• Alison Acerra MS, RDN

Food as (Anti-Anxiety) Medicine

Updated: Feb 16, 2021

Rapid heart beat, racing thoughts, insomnia, sense of impending doom.... Whether it’s the trepidation we feel before a big presentation, the tension we might feel walking into a room full of strangers, or the butterflies in our belly before a first date, anxiety is real - and we’ve all been there! It’s normal to experience these classic symptoms from time to time and while some anxiety can actually be a good thing (researchers have found that people with low levels may be better at responding to threats than people without any at all), persistent anxiety can take a big toll on our physical health and quality of life. The question that persists as I dive deep into nutritional psychiatry as part of an Integrative and Functional Nutrition immersion program, is “how might our food choices be making our anxiety and stress levels worse?”

Anxiety & Stress: A Bad Problem Made Worse

Heightened anxiety and stress are nothing new in America, and the pandemic certainly has not helped matters. Eighteen percent of the population suffers from anxiety, and in a GoodRX survey of over 1000 people, 62% of people surveyed reported that their anxiety symptoms were “worse” or “much worse,” since Covid began. Prescriptions for anti-anxiety medications are also up by 10% since 2019. It’s worth noting that while medications can absolutely be helpful in stabilizing mood, they come with their own unwelcome side effects that can create more problems down the road. Always weigh the benefits and risks before engaging with pharmaceutical medications and work with a trusted practitioner to determine if they are the best choice for you.

Lifestyle, Nutrition, Mind and Mood

Of course mindfulness practices that increase our awareness of our triggers while bringing about more peace and calm, can be incredibly helpful to manage anxiety levels. (Sorting out which ones work and building them into a daily routine has been life changing, a post for another day!) That said, we know the nutrients in the foods we eat everyday are the building blocks of every hormone, neurotransmitter and a host of other compounds that directly impact our central nervous system and therefore the way we think, feel and behave. So while we can’t control external circumstances that may be the source of our worries and fears, what we eat (or don’t eat) can directly affect the way we respond to the stressors in our lives.

Food As (Anti-Anxiety) Medicine

Here are 5 common diet misteps that could be contributing to worsening anxiety, or even the root cause.

1. Not enough magnesium. This mineral is incredibly crucial, acting as a cofactor in more than 300 enzyme systems that regulate diverse biochemical reactions in the body, notably here...brain function. A 2017 review found that magnesium did in fact reduce anxiety levels and in another study by 52%! Wow, this is a biggie because 48% of U.S. adults are estimated to not meet the recommended intakes. It’s also important to note that low magnesium levels make it harder to effectively absorb vitamin D and we know how important Vitamin D is for health and happy minds.

What you can do: Take this Evaluation to determine if your diet is getting you enough magnesium, or depleting your levels (hint - calcium foods and supplements can compete with magnesium for absorption while caffeine and soda can cause excess magnesium loss through the kidneys). If you have digestive issues that limit nutrient absorption, low magnesium intakes, or any other factors impacting your levels, you might benefit from eating more magnesium rich foods and possibly taking a magnesium supplement.

2. Severe carb restriction. Made clear by the explosive interest in keto, low carb diets are still very much a thing. There is some anecdotal evidence to suggest that a very low carbohydrate/keto diet (like <10% calories from carb) can improve symptoms of depression and anxiety, but things don’t pan out according to this review and this study. Don’t get me wrong - keto may work for some and may have interesting implications as a therapeutic diet to manage certain diseases. That said, one thing the emerging science of personalized nutrition keeps telling us is that there is no one size fits all approach and we all respond to foods and supplements differently. For those with lower serotonin levels, caused by say a genetic variability, a low carb diet could make mood and depression much worse. It also may be impacting sleep. Just a small amount of a carbohydrate rich food can help raise serotonin levels that can help induce sleep.

Here's what’s clear: limiting carbohydrates may work for some but it certainly does not work for all.

Here’s the thing: while protein rich foods provide the amino acid tryptophan, a building block of serotonin, (our body’s “natural prozac” that elicits feelings of calm and relaxation), it is carbohydrates that are responsible for the movement of this hormone across the blood brain barrier for use. Without enough carbohydrates on board, this system breaks down and can severely limit serotonin levels, therefore impacting mood and a host of other processes in the body.

Unfortunately, keto is a plan that’s incredibly difficult to maintain and this is why we have such limited research to truly support its long term use. Despite all of the media attention keto gets as the pathway to miracles in health, I have seen over and over in my 1:1 nutrition coaching work the ways this trendy diet is leading people astray, creating unwarranted fears around the carbohydrates their body and brain truly need.

What you can do: For anyone considering or currently heavily restricting their carbs, I would encourage you to explore whether this is an approach that truly “works.” Beyond just weight loss, ask yourself -How do I feel? How is my mood? How is my energy? How is my digestion? Experiment with varying amounts of quality carbohydrates (see #2 above!) to determine the right levels based on your unique make-up and avoid getting caught up in all the media and fanfare (one word)around keto and carb-hating.

3. Excessive calorie restriction - This could mean extreme dieting in some of us (one study found 62% of extreme dieters experienced anxiety and depression), but more commonly, this may simply mean going long hours between meals. While calorie restriction and intermittent fasting (which is not truly calorie restriction but a change in meal timing) has proven to be very effective for some people in terms of overall health benefits and mood regulation, here again lies the importance of a personalized approach based on self-experimentation (see #3!). (For me personally, I'M doesn't work - a healthy, happy mindset turns into doom and gloom fast!)

What you can do: Check out my last blog on healthy snack hacks for more info, but the short of it is that well-timed, nourishing and mindful mini-meal/snack breaks can help maintain blood sugar balance, reduce HANGRY symptoms and minimize anxiety levels.

4. Not enough fiber, too many refined carbohydrates. This is perhaps the other end of the spectrum presented in #2! This approach impacts mood and anxiety in 2 important ways:

  1. Diets low in fiber are strongly associated with gut dysbiosis, a term used to refer to an imbalance in the good and bad bacteria (that’s more of the bad than the good) that reside in our belly. This imbalance contributes massively to the inflammation building in our body and is directly associated with numerous chronic diseases like diabetes, auto-immune diseases and mental health issues like depression and anxiety. Gut dysbiosis is an epidemic and while there are numerous contributing factors at play, diets low in fiber and high in processed foods are very much a source of the problem.

  2. Sweets and grains that have been stripped of their bran and therefore fiber, nutrients and antioxidants (i.e. their nutritional benefit!) break down into glucose very quickly in our bloodstream sending our blood sugars on a roller coaster ride that can lead to mood changes and anxiety. Refined grains include white bread, white rice, cookies, crackers and chips

What you can do: Improve the health of your gut, increase the counts of healthy gut bacteria and steady your blood sugars:

  1. slowly replace some of the processed carbs in your diet with whole grains (quinoa, bulgur, barley, wild rice) beans and legumes that will allow for the ‘slow burn’ that 1. provides necessary fiber to feed the healthy bacteria in your gut. 2. helps slow down sugar entering your bloodstream. These changes can help with weight management, blood sugar control and a healthier microbiome and relief from depression and anxiety. Ideally the goals is at least 30 grams per day from a variety of plant-based sources.

  2. incorporate more fermented foods like sauerkraut, kimchi, yogurt and kefir. (Go to John’s Super Foods and enter SND20 coupon code at checkout to receive 20% off high quality ferments delivered to your doorstep.)

  3. consider taking daily probiotic supplements.

5. Too many additives and preservatives. Not only are processed foods refined foods (see #2), they are highly inflammatory (see #3) and often contain additives and preservatives that can act as neurotoxins that can wreak havoc on our mental health and mood (especially in children!). Here are a few to consider:

  • MSG, an umami-enhancing flavoring agent and food additive. Check food labels and seek out restaurants that don’t use MSG.

  • Artificial food colorings

  • Artificial emulsifiers (e.g. carboxylmethylcellulose and polysorbate 80)

What you can do: Seek out more whole foods like fruits, vegetables, whole grains and legumes, quality and sustainable proteins and dairy, healthy fats (avocado, EVOO, grass-fed butter) nuts and seeds. Find recipes that will help you prepare delicious and convenient meals and commit to preparing more foods fresh from scratch. Hint: for those of you looking for fresh food delivery, check out my friends over at Thistle!

Products I love + Coupons!:

John’s Super Foods: High quality custom fermented foods; custom kimchi, kraut and pickles. Use Coupon Code SND20 for 20% off your order of $30.00 or more.

Thistle! Healthy and fresh meal delivery. Use Coupon Code SND50 for $50 off your first delivery (SF Bay Area, LA, LV, Seattle, PDX).

Alison Acerra MS, RDN founded Strategic Nutrition Design where she and her team provide nutrition consulting and coaching services to businesses, employers, groups and individuals. If you would like to schedule a FREE 30 minute discovery session to learn how we can help you personally or your business, schedule a time with her here.

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