Anxiety disorders are the most common mental illness in the USA, which translates into 40 million adults, or 18% of the population. In Australia, 17% of the population aged between 16 and 85 have experienced anxiety, or an affective disorder, during the past 12 months.

Stress and anxiety may be understood as being fairly synonymous by those not intimately aware of the differences. However, stress is defined as a state of emotional strain or tension from adverse or demanding circumstances that a person feels inadequate to address. And anxiety is defined as a feeling of unease or restlessness about something with an uncertain outcome.

So, stress can, and does, drive anxiety. And, during this uncertain and overwhelming time in our history, it would be unusual if these two states of mind didn’t co-exist in the minds of millions of people globally.

In addition, large population level studies report high rates of anxiety and depression occurring together – comorbidity – with between 75 – 78% of those reporting one disorder also presenting with the other. So, symptoms of stress, anxiety and depression are existent in millions of peoples lives presently.

Due to the complex interplay of environment, cognition, emotions and resultant mood, and the sensitivity of the limbic system, where the brain manages emotion, it’s understandable that these mental states are challenging to address.

Although stress can drive anxiety and depression, which are complex and require a multi-faceted approach to healing, we cannot ignore the fact that a rapidly growing body of evidence is linking dietary choices to these affective disorders, as the references below showcase. But, what are the underlying mechanisms linking nutrition and anxiety?

1 Processed, nutrient-deficient, ‘so-called’ foods can predispose us to anxiety

Nutrient dense foods are required to facilitate the synthesis of neurotransmitters. Specific vitamins and minerals act as co-factors and support the synthesis of specific nutrients into more complex compounds, such as neurotransmitters.

For example, serotonin and GABA are neurotransmitters that support calm, restful thinking and need to be synthesized from foundational compounds, such as specific B vitamins and minerals. Without them, these neurotransmitters cannot be synthesized.

And yes, even though it’s estimated that 80%+ of serotonin is synthesized in the gut, the other +-20% is synthesized in the brain, so the lack of nutrients with which to synthesize serotonin impact both the gut and the brain, which interact too, when these nutrients are lacking.

And when we don’t make enough serotonin, we can’t make enough melatonin, which directly impacts sleep onset and maintenance. And lack of sleep leads to feelings of anxiety too.

Fix:

Find recipes that use nutrient dense produce to quickly create delicious foods – it’s not all about salads but can be about rich stews, pilafs, pastas, soups and roasted vegetables. Fresh produce will also increase your fiber intake, which will increase the quality of your pre- and probiotic gut flora, which is related to mental wellbeing.

2 Highly refined and sugary foods can contribute directly to increased feelings of anxiety

They do this not only because they may be replacing nutrient dense foods and thus lead to a lack of specific nutrients as described above, but also because refined sugar on its own destabilizes blood glucose levels.

Quick spikes and dips in blood glucose levels result in the release of cortisol, which is related to both feelings of stress and anxiety.

However, the initial rush of opioid-like compounds that the first few bites of sugary foods release, result in a desire to both repeat the experience, and reduce the feelings of stress and anxiety that the blood sugar spikes and dips have caused.

Unfortunately, there’s more bad news, because when cortisol levels are high, insulin release is suppressed. Insulin facilitates the uptake of carbohydrates to be used for energy. When its working inefficiently carbohydrates are stored as fat versus being used for energy. And weight gain leads to anxiety independently.

It is clear that this situation can easily become a nasty, vicious cycle.

Fix:

Find recipes that use good fats and natural forms of sweetness to create delicious treats and desserts, and if you do eat something very sweet make sure you also eat good fat with it, as that will slow the blood glucose spike somewhat.

3 Caffeine can drive anxiety indirectly

Coffee, and caffeine-spiked drinks do initially stimulate positive feelings of pleasure and energy via dopamine release, it also causes blood glucose spikes and dips. This stimulates the release of cortisol, so may increase feelings of anxiety over the day.

Over time, people who are stressed and anxious may find themselves becoming more so due to the ongoing release of cortisol and their unstable blood glucose levels which also stimulate cortisol independently.

Naturally, combining sugar and caffeine leads to a heightened response from their interaction.

And this combination can significantly impact sleep quality.

Although the relationship between energy drinks and anxiety is less well researched, some studies have linked such drinks with increased risk of negative mental health outcomes including increased levels of anxiety.

Fix:

Experiment with tapering off the amount of caffeine you consume with each serve, or replacing every second cup of coffee with water-filtered, decaffeinated coffee, preferably organic.

4. Damaged fats impact brain functioning negatively

Fats play a complex and critical role in overall health and wellbeing, and an essential role in brain health. They form part of every one of the 85+ billion neurons in the human brain and without the right kinds of fats both the synthesis and the functioning of neurotransmitters are negatively impacted.

Apart from improving overall cognitive functioning, the presence of good fats is related to lower rates of stress and anxiety while damaged fats are related to higher rates of such.

Therefore, any food items that contain damaged fats may contribute to poor mood states, including anxiety. Combine damaged fats with nutrient deficient foods and the odds go up that anxiety will too.

Fix:

Use undamaged, good fats in all dressings, sauces and drizzled over cooked foods and find recipes that don’t require the use of damaged fats but still taste delicious. Ensure all your meals contain good fat, which increase flavor via improved mouth feel. 

5. Artificial Sweeteners interfere with our neurochemistry

A number of the compounds used to sweeten soft drinks have known neurotoxic properties. They interfere with the synthesis of other neurotransmitters ad have been linked to a number of mental health challenges, including mood swings and anxiety.

 Furthermore, although artificial sweeteners were developed to support weight loss, they don’t do this as they interfere with the metabolic processes that underpin energy usage and storage and don’t habituate taste buds to enjoy less sweet foods.

Although sugar isn’t a health food, artificial sweeteners are less so.

Fix:

Create delicious, sparkling drinks with carbonated water and small quantities of natural fruit juices like pomegranate and berry.

Conclusion

Any behaviors that are complex and consist of their own positive feedback loop are a challenge to change. It’s therefore imperative that shifting your behavior includes pleasant experiences and minimizes deprivation.

Fortunately, it’s possible to positively impact a number of factors underpinning mental health simultaneously as they are intimately linked. For example, when you increase nutrient dense food intake you’ll naturally also increase fiber intake, which supports improved gut flora, both of which stabilize blood glucose, which increases energy, reduces the need for caffeine, improves sleep patterns and improves mood. A splendid domino effect!

And it’s possible to do this without deprivation if you know how to make delicious foods that satisfy all these criteria!

References

Bakhtiyari M, Ehrampoush E, Enayati N, et al. Anxiety as a consequence of modern dietary pattern in adults in Tehran—Iran. Eating behaviors. 2013;14(2):107-112.

Choudhary AK, Lee YY. Neurophysiological symptoms and aspartame: What is the connection? Nutr Neurosci. Jun 2018;21(5):306-316.

Firth J, Marx W, Dash S, et al. The effects of dietary improvement on symptoms of depression and anxiety: a meta-analysis of randomized controlled trials. Psychosom Med. 2019 Apr;81(3):265-80.

Gangwisch JE, Hale L, Garcia L, et al. High glycemic index diet as a risk factor for depression: analyses from the Women’s Health Initiative. The American Journal of Clinical Nutrition. 2015;102(2):454-463.

Glabska D, Guzek D, Groele B, Gutkowska K. Fruit and vegetables intake in adolescents and mental health: a systematic review. Rocz Panstw Zakl Hig. 2020;71(1):15-25.

Hashemi S, Amani R, Cheraghian B, Neamatpour S. Stress and Anxiety Levels Are Associated with Erythrocyte Fatty Acids Content in Young Women. Iranian journal of psychiatry. Jan 2020;15(1):47-54.

Jacka FN, Pasco JA, Williams LJ, Meyer BJ, Digger R, Berk M. Dietary intake of fish and PUFA, and clinical depressive and anxiety disorders in women. Br J Nutr. 2013;109(11):2059-2066.

Luna RA, Foster JA. Gut brain axis: diet microbiota interactions and implications for modulation of anxiety and depression. Curr Opin Biotechnol. Apr 2015;32:35-41.

McCabe D. Feed Your Brain. 7 Steps to a Lighter, Brighter You! Exisle; 2016:286.

McCabe D. Dietary supplementation to manage anxiety and stress: hope, hype or research-based evidence? (Editorial). Joanna Briggs Institute: Database of Systematic Reviews and Implementation Reports. 2017:188-189.

Mujcic R, Oswald AJ. Does eating fruit and vegetables also reduce the longitudinal risk of depression and anxiety? A commentary on ‘Lettuce be happy’. Soc Sci Med. 2019;222:346-348.

Murphy M, Mercer JG. Diet-regulated anxiety. Int J Endocrinol. 2013;2013:701967-701967.

Richards G, Smith AP. A Review of Energy Drinks and Mental Health, with a Focus on Stress, Anxiety, and Depression. Journal of caffeine research. Jun 1 2016;6(2):49-63.

Rooney C, McKinley MC, Woodside JV. The potential role of fruit and vegetables in aspects of psychological well-being: a review of the literature and future directions. Proc Nutr Soc. 2013;72(04):420-432.

https://adaa.org/about-adaa/press-room/facts-statistics (Accessed 19 May, 2020)

https://www.beyondblue.org.au/media/statistics (Accessed 19 May, 2020)