The Anti-Anxiety Diet

by Ali Miller

  From this explanation you may think I am going to provide you with a low-histamine food list and recommend reduced histamine intake. However, research also supports that histamine food compounds can have calming, sedative effects when they cross the blood-brain barrier. Histamine neurons project from the hypothalamus (the start of the fight-or-flight axis) in significant levels, affecting sleep and circadian rhythm, appetite regulation, cravings, and stress and anxiety. If there is not enough histamine activity in the brain, these physiological functions are disturbed.

  So, too little histamine can drive mental health imbalance, as it is unable to cross the blood-brain barrier to influence regulatory function. With anything, there is a tipping point and balance. An individual who has significant bacterial dysbiosis and high amounts of histamine in the gut may benefit from a low-histamine diet while in bacteria reset. Similarly, someone with chronic fatigue syndrome and low cortisol will have increased histamine expression so, especially during allergy season, this individual would likely benefit from a low-histamine diet as well. Histamine levels can also build up in the body based on genetic metabolic influence, which we will touch on more in the next chapter with methylation and nutrient repletion.

  To be clear, a low-histamine diet can help the body cope with symptoms of anxiety while addressing an underlying mechanism of imbalance, such as gut dysbiosis or adrenal fatigue, but it is not a solution for sustainable outcomes on its own. If you are dealing with anxiety and imbalance, you may consider a short-term low-histamine diet to aid with your body’s rebound. The highest source of histamine in diet is not in the amino acid L-histadine itself, it is in the aging of food or a production of bacteria in foods. Fermented and cultured foods are at the top of the list, including probiotics. If an individual has a poor reaction to a probiotic supplement, it may be both a combination of dysbiosis and excessive histamine buildup. Consider reducing or removing these foods for six to eight weeks minimum during your anti-anxiety diet if your symptoms get worse during the program. As you heal your leaky gut, replete your nutrient deficiency, and rebound your adrenal glands, your histamine reactivity should reduce and be nonreactive.

  Histamine Levels of Certain Foods*

  Very high histamine levels: Cultured foods such as aged cheese, alcohol, cured meat, kefir, kimchi, sauerkraut, vinegar, and yogurt

  High histamine levels: Fish and seafood, especially if smoked or preserved

  Moderate histamine levels: Avocado, canned vegetables, eggplant, spinach, tomato

  *Source: The Journal of Clinical Nutrition

  Foods that have the amino acid L-histadine should not be limited, as they will help create balance in the body. This includes fresh, protein-rich foods. The less aged a food is, the better. Very sensitive individuals should avoid leftovers.

  Supplements to Support Gut Lining and Reduce Inflammation

  During this portion of the protocol we work with restoration of anti-inflammatory compounds, such as omega-3, and botanicals, such as curcuminoids, to reduce inflammation in the gut, which will ultimately aid in repair. You can’t rebuild a house that is currently on fire! After the removal of inflammatory foods, as detailed in Chapter 2, the addition of anti-inflammatory compounds will soothe and cool the gut.

  Omega-3 fatty acids, proteolytic enzymes, and specific plant compounds, including curcuminoids from turmeric and bromelain from tropical plants, have been shown to reduce inflammation in the intestines. The dietary approach removes the lighter fluid while the supplemental support can trap and put out the flames. The Appendix’s Supplement Support for the 6 Foundational Rs section includes dosage, details, and unique attributes to the formulas I use in clinic to aid in reducing inflammation in the gut and throughout the body.

  Glutamine and Mucilaginous Herbs

  Glutamine is an amino acid that supports healthy gut cell function, aiding with both lining and repairing the GI tract and healing ulcerations or damaged areas of the leaky gut. To further support gut restoration in my clinic, I recommend a GI lining powder that includes L-glutamine, deglyclyrrhizinated licorice (DGL), and aloe, to therapeutically rebuild the GI lining. This is a great tool to more directly address leaky gut, coat and soothe the intestines, and reduce food reactivity.

  Beyond the GI tract, L-glutamine can be used to tame sugar cravings and has been used in rehabilitation clinics for substance and alcohol abuse. I often recommend clients take 3 to 5 grams of L-glutamine under the tongue to curb sugar cravings.

  Food as Medicine to Support Leaky Gut

  Bone Broth for Gut Repair

  Preparing a bone broth is an ideal way to repair the gut lining, prevent future food sensitivities or allergies, and promote tolerance. The glutamine in bone broth acts as both a nutrient source and a building block for enterocytes, the cells along the gut lining. The gelatin not only prevents muscle wasting and promotes healthy digestion; it also lines the GI tract, reducing breakdown of the gut lining. Gelatin also contains collagen, which can aid in healthy connective tissue in the hair, skin, nails, and joints.

  Bone broth also supports relaxation and can actually be a driver for GABA production—the same neurotransmitter that, along with serotonin, reduces anxiety and stress response. Another anti-anxiety compound to note in bone broth is glycine, which aids in neuromuscular relaxation, sleep, and neurological regulation. Sipping on bone broth in the evening can help you find your mellow and support your gut in the healing process while building healthy connective tissue. Bone broth and gelatin gummies add a therapeutic “gut lift” and mood boost!

  Suggested use: Aim to have 6 to 8 ounces of bone broth at least four times weekly. You can sip on your broth in a mug or use it as a cooking liquid or the base of a soup. Check out Grass-Fed Beef Knuckle Bone Broth on page 123.

  Gelatin Gummies for Gut Repair

  Gelatin is comprised of glycine and proline, two amino acids that are generally limited in the American diet as they are found abundantly in organs, bones, and fibrous animal tissues not commonly consumed. These amino acids promote collagen formation and contribute to healthy skin, as well as hair, nail, and joint strength. Their main claim to fame is the ability to line the gut and reduce inflammation caused by food allergies or inflammatory bowel disease. Gelatin has mucilaginous (aka “oopy-goopy”) compounds that reline the gut, essentially servings as a face-lift for the GI tract! Beyond these benefits, there is some compelling research that it may reduce cellulite and boost weight loss!

  Suggested use: Try to make a gelatin recipe or two monthly to support optimal gut lining and connective tissue health. This is a great summer option when bone broth becomes less appealing, and it is also a great delivery for kids. Your anti-anxiety diet recipes include a gelatin noted on the opposite page, as well as the Turmeric Orange Gummies (page 148).

  FOOD AS MEDICINE

  Repair GI Lining

  These recipes feature glutamine, collagen, and gelatin with additional therapeutic elements to synergize flavor and function. Learn how to make bone broth with beef bones, whip up your chicken stock into a creamy zesty soup, and play with making a gelatin pudding and an indulgent, dairy-free hot chocolate.

  Almond Collagen Hot Cocoa, page 110

  Grass-Fed Beef Knuckle Bone Broth, page 123

  Gut-Restoring Chicken Bone Broth, page 125

  Zesty Creamy Carrot Soup, page 127

  Naturally Nourished Pot Roast, page 128

  Chai Gelatin Panna Cotta, page 143

  CHAPTER 5

  Restore Micronutrient Status

  Micronutrients, which include vitamins, minerals, amino acids, and antioxidants, are involved in every biological process in the body and thus have a great influence on overall health, from neuromuscular function, hormonal balance, metabolism, and energy to sleep, relaxation, and mood stability. Many symptoms of disease are correlated with micronutrient deficiencies due either to a medication’s influence on micronutrient absorption or the mechanism of the disease demanding more of a nutrient. When considerin
g repletion of micronutrients, it is important to understand the underlying cause of deficiency to promote sustained repletion and to prevent future deficiencies. The three main categories that can potentially lead to micronutrient deficiencies are increased demand, inability to absorb or use, and inadequate intake.

  Increased Demand

  Increased demand for a nutrient could be due to lifestyle, lifecycle, or a life stage. Both physiological and psychological demands can drive deficiency patterns. General aging, trauma, and healing from injury, pregnancy, breastfeeding, and even exercise can also influence physical demands of nutrients.

  There is an increased need for nutrients following physical activity to aid in tissue recovery and repair. Also, increased oxidative stress from respiration or aerobic training can deplete antioxidant status.

  Beyond running a marathon or carrying a child, there are psychological demands on nutrients. At times of mental stress or anxiety, more B vitamins are needed to act as cofactors for neurotransmitter production. Excess amounts of vitamin C are needed to support the adrenal glands in their production of cortisol. Another marker of stress demand on the body is glutamine depletion. As discussed in Chapter 4, glutamine is a fuel source for the gut cells, and anxiety can drive leaky gut, thus burning through glutamine at higher demand.

  Inability to Absorb

  The inability to absorb nutrients could be directly related to the efficiency of the digestive tract, including digestive enzymes, stomach acidity, bile, and the state of the gut lining. Bowel irregularity can be a marker of absorption issues, especially as seen with loose stools and clients with undigested particles of food or fat in the stool. A patient without a gallbladder is prone toward fatty acid and fat-soluble vitamin deficiency, often requiring a digestive enzyme with ox bile, hydrochloric acid (HCl), and lipase to help compensate. Alternatively, low stomach acid due to stress or use of acid-reducing medications can drive, as this acidity from HCl is actually needed to absorb nutrients such as amino acids, B12, calcium, and iron.

  Medications play a significant role in nutrient deficiency trends. Cholesterol-lowering medications block the body’s production of coenzyme Q10 (CoQ10), an antioxidant and enzyme demonstrated in studies to have natural antidepressant effects by supporting mitochondrial function. Blood pressure medications can reduce levels of minerals, especially those that have diuretic effects or are combined with an additional diuretic medication. Metformin, used to treat diabetes and elevations of blood sugar level, has been shown to deplete B12 levels.

  The concern with these drug-induced nutrient deficiencies are that often the nutrients that drop due to prescription use are those very nutrients which are required on higher demand for regulation in the body, thus driving medication dependency and, ultimately, undesired side effects from further depletion. For example, some of the minerals that become depleted with blood pressure medications are the very nutrients that aid in vascular relaxation and blood pressure regulation effects.

  On an anxiety specific approach, selective serotonin reuptake inhibitor (SSRI) drugs are no exception to this connection of prescription drugs driving deficiency and creating further need for medication. Beyond the central nervous system, serotonin receptors are found in the gut, blood vessels, and connective tissues, including smooth muscle and bone. SSRIs have been shown to have unfavorable effects on serotonin receptors for bone health, which is demonstrated with use of these drugs and increased risk of osteopenia and bone fracture. The use of common SSRIs, such as Zoloft, Prozac, and Xanax, to name a few, drive reduced calcium levels in the blood, which can drive acute anxiety and panic attacks! These drugs also can deplete levels of CoQ10, magnesium, and B-vitamins, which can result in chronic fatigue, arrhythmias, muscle tension, insomnia, and depression. Beyond the deficiency of medications on a blood level, many antidepressants and anti-anxiety drugs require higher amounts of B vitamins for optimal functionality. So, both the influence of driving depletion by interference with absorption as well as increased demand can be seen with use of anxiety medications.

  Inability to Use

  The inability for your body to use a nutrient is often due to genetic predisposition or mutation that would limit the conversion of nutrients from foods or supplements into the active form to be available functionally on a cellular level. Genetic single nucleotide polymorphisms (SNPs), or mutations at the genetic level, for example, include the body’s inability to use, build, bind, excrete, and transfer compounds. The most known and relevant to anxiety is the genetic SNP MTHFR (methyl-tetrahydrofolate reductase). Over 40 percent of the population has methylation issues due to the MTHFR gene, which influences the body’s ability to build neurotransmitters, excrete toxins, generate activated folate (vitamin B9) and convert other compounds via a methyl compound.

  For someone with the genetic SNP MTHFR, taking nutrients in the inactive form, such as folic acid, might actually lead to fatigue or toxicity. Their body needs help with converting the supplement, so they would instead need to take an active form with the methyl compound, such as 5-methyltetrahydrofolate, to drive the methylation process.

  In general, it is ideal for everyone to take nutritional supplements that are in the active and absorbable form regardless of genetics, as this ensures optimal utilization without having to delve into expensive genetic assessments. I will dig a bit deeper into MTHFR and this gene’s role in anxiety in the B-vitamin section of this chapter.

  Inadequate Intake

  Nutritional deficiency is common in picky eaters, those whose diets are composed of processed foods and refined carbohydrates, or those who have little to no variety in their diet, even if it is from the “healthy” food selection (e.g., oatmeal every day for breakfast). Inadequate intake might also occur in those with a restricted diet for medical or personal reasons, such as a vegan diet low in B vitamins and bioavailable minerals. Without biological proteins consumed from meat and fish, an individual would be more likely to be deficient in B12, zinc, iron, and glycine, as vegetarian sources are limited and their forms are less bioavailable.

  Next, I will walk you through trends of nutrient deficiency correlated with racing thoughts, difficulty concentrating, heart palpitations, insomnia, and generalized anxiety. Beyond your focus of meeting recommended intake, take some time to reflect back on these drivers of deficiency to address the root cause!

  Genetic Drivers toward Anxiety and Nutrient Deficiency

  As noted, genetic SNP MTHFR affects about 40 percent of the population and is now proposed as a major mechanism in anxiety and depression. Remember, the MTHFR gene influences your body to produce neurotransmitters, including serotonin and stress-responding norepinephrine, epinephrine, and dopamine. With over a third of the population experiencing anxiety, this correlation of genetic influence is of great interest in regard to regulation and reduction of anxiety disorder.

  The science of epigenetics explores the environmental drivers, and nutrigenomics studies the influence of nutrients on genetic expression. What this means is that a genetic SNP may be present, but it does not drive destiny; it drives the tendency of how your body will respond if not provided the nutrients to compensate. In the case of MTHFR and epigenetics, environmental drivers such as mental stress, lack of sleep, exposure to toxins, and a dysbiotic state in the gut can contribute toward more accelerated MTFHR burnout, thus driving more deficiency trends with methylation nutrients, including folate, B12, and SAM-e (s-adenosyl-methionine).

  Modifying stress demand and reactivity, focusing on sleep hygiene, eating a clean non-processed diet, and resetting your microbiome can all aid in reducing the effects of the MTHFR genetic SNP by reducing the demands on the process of methylation. Using nutrigenomics to fight against anxiety would include focused supplementation with methylated folate and B-12 (5-methyltetrahydrofolate and methylcobalamin) as well as providing mood-stabilizing support from SAM-e.

  Now, like many things in life, too much of a good thing can drive dysfunction as well. Meet COMT, catechol-O-methyl
transferase, a gene that influences the metabolism of stress-responding chemicals, supports a calm mood, and reduces estrogen dominance. An individual with COMT SNP can over-methylate due to stress driving the cycle or from excess methyl donors from over-supplementation. This buildup of stress chemicals can drive anxiety as well as brain fog, difficulty concentrating, irritability, and increased risk for estrogen-related cancers.

  This is where SAM-e comes in to support the process of MTHFR as well as the COMT pathway by donating a methyl group (basically a building block) to release the buildup of stress-responding chemicals and estrogen while supporting a focused, relaxed mood. Reducing excess estrogen can reduce anxiety, worry, and panic while preventing cardiovascular, thyroid, autoimmune and cancer risks, as well as PMS, fibroids, and endometriosis in women. Methylation both regulates the amount of estrogen in the body and influences which receptors are targeted. Supporting your body’s methylation pathways with essential nutrients promotes expression of beta estrogen receptors, which are known to have anxiety-reducing effects. Those that have hindered methylation will see more expression on the alpha estrogen receptors, which have an anxiogenic effect.

  COMT works in hand with monoamine oxidase (MAO), another genetic SNP with similar properties, focusing on breakdown of neurotransmitters. You may be familiar with the name, as some medications for depression are MAO inhibitors working to keep higher levels of neurotransmitters in the brain. In an anxiety-induced individual, these medications can provoke the stress response in a similar way to how the genetic SNP for MAO would, by slowing removal of stress chemicals. SAM-e with its ability to reduce buildup, has a nice, calming, anti-anxiety effect on MAO and COMT pathways.