Topic Expert Roundup: How Do Diet and Nutrition Affect Mental Health?

We’ve all heard it said: “You are what you eat!” And while it’s widely known that eating certain foods carries far-reaching physical risks, less recognized and understood are the potential mental health ramifications of poor nutrition and diet.

A growing body of research suggests that what we eat has a significant impact on how we think. Several mental health issues—including depression, anxiety, and attention-deficit hyperactivity—have been linked to deficiencies in certain vitamins, magnesium, and omega-3 fatty acids. Our moods also can be adversely affected when we consume processed foods, especially those containing refined sugars, wheat products, dairy products, and artificial ingredients.

Any discussion of why people develop unhealthy eating habits must acknowledge the influence of socioeconomic factors. Particularly for lower-income and larger families, fast/processed food is not only the most readily accessible option, but often the most affordable one. Meanwhile, foods known to have a positive effect on mental well-being, including fruits, vegetables, fish, and nuts, are often viewed as supplemental luxuries or snacks.

Getting people to embrace the idea that their diet affects their well-being is one thing; getting them to change deeply embedded routines is quite another. We turned to our Topic Expert panel for answers. We asked them the following questions: Why is it that the mental health effects of poor diet receive less attention than the physical effects? What can be done to help people understand the role nutrition plays in their mental health? What do people simply not know enough about? And most importantly, how can people be convinced to change their ways?

Here are their responses:

• Sarah Swenson (autism spectrum): “ ‘We are what we eat’ falls on deaf ears because we have all heard it too often without giving it much thought. But if we do think about it, we quickly realize the profound implication of this statement. Our bodies can utilize only the nutrients we provide. We have all heard the horror stories of individuals who have died because of drinking too much cola or by eliminating entire food groups over long periods of time. There are reasons for this. We are complex mechanisms and require a varied stream of constant nutritional support in order to thrive. If we ignore this, how can we expect anything but compromised results? Look at the damage wrought by alcoholism on every organ in the body. Conversely, good nutrition works to our advantage. To separate mental health from physical health, mental soundness from physical soundness, is to make assumptions based in magical thinking. You don’t expect your car to operate correctly if you don’t provide it with the necessary fuel and fluids. Why would you expect to be able to perform optimally yourself if your diet consists of coffee and salads? Unbalanced pseudo-vegetarian menus? Constant sugar and salt? Our bodies are complex, but this thought is quite simple: eat well to be well; be well to feel good. Of course, there are chemical imbalances in the brains of some individuals that can cause mental health issues. But for the vast majority of us, eating well is our first line of defense in maintaining a sound mind in a sound body.”
• Stephen Salter (values clarification; eating and food issues): “True, you are what you eat. But it runs both ways. You also eat what you are. Let me explain: Feeling unwell can lead to a lack of will and therefore poor eating habits. Eating well takes willpower. If you feel terrible about yourself, you won’t feel worthy of being nourished by good food. It is a vicious cycle. Eating poorly causes depression;  depression causes poor eating.”
• Michael Fraser (Internet addiction): “Any comprehensive therapy ought to take into account the broader picture of nutrition—the good and the bad of what we expose our minds/bodies to: food, exercise, sleep, technology, nature, etc. It’s extremely important for clinicians—especially before recommending medication—to be aware of how poor diet can mimic symptoms of depression, anxiety, and attention-deficit hyperactivity, as well as other behavioral issues. Moreover, it can be a side effect of certain psychiatric medications. Not eating well or at regular intervals can make us more moody and irritable, and it can decrease our ability to focus and concentrate. It can also make young children more prone to temper tantrums. But most of us know this already, so the bigger question is why don’t we do better? A good question for therapy. Nutrition—how we take care of our minds and bodies—should be a part of the discussion in any sound therapy.”
• Tina Gilbertson (self-esteem): “Your physical body and brain aren’t the only things affected by what you eat. You send yourself a message with every meal. When you eat stuff you know is junk, it’s like you’re saying, ‘It doesn’t matter if I neglect or even harm my body.’ There’s an undeniable impact on self-esteem and emotional well-being, even if it’s subtle. I find that I eat most conscientiously during those times when I’m already feeling good about myself. Feeling good creates a ‘virtuous circle’ of doing good, which creates more good feelings. Food can be an entrée (get it?) into that wonderful, virtuous circle of physical, mental, and emotional self-nourishment.”
• Cindy Ricardo (mindfulness-based approaches/contemplative approaches; self-care): “I believe the mental health effects of poor diet receive less attention than the physical because the results show up differently. For example, when someone is stressed, depressed, or anxious, the focus is mostly on exploring their thoughts, behavior, and emotions in an attempt to help them restore emotional well-being. What is often not addressed is how this situation may be affecting their eating habits. The only time it is addressed is if we see a decrease/increase in weight. However, poor diet doesn’t always create a change that can be seen on a physical level, and it isn’t always about confronting a stressful situation. Sometimes poor diet is caused by poverty, and these individuals (children/adults) who can’t get enough to eat or can’t afford to buy healthy foods are often unable to focus, concentrate, or play or do well in work or school. I believe that if the media, the health-care industry, and society at large were to address this in the same way they address being physically fit, this would begin to create a change in our perception of how eating affects mental health—that eating isn’t just about how we look on the outside but also how we function and feel on the inside.”
• Traci Ruble (pragmatic/experiential therapy for couples): “There is nothing like pain, vanity, or mortality to motivate us around how we eat. Maybe mental health pales in comparison … and maybe that is because the lines are too blurry. Food’s impact on mental health may not be of interest to someone in crisis who needs a quick mood fix or to someone who associates bad food with feeling good.  Information about diet’s impact on mental health has to arm people with more than good research but also combine it with the symbolic nature of food and what food means to us as individuals. If eating lots of an unhealthy food soothes us, helps us sleep, or gives us a sense of belonging, then addressing those underlying symbolic connections must also be part of the change dialogue.”
• Diann Wingert (biofeedback/neurofeedback; adjusting to change/life transitions): “We now know that there are more serotonin receptors in the gut than there are in the brain, so it naturally follows that diet may have a much greater impact on mood, energy, and motivation than previously understood and may help explain why so many people are still depressed while taking antidepressant medication. The latest research points to the role of inflammation in the body as a likely cause/contributor to symptoms of anxiety, depression, sleep disturbance, fatigue, inattention, poor memory, and low motivation. A diet high in processed foods, composed primarily of sugars, simple starches, and dairy, causes inflammation not only in the gut, but also in the brain. Switching to a diet high in complex carbohydrates (vegetables), legumes, lean proteins, whole grains, and a moderate amount of fruit (too much fruit equals too much sugar) can boost mood, energy, motivation, and mental clarity. Simply substituting one inflammatory food (candy bar or bagel) for a noninflammatory food (handful of almonds, chicken breast, or carrot/celery sticks) can get you going in the right direction for your body and your brain.”
• Valerie Kuykendall-Rogers (abuse/survivors of abuse): “The mental health effects of a poor diet receives less attention than the physical effects because people are more focused on what’s salient versus what’s invisible. We tend to focus on external beauty; choosing to focus on losing weight to ‘look good’ rather than eating healthy to ‘feel good.’ Consequently, people spend huge amounts of resources (i.e., time, energy, and money) into achieving that physical appearance that gets reinforced by their peers, family, and friends. People simply don’t know enough about the causes of their poor diet because little, if any, partnership exists between mental health professionals and nutritionists. By doing so, we can help people better understand the role nutrition plays in their mental health. The more people hear about the importance of mental health from different sources, the more it is repeated, the more likely the message becomes internalized, and the more likely people will change their habits.”
• Lynn Somerstein (object relations): “Mental health and nutrition are two subjects that people often know very little about and they like it that way. But listen to this. Drink too much sugary sodas? You’ll get fat and jittery. Stick to diets big on cheeseburgers? You’ll get fat, your metabolism will slow down, and you’ll feel depressed. Overdo the caffeine? You’ll have an anxiety festival and the shakes, too. Skip too many meals? Your hair will fall out, you’ll lose muscle tissue, and you’ll likely experience anxiety, depression, and maybe even suicidal ideation. People criticize Mayor Bloomberg’s limits on big sodas, but I think he’s got the right idea. He’s trying to protect people’s health. Some say he’s interfering in a person’s individual rights, and they do have a point, but he’s also bringing lots of attention to the standard American diet, also known as SAD. It is. And we are, too, if we don’t eat enough fruit, carbs, good fats, and vegetables. Plus a little animal meat for those who aren’t vegetarians.”
• Ruth Hoffman Cooper (family problems): “How to eat well—nutritionally and aesthetically—is information that is traditionally handed down from generation to generation through sharing family meals and the preparation of those meals. People gather, take some time together, and eat the foods of their culture. Eating for good mental as well as physical health involves treating meals as a small daily sacrament, mindfully connecting with ourselves and what our bodies are needing, and preparing food, however simple, in a loving, conscious manner. I see a lot of people in my psychotherapy practice who deal with the need for sustenance as a mechanical task, which they dispatch as quickly as possible. These same people may also have episodes of excessive eating with a focus on high-sugar, high-fat foods. When they begin to eat more mindfully, feeding themselves in a conscious, enjoyable way, they report having more balanced energy and mood, and fewer binging episodes.”
• Moushumi Ghose (sexuality/sex therapy): “The fact eating is so directly related to mental health is gaining more and more popularity in our society, as people are gaining more and more knowledge about food companies and health risks associated with many foods, but the information is still fragmented and superficial. Not to mention that what we eat is so often tied into what the private companies are marketing directly to us, which makes it difficult for the general public to see how some of these foods could possibly be unhealthy either by design or by virtue of their ingredients. When something is spoon-fed to us, such as fancy packaging, yummy foods, and creative marketing, it’s hard to see the forest for the trees. We are hungry, and there are so many options. It’s easy to fall prey to the food marketing industry, without taking a lot of stock into what they are actually selling us. Dieting and weight-control plans are not foreign in our society, and neither is obesity, but still there seems to be a general malaise when it comes to seeking out information about healthy lifestyles and nutrition. If it is legal, it must be safe to eat, or so the thinking goes. It has long been understood that exercise is important, and what has been most common in our society is the binge/purge process. Eat what looks and tastes good right now, then exercise or diet to try to lose the weight later, and then repeat this process. Embracing a healthy lifestyle requires education, knowing what foods are good for you, and understanding how certain foods may affect your mind and body. Embracing a healthier lifestyle is a lifelong journey, and can take quite a while to completely embrace. Certain foods can have addictive qualities and can affect moods, but mental health professionals are not often trained nor knowledgeable about nutrition, foods, and diet, and not privy to this information, which makes it difficult. As therapists who practice and role-model self-care, we can plant the seeds to help our clients see that it is in their power and control to get the knowledge about what foods to eat, what works best for them, and encourage them to understand that there is a clear mind-and-body connection.”
• Sarah Jenkins (eye movement desensitization and reprocessing): “A conscious awareness of our relationship to food, and mindful eating, stands in contrast to what the external world often shares with us—messages about how and what we ‘should’ look like. Be thin. Look like the model in the magazine. Fit into the latest skinny jeans. One of the first ways we can challenge these messages is by becoming aware of how we relate to those messages and how we are ingesting them as well as the food we eat. Exploring how we relate to food, to me, is one of the most important aspects of examining our innermost worlds. Equally important is actually listening to our bodies, really listening, as we eat so that we can determine what nurtures, provides sustenance, and has a positive uplifting energy for our systems. Furthermore, as opposed to eating being an activity to ‘get done,’ a mindless activity, we can invite it to become an inner meditation, one that helps us to further explore our internal emotional states in a conscious fashion. By doing so, we can expand into a greater willingness to take in foods that are good for us. From this, we can really get to know why we are making our food choices, as well as becoming more in touch with how food impacts our innermost selves as well as our physical health.”
• The Rev. Christopher L. Smith (spirituality): “While diet can contribute to both mental health and mental problems, diet can also be an indicator to be watched. One’s diet, both what you eat and how/when you eat, can signal when something is going on. When you notice these changes, ask what is behind them. For instance, if you find yourself skipping meals, are your thoughts racing and taking over so you are not aware of when it is meal time, are you afraid to go out to buy groceries/go to a restaurant, or do you not have the energy to prepare a meal? These and other causes can help you as warning signs that trigger a chance to address what may just be beginning to happen.”
• Margaret Nichols (LGBT issues): “As a sex therapist, I’d like to focus on an unusual way diet and fitness affect our mental health: the negative impact of poor diet on our sex lives, which in turn impacts mood and general happiness and well-being. For starters, being a passionate lover requires a certain amount of energy, strength, and stamina, and all of these suffer when nutrition is bad. But perhaps just as important is the way being overweight, out of shape, and unfit destroy body image. When we don’t ‘look good’ to ourselves, we don’t feel sexy; there is a certain amount of sex drive that depends on what is called our ‘erotic self-image.’ When we don’t feel sexy, we aren’t ‘in the mood,’ much less aroused. We avoid sex or check out while it is taking place. That’s never good for  a relationship—or an individual.”
• Angela Lee Skurtu (relational psychotherapy): “Society and the media place less emphasis on emotional health and more importance on physical appearance. We are bombarded by diets that promise weight loss but don’t produce long-term effects. In order to combat this problem, the public needs to know more information about how to create a balanced diet. To convince people to change their normal habits, start with basic education in childhood that emphasizes healthy eating and exercise habits. In adulthood, employers can encourage a healthy lifestyle by offering incentives to employees who engage in company-sponsored health programs such as marathon trainings or weight-loss management. Ultimately, the key to changing unhealthy habits is to educate the public and to incorporate healthy practices daily.”
• Lillian Rozin (aging and geriatric issues): “Ancient yogis got it right when it comes to the relationship between food and mental health: You can’t feel good without first attending to your belly’s health. Ayurveda, the sister science to yoga, is a comprehensive system meant to cleanse and manage the body so that a person can thrive through life’s challenges—physically, mentally, and spiritually. The yogis understood that if you want to feel mentally healthy, you have to maintain your gut first! So the first line of treatment is always to regulate the digestive tract. Once you achieve that, all else will begin to fall into place. How is it that we think we can bypass this fundamental need? Just eat a few donuts and wash them down with coffee brewed with unfiltered water … pop a few probiotics and an antacid and we should be good to go.”
• Andre S. Judice (posttraumatic stress/trauma): “It is very true that nutrition is as important to mental health as it is to physical health. Unfortunately, we live in a culture where, despite the evidence pointing to the impact of our nutritional choices on our physical well-being, many of us still choose poor dietary habits for many reasons, including the easy accessibility of unhealthy food, our addiction to sugary foods, and a low tolerance for the time and effort a healthy diet requires. Because as a whole we are not willing to make good nutritional choices even in the face of obvious physical effects, it is that much harder for people to make healthy eating choices for less measurable or tangible results related to our mental health. Educating people about the role of nutrition in mental health most likely needs to come from ‘mainstream’ health-care providers such as physicians, therapists, and chiropractors. I would venture to say that these types of providers also need additional education about the role of nutrition in mental health. People trust their health-care providers, and this discussion is probably not occurring on a regular basis during office visits.”
• Kelly Baez (depression): “Like talking to a false friend, treating ourselves with junk foods can leave us feeling disappointed, insecure, and hungry for more—more food, more connection, more well-being. Just like that false friend who we may not be able to eliminate from our lives, we can’t eliminate junk foods. Instead, we can recognize it for what it is, take the power from it, and use that knowledge to empower ourselves on a journey to make dietary changes. When starting this journey, many people feel lost because they are essentially a one-trick pony. Happy? Celebrate by going out for pizza. Depressed? Let’s have some cookies. Counseling can be a huge help to learn how unhealthy food choices keep us in a cycle of feeling sad, angry, tired, lonely, and how applying healthful approaches to food can have tremendously positive, far-reaching effects.”

Do you agree or disagree with our Topic Experts? What would you add? How have your eating habits affected your mental health or well-being? Please share your thoughts below.

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