All blog posts from Dr. Allott are provided for educational and informational purposes only. As Dr. Allott is also a licensed medical practitioner, we must make it clear that nothing on the blog is intended to constitute medical advice, consultation, recommendation, diagnosis, or treatment. If you are concerned about your health, please seek appropriate care in your area.

What diet types contribute to depression and anxiety?

/

I am reluctant to write this post. I’m sure I’m going to make a few people mad. In last month’s Connectors Meeting there were questions about how different diet types contribute to mental health concerns. When a person's diet choice restricts food categories, they can find over time that their diet is contributing to increased anxiety and depression. This is because a diet that limits food groups can lead to nutrient deficiencies if health metrics are not carefully monitored through diagnostic labs.

In this post I’ll review some things to watch out for when eating significant amounts of highly processed foods, following vegetarian or vegan diets, and keto/paleo/Atikins types of diets.

Highly Processed Food Diets

frozen-food-1336013_640.jpg

Diets high in processed foods have been shown to increase depression and anxiety. These are diets with lots of white foods (bread, rice, potatoes, pasta, muffins, bagels, chips, sweets, fast food). With this diet, when I look at an individual's labs what I typically see are deficiencies in nutrients that help to synthesize dopamine and serotonin. Common deficiencies are protein, B vitamins, magnesium, zinc, omega 3, Vitamin D3, and fiber. Additionally, there is increased inflammation as indicated by elevated C-reactive protein (CRP) levels. Inflammation contributes to depression, fatigue, bipolar, cardiovascular disease, dementia, and diabetes, to name a few concerns. Dr. Felice Jacka provides a whole body of research about the impact of diet on mental health. Here is her seminal paper: Association of Western and traditional diets with depression and anxiety in women.

Vegetarian/Vegan

When I see vegetarians and vegans in my office, they tend to be very anxious individuals and the anxiety often leads to depression. I’m not saying that all vegetarians and vegans struggle with anxiety and depression. Rather, that individuals who are anxious and depressed and vegetarian tend to have higher levels of anxiety and depression due to nutrient deficiencies. Their anxiety is often caused by fluctuations in blood sugar levels because of the low carbohydrate to protein ratio in many of the foods they typically consume.

For example, let’s consider a bean burger. Beans have some protein and some carbohydrates. The bread is all carbohydrates. So this bean burgers contain a lot of carbs and not a lot of protein

Clinically, I have seen anxiety decrease significantly when we assure that they are getting enough protein throughout the day (8 grams per 20 pounds of body weight or at least 65 grams divided throughout the day for anyone over 140 lbs.)

There is a large body of research that suggests vegetarians have better physical health then omnivores. Vegetarians tend to have lower body mass index and cardiovascular disease. However, an Australian study with 9113 participants indicated that vegetarians and vegans have more anxiety and depression then omnivores.

Here are two more studies that may be of interest:

For vegetarians, the labs that I carefully look at are total protein, Omega 3, ferritin (iron stores), B vitamins, and Vitamin D3. In my client base, vegetarians and vegans tend to carry less muscle mass and more fat mass.

For vegans, I will also look to see what their primary sources of fats are. The addition of coconut milk and oil can help with fatigue caused by a lack of cholesterol in their diet; consuming enough cholesterol is important because it helps synthesize hormones.

Keto/Paleo/Atkins

I am going to make a “no duh” statement… But it’s one we often forget: Weight does not determine health.

High-fat mass can impact health, but it’s not everything. I’m far more concerned about an individual's ability to be self-compassionate, eat primarily health-sustaining foods, engage in some level of regular movement or exercise, sleep well, and have healthy labs.

meat-1030729_640.jpg

I have seen a number of individuals who started on a keto diet (low carbohydrate with high protein and high fat) to lose weight. However, after the initiation phase of just meat and fat, they did not add fruits or veggies back into their diets for years. They explain that primary reason for staying with this phase is because adding back fruits and veggies caused them to gain back the weight they had lost. This is true, because when we do quick weight loss programs it’s hard to not do quick weight gain as well. However, there are some serious health consequences not eating fruits and vegetables.

One of the consequences is that they became very low in B vitamins and Vitamin K. For women following this type of dietary restrictions, they started having heavy menses because their blood was not clotting well. This then also led to iron deficiency, which contributed to their story of depression/fatigue.

Check out these articles:

In conclusion

Diets that support physical health do not always support mental health. Diets that are low in nutrient dense foods can contribute to mental health concerns through presentation of depression/fatigue and hypoglycemia/anxiety. When someone is considering medications or has tried medicines without the expected positive impact, it’s worth suggesting that they ask their primary care providers for a laboratory workup for fatigue. Going to a naturopathic physician, nutritionist, or acupuncturist to have their diet evaluated for deficiencies that could be contributing to their mental health status is also a good option.

Here are some additional resources:

Is this the Diet for Me? Is it for you?

/

Intention

tray-2546077_640.jpg

There is a lot of information on the internet and from our friends and family about new diets to try. There are systems such as weight watchers, Nutrisystem, and 30/10. There are diets that tend to be based on values: vegetarian, vegan, and paleo. There are also styles of diet, like the Mediterranean Diet and DASH; and there are diets based on convenience. Then we also factor in things like culture, economics, family traditions, personal preferences, personal health history, time in life, gender, exercise pattern and age. How do we know what is “right” for us?

So from the start, we can say that every diet is personal to the individual. What works for us when we’re 20 years old may not work for us when we have kids, a different job, or a change in where we live. “Diet” is not a box we stay in for life, it’s a dynamic choice that we make every day.

I want to start a discussion on how to know if your diet is working for you and if you make a change in your diet, how (and when) do you know that it’s a going to work for you.

One step that people often miss is considering their intention for your diet. It seems so obvious, but we actually use our diet for lots of things: to nourish our ourselves, for entertainment, to connect to family and friends, to drug ourselves in to a sugar coma, to manage our emotions, to celebrate. If we change our diet, we may be trying to change our intention about what our diet will do for us.

I believe the main goal of any diet, 80% of the time, should be nourishment, and to provide long-term and short-term health and mental clarity. Then, 20% is for celebration and connection. It’s natural to use food to manage our emotions - it works so well - but we should be working to diversify our options to self soothe.

What does it mean to have a diet that nourishes our bodies? It’s important to protect our power supply. This means that we need to meet our basic nutritional needs: Are we getting enough amino acid/protein, fats, carbohydrates, fiber, vitamins and minerals, and – importantly - is there diversity in what we’re eating?

health-1805117_640.png

When we make changes to our diets, we should have a sense of how the nutrient content might also be changing, and how the body will respond to that change. Our bodies work hard to maintain homeostasis. If we cut our calories, the body’s natural response is to slow the metabolic rate. This is why quick weight loss diets fail: cutting significantly back on calories signals that there is famine (which means we need to hold on to our fat stores), and it also exposes our brains to stress hormones which makes us anxious, irritable or not present to our daily lives, particularly if we have a history of trauma.

Social Interactions

dinner-2330482_640.jpg

Eating food together is an ancient way of interacting. Depending on our jobs, families, and economics, we have more or less ability to be in control of what we eat. When we are changing our diets, we need to consider the impact our new diet will have on our ability to engage in social events. We also need to understand and be prepared to advocate for our dietary needs. Another way of thinking about this is how we can be responsible for our own choices, so that other don’t have to guess at what we need. We also need to have clear plans in place to handle holidays and special events, so that we can still enjoy the social aspects without having our diets derailed.

Personal History

In my clinical office, I often work with individuals who have significant trauma histories in their childhoods. An amazing study on the impact of Adverse Childhood Events (ACEs) shows that individuals who have had a number of traumatic events in childhood are at risk for chronic diseases such as diabetes, cardiovascular disease and obesity. These disease risks can be lowered by our diet choices in adulthood. It’s helpful for individuals with trauma histories to have clear intentions for their diets. Restrictive diets rarely work, because the restrictions often get tangled up with feelings of being deprived. Instead, changing to a diet where they notice that they feel better (in their bodies and minds), and occasionally testing if a new routine is helpful, seems to be more effective because part of recovering from trauma is choice. Being forced - even by one’s own self - is just another trauma.

Shallow end, Deep end

Some people wade into pools from the shallow end and some just jump into the deep end. Generally, if you are going to jump all in to a radical diet change it is worth having some outside support, or a way of reflecting back an accurate picture of how the change in diet is affecting you.

What skills do you need to change your diet? How do you know if it’s working for you, and when should you check back in with yourself to be sure that it continues to meet your intentions? What if your needs or intentions change?

Listen to or watch the Connectors Group webinar - and download the handout to help you assess whether a diet is a good fit for you.