Ubiquitous modern disruptions like microplastics, pesticides, and pervasive environmental toxins (NIOSH, 2023; Doroftei et al., 2025; Brander et al., 2026).

Although the prognosis can look bleak, Grantham doesn’t just sound the alarm; he offers realistic strategies. He outlines how to protect yourself from the impending financial bubble collapse, as well as what you and your community can do to minimize toxic exposure and enhance fertility.

I smiled as I listened to the podcast, because his systemic analysis and practical recommendations are very similar to what we described in our just-published book, Cancer reconsidered-Why Environment, lifestyle, and immunity matter more than we thought (Peper et al., 2026).

To prepare yourself for the financial future and optimize your health and fertility, listen to Grantham’s insights on the podcast episode, “Billionaire’s WARNING: I’m SELLING. The Crash Is Already Here!”,

See the following blogs for more detailed information:

References

Brander, S.M., Swan, S.H., Mehinto, A.C., & et al. (2026). Impacts of environmental stressors on fertility and fecundity across taxa, with implications for planetary health. npj Emerging Contaminants, 2, Article 12. https://doi.org/10.1038/s44454-026-00032-6

Dilmaghani, D., Ainsworth, A. J., Nath, K. A., & Garovic, V. D. (2024). Decreasing fertility rate in the United States: Demographics, challenges, and consequences. Mayo Clinic Proceedings, 99(11), 1693–1697. https://doi.org/10.1016/j.mayocp.2024.09.004

Doroftei, B., Savuca, A., Cretu, A.-M., Maftei, R., Anton, N., Ilea, C., Doroftei, M., & Puha, B. (2025). Microplastics and human fertility: A comprehensive review of their presence in human samples and reproductive implication. Ecotoxicology and Environmental Safety, 303, Article 118939. https://doi.org/10.1016/j.ecoenv.2025.118939

Inam, Ö. (2025). Impact of microplastics on female reproductive health: Insights from animal and human experimental studies: A systematic review. Archives of Gynecology and Obstetrics, 312(1), 77–92. https://doi.org/10.1007/s00404-024-07929

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NIOSH. (2023, December 15). About pesticides and reproductive health. National Institute for Occupational Safety and Health Centers for Disease Control and Prevention. https://www.cdc.gov/niosh/reproductive-health/prevention/pesticides.html

Peper, E. Gorter, R. & Faass, N. (2026). Cancer Reconsidered: Why Environment, Lifestyle, and Immunity Matter More Than We Thought. BiofeedbackHealth/Regent Press. https://www.amazon.com/Cancer-Reconsidered-Environment-Lifestyle-Immunity/dp/1587907402/

Ravitsky, V. & Kimmins, S. (2019). The forgotten men: rising rates of male infertility urgently require new approaches for its prevention, diagnosis and treatment. Biol Reprod. 101(5), 872-874. https://doi.org/10.1093/biolre/ioz161

Santayana, G. (1905). The Life of Reason: Vol. 1. Reason in Common Sense. Charles Scribner’s Sons. p. 284. https://www.amazon.com/Reason-Phases-Progress-Introduction-Common/dp/B01DF937WU


Can Your Daily Choices Influence Cancer Risk and Recovery?

What if the way you eat, move, sleep, manage stress, and connect with others could influence your body’s ability to prevent disease and support healing?

Most of us have been taught to think of cancer primarily as a genetic disease. Yet an expanding body of scientific research tells a more hopeful story: while genes matter, they are only part of the picture. Our environment, lifestyle, immune system, and even the quality of our relationships can profoundly influence health.

These are the questions explored in the newly published book Cancer Reconsidered: Why Environment, Lifestyle, and Immunity Matter More than We Thought, by Erik Peper, Robert Gorter, and Nancy Faass.

Written for people living with cancer, their families, healthcare professionals, and anyone interested in optimizing health, the book translates decades of scientific research into practical, evidence-based strategies that readers can use in everyday life.

Rather than viewing cancer through a single lens, Cancer Reconsidered brings together insights from conventional medicine with evidence-based complementary approaches. The authors explore how nutrition, physical activity, stress, sleep, environmental exposures, immune function, and social support interact to influence both cancer risk and the body’s remarkable capacity for repair and resilience.

One of the book’s central messages is both simple and empowering: although we cannot change our genes, we can often change the conditions in which our genes are expressed. Daily choices matter. Healthy habits can strengthen the body’s natural defenses, reduce inflammation, support immune function, and improve quality of life.

A particularly practical chapter explores blood sugar regulation and metabolism. Using continuous glucose monitors (CGMs) together with smartphone apps, readers can observe in real time how different foods, exercise, stress, and sleep affect their glucose levels. Instead of following one-size-fits-all advice, they become active investigators of their own health, discovering what works best for their unique physiology.

Throughout the book, the emphasis is not on fear, but on possibility. Scientific evidence increasingly shows that hope, meaningful social connections, regular movement, nourishing food, restorative sleep, effective stress management, and resilience are not simply “nice ideas”—they are biological factors that can significantly influence health and well-being.

Cancer Reconsidered invites readers to move beyond the question, “What causes cancer?” and instead ask, “What can I do today to create the best possible conditions for health?” It offers a thoughtful, scientifically grounded roadmap for anyone seeking to answer that question.

Cancer Reconsidered: Why Environment, Lifestyle, and Immunity Matter More than We Thought is now available on Amazon in paperback and and affordable ebook Kindle editions. https://www.amazon.com/s?k=cancer+reconsidered


Managing Blood Sugar: Lifestyle Changes for Better Health

It was 4:45 p.m., and I was looking forward to swimming. I briskly walked the eight blocks from my house to the heated outdoor city pool. The pool is unusual—100 feet long instead of the standard 25 yards—and I enjoy the rhythm of swimming lap after lap.

I arrived just as the sign flipped from Closed to Open. I quickly changed into my bathing suit, locked my clothes in a metal locker, took a short shower, and jumped into the lane. The sun was still out, and only one other swimmer shared my lane. I felt energized and expected to complete my usual forty laps.

However, after about eighteen laps, my energy suddenly disappeared. There was nothing left in the tank. I swam to the side, pulled myself slowly onto the pool deck, and even slowly and unsteadily walked to the men’s locker room. I sat down on the bench feeling shaky, weak, and exhausted. This was not ordinary fatigue. After resting for several minutes, I slowly showered, dressed, and walked home with heavy, almost uncoordinated legs.

As I reflected on the experience, I remembered something similar that had happened two weeks earlier. Around 5 p.m, I had taken my son’s dog for a brisk walk. Again, I began energized, walking quickly, and then suddenly felt drained and sweaty. When I returned home, all I could do was sit down and recover.

What happened

Reflecting back, I realized that both cases I had eaten sweets—cake one time and a large chocolate chip cookie the other about two hours earlier Most likely, the rapidly absorbed sugars and refined carbohydrates caused a sharp increase in blood glucose, followed by a significant insulin response (Ludwig & Ebbeling, 2018). During exercise, my muscles then demanded additional glucose, and my blood sugar may have dropped rapidly enough to trigger symptoms of reactive hypoglycemia: shakiness, sweating, weakness, and fatigue (Morales-Brown, 2025, June 12).

The process is more complex than simply “sugar highs” and “crashes.” Carbohydrates are broken .break down into glucose during digestion, which begins in the mouth. Chewing breaks down food physically, while the enzyme amylase in saliva starts the chemical breakdown by splitting starches into sugars (Peyrot des Gachons & Breslin, 2016).  This raises blood glucose levels, which stimulates insulin release from the pancreas. Insulin helps move glucose from the bloodstream into cells. In some people—especially those developing insulin resistance or prediabetes—the insulin response may overshoot, leading to a later drop in blood glucose. Exercise can amplify this effect because active muscles rapidly consume glucose for energy (American Diabetes Association, 2024).

This experience was a wake-up call for me because my hemoglobin A1C is 5.7%, the lower threshold for prediabetes. Hemoglobin A1C reflects average blood glucose levels over approximately the previous three months (American Diabetes Association, 2026).

Like many people, I enjoy and am  even addicted to bread, potatoes, pastries, and sweets. Looking back, the subtle changes began during COVID. Before the pandemic, I spent much of the day teaching in person, walking across campus, moving, and interacting with students. During lockdown, I sat for hours teaching online. My physical activity during the day dramatically decreased while my eating habits did not significantly change.

When we are inactive, excess sugars and refined carbohydrates are less likely to be immediately used by muscles for fuel. Instead, repeated spikes in blood glucose and insulin can contribute over time to insulin resistance, weight gain, metabolic dysfunction, and increased inflammation (Ludwig & Ebbeling, 2018).

Although my episodes were minor, they reminded me that lifestyle patterns especially eating ultra-processed foods can increase the risk for chronic diseases such as type 2 diabetes, cardiovascular disease, obesity, and some cancers and dementia (Lane et al., 2024; Menegassi  & Vinciguerra, 2025). The scientific literature strongly links obesity, insulin resistance, and type 2 diabetes with increased risk for several cancers, including colorectal and postmenopausal breast cancer (Peper et al., 2026; Scully et al., 2021: Lauby-Secretan et al., 2016). Ultra-processed foods and sugar-sweetened beverages are also associated with increased risk for obesity and metabolic disease; moreover, cancer survivors who consume higher amounts of ultra processed foods face a significantly increased risk of both all-cause and cancer-specific mortality (Hall et al., 2019; Bonaccio et al., 2026). However, cancer is multifactorial, and no single food alone “causes” cancer. Rather, long-term dietary patterns, inactivity, obesity, chronic inflammation, genetics, environmental exposures, sleep, and stress all interact together ( Marino et al., 2024; Dalamaga et al., 2026; Peper et al., 2026).

What to do

The encouraging news is that these processes are often reversible.

Weight, hunger, blood sugar fluctuations, and even A1C are not fixed. They can improve significantly through lifestyle changes. Research consistently shows that reducing ultra-processed foods, lowering intake of refined carbohydrates and sugary beverages, increasing fiber-rich vegetables, improving sleep, reducing stress, and exercising regularly can improve insulin sensitivity and metabolic health (Bird & Hawley, 2017; Vaezi et al., 2025; American Diabetes Association, 2024; Peper et al., 2026).

For many people, continuous glucose monitors (CGMs) can provide powerful real-time feedback (Ehrhardt & Zaghal, 2020). Seeing how specific foods affect your glucose levels can increase awareness and motivate healthier choices. Often, we do not realize how dramatically a muffin, fruit juice, or bowl of white rice may affect blood sugar until we see the data on the screen.

The goal is not perfection or rigid dieting. Instead, it is learning to observe how your body responds and gradually shifting toward foods that support stable energy, satiety, and long-term health.

Before making major dietary changes, watch the superb interview with Dr. David Unwin, a British physician known for his work using lower-carbohydrate dietary approaches to help patients improve type 2 diabetes and metabolic health. His clinical work demonstrates that many patients can significantly improve blood sugar control and sometimes reduce medications through lifestyle changes (Unwin et al., 2020). The video, The Sugar Doctor’s Warning: The “Healthy” Foods Quietly Destroying Your Body! – Dr. David Unwin, is from the podcast, The Diary of a CEO with Steven Bartlett.

The Link Between Diet, Lifestyle, and Cancer Risk: Steps You Can Take

Read the new book, Cancer Reconsidered: Why Environment, Lifestyle, and Immunity Matter More than We Thought, by Erik Peper, Robert Gorter, and Nancy Faass. It explore the many of the lifestyle factors that can increase cancer risk—or help protect against it. The book brings together an extraordinary range of scientific research to illuminate how everyday habits and modern lifestyles influence cancer risk and healing. Drawing from both conventional medicine and integrative approaches, the authors thoughtfully examine the many factors involved in cancer causation while offering hopeful, evidence-based strategies for supporting recovery and restoring health.

What makes this book especially compelling is that it goes far beyond reviewing the science. It translates research into practical, everyday actions people can use to support healing and improve quality of life. At its heart is lifestyle medicine—the recognition that stress management, hope, physical activity, nourishing foods, supportive relationships, community, and resilience during times of crisis profoundly affect health and well-being. The book also offers a detailed and highly practical discussion of sugar metabolism and explains how continuous glucose monitoring sensors (CGMS) with the smartphone app can help people directly observe how specific foods and daily habits influence their blood sugar levels. Instead of relying on abstract nutrition advice, readers learn how to become active investigators of their own health.

Throughout the book, the message is empowering: our daily habits, social connections, attitudes, and environment may influence health as much as—if not more than—genetics alone. The book is available from Amazon: https://www.amazon.com/Cancer-Reconsidered-Environment-Lifestyle-Immunity/dp/1587907402

Listen to the in-depth discussion of this blog created with Google NotebookLM

Addition relevant blogs

References

American Diabetes Association. (2026). Blood glucose and exercise. American Diabetes Association. Retrieved May 24, 2026, from https://diabetes.org/health-wellness/fitness/blood-glucose-and-exercise

American Diabetes Association. (2024). Standards of care in diabetes—2024. Diabetes Care, 47(Suppl. 1). https://diabetesjournals.org/care/issue/47/Supplement_1

Bonaccio, M., Di Castelnuovo, A., Costanzo, S., Ruggiero, E., Esposito, S., Panzera, T., Di Costanzo, G., De Curtis, A., Magnacca, S., Cerletti, C., Donati, M. B., de Gaetano, G., & Iacoviello, L., for the Moli-sani Study Group. (2026). Ultra-processed food and mortality among long-term cancer survivors from the Moli-sani Study: Prospective findings and analysis of biological pathways. Cancer Epidemiology, Biomarkers & Prevention, 35(4), 664–674. https://doi.org/10.1158/1055-9965.EPI-25-0808

Dalamaga, M., Rozani, S., & Petropoulou, D. (2026). Why is colorectal cancer occurring earlier? Metabolic dysfunction, underrecognized carcinogens, and emerging controversies. Current Obesity Reports, 15(1), 24. https://doi.org/10.1007/s13679-026-00700-z

Ehrhardt, N., & Al Zaghal, E. (2020). Continuous glucose monitoring as a behavior modification tool. Clinical Diabetes, 38(2), 126–131. https://doi.org/10.2337/cd19-0037

Hall, K. D., Ayuketah, A., Brychta, R., Cai, H., Cassimatis, T., Chen, K. Y., Chung, S. T., Costa, E., Courville, A., Darcey, V., Fletcher, L. A., Forde, C. G., Gharib, A. M., Guo, J., Howard, R., Joseph, P. V., McGehee, S., Ouwerkerk, R., Raisinger, K., … Zhou, M. (2019). Ultra-processed diets cause excess calorie intake and weight gain: An inpatient randomized controlled trial. Cell Metabolism, 30(1), 67–77. https://doi.org/10.1016/j.cmet.2019.05.008

Lane, M. M., Gamage, E., Du, S., Ashtree, D. N., McGuinness, A. J., Gauci, S., Baker, P., Lawrence, M., Rebholz, C. M., Srour, B., Touvier, M., Jacka, F. N., O’Neil, A., Segasby, T., & Marx, W. (2024). Ultra-processed food exposure and adverse health outcomes: Umbrella review of epidemiological meta-analyses. BMJ, 384, e077310. https://doi.org/10.1136/bmj-2023-077310

Lauby-Secretan, B., Scoccianti, C., Loomis, D., Grosse, Y., Bianchini, F., & Straif, K. (2016). Body fatness and cancer—Viewpoint of the IARC Working Group. New England Journal of Medicine, 375(8), 794–798. https://doi.org/10.1056/NEJMsr1606602

Ludwig, D. S., & Ebbeling, C. B. (2018). The carbohydrate-insulin model of obesity: Beyond “calories in, calories out.” JAMA Internal Medicine, 178(8), 1098–1103. https://doi.org/10.1001/jamainternmed.2018.2933

Marino, P., Mininni, M., Deiana, G., Marino, G., Divella, R., Bochicchio, I., Giuliano, A., Lapadula, S., Lettini, A. R., & Sanseverino, F. (2024). Healthy lifestyle and cancer risk: Modifiable risk factors to prevent cancer. Nutrients, 16(6), 800. https://doi.org/10.3390/nu16060800

Menegassi, B., & Vinciguerra, M. (2025). Ultraprocessed food and risk of cancer: Mechanistic pathways and public health implications. Cancers, 17(13), 2064. https://doi.org/10.3390/cancers17132064

Morales-Brown, P. (2025, June 12). What is reactive hypglycemia. Medical News Today. Accessed May 24, 2026. https://www.medicalnewstoday.com/articles/reactive-hypoglycemia

Peper, E., Gorter, R., & Faass, N. (2026). Cancer reconsidered: Why environment, lifestyle, and immunity matter more than we thought. Biofeedback Health. https://www.amazon.com/Cancer-Reconsidered-Environment-Lifestyle-Immunity/dp/1587907402

Peyrot des Gachons, C., & Breslin, P. A. S. (2016). Salivary amylase: Digestion and metabolic syndrome. Current Diabetes Reports, 16, 102. https://doi.org/10.1007/s11892-016-0794-7

Scully, T., Ettela, A., LeRoith, D., & Gallagher, E. J. (2021). Obesity, type 2 diabetes, and cancer risk. Frontiers in Oncology, 10, 615375. https://doi.org/10.3389/fonc.2020.615375

Unwin, D., Khalid, A. A., Unwin, J., Crocombe, D., Delon, C., Martyn, K., Hasan, M., & Tobin, S. D. (2020). Insights from a general practice service evaluation supporting a lower carbohydrate diet in patients with type 2 diabetes mellitus and prediabetes: A secondary analysis of routine clinic data including HbA1c, weight and prescribing over 6 years. BMJ Nutrition, Prevention & Health, 3(2), 285–294. https://doi.org/10.1136/bmjnph-2020-000072

Vaezi, S., Freeling, J. L., de Vargas, B. O., Weidauer, L., Shoemaker, M. E., Sanders, W. M., & Dey, M. (2025). Impacts of minimally-processed omnivorous vs lacto-ovo-vegetarian diets on insulin sensitivity, lipid profile, and adiposity in older adults: Secondary findings from a randomized crossover feeding trial. Clinical Nutrition, 55, 90–103. https://doi.org/10.1016/j.clnu.2025.10.010


Tell Me Where It Hurts

In my biofeedback practice, I’ve repeatedly seen that healing rarely comes from a single technique. It emerges from observation, integration and practicing and integrating skills in daily life.  When clients learn to combine biofeedback with other strategies to make it their own such as slower, more coherent breathing, guided imagery, shifts in internal dialogue, and practical lifestyle changes, something important happens: the body begins to reorganize itself toward health.

Again and again, clients report meaningful changes. Stress symptoms, headaches, eye problem, neck shoulder and back pain decrease or disappear. Gastrointestinal symptoms often fade out. Anxiety loosens its grip. Asthma improves.  Chronic neck, shoulder, and pelvic pain diminish.  These are not isolated outcomes; they reflect a pattern. When people gain the skills to regulate their physiology and reinterpret their internal experience, decrease in symptoms often follow (see the list of articles that describe successful outcomes).

Even though many of my clients benefit, I am continually searching for strategies and approaches that can improve their health and reduce suffering and for materials that I can recommend to them.

Now when I see a client who reports pain or who takes care of someone with pain, the first thing I do is to recommend the book, Tell Me Where It Hurts, by Rachel Zoffness, PhD, a leading pain expert and psychologist. The book offers a clear, science-based framework grounded in modern neuroscience, yet conveyed through compelling human stories. Her work aligns closely with what we observe in biofeedback: pain is not simply a signal from injured tissue. It is an experience shaped by the interaction of body, brain, emotions, beliefs, culture and context.

She makes a crucial point that pain may begin with injury or illness, but it is always modulated by factors such as physiological state, emotional meaning, cognitive interpretation, and social and cultural influences. In other words, pain is real, but it is also dynamic and changeable.

The first step she emphasizes is education. When people understand how pain actually works, fear often decreases. From there, the task becomes identifying what amplifies pain and what reduces it and then systematically strengthening the factors and behaviors and skills that support recovery.

One striking story captures this perfectly: a construction worker jumps from a plank onto what appears to be a 7” nail, which is driven through his boot. He experiences excruciating pain and is rushed to the emergency room. Yet when the boot is removed, the nail is found to have passed cleanly between his toes—there is no tissue damage. The pain was real, but it was driven by perception and expectation. This is not an anomaly; it is a powerful illustration of how the brain constructs pain.

Equally compelling are the recovery stories. Patients with severe chronic pain that continue and got worse after failed surgeries, long-term disability, or even amputation, find relief not through more invasive procedures or medication alone, but through learning how to retrain their nervous system. In many of these cases, even opioids had failed to provide meaningful relief. What made the difference was a shift in understanding, combined with evidence-based self-regulation strategies. They are no longer abstract ideas; they are lived experiences.

The larger message is both simple and profound: pain can change. And when people are given the right framework and tools, they can actively participate in that change. For anyone living with pain, or working professionally with those who do, this book is not just informative. It is practical, empowering, and, in many cases, transformative.

This is the book to read if you have pain or care for someone with pain. It is also the book every therapist who works with people with pain should read and recommend to their clients.

Zoffness, R. (2026). Tell me where it hurts. Grand Central. https://www.amazon.com/Tell-Me-Where-Hurts-Science/dp/1538758148/

I recommend listening to the excellent podcast generated with Google NotebookLM, which thoughtfully expands upon and clarifies the underlying research.isten to the expanded podcast based on this blog and created with Google Notebook LM.

The following blog has a link to a superb podcast featuring Rachel Zoffness.

Then listen to the podcast from Dolorology (PAIN) Encore with Dr. Rachel Zoffness. https://www.alieward.com/ologies/dolorologyencore

Examples of integrated biofeedback outcomes

Peper, E. (2015). Pain as a Contextual Experience. Townsend Letter-The Examiner of Alternative Medicine, 388, 63-66. https://townsendletter.com/peper-contextual-pain-09-11-15/

Peper, E., Booiman, A. & Harvey, R.  (2025a). Pain-There is Hope. Biofeedback, 53(1), 1-9. http://doi.org/10.5298/1081-5937-53.01.16 Also, republished in Townsend Letter-Innovative Health Perspectives. https://townsendletter.com/pain-there-is-hope/

Peper, E., Chen, S., Heinz, N. & Harvey, R. (2023). Hope for menstrual cramps (dysmenorrhea) with breathing.  Biofeedback,. 51(2), 44–51. https://doi.org/10.5298/1081-5937-51.2.04

Peper, E. & Cohen, T. (2017). Inhale to breathe away pelvic floor pain and enjoy intercourse. Biofeedback, 45(1), 21–24. https://doi.org/10.5298/1081-5937-45.1.04

Peper, E., Cosby, J., & Almendras, M. (2022a). Healing chronic back pain. NeuroRegulation, 9(3), 164–172. https://doi.org/10.15540/nr.9.3.164

Peper, E., Covell, A., & Matzembacker, N. (2021). How a chronic headache condition became resolved with one session of breathing and posture coaching. NeuroRegulation, 8(4), 194–197. https://doi.org/10.15540/nr.8.4.194

Peper, E. & Harvey, R. (2008). From technostress to technohealth.  Japanese Journal of Biofeedback Research, 35(2), 107-114. https://www.jstage.jst.go.jp/article/jjbf/35/2/35_KJ00005060045/_pdf

Peper, E., Harvey, R., Chen, S., & Heinz, N. (2025b). Practicing diaphragmatic breathing reduces menstrual symptoms both during in-person and synchronous online teaching. Applied Psychophysiology and Biofeedback. https://do.org/10.1007/s10484-025-09745-7   

Peper, E., Harvey, R., Cuellar, Y., & Membrila, C. (2022b). Reduce anxiety. NeuroRegulation, 9(2), 91–97. https://doi.org/10.15540/nr.9.2.91 

Peper, E., Martinez Aranda, P., & Moss, E. (2015). Vulvodynia treated successfully with breathing biofeedback and integrated stress reduction: A case report. Biofeedback. 43(2), 103-109. https://doi.org/10.5298/1081-5937-43.2.04

Peper, E., Mason, L., Harvey, R., Wolski, L, & Torres, J. (2020). Can acid reflux be reduced by breathing? Townsend Letters-The Examiner of Alternative Medicine, 445/446, 44-47. https://www.townsendletter.com/article/445-6-acid-reflux-reduced-by-breathing/

Peper, E., Oded, Y., & Harvey, R. (2024). Quick somatic rescue techniques when stressed. Biofeedback, 52(1), 18–26. https://doi.org/10.5298/982312

Peper, E. & Tibbitts, V.  (2003). Protocol for the treatment of asthma.  In:  Zheng, Y. (ed).  Clinical Practice of Biofeedback. Beijing:  High Education Press (HEP). 163-176. ISBN 7-04-011420-8 https://biofeedbackhealth.org/wp-content/uploads/2011/01/protocol-for-asthma-treatemtn2001-china.pdf

Peper, E. & Yirmiyahu, D. (2023). Transforming a “bad eye” to an “amazing eye”: a case report and protocol. Townsend Letters. The Examiner of Alternative Medicine, Saturday, July 29, 2023 https://townsendletter.com/transforming-a-bad-eye-to-an-amazing-eye-a-case-report-and-protocol/


Breathing for Health: Four Part Audio Series for Regeneration and Well-Being

Adapted from Peper, E. (1990). Breathing for Health with Biofeedback. Mont­real: Thought Technology Ltd and produced by Larry Klein.

Breathing is the most intimate rhythm of life. From the moment we are born until our last breath, our breath is always there—quietly sustaining us. And yet, most of the time, we are unaware of how we breathe or how profoundly it shapes our health. Learn how to use your breath to optimize your health and enhance your well-being.

Dysfunctional breathing patterns contribute significantly to a range of illnesses, ranging from chronic pain and anxiety to fatigue and stress-related disorders. For example, when anxious, breathing often becomes rapid and shallow; when calm, breathing tends to slow and deepen. Symptoms can often be reduced, and health, resilience, and a deep sense of well-being can be enhanced after mastering and implementing effortless breathing. Breathing affects the mind, body, emotions, and spirit; when you change your breathing, you change your state of being.

The audio series by Erik Peper was conceived and produced by Larry Klein co-founder of Thought Technology, Ltd in 1990 to make the science and practice of breathing with biofeedback accessible to everyone. Although it was recorded more than 35 years ago, the principles and instructions remain as relevant and evidence-based today as they were then.

It was designed to help you observe your own breathing patterns and cultivate the foundational skill of effortless diaphragmatic breathing. Even more importantly, it guides you in integrating this breathing pattern into daily activities so that it becomes your default—whether you are working, speaking, exercising, or resting.

The discussion and guided practices are both simple and profound. When you change how you breathe, you change how you regulate yourself. Breathing both reflects and influences your physiology, emotions, and cognitions—often outside of conscious awareness.

As you listen to and practice the techniques in this four-part audio series, you will develop greater awareness, appreciation, and mastery of effortless breathing. Enjoy applying these practices in everyday life until they become automatic. Like any skill, effortless breathing is learned through gentle, consistent practice—practice makes permanent.

Part 1: Background Information on Breathing
Listen once to understand the scientific foundations and underlying rationale

Part 2: Learning Slow Diaphragmatic Breathing
Listen repeatedly and practice consistently until the skill becomes natural, effortless, and reliable.

Part 3: Integrating Breathing in All Conditions
Alternate between Parts 2 and 3. Practice during everyday activities so the skill generalizes beyond formal sessions and becomes your default way of breathing.

Part 4: Integrating Breathing, Imagery and Meditation for Health
Experience how guided imagery and meditative awareness deepen and amplify the benefits of effortless breathing.

Additional Recommended Blogs to Support the Learning and Generalization of Effortless Breathing

Additional Recommended Blogs: How Breathing Can Help Relieve Pain


Welcome the New Year with Inspiration

As the holiday season begins, I find myself looking back on all that has unfolded this year and looking forward with hope to the year ahead. My social media feed is full of touching, uplifting messages and videos—reminders of resilience, creativity, and the simple goodness in the world. Best wishes for the holidays and the New Year and I hope you will enjoy the two inspiring videos.

1. Nine life lessons from comedian Tim Minchin, presented at the University of Western Australia. His humor and wisdom offer a refreshing take on what truly matters.

2. A powerful story about transforming disaster into blessing.
If you ever feel stuck or unsure about the future, this video is a beautiful reminder that unexpected turns can lead to new possibilities.

Wishing you a healthy and inspiring New Year!

Erik


Reduce Interpersonal Stress*

Adapted from: Peper, E. & Harvey, R. Adjunctive techniques to reduce interpersonal stress at home. Biofeedback. 53(3), 54-57. https://rdcu.be/eMJqt

Stress often triggers defensive reactions—manifesting as anger, frustration, or anxiety that may mirror fight-or-flight responses. These reactions can reduce rational thinking, increase long-term health risks, and contribute to psychological and physiological disorders. and complicate the management of specific symptoms. Outlined are some pragmatic techniques that can be implemented during the day to interrupt and reduce stress.

After we had been living in our house for a few years, a new neighbor moved in next door. Within months, she accused us of moving things in her yard, blamed us when there was a leak in her house, claimed we were blowing leaves from her property onto other neighbors’ properties, and even screamed at her tenants to the extent that the police were called numerous times. Just looking at her house through the window was enough to make my shoulders tighten and leave me feeling upset.

When I drove home and saw her standing in front of her house, I would drive around the block one more time to avoid her while . . . feeling my body contract. Often, when I woke up in the morning, I would already anticipate conflict with my neighbor. I would share stories of my disturbing neighbor and her antics with my friends. They were very supportive and agreed with me that she was crazy. However, the acknowledgment and validation from my friends did not resolve my anger or indignation or the anxiety that was triggered whenever I saw my neighbor or thought of her. I spent far too much time anticipating and thinking about her, which resulted in tension in my own body—my heart rate would increase, and my neck and shoulders would tighten.

I decided to change. I knew I could not change her; however, I could change my reactivity and perspective. Thus, I practiced a “pause and recenter” technique. At the first moment of awareness that I was thinking about her or her actions, I would change my posture by sitting up straight, begin looking upward, breathe lower and slower, and then, in my mind’s eye, send a thought of goodwill streaming to her like an ocean wave flowing through and around her in the distance. I chose to do this series of steps because I believe that within every person, no matter how crazy or cruel, there is a part that is good, and it is that part I want to support.

I repeated this pause and recenter technique many times, especially whenever I looked in the direction of her house or saw her in her yard. I also reframed and reappraised her aggressive, negative behavior as her way of coping with her own demons. Three months later, I no longer reacted defensively. When I see her, I can say hello and discuss the weather without triggering my defensive reaction. I feel so much more at peace living where I am.

When stressed, angry, rejected, frustrated, or hurt, we so often blame the other person (Leary, 2015). The moment we think about that person or event, our anger, indignation, resentment, and frustration are triggered. We keep rehashing what happened. As we relive the experiences in our mind, we are unaware that we are also reliving bodily reactions to past events.

We are often unaware of the harm we are doing to ourselves until we experience physical symptoms such as high blood pressure, gastrointestinal distress, and muscle tightness along with behavioral and psychological symptoms such as insomnia, anxiety, or depression (Carney et al., 2006; Gerin et al., 2012). As we think of past events or interact again with a person involved in those past events, our body automatically responds with a defense reaction as if we were being threatened again in the present moment.

This defense reaction to memory of past threats from a “crazy” neighbor activates our fight-or-flight responses and increases sympathetic activation so that we can run faster and fight more ferociously to survive; however, this reaction also reduces blood flow through the frontal cortex—a process that reduces our ability to think rationally (van Dinther et al., 2024; Willeumier, et al., 2011). When we become so upset and stressed that our mind is captured by the other person, this reaction contributes to symptoms of chronic stress such as an increase in hypertension, myofascial pain, depression, insomnia, cardiovascular disease, and other chronic disorders (Duan et al., 2022; Russell et al., 2015; Suls, 2013).

Sharing our frustrations with friends and others is normal. It feels good to blame people for their personal limitations or mental illness; however, over time, blaming others avoids building adaptive capacity in strengthening skills that reduce chronic stress reactions (Fast & Tiedens, 2010; Lou et al., 2023). The time spent rehashing and justifying our feelings diminishes the time we spend in the present moment and our focus on upcoming opportunities.

In the moment of an encounter with a difficult neighbor, we may not realize that we have a choice. Some people keep living and reacting to past hurts or losses perpetually. Some people can learn to let go and/or forgive and make space in favor of considering new opportunities for learning and growth. Although the choice is ours, it is often very challenging to implement—even with the best intentions—because we react automatically when reminded of past hurts (seeing that person, anticipating meeting or actually meeting that person who caused the hurt, or being triggered by other events that evoke memories of the pain).

What Can You Do

Choose to change your response. Choose to reduce reactivity. Choosing adaptive reactions does not mean you condone what happened or agree that the other person was right. You are just choosing to live your life and not continue to be captured by nor react to the previous triggers. Many people report that after implementing some of the practices described below along with many other stress management techniques, their automatic reactivity was noticeably decreased. They report that their chronic stress symptoms were reduced and they have the freedom to live in present instead of being captured by the painful past.

Pause and Recenter by Sending Goodwill

Our automatic reaction to the trigger elicits a defense reaction that reduces our ability to think rationally. Therefore, the moment you anticipate or begin to react, take three very slow diaphragmatic breaths, inhaling for approximately 4–5 seconds and exhaling for about 5–6 seconds, where one in-and-out breath takes about 10 seconds to complete. As you inhale, allow your abdomen to expand; then as you exhale, slowly make yourself tall and look up. Looking up allows easier access to empowering and positive memories (Peper et al., 2017).

Continue looking up, inhaling slowly to allow the abdomen to expand. Repeat this slow breath again. On the third long, slow breath, while looking up, evoke a memory of someone in whose presence you felt at peace and who loves you, such as your grandmother, aunt, uncle, or even a pet. Reawaken positive feelings associated with memories of being loved. Allow a smile inwardly or outwardly and soften your eyes as you experience the loving memory.

Next, put your hands on your chest, take another long slow breath as your abdomen expands, and as you exhale bring your hands away from your chest and stretch them out in front of you. At the same time in your mind’s eye, imagine sending goodwill to that person involved in the interpersonal conflict that previously evoked your stress response. As if you are sending an ocean wave that is streaming outward to the person.

As you do the pause and recenter technique, remember you are not condoning what happened; instead, you are sending goodwill to that person’s positive aspect. From this perspective, everyone has an intrinsic component—however small—that some label as the individual’s human potential, Christ nature or Buddha nature.

Why would this be effective? This practice short-circuits the automatic stress response and provides time to recenter, interrupting ongoing rumination by shifting the mind away from thoughts about the person or event that induced stress toward a positive memory. By evoking a loving memory from the past, we facilitate a reduction in arousal, evoke a positive mood, and decrease sympathetic nervous system activation (Speer & Delgado, 2017). Slower diaphragmatic breathing also reduces sympathetic activation (Birdee et al., 2023; Siedlecki et al., 2022). By combining body-centered and mind-centered techniques, we can pause and create the opportunity to respond positively rather than reacting with anger and hurt.

Practice Sending Goodwill the Moment You Wake Up

So often when we wake up, we anticipate the challenges, and even the prospect of interacting with a person or event heightens our defense reaction. Therefore, as soon as you wake up, sit at the edge of the bed, repeat the previous practice, pause, and center. Then, as you sit at the edge of the bed, slightly smile with soft eyes, look up, and inhale as your abdomen expands. Then, stamp a foot into the floor while saying, “Today is a new day.” Next, inhale, allowing your abdomen to expand; as you look up, stamp the opposite foot on the floor while saying, “Today is a new day.” Finally, send goodwill to the person who previously triggered your defensive reaction.

Why would this be effective? Looking up makes it easier to access positive memories and thoughts. Stamping your foot on the ground is a nonverbal expression of determination and anchors the thought of a new day, thereby focusing on new opportunities (Feldman, 2022).

Interrupt the Stress Response with the ABCs

The moment you notice discomfort, pain, stress, or negative thoughts, interrupt the cycle with a simple ABC strategy (Peper, 2025):

  • Adjust posture and look up
  • Breathe by allowing your abdomen to relax and expand while inhaling
  • Change your internal dialogue, smile and focus on what you want to do

Why would this be effective? By shifting your posture and gently looking upward, you make it easier to access positive and empowering memories and thoughts (Peper et al., 2019).  This simple change in body position can interrupt habitual stress responses and open the doorway to more constructive states.

Slow, diaphragmatic breathing further supports this process by reducing sympathetic arousal and restoring a sense of calm. As your breathing deepens, clarity of mind increases, allowing you to respond rather than react (Peper et al, 2024b; Matto et al, 2025).

Equally important is transforming critical, judgmental, or negative self-talk into affirmative, supportive statements. Describe what you want to do—rather than what you want to avoid. This reframing creates a clear internal guide and significantly increases the likelihood that you will achieve your desired goals.

Complete the Alarm Reaction a Burst of Physical Activity

When you feel overwhelmed and fully captured by a stress reaction, one of the most effective strategies is to complete the fight-flight response with a brief burst of intense physical activity. This momentary action such as running in place, vigorously shaking your arms, or doing a few rapid push-offs from a wall (Peper et al., 2024a). After completing the physical activity implement your stress management strategies such as breathing, cognitive reframing, meditation, etc.

Why would this be effective? The intense physical activity discharges the excessive physiological arousal and interrupts the cycle of rumination.  For practical examples and step-by-step guidance, see the article Quick Rescue Techniques When Stressed (Peper et al., 2024a) or the accompanying blog post: https://peperperspective.com/2024/02/04/quick-rescue-techniques-when-stressed/

Discuss Your Issue from the Third-Person Perspective

When thinking, ruminating, talking, texting, or writing about the event, discuss it from the third-person perspective. Replace the first-person pronoun “I” with “she” or “he.” For example, instead of saying “I was really pissed off when my boss criticized my work without giving any positive suggestions for improvement,” say “He was really pissed off when his boss criticized his work without offering any positive suggestions for improvement.”

Why would this be effective? The act of substituting the third-person pronoun for the first-person pronoun interrupts our automatic reactivity because it requires us to observe and change our language, which activates parts of the frontal cortex. This third-person/first-person process creates a psychological distance from our feelings, allowing for a more objective and calmer perspective on the situation, effectively reducing stress by stepping back from the immediate emotional response (Moser et al., 2017). This process can be interpreted as meaning that you are no longer fully captured by the emotions, as you are simultaneously the observer of your own inner language and speech.

Compare Yourself with Others Who are less Fortunate

When you feel sorry for yourself or hurt, take a breath, look upward, and compare yourself with others who are suffering much more. In that moment, consider yourself incredibly lucky compared with people enduring extreme poverty, bombings, or severe disfigurement. Be grateful for what you have.

Why would this be effective? Research shows that when we compare ourselves with people who are more successful, we tend to feel worse—especially when we have low self-esteem. However, when we compare ourselves with others who are suffering more, we tend to feel better (Aspinwall, & Taylor, 1993). This comparison relativizes our perspective on suffering, making our own hardships and suffering seem less significant compared with the severe suffering of others.

Conclusion

It is much easier to write and talk about these practices than to implement them. Reminding yourself to implement them can be very challenging. It requires significant effort and commitment. In some cases, the benefits are not experienced immediately; however, when practiced many times during the day for six to eight weeks, many people report feeling less resentment and experience a reduction in symptoms and improvements in health and relationships.

*This blog was inspired by the podcast “No Hard Feelings,” an episode on Hidden Brain produced by Shankar Vedantam (2025) that featured psychologist Fred Luskin, and the wisdom taught by Dora Kunz (Kunz & Peper, 1983, 1984a, 1984b, 1987).

See the following posts for more relevant information

References

Aspinwall, L. G., & Taylor, S. E. (1993). Effects of social comparison direction, threat, and self-esteem on affect, self-evaluation, and expected success. Journal of Personality and Social Psychology, 64(5), 708–722. https://doi.org/10.1037/0022-3514.64.5.708

Birdee, G., Nelson, K.,Wallston, K., Nian, H., Diedrich, A., Paranjape, S., Abraham, R., & Gamboa, A. (2023). Slow breathing for reducing stress: The effect of extending exhale. Complementary Therapies in Medicine, 73. https://doi.org/10.1016/j.ctim.2023.102937

Carney, C. E., Edinger, J. D., Meyer, B., Lindman, L., & Istre, T. (2006). Symptom-focused rumination and sleep disturbance. Behavioral Sleep Medicine, 4(4), 228–241. https://doi.org/10.1207/s15402010bsm0404_3

Defayette, A. B., Esposito-Smythers, C., Cero, I., Harris, K. M.,Whitmyre, E. D., & López, R. (2023). Interpersonal stress and proinflammatory activity in emerging adults with a history of suicide risk: A pilot study. Journal of Mood and Anxiety Disorders, 2. https://doi.org/10.1016/j.xjmad.2023.100016

Dienstbier, R. A. (1989). Arousal and physiological toughness: Implications for mental and physical health. Psychological Review, 96(1), 84. https://doi.org/10.1037/0033-95x.96.1.84

Duan, S., Lawrence, A., Valmaggia, L., Moll, J., & Zahn, R. (2022). Maladaptive blame-related action tendencies are associated with vulnerability to major depressive disorder. Journal of Psychiatric Research, 145, 70–76. https://doi.org/10.1016/j.jpsychires.2021.11.043

Fast, N. J., & Tiedens, L. Z. (2010). Blame contagion: The automatic transmission of self-serving attributions. Journal of Experimental Social Psychology, 46(1), 97–106. https://doi.org/10.1016/j.jesp.2009.10.007

Feldman, Y. (2022). The dialogical dance–A relational embodied approach to supervision. In C. Butte & T. Colbert (Eds.), Embodied approaches to supervision: The listening body (chap. 2). Routledge. https://www.amazon.com/Embodied-Approaches-Supervision-C%C3%A9line-Butt%C3%A9/dp/0367473348

Gerin,W., Zawadzki,M. J., Brosschot, J. F., Thayer, J. F., Christenfeld, N. J., Campbell, T. S., & Smyth, J. M. (2012). Rumination as a mediator of chronic stress effects on hypertension: A causal model. International Journal of Hypertension, 2012, 453465. https://doi.org/10.1155/2012/453465

Hase, A., O’Brien, J., Moore, L. J., & Freeman, P. (2019). The relationship between challenge and threat states and performance: A systematic review. Sport, Exercise, and Performance Psychology, 8(2), 123. https://doi.org/10.1037/spy0000132

Hassamal, S. (2023). Chronic stress, neuroinflammation, and depression: An overview of pathophysiological mechanisms and emerging anti-inflammatories. Frontiers in Psychiatry,

14, 1130989. https://doi.org/10.3389/fpsyt.2023.1130989

Kunz, D., & Peper, E. (1983). Fields and their clinical implications—Part III: Anger and how it affects human interactions. The American Theosophist, 71(6), 199–203. https://www.researchgate.net/publication/280777019_Fields_and_their_clinical_implications-Part_III_Anger_and_how_it_affects_human_interactions

Kunz, D., & Peper, E. (1984a). Fields and their clinical implications IV: Depression from the energetic perspective: Etiological underpinnings. The American Theosophist, 72(8), 268–275. https://www.researchgate.net/publication/280884054_Fields_and_their_clinical_implications_Part_IV_Depression_from_the_energetic_perspective-Etiological_underpinnings

Kunz, D., & Peper, E. (1984b). Fields and their clinical implications V: Depression from the energetic perspective: Treatment strategies. The American Theosophist, 72(9), 299–306. https://www.researchgate.net/publication/280884158_Fields_and_their_clinical_implications_Part_V_Depression_from_the_energetic_perspective-Treatment_strategies

Kunz, D., & Peper, E. (1987). Resentment: A poisonous undercurrent. The Theosophical Research Journal, IV(3), 54–59. Also in: Cooperative Connection, IX(1), 1–5. https://www.researchgate.net/publication/387030905_Resentment_Continued_from_page_4

Leary, M. R. (2015). Emotional responses to interpersonal rejection. Dialogues in Clinical Neuroscience, 17(4), 435–441. https://doi.org/10.31887/DCNS.2015.17.4/mleary

Lou, Y., Wang, T., Li, H., Hu, T. Y., & Xie, X. (2023). Blame others but hurt yourself: Blaming or sympathetic attitudes toward victims of COVID-19 and how it alters one’s health status. Psychology & Health, 39(13), 1877–1898. https://doi.org/10.1080/08870446.2023.2269400

Matto, D., Peper, E., & Harvey, R. (2025). Monitoring and coaching breathing patterns and rate. Townsend Letter-Innovative Health Perspectiveshttps://townsendletter.com/monitoring-and-coaching-breathing-patterns-and-rate/

Moser, J. S., Dougherty, A., Mattson, W. I., Katz, B., Moran, T. P.,Guevarra, D., Shablack, H.,Ayduk,O., Jonides, J., Berman, M. G., & Kross, E. (2017). Third-person self-talk facilitates emotion regulation without engaging cognitive control: Converging evidence from ERP and fMRI. Scientific Reports, 7(1), 4519. https://doi.org/10.1038/s41598-017-04047-3

Peper, E. (2025). Breathe Away Menstrual Pain- A Simple Practice That Brings Relief. the peper perspective-ideas on illness, health and well-being from Erik Peper. https://peperperspective.com/2025/11/22/6825/

Peper, E., Harvey, R., & Hamiel, D.  (2019). Transforming thoughts with postural awareness to increase therapeutic and teaching efficacy.  NeuroRegulation, 6(3), 153-169.  https://doi.org/10.15540/nr.6.3.1533-1

Peper, E., Lin, I.-M., Harvey, R., & Perez, J. (2017). How posture affects memory recall and mood. Biofeedback, 45(2), 36–41. https://doi.org/10.5298/1081-5937-45.2.01

Peper, E., Oded, Y., & Harvey, R. (2024a). Quick somatic rescue techniques when stressed. Biofeedback, 52(1), 18–26. https://doi.org/10.5298/982312

Peper, E., Oded, Y., Harvey, R., Hughes, P., Ingram, H., & Martinez, E. (2024b). Breathing for health: Mastering and generalizing breathing skills. Townsend Letter-Innovative Health Perspectives. November 15, 2024.  https://townsendletter.com/suggestions-for-mastering-and-generalizing-breathing-skills/

Russell, M. A., Smith, T. W., & Smyth, J. M. (2015). Anger expression, momentary anger, and symptom severity in patients with chronic disease. Annals of Behavioral Medicine, 50(2), 259–271. https://doi.org/10.1007/s12160-015-9747-7

Siedlecki, P., Ivanova, T. D., Shoemaker, J. K., & Garland, S. J. (2022). The effects of slow breathing on postural muscles during standing perturbations in young adults. Experimental Brain Research, 240, 2623–2631. https://doi.org/10.1007/s00221-022-06437-0

Speer, M. E., & Delgado, M. R. (2017). Reminiscing about positive memories buffers acute stress responses. Nature Human Behaviour, 1, 0093. https://doi.org/10.1038/s41562-017-0093

Suls, J. (2013). Anger and the heart: Perspectives on cardiac risk, mechanisms and interventions. Progress in Cardiovascular Diseases, 55(6), 538–547. https://doi.org/10.1016/j.pcad.2013.03.002

van Dinther, M., Hooghiemstra, A. M., Bron, E. E., Versteeg, A., et al. (2024). Lower cerebral blood flow predicts cognitive decline in patients with vascular cognitive impairment. Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, 20(1), 136–144. https://doi.org/10.1002/alz.13408

Vedantam, S. (2025). No hard feelings. Hidden brain. Accessed February 5, 2025. https://hiddenbrain.org/podcast/no-hard-feelings/

Willeumier, K., Taylor, D. V., & Amen, D. G. (2011). Decreased cerebral blood flow in the limbic and prefrontal cortex using SPECT imaging in a cohort of completed suicides. Translational Psychiatry, 1(8), e28. https://doi.org/10.1038/tp.2011.28

Zannas, A. S., & West, A. E. (2014). Epigenetics and the regulation of stress vulnerability and resilience. Neuroscience, 264, 157–170.  https://doi.org/10.1016/j.neuroscience.2013.12.003


Ensorcelled: Breaking the Digital Enchantment

My mom called, “Stop playing on your computer and come for dinner!” I heard her, but I was way too into my game. It felt like I was actually inside it. I think I yelled “Yeah!” back, but I didn’t move.

A few seconds later, I was totally sucked into this awesome world where I was conquering other galaxies. My avatar was super powerful, and I was winning this crazy battle.

Then, all of a sudden, my mom came into my room and just turned off the computer. I was so mad. I was about to win! The real world around me felt boring and empty. I didn’t even feel hungry anymore. I didn’t say anything, I just wanted to go back to my game.

For some, the virtual world feels more real and exciting than the actual one. It can seem more vivid precisely because they have not yet tasted the full, multi-dimensional richness of real human connection, those moments when you feel seen, touched, and understood.

This theme comes vividly alive in my son Eliot Peper’s new novella, Ensorcelled. I am so proud of him. He has crafted a story in which a young boy, captured by the spell of the immersive digital world, discovers that real-life experiences carry far deeper meaning. I won’t give away the plot, but the story creates the experience, it doesn’t just tell it. It reminds us that meaning and belonging arise through genuine connection, not through screens. As Eliot writes, “Sometimes a story is the only thing that can save your life.” It’s a story everyone should read.

The effects of our immersive digital world

Our new world of digital media can take over the reality of actual experiences. It is no wonder that more young people feel stressed and have social anxiety when they have to make an actual telephone call instead of texting  (Jin, 2025).  They also experience a significant increase in anxiety and depression and feel more awkward initiating in-person social communication with others. The increase in mental health problems and social isolation affects predominantly those who are cellphone and social media natives; namely, those who started to use social media after Facebook was released in 2004 and the iPhone in 2007  (Braghieri et al., 2022).

Students who are most often on their phone whether streaming videos, scrolling, texting, watching YouTube, Instagram or TikTok, and more importantly responding to notifications from phones when they are socializing,  report higher levels of loneliness, depression and anxiety as shown inf Figure 1 (Peper & Harvey 2018). They also report less positive feelings and energy when they communicate with each other online as compared to  in person (Peper & Harvey, 2024).

Figure 1. The those with the highest phone use were the most lonely, depressed and anxious (Peper and Harvey, 2018).

Even students’ sexual activity has decreased in U.S. high-school from 2013 to 2023 and young adults (ages 18-44) from 2000-2018 (CDC, 2023; Ueda et al., 2020). Much of this may be due to the reality that adolescents have reduced face-to-face socializing (dating, parties, going out) while increasing their time on digital media (Twenge et al., 2019).

What to do

As a parent it often feels like a losing battle to pull your child, or even yourself, away from the intoxicating digital media, since the digital world is supercharged with  AI-generated media. It is  all aimed at capturing eyeballs (your attention and time),  resulting reducing genuine human social connection. (Peper at al., 2020; Haidt, 2024). To change behavior is challenging and yet rewarding. If possible, implement the following (Peper at al., 2020; Twenge, 2025; Haidt, 2024):

  • Create tech-free zones. Keep phones and devices out of bedrooms, the dinner table, and family gatherings. Make these spaces sacred for real connection.
  • Avoid screens before bedtime. Turn off screens at least an hour before bed. Replace scrolling with quiet reflection, reading, or gentle stretching. Read or tell actual stories before bedtime.
  • Explore why we turn to digital media. Before you open an app, ask: Why am I doing this? Am I bored, anxious, or avoiding something? Awareness shifts behavior.
  • Provide unstructured time. Let yourself and your children be bored sometimes. Boredom sparks creativity, imagination, and self-discovery.
  • Create shared experiences. Plan family activities that don’t involve screens—cooking, hiking, playing music, or simply talking. Real connection satisfies what digital media only mimics.
  • Implement social support. Coordinate with other parents, friends, or colleagues to agree on digital limits. Shared norms make it easier to follow through.
  • Model what you want your children to do. Children imitate what they see. When adults practice digital restraint, kids learn that real life matters more than screen life.

We have a choice. 

We can set limits now and experience real emotional connection and growth or become captured, enslaved, and manipulated by the corporate creators, producers and sellers of media.

Read Ensorcelled. which uses storytelling, the traditional way to communicate concepts and knowledge. Read it, share it. It may change your child’s life and your own.  

Available from

Signed copy by author: https://store.eliotpeper.com/products/ensorcelled

Paperback: https://www.amazon.com/Ensorcelled-Eliot-Peper/dp/1735016535/

Kindle: https://www.amazon.com/Ensorcelled-Eliot-Peper-ebook/dp/B0FLGQC3BS/

References

Braghieri, L., Levy, R., & Makarin, A. (2022).  Social Media and Mental Health (July 28, 2022)   http://dx.doi.org/10.2139/ssrn.3919760

CDC. (2023). Centers for Disease Control and Prevention. (2023). Youth Risk Behavior Survey: Data summary & trends report 2011–2021. U.S. Department of Health and Human Services. https://www.cdc.gov/healthyyouth/data/yrbs/index.htm

Haidt, J. (2024). The Anxious Generation: How the Great Rewiring of Childhood Is Causing an Epidemic of Mental Illness. New York: Penguin Press. https://www.amazon.com/Anxious-Generation-Rewiring-Childhood-Epidemic/dp/0593655036

Jin, B. (2025). Avoidance and Anxiety About Phone Calls in Young Adults: The Role of Social Anxiety and Texting Controllability. Communication Reports, 1–14. https://doi.org/10.1080/08934215.2025.2542562

Peper, E. & Harvey, R. (2018). Digital addiction: increased loneliness, depression, and anxiety. NeuroRegulation. 5(1),3–8doi:10.15540/nr.5.1.3 5(1),3–8. http://www.neuroregulation.org/article/view/18189/11842

Peper, E. & Harvey, R. (2024). Smart phones affects social communication, vision, breathing, and mental and physical health: What to do! Townsend Letter-Innovative Health Perspectives, September 15, 2024. https://townsendletter.com/smartphone-affects-social-communication-vision-breathing-and-mental-and-physical-health-what-to-do/

Peper, E., Harvey, R. & Faass, N. (2020). TechStress: How Technology is Hijacking Our Lives, Strategies for Coping, and Pragmatic Ergonomics. Berkeley: North Atlantic Books.

Ueda, P., Mercer, C. H., Ghaznavi, C., & Herbenick, D. (2020). Trends in frequency of sexual activity and number of sexual partners among adults aged 18 to 44 years in the US, 2000–2018. JAMA Network Open, 3(6), e203833. https://doi.org/10.1001/jamanetworkopen.2020.3833

Twenge, J.M. (2025). 10 Rules for Raising Kids in a High-Tech World: How Parents Can Stop Smartphones, Social Media, and Gaming from Taking Over Their Children’s Lives.  New York: Atria Books. https://www.amazon.com/Rules-Raising-Kids-High-Tech-World/dp/1668099993

Twenge, J. M., Spitzberg, B. H., & Campbell, W. K. (2019). Less in-person social interaction with peers among U.S. adolescents in the 21st century and links to loneliness. Journal of Social and Personal Relationships36(6), 1892-1913. https://doi.org/10.1177/0265407519836170