The Anti-Anxiety Diet

by Ali Miller

  How Is This Program Different?

  The foods we eat play a dynamic role, both good and bad, on our brain chemistry. In fact, foods can regulate mood, emotions, and brain-signaling pathways. Some choices, such as chocolate, even have psychoactive compounds. Unfortunately, during times of anxiety, one is more likely to overindulge in sugary or processed super-flavored foods to create a dopamine spike, numb the racing mind, or redirect thought patterns from restlessness and worry to bliss.

  Research has shown that emotional eating or using food as a coping mechanism can drive obesity, which in turn promotes vulnerability to more severe depression or anxiety. Physiological and hormonal changes, such as increased stress sensitivity and altered cortisol levels, are also seen with high-calorie intake or anxiety-induced binge eating, which only perpetuates the vicious cycle. Refined carbohydrates and processed foods can leach minerals, deplete B vitamins, and drive blood sugar imbalance, perpetuating mood instability, cravings, and dissatisfaction.

  Just as anxiety can be the crux in preventing weight loss or healing, addressing anxiety and improving the status of your gut can greatly enhance the function of your brain and, ultimately, your entire body. When the brain is running on high-octane fuel supported by essential nutritional compounds without inflammatory distraction, the reciprocal relationship of brain chemistry and mood stability on whole body physiology is favorable.

  I created The Anti-Anxiety Diet to be your guide to get you back in the driver’s seat of the vehicle of your body. This is the manual to learn how to thrive versus simply survive! Adopting an anti-anxiety diet helps reduce inflammation, repair gut integrity, and provide necessary nutrients in abundance with enhanced absorption. As the body’s nutritional status is optimized and stress signals are reduced, the systems that regulate hormones and stress chemicals are able to downshift from high-alert, chronic anxiety to reactive only in times of need. This creates a more even-keeled mood and mental processing with balanced physical responses, which then relaxes the body and gives positive feedback to the mind.

  The foods you select can function as drivers of deficiency or building blocks for restoration. The Anti-Anxiety Diet will provide you with a plan to nourish your body while satiating cravings and supporting your brain signaling.

  This program includes a focus on animal products, as they are rich in bioavailable forms of glycine, glutamine, collagen/gelatin, B12, zinc, B6, and other important compounds that you will soon learn more about! Although it is possible to follow some of the guidelines of the anti-anxiety diet as a vegetarian, you will likely need more supplemental support from protein powders, animal by-products (fish collagen/bone broth), and nutritional supplements. Also, be prepared for a heavy reliance on eggs (12 to 16 per week, minimum) because dairy is not recommended in the foundational levels of this program. If you are a vegetarian open to consuming bone broth and high amounts of eggs, then this program will still be very effective!

  Rather than solely focusing on what you can’t have, this diet is about prescribing an abundance of certain foods to aid in tonifying the body. Phase 1 of the anti-anxiety diet is a six-week high-fat, low-carb (HFLC) ketogenic approach that allows the body to starve off bacteria, start gut restoration if treating leaky gut, reduce food sensitivities, improve insulin signaling, and promote hormonal balance. This program offers a synergistic platform to many autoimmune, inflammatory, and dysbiosis/candida and digestive protocols. From there, you will have the option to transition to Phase 2, a low-glycemic approach that offers a more varied and sustainable diet, or you can cycle Phase 2 with your Phase 1 HFLC plan.

  Additionally, pharmaceutical grade–supplements, called nutraceuticals, are necessary to optimize outcomes in functional medicine. When a system is expressing increased demand through deficiency, it often needs support beyond that from food alone. Throughout this book, I will highlight various nutritional supplements and tools to consider in your anti-anxiety diet program. See Supplement Support for the 6 Foundational Rs (page 159), which identifies a compound, dosage range, mechanism of action, and what formula I use at the Naturally Nourished clinic.

  During your program, you will become reconnected with your body and have an opportunity to redefine your relationship with food. I developed this program so you can fall in love with the natural sweetness of a sun-ripened peach picked just off the branch; so you can learn to crave and feel satiated with real, nourishing whole foods, and free yourself from the ever-consuming thoughts of body image, withdrawal, and restriction! Not only will the structure of this diet successfully promote a reset of your system, it will likely support favorable body composition change while leaving you feeling energized, balanced, and grounded.

  CHAPTER 1

  Anxiety, the Driver of Dysfunction

  In the past 10 years as a clinician, I have seen many trends and have directly served over 2,500 patients through my clinic, Naturally Nourished, addressing chronic illness, optimal wellness, and weight loss. Like many other functional medicine or naturopathic practitioners, I prefer to take the time with the individual to understand why certain diseases or disorders manifest. Practitioners often try to “outscience” nature by biohacking our way out of an imbalance. However, I discovered that as fancy as I got with cutting-edge genomics and other methods of advanced testing, if the mind and stress response are not sound, my patient will not heal.

  For years I focused on my application of functional medicine with nutritional therapies, including strategic use of nutritional supplements, elimination diets, gut-restoration protocols, and adrenal support and hormonal rebalance, always pairing these approaches with implementation of an anti-inflammatory, low-glycemic diet. I saw good outcomes through each avenue, realizing every patient has a different entry point to the unfurling of their health, and if I could address that driving cause, the diet therapy and nutrient focus would yield desired results. However, if the driving cause was overlooked, the diet and strategic supplements would have temporary effects and constantly need to be adjusted or added to.

  FUNCTIONAL MEDICINE AS DEFINED BY THE INSTITUTE OF FUNCTIONAL MEDICINE

  The functional medicine model is an individualized, patient-centered, science-based approach that empowers patients and practitioners to work together to address the underlying causes of disease and promote optimal wellness. It relies on a detailed understanding of each patient’s genetic, biochemical, and lifestyle factors and leverages that data to direct personalized treatment plans that lead to improved patient outcomes.

  By addressing root cause rather than symptoms, practitioners become oriented to identifying the complexity of disease. They may find one condition has many different causes and, likewise, one cause may result in many different conditions. As a result, functional medicine treatment targets the specific manifestations of disease in each individual.

  When working with a patient I take on the role of detective of their body. I seek to determine the antecedent, or driving cause, of their imbalance, essentially discovering the Achilles’ heel interfering with their path of healing. In an initial session, I spend 90 minutes thoroughly getting to know my patient’s story, what steps and incidents drove them to simply surviving versus thriving. All too often, stress and anxiety are overlooked or unacknowledged.

  Anxiety can create an imbalance in hormones, driving infertility, polycystic ovarian syndrome (PCOS), loss of or irregular menstruation, and weight gain. It can also create an imbalance in digestion and inflammatory compounds, leading to over- or under-reactive immune function.

  Time and time again, I find that my clients feel that stress and anxiety are something they just have to deal with. They are dragged by the bumper of the vehicle of their body and accept the repercussions as normal.

  “Well, doesn’t everyone get shakiness in their hands before a big lecture or a first date?”

  “Doesn’t everyone feel like they want to crawl out of their skin at times?”

  “Isn’t everyone struggling to get a good night’s
sleep and wake well-rested?”

  None of these statements has to be true!

  When identifying their level of stress and the way their body responds, most people note a coping mechanism, say they don’t know what the physical response is, or reply that they just deal with it. Is this because we are so disconnected from our bodies? Or because we live in a society that believes stress and anxiety are normal and you just deal with them by continuing to take on more while ignoring the shouts from your body? Is there a negative association with anxiety as a sign of weakness or mental illness?

  A typical stress and anxiety intake with a client includes questions such as the following:

  1. How does stress physiologically influence your body?

  2. Are you experiencing:

  •Body temperature changes, either cold and clammy or hot and moist?

  •Tension in the shoulders, neck, or jaw?

  •Teeth grinding?

  •Bloating or distention?

  •Changes in digestion, such as cramping, gas, or belching?

  3. Does food transit time feel different under stress? Do you feel more hungry or forget to eat?

  4. Any changes in bowels, such as constipation or urgent, loose stools?

  5. Any changes in heart rate, flutters, or tightness in the chest?

  6. Any muscle or nerve tremors or spasms? Twitching in the eye? Shakiness in the hands?

  7. Do you have changes in energy, such as a surge of energy or adrenaline, or do you get fatigued by stress? Is there a fluctuation?

  8. Any insomnia? Do you have difficulty falling asleep or staying asleep without intermittent waking?

  9. Does your mood shift into irritability and agitation, or do you get a short fuse?

  10. Do you experience racing thoughts or difficulty concentrating?

  Then I dig deeper, asking, “When in your silent mental space, are more of your thoughts focused on rumination of what was or anticipatory stress of what may be (the ever-loved “what ifs”)?

  Finally, I have all my clients select if they are “stressed and wired” or “stressed and tired” to determine if their fight-or-flight center, the hypothalamic-pituitary-adrenal axis (HPA-axis), is in overdrive or if they are in a state of adrenal fatigue. (I will discuss the HPA-axis in detail on page 54.)

  Anxiety, although typically associated with the “stressed and wired” expression, when chronic, can drive “stressed and tired” manifestations. This can be both mental exhaustion as well as physiological. Anxiety, over time, can be debilitating, driving chronic fatigue and dissociative behavior, and causing one to miss out on opportunities that would potentially enhance their life.

  Whether they are related to weight gain, inflammation, an autoimmune condition, or a digestive issue, anxiety and stress response play a vital role in the pathology of many conditions, and managing them is essential in recovery.

  When mismanaged, anxiety throws off our neurotransmitters, which can create more alarm bells in the brain, which then stimulates more cortisol response from the adrenals. This tells the body to store more visceral body fat, which drives weight gain and insulin resistance, elevating blood sugars. The higher amount of sugar in the blood can drive elevated blood pressure and diabetes. Additionally, the stress response can have a sterilizing hit on the gut microbiome, and this, paired with elevated blood sugars, drives yeast and bacterial overgrowth, which further influences neurotransmitters, as 90 percent of our serotonin and a majority of our dopamine is produced in the gut.

  Inflammation and autoimmune disease are directly related to the HPA-axis and anxiety management as well. Cortisol, produced by the adrenal glands, has anti-inflammatory mechanisms, such as reducing histamine reactivity, so an ample amount of cortisol is healthy. However, under ongoing anxiety, the adrenal glands get exhausted from overreactivity and then respond with deficiency. This is when inflammatory cascades go on high release as the cortisol dam that was holding back the inflammation breaks down. Also, when under anxiety and high stress, the body goes into hyperactivity mode, often driving autoimmune disease, when the body perceives itself as an invader and goes into auto-attack. As you can see, unmanaged anxiety can play a significant role in an array of diseases. Similarly, when mechanisms in the body are imbalanced, anxiety can be greater expressed.

  Regardless of where I start with a client on a functional medicine level, I am assessing inflammation, the gut bacterial status (microbiome), micronutrient needs, adrenal stress gland status, and the expression of neurotransmitters. For a preliminary diet, I always start with either the low-glycemic diet with a healthy fat focus (Phase 2 of the anti-anxiety diet) or a more aggressive jump into a high-fat, low-carb ketogenic diet (Phase 1 of the anti-anxiety diet).

  The Anti-Anxiety Diet Foundational 6 Rs

  I developed the anti-anxiety diet as a way to reset multiple processes of the body using my Foundational 6 R approach to accelerate mind-body balance and promote optimal health. The food therapy recommended in this book is focused on fueling the body with vitamins, minerals, and amino acids to aid with providing building blocks for neurotransmitters and signals in the brain that aid in managing mood, reducing cravings, and resolving anxiety. In the following chapters, we’ll discuss each of the six Rs in detail.

  REMOVE Inflammatory Foods: In Chapter 2, we will kick off by identifying foods that drive inflammation in the body and replace these with alternatives that are less irritating. Not only will this cool and soothe your GI tract, but your immune system will be less burdened by compounds in the bloodstream and will start to call your inflammatory army to retreat.

  RESET Gut Microbiome: In Chapter 3, we will identify drivers of gut bacteria imbalance and discuss how to starve off bad bacteria overgrowth, as well as tools to promote viability of beneficial bugs to support healthy neurotransmitter production. When you are able to get those bugs working for you versus against you, you may benefit beyond the increase of feel-good neurotransmitters such as serotonin and gamma-aminobutyric acid (GABA), and experience improved regularity, less bloating, and clearer skin.

  REPAIR GI Lining: Now that the primary dietary irritants are removed, we will talk about healing your gut lining to support absorption of nutrients and reduce inflammatory reactions. We will work with therapeutic foods to “seal the tank” of your GI tract, preventing leaky gut reactivity. This will be the final stage of gut restoration, ensuring we have removed irritants, reinoculated good bacteria, and finally, repaired any gut damage. See Chapter 4.

  RESTORE Micronutrient Status: In Chapter 5, we will discuss synergistic eating to aid in absorption and bioavailability of nutrients. We will discuss primary nutrients that are integral to mood regularity and management of the stress response. Beyond foods that are potent in nutrients of need, this section will include nutritional supplementation recommendations to get you “above water,” and then discuss a timeline in which you will be able to maintain management with primarily diet.

  REBOUND Adrenals: In Chapter 6, we will discuss the symphony of the sympathetic nervous system and how the stress axis can cause over- or underreactivity in the body, ultimately influencing adrenal gland output and function. You will learn how to reduce excessive output as well as rebound fatigued adrenals to gain support of the feel-good influence without excessive excitatory response. We will dive into the role of cortisol and how it acts in both excess or deficiency, and learn about the other products of the adrenals, including the hormone precursor dehydroepiandrosterone (DHEA).

  REBALANCE Neurotransmitters: Finally, in Chapter 7, we will talk about how to assess the output of the stress hormone catecholamine, and how anxiety can be managed with amino acid therapy to produce deficient neurotransmitters or those needed in higher demand. You will learn about foods that contribute to production and regulation. You will understand the broad function of neurotransmitters beyond contributing as drivers of mood stability, including management of inflammation, enhanced cognition, and piloting many autonomic nervous system functions
.

  CHAPTER 2

  Remove Inflammatory Foods

  Chronic inflammation is associated with many diseases, especially age-related diseases, including atherosclerosis, cancer, arthritis, obesity, allergies, stroke, diabetes, congestive heart failure, digestive disorders, Alzheimer’s disease, mood imbalance, and more. The suffix “itis” translates to inflammation; any disease with this suffix (e.g., arthritis, diverticulitis), can benefit from anti-inflammatory mechanisms.

  The natural process of aging sets the foundation for increased inflammation as the production of destructive chemicals known as cytokines increases. Many lifestyle factors also contribute to increased inflammation, such as diet, quality of sleep, psychological stress, environmental exposure to toxic chemicals (smoking, environmental pollutants, unpurified water), and dietary consumption of inflammatory foods.

  In this chapter, I will teach you about what inflammation is, why it matters for your mood, and how to navigate an anti-inflammatory diet.

  What Is Inflammation?

  Inflammation has been coined “the silent killer” as it can often lurk in the body, causing destruction slowly, seemingly silent until the inflammatory chemicals build up so high that disease or a dynamic symptom strikes. Although inflammation is a normal and essential bodily response, when the immune system and metabolic function of the body is overwhelmed with inflammatory foods and processed ingredients, the body responds with imbalanced and excessive inflammatory reaction.

  The natural immune response of inflammation occurs in reaction to a bodily insult by a foreign invader such as a virus, bacteria, or fungi, or to an injury like a cut, impact, or chemical exposure. Five cardinal signs associated with inflammation are essential in the process of healing the injury while protecting it from spreading. I was educated by their Latin names: rubor, calore, tumor, dolor, and functio laesa.