There’s a strong link between anxiety and the food we eat, says Registered Dietitian Ali Miller author of the Anti-Anxiety Diet. If you want to balance your mood, start by avoiding these inflammatory foods
The current anxiety epidemic has produced some sobering statistics, with one in six adults in the UK now experiencing some sort of anxiety episode in any given week, according to mental health charity mind.org.uk . Could what we’re eating be part of the problem? That’s the science-backed theory put forward by registered dietitian Ali Miller . She takes a ‘food as medicine’ approach to wellbeing and her new book The Anti-Anxiety Diet aims to help anxiety sufferers like herself to ‘stop racing thoughts, banish worry and live panic free’ with a 12-week eating plan.
It's part of a new direction in the traditional New Year diet books, which are shifting away from dropping physical pounds and focusing on the link between food and anxiety; this year, it's all about losing mental weight. Just published are Shrink: The Diet For the Mind by psychotherapist Phil Tahon, Laura Thomas's Just Eat It which focuses on intuitive eating and taking the emotion out of food choices. Soon to come is How to Feel The Fear and Eat It Anyway , by Eve Simmons and Laura Dennison, the duo behind the Not Plant Based blog, who've both had eating disorders in the past.
Miller’s own experience with an overactive mind, shortness of breath, brain fog, insomnia and chronic anxiety began while she was at college and on a vegan (and then a raw vegan) diet before being diagnosed with an autoimmune disease. What helped her recovery was reintroducing organic animal products, lowering her intake of grains and completely eliminating processed grain and soy products. She went on to refine her approach to mental health through food by reducing the ‘inflammatory compounds’ in her diet (more of this below) and healing her gut lining.
Those who have anxiety, brain fog, and racing thoughts have a higher amount of inflammatory chemicals in their body – DR Ali Miller
So what can you expect from the Anti-Anxiety Diet? It takes a three-step approach beginning with a two-week clean-up, in which you eliminate the five main inflammatory foods listed below. Then comes Phase 1, a ketogenic eating plan for six weeks which involves very minimal carbs derived from nuts, seeds and non-starchy veg, and lots of fats and proteins (it’s not advised for people with a history of eating disorders, pregnant women, those with adrenal fatigue and certain medical conditions. It goes without saying that it’s always best to seek medical advice before embarking on any diet).
Then Phase 2, which lasts for at least another six weeks, is a low GI way of eating, where up to a quarter of your plate consist of low GI carbs and includes starchy veg and fresh fruit for fibre and to support serotonin production. There’s emphasis on resetting the gut microbiome, repairing the gut lining and eating the right micronutrients such as antioxidants for anxiety support as well as mood-stabilising vitamins and minerals.
Given the stats on current UK levels of anxiety, it’s appealing to think that simply changing our diet can provide measurable support for a condition that’s so prevalent and so widely medicated.
So where to start? Here, Dr Miller explains why reducing inflammation by cutting out five trigger foods, is the vital first step in managing anxiety through diet.
What is inflammation? By registered dietitian Ali Miller
Inflammation is a natural immune response in reaction to a foreign invader such as a virus, bacteria, or fungi, or to an injury like a cut, impact, or chemical exposure A healthy and balanced body is capable of shutting off the inflammatory response; however, in an unbalanced state, the inflammatory response may perpetuate, leading to chronic, asymptomatic inflammation that can wreak silent havoc or cause painful flare-ups.
As we get older inflammation increases
Chronic inflammation is associated with many diseases, especially age-related diseases, including atherosclerosis (clogged arteries), cancer, arthritis, obesity, allergies, stroke, diabetes, congestive heart failure, digestive disorders, Alzheimer’s disease, mood imbalance, and more. Diseases ending in “itis” (e.g., arthritis, diverticulitis) mean inflammation; any “-itis” can benefit from anti-inflammatory mechanisms.
The natural process of ageing sets the foundation for increased inflammation because our bodies produce more destructive chemicals known as cytokines. Lifestyle factors also contribute to increased inflammation, such as diet, quality of sleep, psychological stress, exposure to toxic chemicals (smoking, environmental pollutants, unpurified water), and eating inflammatory foods.
The link between inflammation and anxiety
The past decade of psychology and neurology research has linked the presence of inflammatory chemicals in the body with mood instability, depression, and anxiety. Those who have anxiety, brain fog, and racing thoughts have a higher amount of inflammatory chemicals in their body. It is a chicken-egg relationship. They get a surge of excitatory neurotransmitters in response to the inflammatory chemicals, further perpetuating feelings of anxiety or panic. This creates a chronic fight-or-flight worried mode.
The gut/brain anxiety connection
To add insult to injury, in response to dietary inflammation, the gut can drive swelling or bloating in the belly as well as reduce digestive function, causing bowel irregularity and limiting the production of feel-good neurotransmitters. In a healthy gut, over 90 per cent of the brain’s serotonin, a key anti-anxiety compound, is manufactured, but in a gut that is inflamed and damaged, production of serotonin is hindered — limiting our ability to respond to stress.
Anxiety and leaky gut
Anxiety is also connected to gut inflammation via the concept of leaky gut – i.e. the gut is inflamed and the barrier lining of the gut, which is supposed to keep food particles in and absorb nutrients, doesn’t stay tight. Food particles that are too large cross into the bloodstream and drive immunological response as well as inflammation.
This means that the gastrointestinal (GI) tract is permeable to more food compounds and these make our immune system over-reactive due to excess foreign invaders (antigens) in the bloodstream. The immune system responds to these particles as if there is a high pollen day, but instead of histamine alone, it produces a whole gamut of inflammatory chemicals. Also, when very large particles cross the gut lining into the bloodstream, they have the potential to also cross the blood-brain barrier and directly drive mood disturbances.
The Top 5 inflammatory foods to avoid
Now that you understand how inflammation is a root cause of anxiety, let’s get back to that question of what happens when inflammation is in response to food rather than an injury. Could something you are eating be driving inflammation, reducing healthy neurotransmitter production, and promoting leaky gut? The answer is YES! This section will start with stripping away the top five drivers of inflammation in the diet: gluten, corn, soy, sugar, and dairy.
Remember, food is a double-edged sword; it can provide nourishment as building blocks for brain and mood health, as well as impact brain and body function. Although I highlight the removal of inflammatory foods, I ensure that the Anti-Anxiety Diet provides ample replacements to satisfy your palate and support optimal function in your body, support your brain and provide compounds to balance mood while curbing cravings and satisfying your taste buds. (For more information see recipes in the book).
Eating a diet comprised of whole, unprocessed foods is a great place to start to reduce inflammation and resolve anxiety.
Sources: Wheat, barley, rye, spelt, and their byproducts, including wheat and white flours
Hidden sources: Malted barley, malt syrup, malt vinegar, brewer’s yeast, seitan (wheat gluten), soy sauce, gravy, sauces, and thickened dressings
Replace with: For pasta - courgetti (courgette noodles) or other spiralized veggies (sauté with olive oil and herbs, top with protein and sauce of choice). For pizza use cauliflower pizza crust, almond/ coconut flour blend.
Gluten is a protein found in various grains of wheat (spelt, kamut, triticale, etc.) as well as in barley, farro, and rye. The rise of gluten intolerance has been dramatic over the past decade, and the even more severe coeliac disease is now said to affect 1 in 133 Americans according to the Centers for Disease Control and Prevention (CDC). Wheat available in the supermarket in whole wheat or white flour (as well as their respective food products) comes from the most commonly available crop, short dwarf wheat, which is significantly higher in gluten and gliadin, the primary inflammatory compound in gluten.
Gliadin is not easily digested or broken down by enzymes in the digestive tract and can cause havoc to the body, leading to fatigue, acne, loose stools, constipation, depression, anxiety, joint pain, and more. Gliadin also plays a role on opioid receptors in the brain that can lead to addictive tendencies and mood disturbances. Gluteomorphin proteins, found in gliadin, have highly addictive effects and have been hypothesized as drivers of inflammation in the blood-brain barrier, contributing to anxiety, depression, and schizophrenia.
Pain, weight gain, addictive tendencies, and mood disturbances are compelling enough responses to a food for me to rule it out of a balanced diet, but there’s more: Refined grains can play a negative role on gut bacteria and the microvilli that line our intestines. The combination of gluten as an abrasive sticky protein (the Latin translation of gluten is “glue”) and lectins (a type of plant protein) found in all grains create wear and tear on the gut lining, which can contribute further to leaky gut. One easy way to end this vicious cycle is to remove gluten and gluten-containing products.
The Anti-Anxiety Diet involves a 12-week removal of all grains and filling the void with more nourishing alternatives that can satisfy your sweet tooth and your need for that nice chew or crunch!
Sources: Popcorn, cornflour, polenta, high-fructose corn syrup, corn oil or Mazola (sometimes called vegetable oil)
Hidden sources: Baking powder, maltodextrin, dextrin, dextrose, maltitol, mannitol, MSG, iodized salt (Morton’s), calcium citrate, sorbitol, sucralose, Sweet’N Low, xylitol, xanthan gum
Corn is high in linoleic acid, a type of polyunsaturated fat known as an omega 6. One important element in controlling inflammation is ensuring a proper ratio of omega 6 fatty acids, which are pro-inflammatory, to omega 3 fatty acids, which are anti-inflammatory. Because these fatty acids fight each other for a place within the cells, the goal is to reach a ratio as close to 1:1 as possible so inflammation levels can be regulated. Research published in the American Journal of Clinical Nutrition hypothesizes that hunter-gatherers were at a ratio of 4:1 or even 3:1, whereas modern society tends to trend at a 25:1 ratio.
The primary source of omega 6 in the diet is fried and processed foods. Frying oils are generally vegetable, meaning corn, soy, or rapeseed oil. These oils are all high in omega 6, and they are significantly processed from a grain to a clear odourless oil that has a high smoke point to withstand frying temperatures. Industrialised oils are extracted using solvents and bleach, then they are degummed, winterized, and deodorized, all steps involving toxic chemical ingredients and creating oxidative damage.
The Anti-Anxiety diet is geared toward an increased intake of omega-3 rich foods, including wild-caught fish, leafy greens, nuts/seeds, pasture-raised eggs, and grass-fed meats. The diet is devoid of processed foods that are extremely high in omega-6 fatty acids, with corn and soy being the primary contributors. By making an effort to eat whole fruits and vegetables in their natural state, you take steps toward decreasing inflammation in your body.
In addition, in the US most corn is made from genetically modified (GMO) crops and has been linked to, among other things, increased food sensitivities and leaky gut.
Sources: edamame, soy sauce, tofu, tempeh, miso, soy milk, soy protein powder, textured vegetable protein, isolated soy protein and vegetable oil
Hidden sources: Sugar icings, processed meats, soy lecithin (may be just noted as lecithin), baked goods, vegetable broth, artificial and natural flavouring, thickening agents, cooking sprays, and protein bars and products
Replace with: coconut liquid aminos instead of soy sauce. Some traditionally prepared soy, including tamari (gluten-free soy sauce), tempeh, natto, and miso paste, when organic, are OK in moderation
Common processing byproducts of soy, such as soy protein isolate and partially hydrogenated soybean oil, cause inflammation via oxidation and trans fats. Additionally, soy can work against the thyroid, driving reduced thyroid function or hypothyroidism.
Structurally, soy may be unfit for human consumption due to its high phytate concentration. Phytates are components of plants that can block nutrient absorption, driving nutritional deficiency. Traditional soy as consumed in Asia is fermented or aged to reduce phytate concentration. Some sources of traditionally prepared soy, including tamari (gluten-free soy sauce), tempeh, natto, and miso paste, when organic, are OK in moderation and have some unique benefits due to isoflavones and probiotic synergy from fermentation. However, most soy in processed foods is not fermented. It is raw or heated, which does not break down the phytates. This means consumption of soy foods can deplete your body of mood-stabilising nutrients such as magnesium, zinc, and calcium.
In addition, in the US soy is predominantly genetically modified (GMO).
Sources: cane and GMO-beet sugar, evaporated cane juice, fructose, sucrose, glucose, corn syrup, high- fructose corn syrup, agave, maltose, and all sweets and sweetened foods
Hidden sources: breads, condiments, salad dressings, bars, cereals, most processed foods
Replace with: fruit in small amounts (but not Phase 1, the ketogenic part of the diet)
Sugar may be the most addictive inflammatory food that you will remove. Brain scans demonstrate that people who eat a lot of sugar and high-glycemic food show similar addictive patterns to those who take cocaine. Carbohydrates stimulate serotonin and endorphin release, which aids in a feelgood signal in our brain. The intake of simple or refined sugars accelerates this process, which leads to a rapid pick-me-up or “sugar high”; however, just as rapidly as we get a kick, we notice an almost more dynamic drop or slump in energy levels and mood. This can truly create a vicious cycle of excessive sugar intake, such as a chocolate bar after a high-carbohydrate lunch, then a fizzy drink as a pick-me-up following the chocolate bar, and so on.
Often the sugar train can traverse peaks and valleys of energy and mood, with anxiety present on either end. A sugar high can include symptoms of brain fog, fatigue, and blurred vision; often, confusion can drive anxiety and panic, along with the feeling of loss of control. On the other hand, a sugar low or blood sugar crash can include symptoms of shakiness, tension, and irritability, which can drive panic-like reactivity. Withdrawal from sugar has proven to be as destructive as blood sugar highs, with studies showing that a diet of binging on sugar followed by restriction creates a state that involves anxiety and altered brain chemical balance.
Refined sugar and excessive carbohydrate intake are also linked to obesity, hypertension, hypoglycemia, depression, headaches, fatigue, nervous tension, aching limbs, diabetes, acne, IBS, skin irritation, stiffening of arteries, advancement in cognitive decline, violent behaviour, and more.
Although often referred to as “empty calories,” sugar is anything but neutral. Sugar quickly dissolves into the bloodstream, leading to excessive insulin production. In our body’s attempts to lower blood sugar levels, excess energy is stored as fat driven by inflammatory insulin. Over time, excessive sugar drives glycation , which is the coating of sugar that can build up on cells and nerves, creating plaque and creating havoc. These play a role in Alzheimer’s, cognitive decline, neuropathy, cardiovascular disease, ageing, and diabetes.
Sources: milk, cheese, butter, cream, yoghurt, cream cheese, sour cream, and milk protein. Avoid at least 6 weeks: whey and ghee
Hidden sources: processed meats, artificial and natural flavouring, high protein flour, granola mixes, canned tuna, broths and stocks, medications and vitamins, cosmetics, fat replacements
Replace with: coconut milk, almond milk, or any nut milk of choice, unsweetened (look for options free of binders and fillers such as carrageenan and guar gum). Replace cheese with other savoury snacks or toppings such as avocado, olives, or nut cheese options and dairy yoghurt with homemade coconut yoghurt using a quality probiotic capsule.
Dairy has two primary irritants: lactose and casein. Most adults who are lactose intolerant lack the enzyme lactase, and therefore can’t digest milk sugar lactose. This can cause GI discomfort, bloating, and irritation, triggering inflammation. This can be easily addressed with taking lactase enzyme in a digestive enzyme formula or consuming raw milk, which has not lost its enzymes through heat processing. Difficulty digesting casein, the primary protein in dairy, can cause a lot more drama in the body. Those with low stomach acid, poor digestion, and inflammation in the gastrointestinal tract will react more adversely to casein.
Studies have linked casein consumption with opioid activity-induced mood disturbances and antioxidant depletion in those with autism and ADHD, which negatively impacts mental health. Like gluten, casein has morphine-like influence by producing casomorphines, which drive addictive tendency and mood disturbance. Finally, for those with coeliac disease, casein can lead to inflammation by cross-reacting with gluten or being mistaken by the body as gluten. Also like gluten, the large particle size of casein can often cross a leaky gut and the blood-brain barrier to influence brain function.
Dairy, like soy, has some health-redeeming properties, which come down to the quality of the source and how the dairy inflammation. Ghee or clarified butter is free of casein and lactose, as the process of slow cooking and clarifying removes these compounds. This is a great fat to use in cooking and, when sourced from grass-fed cows, can provide a variety of nutrients, including vitamins A, D, and E, and conjugated linoleic acids (CLAs), a healthy fatty acid that can help burn visceral fat and build the immune system.
Grass-fed whey is a bioavailable protein that is easy to absorb. Whey is free of casein and will likely be free of lactose as well. A quality whey will be low-heat processed or non-denatured. This will allow it to maintain active immunoglobulins and antioxidants, such as glutathione, which actually reduce inflammation. If not sure if you tolerate dairy, try to eliminate all forms for 12 weeks if you are on the Anti-Anxiety diet; however, you may consider bringing back casein-free options such as ghee and grass-fed whey at week seven. If you choose to reintroduce dairy products, be sure to add one food per week to distinguish reactivity, if any.
Most processed foods contain gluten, corn, soy, dairy, and/or sugar, but foods and food products are not the only sources. Encapsulated medications or supplements, cosmetics, and even detergents can contain these inflammatory ingredients. Become a label reader and focus on local, non-GMO, pesticide-free whole foods. Stock your home with toxin-free natural products and remove items with inflammatory ingredients, like those found in fried, processed, mass-prepared foods.
One way we can limit the number of toxins we are exposed to is by choosing local, non-GMO, pesticide-free whole foods and products. Take the first step to lowering your inflammation by eliminating these five foods for at least 12 weeks and, in the removal process, ensure your replacements are comprised of low-carb, antioxidant-rich, organic ingredients.
An edited Extract from The Anti-Anxiety Diet – a whole body programme to stop racing thoughts, banish worry and live panic free by Ali Miller RD published by Headline £14.99 - buy it now