Nutrition and Anxiety

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May is Mental Health Awareness month. It’s one of the main reasons I became interested In nutrition. I felt firsthand the impact food had on my mental health when I was in high school. It was like a lightbulb went off and I realized a majority of my (mental) health struggles were a result of what I was eating, drinking, and how much sleep and movement I gave my body. .

I lost my Dad to mental illness 5 years ago. This month is very important to me, almost more than the anniversary of his death. I use it as a month to remember my father and to raise awareness for all those who suffer from mental health. I have been using my Instagram account to highlight nutrition and mental health this month and below is a post that my intern Kristen wrote last week on the connection between nutrition and anxiety. I hope you enjoy it and please share it with anyone who might benefit. 

With it being Mental Health Awareness month, I want to talk about something many people don’t know: mental health can be influenced by diet. Not only is the gut microbiome influenced by what we eat, but deficiencies in nutrients can also affect our mental health. A remarkable 1 in 5 U.S adults suffers from mental illness - that’s 20% of the population. According to the National Alliance on Mental Illness, anxiety disorders are the most common mental illnesses in the United States, and 18% of the population struggles with it. Anxiety and depression often go hand in hand, with about half of those with depression also experiencing anxiety. There are certain vitamins and minerals that improve anxiety and certain common American dietary practices that do not. 
 
Caffeine
 
Let’s start with the bad news. Caffeine in any form can worsen anxiety when too much is consumed. According to the American Psychological Association, 85% of Americans consume caffeine on a regular basis. Caffeine interferes with receptors and neurotransmitters in the brain to inhibit drowsiness. Individuals who are sensitive to the effects of caffeine can get symptoms of “caffeinism”, which include anxiety, restlessness, nervousness, and agitation. Those who are not sensitive and consume caffeine every day may experience caffeine withdrawal when they do not have it, which can cause headache, fatigue, anxiety and depression lasting for 48-72 hours. Studies have found that those who have light caffeine intake (120 mg/week) do not experience adverse effects. In another study, no adverse effects were found at 50 mg and 150 mg, but at 450 mg adverse effects were observed. To put this into perspective, a medium iced coffee (24 oz) from Dunkin Donuts has 300 mg of caffeine and a Venti Iced Coffee (24 oz) from Starbucks has 235 mg. To minimize anxiety, keep track of your caffeine intake and take note of levels where you begin to exhibit agitation and anxious feelings. The anxiogenic effects of caffeine are very individualized, so know how much YOU can have.
 
Magnesium
 
Magnesium is an important nutrient in the diet and the majority of Americans don’t get enough. Magnesium has an important role in a specific region in the brain, and if the pathway is impaired depression can occur. Low levels of magnesium in the blood and brain have been found to increase severe depression and self-harm. Studies have shown a positive effect of magnesium supplementation in depression. Magnesium may also play a role in stress response in the body, reducing anxiety. In a 2017 study, magnesium was found to improve anxiety outcomes in those suffering from mild to moderate anxiety. The daily recommendation for magnesium for an adult is 310-420 mg. As nutrition professionals, we always recommend getting your nutrients from food first compared to supplements. Foods high in magnesium include avocados, almonds, cashews, beans, chickpeas, tofu, quinoa, whole grains, salmon, bananas, spinach and kale.
 
Omega-3 fatty acids
 
The brain is made up of predominantly fat! Recent studies have found that American diets are higher in omega-6 fatty acids and lower in omega-3 fatty acids, which is associated with increased inflammation in the body. Omega-3 fatty acids reduce inflammation in the body and decrease anxiety and depressive symptoms. In a research study done on medical students, half were given omega-3 supplementation and the other half received a placebo. They then measured the inflammatory markers in both groups to see if the increased omega-3 fatty acids decreased inflammation. At the end of the study there was a negative correlation between omega-3 fatty acids and anxiety symptoms in the test group and positive association between anxiety in those consuming the standard American diet with a higher ratio of omega-6 to omega-3 fatty acids. Your body does need omega-6 fatty acids, but it’s the omega-3s we tend to be lacking more of. Foods high in omega-3 fatty acids include eggs, chia seeds, soybeans, salmon, oysters, mackerel, sardines, anchovies, cod liver oil, flaxseed and walnuts.
 
Vitamin B12
 
Vitamin B12 plays an important part of a pathway in the body which determines DNA synthesis. If this pathway is impaired, anxiety and depression can develop because the brain isn’t able to produce the neurotransmitters that it needs. A recent study found that participants with an average B12 level of 260 pg/ml had considerably higher symptoms of depression and anxiety compared to the group of participants with an average B12 level of 365 pg/ml. According to this study, 10-30% of individuals who suffer from depression have low B12 levels, and the study recommends the consumption of 1mg of B12 per day for those with a deficiency. The recommended daily intake for B12 is 2.4mcg. If you suffer from depression or anxiety, try eating more foods high in B12 which include beef, fortified cereal, tuna, nutritional yeast, salmon, dairy products, and eggs. Vegans should consider taking a supplement as B12 is only found in animal products. 
  
Folate
 
Folate and B12 are involved in many of the same pathways as they can serve as stimulators to each other’s reactions. If one intake is lacking, the other pathway is also not able to be completed. Low folate has been found in patients with depression. Recent studies have found that those with low folate also do not tolerate antidepressants as well, and that folate intake can improve the efficacy of the antidepressant. The recommended daily intake of folate is 400mcg. One food that is high in folate is asparagus which provides two-thirds of the daily recommendation. Other foods high in folate include broccoli, spinach, avocados, brussels sprouts, eggs, oranges and peanuts.
 
Stable Blood Sugar
 
While this is not a nutrient, this is very important. Everyone has experienced that “hangry” feeling! Well, it has a scientific basis. When you experience low blood sugar or have imbalanced blood sugar throughout the day, you are more likely to experience symptoms of anxiety and depression. Eating every 3-4 hours can be a good way to maintain blood sugar balance even if it’s just a snack. Balancing your plate with enough protein, carbohydrates, and vegetables can help with blood sugar balance. Most importantly, eat when you are hungry!
 

"Although the determinants of mental health are complex, the emerging and compelling evidence for nutrition as a crucial factor in the high prevalence and incidence of mental disorders suggests that diet is as important to psychiatry as it is to cardiology, endocrinology, and gastroenterology" - The Lancet Medical Journal 

References 

  1. https://www.nami.org/Learn-More/Mental-Health-By-the-Numbers

  2. https://www.apa.org/monitor/2008/04/caffeine

    1. Lara DR. Caffeine, mental health, and psychiatric disorders. J Alzheimers Dis. 2010;20(Suppl 1):S239–S248.

    2. Boyle NB, Lawton C, Dye L. The Effects of Magnesium Supplementation on Subjective Anxiety and Stress-A Systematic Review. Nutrients. 2017;9(5):429. Published 2017 Apr 26. doi:10.3390/nu9050429

  3. Kiecolt-Glaser JK, Belury MA, Andridge R, Malarkey WB, Glaser R. Omega-3 supplementation lowers inflammation and anxiety in medical students: a randomized controlled trial. Brain Behav Immun. 2011;25(8):1725–1734. doi:10.1016/j.bbi.2011.07.229

  4. Syed EU, Wasay M, Awan S. Vitamin B12 supplementation in treating major depressive disorder: a randomized controlled trial. Open Neurol J. 2013;7:44–48. Published 2013 Nov 15. doi:10.2174/1874205X01307010044

  5. Coppen, A., & Bolander-Gouaille, C. (2005). Treatment of depression: time to consider folic acid and vitamin B12. Journal of Psychopharmacology, 19(1), 59-65.  https://doi.org/10.1177/0269881105048899

  6. Aucoin M, Bhardwaj S. Generalized Anxiety Disorder and Hypoglycemia Symptoms Improved with Diet Modification. Case Rep Psychiatry. 2016;2016:7165425. doi:10.1155/2016/7165425
     

Erin Kenney