The Connection between Food and Mood

Stacey J. Drubner, JD, LICSW, MPH

 EAP Ask the Expert: Uma Naidoo, MD, Director of Nutritional & Lifestyle Psychiatry – Massachusetts General Hospital

Traditional perceptions about food and health typically focus on physical indicators, such as weight management, cholesterol, diabetes, or hypertension. Many are not aware of how food can impact emotional health. While research on direct causation is evolving, a growing body of literature shows that what we eat may affect our mental health.

To understand this connection and learn how to achieve better emotional health with improved eating habits, we turned to Dr. Uma Naidoo, psychiatrist, nutritionist, and chef, from MGH. Dr. Naidoo draws from both current research and clinical experience to provide guidance.

This discussion will cover trends and will not serve as medical advice. Dr. Naidoo points out that we all have a unique genetic “thumbprint” with relevant nutritional needs. Each of us may respond differently to certain foods.

How does what we Eat Affect our Mood?

Step one – Dietary intake

Consuming Processed foods or unhealthy drinks which tax our system is an initial step in the pathway of negative mood impacts. For example:

• Sugar (not derived from fresh fruits), found in candy, cookies, soft drinks
• Foods with hidden sugars or sodium – some yogurt (with added fruit), protein bars, fruit drinks, canned soups, pretzels
• Refined grains (white flour, some carbohydrates) – which include starch but not healthy fiber
• Alcohol
• Caffeine (more than 2 cups/day) or accompanying additives, such as creamers or sugar

When we talk about what not to eat, it is important to make a distinction between once in a while and long-term. Eating pizza or potato chips occasionally is OK. Dr. Naidoo explains that a simple, one-time snack can make people feel good in the short term. Although we often make light of “stress eating,” a big bowl of ice cream can temporarily make us feel happy. Some foods, (especially processed and ultra-processed foods) are hyper-engineered to create a “high”. However, even in small doses, sugar and processed foods typically include a crash on the other side. Repeated consumption of unhealthy foods leads to a cycle of swings, which are not healthy for the body or the brain. The body remembers and seeks relief (even if transient), especially when we are under stress.

Changes in metabolism and neurochemistry result in the need to eat more to achieve the desired effect (the high). Eventually, you will need to consume more carbs and sugars to feel the same level of satisfaction. This is not unlike what occurs with other substances such as alcohol or marijuana. At the very least, this can be characterized as a dependence, if not an addiction, in which cravings increase with repeated use and a sense of reliance develops and increases over time.

Step 2 – How the body processes the food we eat?

In the discussion above, we covered how unhealthy food sparks a cycle of craving and sub-par eating. In this section we learn about what happens in the body with repeated exposure to sugars and processed foods. There are multiple systems that impact how the body absorbs and reacts to the food we eat. Below, we discuss 3 inter-related areas of the body’s response –blood sugar, inflammation, and gut health.

Blood Sugar

Blood sugar (blood glucose) is a primary source of energy for your body. Food is broken down and enters the blood stream. Sugars and certain types of carbohydrates are more likely to be higher “glycemic” and cause a spike in blood sugar, because it’s released into the bloodstream more quickly. A pattern of high blood sugar increases the risk of many medical conditions, including diabetes, heart disease and obesity. Healthier carbs are attached to components that allow a slower break-down and a more measured absorption into the blood stream.

Inflammation

Intake of foods that raise blood sugar also leads to an increase in chronic inflammation. Acute or temporary inflammation can help us to fight illness or heal, but chronic inflammation is associated with a whole host of side effects, including heart disease, joint pain and gastrointestinal problems.

Gut Health

Sub-par blood sugar and inflammation damages the gut over time. The gut can have positive or negative microbiota (micro-organisms). Consumption of sugars and ultra-processed foods feed negative microbes, leading to a release in toxins, blocking absorption of healthy fatty acids and the result is an unhealthy gut. This may compromise organs, including the brain. Dr. Naidoo explains that “a happy gut contributes to a calm mind.”

What Aspects of Mood might be Impacted by the Food we Eat?

Previously identified factors that contribute to mood and mental health functioning, include:

• Genetics & biological
• Life stressors
• Substance use
• Hormones
• Exercise

Nutrition is now a real consideration for this list. Dr. Naidoo indicates that she sees the greatest impact with nutrition interventions around depression and anxiety. Here are some examples from the literature in this area:

• One study reported observational evidence to suggest that adhering to healthy food intake, in particular a traditional Mediterranean diet, (discussed more below) and avoiding pro-inflammatory foods is associated with reduced risk of depressive symptoms or clinical depression
• Another study suggested that a brief diet intervention can reduce symptoms of depression in young adults and showed positive outcomes on anxiety scales. This was largely with use of Mediterranean and low inflammation diets
• A 3^rd study reported that a dietary pattern characterized by saturated fats and added sugars seems to be related to higher anxiety in older adults

Even if the impacts of food do not rise to the level of clinical depression or anxiety, be on the lookout for signs that things are moving in that direction. In previous features, we have discussed the mind-body connection and how the stress response can be out of synch.  Consider diet as a  contributing factor if you find that your stress is starting to increase.

In particular, keep track of your sleep because what we eat, or drink can affect our sleep, which in turn is connected to short and long-term mood impacts. To maximize sleep, limit use of the following close to bed:

• Alcohol
• Caffeine
• Sugar and processed foods
• Energy drinks

Dr. Naidoo points out that inflammation from all of the above, can eventually have an impact on sleep and a cycle of stress, poor eating and sleep problems may be triggered.

Maximizing Mood with Food

In the discussion above, we outlined how what we eat is getting greater consideration as a factor in our mood. In short, repeated consumption of sugars and processed foods creates a cycle of poor nutrition and mental and physical impacts. A combination of blood sugar swings, inflammation, and compromised gut health lead to downstream negative impacts on mood and potentially mental health issues.

Dr. Naidoo emphasizes that these cycles can be turned around with modifications to eating and drinking habits. In her clinical practice, she observes that patients start to experience a difference in how they feel, even with small changes. The absence of pain, lethargy and less stress serve as motivation to continue to move towards healthy eating. This may require a paradigm shift with a focus on long-term lifestyle changes, rather than a jump-start diet.

Consider protecting your gut as part of a daily routine, like you do with skin care or oral health. Be mindful of body intelligence – respond to what your body is telling you. For example, you notice 3 cups of coffee causes anxiety, then cut back or substitute with decaffeinated alternatives.

Below are suggestions for how you can get started with and maintain a healthy eating strategy. For more complete guidance, you can explore Dr. Naidoo’s books on food and mood:

• This Is Your Brain on Food: An Indispensable Guide to the Surprising Foods that Fight Depression, Anxiety, PTSD, OCD, ADHD
• Calm Your Mind with Food: A Revolutionary Guide to Controlling Your Anxiety

Reduce sugars and processed foods and unhealthy drinks

• Establish an awareness of your food intake
• Identify hidden, unhealthy culprits
• Read labels and be an educated consumer
  – Consider an App such as Yuka, to evaluate nutritional value of ingredients
• Start small and have reasonable expectations of yourself
• The standard is not perfection – you should allow yourself to eat things you enjoy. Instead of having a donut every day, shoot for once a week. If you deprive yourself too often, you risk making more unhealthy choices in the long run

Introduce healthier alternatives

Everyone’s system responds differently to food, but in general a Mediterranean Diet is believed to improve general health, and offers a framework for healthy eating and maximized mood. The core components are:

• Vegetables
• Healthy oils, like olive oil
• Whole grains
• Legumes
• Fruits and nuts
• Fish and shellfish
• Low fat dairy
• Lean proteins
• Moderate alcohol intake

Try to prioritize foods that are anti-inflammatory. Here are some resources for healthy options:

Snacks

• MGH
• Taste of Home

Meal Suggestions

• Dr. Naidoo via WELLNEST
• Eating Well

Ensure that you are getting all the nutrients (see below) you need. Many can be sourced from the foods listed above. Some people may benefit from supplements or vitamins, in cases where they have nutrition gaps. This may be the case with vegans or those who primarily have a meat diet. Dr. Naidoo cautions that you should “test, not guess.” What works for your friend, or a social media influencer might not be a match for you. When in doubt, consult an expert.

Here are some key drivers of good health:

• Vitamins: A, B, C, D
• Omega-3 fatty acids
• Antioxidants
• Fiber
• Folate
• Magnesium
• Potassium
• Selenium
• Thiamine
• Zinc

Make healthy eating as convenient as possible

Dr. Naidoo recommends talking steps to have healthy food accessible when you need it. Otherwise, you may grab whatever is nearby or accommodate your cravings.

• Do a few days of meal prep at a time
• Make overnight oats for a quick, easy, healthy breakfast
• Bring lunch to work or when going on a trip
• Keep healthy snacks (fresh fruits, vegetables, nuts) at work, home and in your car
• Keep your water bottle full all day

– hunger and thirst mechanisms are connected in the brain and adequate hydration can help to control cravings and unhealthy choices

Resources

• EAP Resources on Maintaining a Healthy Diet
• EAP News Feature – Getting back on Track with Healthy Eating

Help from the EAP

The EAP offers free and confidential services for employees and immediate household family members. EAP records are separate from medical and HR records. Contact the EAP at 866-724-4327 or request an appointment via our online form for confidential assistance. In-person appointments are available at the following locations.  Phone or Video (Zoom) appointments are available from all locations.