Anxiety and Nutrition

Anxiety is a normal, human experience that comes for a wide variety of reasons. While diet is not usually the cause of anxiety, research has found that our diet can play a role in the severity of our symptoms, how we manage anxiety, and the impact of stress and anxiety on our body. There are foods and habits that are best to both include and exclude to help mitigate and manage anxiety. Below are 12 evidence based nutritional considerations when it comes to anxiety.

1. Skipping meals

Skipping meals results in a drop in blood sugar and an increase in adrenalin and cortisol, which can easily bring on feelings of anxiety and irritability. Not eating enough at meals or throughout the day can have a similar effect.  Ensure you are nourishing yourself with healthy foods at regular intervals throughout the day, and avoid skipping meals.

2. Refined carbohydrates and sugar

Foods high in refined sugar and simple carbohydrates (and low in fibre) abruptly raise our blood glucose levels, resulting in a quick burst of energy which quickly plummets to below what it was initially (a sugar crash).  These dips in blood sugar are associated with increased anxiety as well as fatigue, irritability, hunger and a long list of other symptoms. Diets high in refined sugar and carbohydrates also contribute to gut dysbiosis (an imbalance of the good and bad bacteria in the large intestine), which can also impact anxiety. Limit your intake of foods high in refined sugar, such as candy/sweets, pastries, sweetened yogurt, ice cream, white bread/pasta, breakfast cereals, juice and other sweetened beverages. Instead, focus on choosing whole, unprocessed grains a majority of the time.

3. Unbalanced meals

Similar to the first two points, consuming meals that do not have the right balance of macronutrients (protein, fat and carbohydrates – including fibre) can also impact our blood sugar and raise our anxiety. Ensure you are consuming at least 20 grams of protein along with healthy fats and at least 5-10 grams of fibre with each meal to help to balance your blood sugar and keep you sustained longer.

4. Caffeine

Caffeine triggers the release of adrenalin to increase energy. Although a small amount may not impact anxiety, too much can induce or amplify anxiety and its associated symptoms, including nervousness, increased heart rate and restlessness. Caffeine withdrawal can also induce these symptoms, as well as headaches, depressed mood, irritability and fatigue.

The use of energy, or “stimulant,” drinks can have an even bigger impact on anxiety as they are packed with not only caffeine, but high amounts of sugar (and/or artificial sweeteners) and other unregulated herbal stimulants. A meta-analysis on energy drinks and mental health found a positive association between excessive energy drink consumption and anxiety. If you experience anxiety it is recommended that you limit caffeinated beverages (such as coffee or tea) to 1-2 cups per day (unless you are sensitive to caffeine, in which case you should avoid it), avoid energy drinks, and ensure adequate hydration. If you are consuming more than this, cut down gradually to avoid withdrawal.

5. Alcohol

Alcohol is often used as a coping mechanism for stress and anxiety, however, research (29189904, 27493821) has demonstrated that regular (particularly prolonged and excessive) alcohol consumption causes dysregulation of the reward system in the brain, resulting in increased anxiety. An occasional drink or two is not necessarily harmful, however, regular and excessive drinking can desensitize its effects, making the stressor(s) even more challenging to manage. Anxiety is also often heightened when the effects of alcohol wear off. It is recommended that you avoid relying on alcohol for the management of anxiety and limit your overall intake. Speak to your doctor if you think you have a dependence or require assistance.

6. Gut health

Our large intestine (where a bulk of the bacteria in our gastrointestinal tract live) and our brain communicate regularly via nerves, hormones and the immune system. In fact, 95% of serotonin (a natural mood stabilizer that can help regulate anxiety and mood) is produced in the gut.  Some studies have attributed gut dysbiosis (an imbalance of the type of microbes in our gut) as the root cause of some anxiety and mental illnesses.  Thus, optimizing our gut health is an important factor when it comes to mental health.

Foods that feed our healthy gut bacteria include plants that are unprocessed and high in fibre, such as fruit, vegetables, legumes/beans, whole grains, nuts and seeds. Probiotic rich foods, such as sauerkraut, kimchi, miso and tempeh also help to optimize our gut microbiome. Foods that feed our unhealthy gut bacteria include processed/fried foods, refined sugar and grains, meat (particularly red and processed meats), alcohol and various food additives (such as MSG). You do not need to avoid these foods, but they should not make up a bulk of your diet. Factors such as exercise, sleep and stress management play a role as well.

7. Omega-3 fatty Acids

Omega-3 fatty acids are essential (required in the diet because our body cannot make them) fats commonly found in flax seeds, chia seeds, hemp hearts, walnuts, soybeans and fatty fish (such as salmon and sardines). Although omega-6 fatty acids are also essential, they are much more prominent in our diet (found primarily in corn, safflower, soy, vegetable and sunflower oils used to make processed foods), and are inflammatory in excess. The recommended ratio of omega-6 to omega-3 fatty acids is 4:1, however, the national average is 16:1. In terms of anxiety, studies have found that individuals with depression and anxiety have lower levels of omega-3 in their blood, and that a reduced ratio of omega-6 to omega-3 fatty acids (consuming more omega-3 and less Omega-6) results in improvements in anxiety. Increasing your consumption of foods high in omega-3 fatty acids, while reducing your intake of inflammatory oils (avocado and olive oil are the best choices) and processed foods is therefore recommended. Depending on your diet, you may also want to speak to a qualified health practitioner about taking an Omega 3 supplement.

8. Hydration

Several studies (PMC8170814, blog) have established a link between dehydration and symptoms of anxiety, as well as and depression and cognitive functioning. There is also a long list of benefits to staying adequately hydrated. Ensure you are consuming at least 8 cups of water throughout the day (unless you have been advised by your doctor or other health care practitioner to do otherwise).

9. Vitamin D

A clear link between depression and Vitamin D deficiency has been long established. A number of studies (PM31478182, PM32213801) have also found a link between vitamin D deficiency and anxiety, suggesting that individuals who do not get enough Vitamin D experience more severe symptoms of anxiety. Vitamin D deficiency has also been linked to fatigue, frequent infections, pain, hair loss, and slow healing. Vitamin D, otherwise known as the sunshine vitamin, can only be synthesized by the body with sun exposure, or consumed in fortified foods or supplements. With the exception of the summer months, most Canadians do not get enough Vitamin D, and Health Canada recommends supplementing with 1000-2000 IU in the winter months.

10. B Vitamins

Collectively, the B Vitamins (there are 8 in total) have been found to have a positive impact on the nervous system, including stress. Lower levels of Vitamin B6 have been linked to depression and anxiety in women (PM31188081), and other research has found a similar association between Vitamin B12 and anxiety. Overall, individuals who eat foods higher in B vitamins have been found to have less anxiety and stress as compared to those who consume lower levels.

Foods high in B vitamins, including whole grains, leafy greens, nuts, seeds, legumes, salmon, nutritional yeast and various types of meat. If you are vegan and exclude all animal products, speak to your doctor about starting a Vitamin B12 supplement.

11. Vitamin C

Vitamin C is one of the most important vitamins. It is a powerful antioxidant and has an impact on nearly every part of the body, including anxiety and mood. While more research is needed, adequate vitamin C intake has been found (PM32745879, PM26353411) to reduce symptoms of anxiety when compared to a placebo. It has also been shown to help manage high levels of cortisol (a result of the stress response). Vitamin C is abundant in a wide variety of fruits and vegetables, including peppers, citrus fruits, kiwi, guava, kale, strawberries, potatoes, broccoli and Brussel sprouts.

12. Magnesium

While more research is needed, a systematic review of the evidence did establish a probable link between magnesium deficiency and anxiety. Foods high in magnesium include pumpkin seeds, almonds, leafy greens, cashews, cacao, dark chocolate, legumes, oily fish, bananas and avocado.

In Summary

As you can see, there are several nutritional factors that can play a role in how we experience and deal with anxiety. If your diet is something you want to improve to better support your mental health, I recommend  focusing on getting to a point where you are consuming a diet that consists of least 80% whole, unprocessed plant-based foods (fruits, vegetables, whole grains, nuts, seeds, beans and legumes), a variety of these foods (aiming for at least 30 different plants per week), eating regular meals, and minimizing your intake of processed and inflammatory foods. If you need help getting started, or would like support and accountability to reach your goals, consider scheduling a free 15 minute Holistic Nutrition consultation with Christy De Jaegher to learn more about her approach and services.

Christy De Jaegher is a registered holistic nutritionist with a background in occupational

therapy. She specializes in helping adults make progressive evidence-based diet and lifestyle changes to improve their stress, anxiety, mood, energy, and overall mental health from the inside out. Services can be provided under either holistic nutrition or occupational therapy, both of which are often included in extended benefit plans. Appointments are available through Lifestyle Refresh Health and Wellness, as well as Panorama Wellness Group in Langley and Living Wellness Centre in South Surrey.