You are what you eat is a saying that dates back to the mid-1800s in France and Germany. It later became popularized in the United States in the 1960s as a catchphrase for healthy eating. When it comes to anxiety disorders, you might consider taking this motto to heart. Research in nutritional psychiatry points towards a strong connection between your symptoms and your diet.
Anxiety disorders are the most common mental disorders in the United States. Nearly 1 in 6 US adults experienced symptoms of anxiety in 2019, and this number increased with the global pandemic.
When you’re struggling with panic attacks, an overwhelming sense of doom, insomnia, or uncontrollable worry, you may need to get help. Your treatment options are psychotherapy, medications, or non-medical natural approaches through diet and lifestyle. Research shows good but not great results for medication and psychotherapy, the gold-standard approaches to anxiety treatment. And while these alone, or in combination, have the potential to greatly reduce anxiety symptoms, it makes sense to approach anxiety from multiple angles for the best possible outcome.
In addition to adjusting your neurochemistry with medications and developing coping strategies in therapy, there is a metabolic component to mental illnesses, including anxiety, that can be treated with dietary changes.
A New Gut Feeling
Have you ever had a gut-wrenching experience or felt butterflies in your stomach? These are cases where you actually experience one of your feelings in your gut. And there’s a good reason for this.
Your gut is a system of critical digestive organs that runs from your mouth to your rectum and is in constant dialogue with your brain. Within your gut live about 40 trillion microbes, called the gut microbiome, which plays a central role in gut-brain communication and can impact mental health issues like depression and anxiety.
Amygdala is affected by the gut microbiome
Amygdala is a part of the brain that manages fear and dealing with threats and becomes hyperactive in anxiety disorders. The amygdala has special receptors for signals from the gut, and your microbiome sends signals to the amygdala. Keeping the gut and your microbiome healthy may be protective from anxiety.
The Link Between Inflammation and Mood
Inflammation is a natural response in your body that arises to defend against invading germs or injuries. The red, swollen, sore region around an infected wound is your body’s way of isolating invaders and supplying much-needed nourishment to the area so that it can heal.
However, inflammation is not always beneficial. Chronic, whole-body inflammation has been linked to multiple diseases and mental illnesses, including anxiety. Research shows that chronic inflammation negatively impacts the brain and increases activity in parts of the brain linked to anxiety. There appears to be a connection between inflammation and anxiety.
Anti-Anxiety Diet
Both your gut microbiome and chronic inflammation are hugely impacted by your diet. Below are 6 dietary changes that you can make to support these bodily systems and reduce your anxiety.
1. Eliminate Artificial Sweeteners
Artificial sweeteners adversely impact both your gut microbiome and your body’s level of inflammation. The popular artificial sweetener, aspartame, has been shown to increase anxiety levels in rats. Aspartame increases the level of the stress hormone cortisol and increases free radical production in humans. It is not clear yet exactly how aspartame causes psychiatric symptoms, although one study exploring the harmful effects of aspartame in people with depression, which is highly correlated with anxiety, had to be halted by the Institutional Review Board that oversees research due to the severe negative reactions to aspartame in those with a history of depression.
If you can’t face giving up your sweetened coffee or tea, you can try erythritol, which gets absorbed in the small intestine and is not fermented by the gut bacteria so likely has less of an impact on the gut microbiome, or stevia which is a natural, calorie-free sweetener. However, the safest, most conservative route would be to eliminate sugar and sweeteners all together.
2. Go Gluten-Free
It can be hard to think about giving up bread, cereal, pasta, and pizza. And that’s not all. Gluten can be found in sauces, soy sauce, supplements, and even some toothpaste. The good news is these days gluten-free options abound in supermarkets and restaurants.
If you’re struggling with anxiety, going gluten-free might be worth trying. Gluten has been linked to inflammation by causing “leaky gut,” or increased permeability of the intestinal barrier, which allows unwanted substances to pass from your intestine to your bloodstream. Those with a true gluten allergy, or celiac disease, have higher rates of anxiety and depression and eliminating gluten from the diet can decrease symptoms, especially anxiety. There are biological links between the systems that gluten activates in the body and mental illnesses including anxiety, even if you don’t get an upset stomach or any GI symptoms after eating gluten. Gluten exposure causes an increase in the release of a molecule called zonulin, which is the master regulator of intestinal permeability as well as blood brain barrier permeability. Individuals with anxiety and depression are more likely to have “gut dysbiosis” or out of balance gut flora with too many bad organisms and too few good ones.
3. Cut the Carbs
Ketogenic–or Keto–diets are high in fat and low in carbs. Think hamburgers without the bun. This diet causes the body to produce ketones as a fuel source for the brain. You might be wondering what that has to do with your anxiety. It turns out that keto diets can be used to treat a wide range of mental health conditions in part by reducing inflammation, neurotransmitter imbalances and oxidative stress.
More research is needed to explore the potential link between ketogenic eating and anxiety in humans. However, the preclinical research in rodents is promising. One study showed reduced anxiety levels in rats given ketone supplements in their food, which induced nutritional ketosis. While another study found that rats given medium chain triglycerides (MCT), something that I add to my bulletproof coffee every morning, had brain changes resulting in an anti-anxiety effect. MCT has a positive effect on mitochondria, which are our cells energy producing bodies and which can produce free radicals leading to oxidative stress. Improved mitochondrial function through reducing production of free radicals has potentially many benefits for human health.
4. Eat Your Omega-3s
Finally, something you should eat! Omega-3 fatty acids reduce inflammation, support a healthy gut microbiome, and as such, are directly linked to mental health. Omega-3s have been shown to reduce anxiety behaviors in rats. In humans, there is an inverse relationship between blood Omega-3 (EPA and DHA) levels and the severity of anxiety symptoms.
If you’re not sure how to get enough Omega-3s into your diet, one study in 68 medical students showed that Omega-3 supplementation reduced anxiety symptoms by 20% when supplementing with about 2000 mg per day of EPA and 350mg of DHA. While a meta-analysis of 19 studies concluded that 2000 mg or more a day of Omega-3 with about 50% but not more than 60% of EPA are most effective for anxiety.
If you want to eat your Omega-3s whole, try roe or krill oil, which have the highest concentrations of the type of Omega-3s you want for anxiety. Another great source is salmon or other fatty fish such as sardines. When eating fish consider risk for contamination with chemicals and microplastics.
5. Take Turmeric
Golden milk, which has roots in Ayurveda, is made from a mixture of turmeric and warm milk or plant-based milk. If that doesn’t appeal to you, worry not. The key ingredient that you want to consume here is turmeric, which is one of the most studied spices in connection to brain health.
Turmeric contains a compound called curcumin, which has powerful anti-inflammatory and neuroprotective effects. Curcumin may be helpful for brain function because of its beneficial effect on the gut microbiome and the “microbiota-gut-brain axis.” Early research in rodents links curcumin with reduced anxiety, while several human studies have also shown that curcumin supplementation can decrease anxiety and depression.
One note about turmeric is that further research is required to determine whether you can get adequate amounts of curcumin through its consumption. Some of the studies enhanced the curcumin absorption by chemical means, due to its unstable nature. While curcumin may not be stable enough to reach the brain, it could have an impact on the gut and the gut microbiome and through that it can have an indirect effect on the brain.
6. Supplement with Vitamin D
In general, modern humans do not get enough vitamin D from the sun and need to consume it. However, eating enough vitamin D is not so simple either, which is why more than three-quarters of US adults are vitamin D deficient. To get the recommended 600 IU daily, which is not even enough to stay out of a deficiency, a person would need to drink 6 glasses of vitamin D enhanced milk each day. I see in my patients that it takes far higher daily doses of vitamin D of 2000 to 5000 IU per day to get out of a deficiency and then to maintain adequate vitamin D levels. To get that much vitamin D would take drinking gallons of milk per day and I do not recommend drinking milk at all because of high prevalence of milk intolerance and allergy. So it is better to take Vitamin D supplements.
Lowered levels of vitamin D have been linked to multiple mental disorders, including anxiety. The mental health benefits of vitamin D are likely linked to its positive impact on the gut microbiome and reduced inflammation.
It’s important to get your daily dose of vitamin D, and since sun exposure is linked to skin cancer and it is hard to get enough from food, you may need to take a vitamin D supplement to maintain sufficient vitamin D levels.
Find the Combination That’s Right for You
Each person is unique and carries their own environment, culture, genetics, and body composition. While there is a lot of research behind nutrition as medicine for anxiety disorder, it is important to find the combination of treatments that work for you.
Though more exploration of each of these topics is warranted, this article offers 6 dietary changes that you can try to reduce your anxiety symptoms.
Mind Body Seven clinicians offer treatment in Brooklyn and via teletherapy for adolescents and adults. If have not worked with us and want to get started please contact us here, so we can set you up with the clinicians that best suit your individual needs. If you are an existing patient get in touch with us here to set up your next appointment.
