Comprehensive Care for Anxiety: The Role of Diet

Diet is the first line of treatment for many physical health conditions, and with good reason. There exists an extensive body of scientific literature supporting the connection between what we eat and our physical health. But can diet affect mental health?

Mental health disorders or diseases, including anxiety disorders, come in a variety of forms and are thought of mainly as biochemically based or emotionally rooted conditions that can’t be affected by diet. Although this may be true in most cases, these can manifest debilitating physical symptoms — increased heart rate, stomach discomfort, stiff jaw, and muscle tension — exemplifying the undeniable link between mind and body.

Forty million Americans are diagnosed with an anxiety disorder. For many, the care plan is limited to psychotherapy, medication or both. However, advances in nutritional neuroscience suggest that what we eat (and what we don’t eat) can influence the onset, occurrence and severity of anxiety symptoms in meaningfully significant ways.

While a majority of the population suffers from nutritional inadequacies, those with mental health conditions are often exceptionally deficient, bringing into question whether or not specific nutrients may contribute to an effective treatment plan for those with anxiety disorders.

A common nutrient inadequacy in people with anxiety disorders is the lack of omega-3 fatty acids. Long-chain omega-3s (EPA and DHA) are found most commonly in fish, and research shows most people fail to get recommended amounts through diet. Additionally, a new study has demonstrated that omega-3 supplements increase omega-3 concentrations in the body more predictably than simply choosing to eat fish more often.

Although the exact mechanism is still in question, long-chain omega-3s may decrease risk of anxiety symptoms by neutralizing the high concentration of pro-inflammatory cytokines seen with depression and anxiety. In a randomized controlled study with medical students, those who received 2.5 grams of omega-3s from fish oil had a 20 percent reduction in anxiety scores compared to the placebo group. What’s more, there was a 14 percent reduction in the inflammatory marker IL-6 (7), leading the researchers to hypothesize that reduced anxiety was related to the decrease in inflammation.

Similar to depression, anxiety is characterized by low levels of the “feel-good” neurotransmitter serotonin. Tryptophan — the same amino acid that makes you sleepy after eating Thanksgiving turkey — influences serotonin levels by acting as a precursor for serotonin. Many foods contain the amino acid — oats, milk, eggs, etc. — however, because the transport system to shuttle tryptophan to the brain is so selective for other amino acids, foods high in tryptophan are not effective at increasing serotonin levels because of competition from other amino acids. Rather, a tryptophan supplement without other amino acids is necessary.

When taken on an empty stomach, supplemental tryptophan is shown in studies to raise production of serotonin and lead to the reduction of stress markers, namely cortisol, diminishing feelings of anxiety. Furthering the evidence, tryptophan depletion in people with anxiety disorders leads to temporary worsening of symptoms.

When it comes to anxiety disorders, what you don’t eat is also just as important. For example, caffeine’s stimulation of the central nervous system — causing increased heart rate, sweaty palms, etc. — can be confused with feelings of impending danger and trigger a panic attack in those susceptible to anxiety symptoms. So it’s best to limit caffeine or cut it out of your diet if you exhibit these symptoms. It’s also important to avoid highly refined foods that cause blood sugar to spike and crash, leaving you vulnerable to an attack. 

Anxiety disorders are extremely complex and require a comprehensive treatment approach. Similar to physical ailments, a nutrient-rich diet is a key component for healthy management of symptoms. After all, your brain needs nourishment for optimal health just as much as the rest of your body. 

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Gillean Barkyoumb
Gillean Barkyoumb, MS, RDN, is the creator of Millennial Nutrition, a hub of nutrition information for health-conscious foodies. Get inspired by connecting with her on Instagram, Twitter or Facebook.