The Anti-Anxiety Diet

by Ali Miller

  If you are not looking to lose weight, it is possible to maintain a healthy weight and even gain weight if needed while implementing the ketogenic diet. Often, malnourishment is due to a state of gut distress along with foods that lack nutrient density, both of which are addressed with the anti-anxiety diet.

  Who Should Not Do Phase 1?

  Depending on where you are with your current diet and your medications, a ketogenic diet may be too drastic and you may choose to stay within the low-glycemic Phase 2 protocol to kick off your anti-anxiety diet. Do not do Phase 1 if you fall under any of the following:

  •Uncontrolled medicated diabetic, unless managed with a certified diabetes educator or medical practitioner

  •History of eating disorder

  •Pregnant, unless monitored by OBGYN and pregnancy team

  •Adrenal fatigue that worsens with diet

  Note: If the adrenal output is extremely low, you will not have DHEA, a stress hormone made by the adrenals used in the production of ketones. Some individuals with advanced adrenal fatigue need to practice two to three months of Phase 2 eating prior to implementing Phase 1 and may need to supplement with adrenal compound or DHEA.

  If adrenal excess is seen, ketosis is a great tool to regulate the elevated DHEA and neurotransmitters to support a rapid reduction in anxiety, as long as it is paired with adaptogenic herbs for resilience to avoid burn out.

  Phase 2: Low-Glycemic Protocol

  Follow for weeks 7+, to intermittently to cycle out of ketosis, or ongoing according to need.

  Macronutrient % distribution:

  •15–25% carbs

  •25–35% protein

  •40–60% fat

  (Relative gram amount is based on a 1200–1400-calorie diet)

  If using a tracker or application such as MyFitnessPal, you can enter these macro percentages and then, based on your weight, the program will provide gram recommendations per macro.

  Note: Carbs and protein are 4 calories per gram, whereas fat is 9 calories per gram, so you may be fat dominant in macros percent by caloric distribution but the numbers in grams of protein and fat may be closer to equal value.

  After six weeks of tight ketosis and allowing your body to convert fat as fuel instead of sugar, you will have an opportunity to transition or intermittently cycle the less-restrictive Phase 2, which is low-glycemic with an upper limit of 90 grams of carbs. It is appropriate to fully transition to Phase 2 if you are feeling low energy on Phase 1 or if you are having unfavorable weight loss or symptom shifts.

  In Phase 2, choose carbohydrates in the form of fruits and starchy vegetables to provide dietary variety, beneficial fibers, support of serotonin expression, and a reset in leptin response. Phase 2 eating is one approach to carb cycling while maintaining ketosis the majority of the time. Carb cycling may be done in times of progesterone shifts to offset the physiological hormone demand for a cycling female or once a week or every other week on a Saturday to create a sustainable approach and more social freedom. Favorable effects such as improved ketone production, hormone balance, and reduced stress response can be seen when cycling carbs after becoming adapted to using fat as your primary fuel. If you notice a decline in your progress when you transition to Phase 2, you may consider going back to Phase 1 for an additional four to six weeks prior to advancing again, if desired. Phase 2, low-glycemic eating, can also be done cyclically every quarter or so, where an individual does a ketogenic phase 1 diet for 10–12 weeks and a phase 2 low-glycemic diet for 7–10 days. Interestingly enough, once you get keto-adapted, many people feel so fantastic they choose to stay fat-fueled and don’t look back; however, others thrive with this approach of flexibility and see metabolic and hormonal benefits from cycling the two phases.

  If you experienced beneficial mood-stabilizing outcomes from the Phase 1 ketogenic approach, consider holding off on transitioning to Phase 2. Men and some women are able to stay in Phase 1 for extended periods of time and continue to reap the benefits; however, often, women, due to hormonal demands, will over time get imbalances in leptin hormone response and, thus, sexual hormone dysfunction. When cycling carbs, the starchy vegetable or fruit choice should be consumed in the evening to enhance serotonin and melatonin function in the brain.

  For women who are menstruating, carb cycling (using Phase 2) should be considered at ovulation and menstruation (typically days 1 to 2 and days 17 to 18 of their cycle) to support hormonal influences on mood, cravings, anxiety influence.

  There is no right or wrong approach to this. You may notice you feel better in ketosis during certain seasons, levels of stress demand, variance in exercise output, and lifecycle demands, whereas there will be other times when maintaining low-glycemic Phase 2 lifestyle feels appropriate. Listen to your body and remember, if you hold virtue and rigidity as priorities in your diet, you will often fall off or get disconnected with your body. One of the mantras I use in clinic with clients when recalling the downslide of my vegan diet on my body is, “Doctrine creates Disconnect.” If you allow principle to override intuition, you will likely not get favorable outcomes or sustainable results.

  The most important thing to understand is that your body is healing and it is dynamic. Be sure to listen to feedback from your body during the process and adjust as needed. Resist getting dogmatic with macros, following inflexible guidelines on numbers and percentages. Focus on the primary tenets of the anti-anxiety diet by using food lists, recipes, and food-as-medicine support as priorities to yield best outcomes. Then, if wanting to get more aggressive, play with Phase 1 and Phase 2 variances. The recipes in this book are indexed as KF, or ketosis friendly, if they are supportive of the ketogenic diet.

  When transitioning into ketosis, you may experience symptoms of the “keto flu,” a collection of flu-like symptoms including headaches, body aches, bowel impact, and fatigue. Both the Anti-Inflammatory Electrolyte Elixir (page 108) and the Electrolyte-Boosting Avocado with a Spoon (page 113) recipes will help ameliorate these undesired side effects when transitioning into a very low carbohydrate diet. Once the body converts to the use of ketones as a primary fuel source, these symptoms of the keto flu resolve.

  Carbohydrate-Containing Foods

  These foods are only allowed at portions noted below in Phase 2. The carbohydrate items in this section will raise your blood sugar levels and are not appropriate in the ketogenic diet as focused foods; however, you may be able to incorporate small amounts in featured recipes as long as your daily total carbohydrate intake stays below 30g. For blood sugar balance and optimal satiety, be sure to pair them with a protein or healthy fat.

  Each serving from this list contains 15 grams of carbohydrates and 80 calories. Aim to select items that are single ingredient whole foods. Focus primarily on starchy vegetables and fruits. Soak beans and grains to limit phytates, lectins, and other inflammatory anti-nutrients. Avoid refined processed foods and starches made with flour at all costs, along with gluten-containing grains and their products. Nut flours such as almond flour, hazelnut meal, and coconut flour are acceptable in larger portions than in they are in the Phase 1 ketogenic protocol and continue as the preferred “flour” choice.

  Starchy Vegetables

  In general, a single serving of starchy vegetables is ½ cup unless noted.

  •Beets

  •Carrots (look for heirloom purple and rainbow carrots)

  •Parsnips

  •Potato (purple, red, Yukon Gold, heirloom)

  •Pumpkin: 1 cup puree, or almost 2 cups chopped

  •Sweet potato

  •Taro root

  •Winter squash (acorn, butternut, delicata)

  •Yam

  •Yucca: ⅓ cup

  Fruit

  Avoid canned fruit and fruit juices. In general, a single serving of fruit is as follows:

  •½ cup of fresh, unsweetened fruit (such as berries) or 1 small piece of fruit (such as an apple)

  •2 tablespoons of dried (organic, sulfite-free) fruit<
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  •Apple: 1 medium

  •Applesauce: ½ cup

  •Apricots: 3 medium

  •Banana: ½ medium (about 3 inches long)

  •Blackberries: ½ cup

  •Blueberries: ½ cup

  •Cantaloupe: 1 cup

  •Cherries: 15

  •Dates: 2

  •Figs: 2

  •Grapefruit: ½

  •Grapes: 15 small

  •Guava: ½ cup

  •Honeydew: 1/4 small

  •Kiwi: 1

  •Mango: ½ small

  •Orange: 1 small

  •Papaya: ½

  •Peaches: 2 small

  •Pear: 1 small

  •Pineapple: 3/4 cup

  •Plantain, ripe: ⅓ cup (yes, technically a fruit, but plantains are mostly used as a starch)

  •Plums: 2 small

  •Pomegranate: 1 medium

  •Raspberries: ½ cup

  •Strawberries: 1 cup

  •Tangerines: 2 small

  •Watermelon: 2 cups

  Once you have completed the first 12 weeks of the anti-anxiety diet program, your gut may be in a state of resilience where it can tolerate the occasional consumption of grains, beans, and dairy. To ensure you are nonreactive, follow the elimination diet reintroduction guidelines on page 21. Even if tolerated, try to limit grains and beans as occasional sides due to lectins and other inflammatory digestive disturbing compounds. Soaking both grains and beans aids in reducing the anti-nutrients and binding compounds that block mineral and vitamin absorption. When soaking, there is an enzyme activation and many of the common irritants are reduced.

  Cereal and Grains (Presoaked 8 to 12 hours)

  In general, a single serving of cooked grain is ⅓ cup.

  •Amaranth

  •Buckwheat

  •Rice (basmati, brown, wild)

  •Millet

  •Teff

  •Quinoa

  Beans, Pea, Lentils (Presoaked 8 to 12 hours)

  In general, a serving size of cooked beans is ½ cup.

  •Beans: black, cannellini, chickpeas, kidney, lima, navy, pinto, white

  •Lentils: brown, green, yellow, red

  •Peas: black-eyed, split

  Using kombu, a seaweed found in the Asian section of your grocery store, in your cooking process aids in further reduction of phytates, which not only enhances mineral and vitamin absorption but also reduces the gas and bloating that can follow bean consumption.

  Dairy

  As a liquid, lactose has carbs. Cheeses are also listed under this section, but you should keep them out for at least three months of your anti-anxiety diet, as they tend to be the most concentrated in casein, the protein of concern for mental health. Once you reach the 12+ week mark, your gut lining is likely more resilient, so it may be appropriate to test the reintroduction of cheese. As you may recall from Chapter 2, dairy intolerance is tied to both lack of enzyme lactase as well as low stomach acid with excessive stress or use of PPI. Consider taking a digestive enzyme with lactase, HCl- to support stomach pH, and DPPIV to reduce the casein hit. See the Appendix’s Supplement Support for the 6 Foundational Rs section for detailed suggestions.

  Follow guidelines in Chapter 2 on elimination reintroduction by consuming cheese three days in a row, increasing the portion per day. Observe shifts in sleep, cognitive function, mood, energy, thought processing, and anxiety. For example, consume 1 ounce, 2 ounces, then 3 ounces, increasing the serving size each day.

  In general, a single serving of dairy is as follows:

  •Cream cheese: 1 tablespoon

  •Cultured sour cream: 2 tablespoons

  •Hard/semi-hard cheeses (best raw/aged), such as blue, cheddar, Colby Jack, Gouda, Monterey Jack, Parmesan, Reggiano, Swiss: 1 ounce

  •Heavy cream: 2 tablespoons

  •Kefir, unsweetened: 1 cup

  •Milk, raw or non-homogenized, pasture-raised/grass-fed, whole fat: 1 cup

  •Soft/semi-soft cheeses, such as boursin, Brie, Colby, fresh mozzarella, paneer, ricotta: 1 ounce

  •Yogurt, plain or Greek, whole fat: 2/3 cup

  •Grass-fed whey: 1 scoop or 2 tablespoon, yielding around 20–24g protein

  2-Week Meal Plan

  Here is a 2-week meal plan providing structure and guidelines to help you visualize and bring your food-as-medicine anti-anxiety diet to life. Phase 1: Ketogenic Protocol falls within the guidelines to consume less than 30 grams of carbs to support ketone production, and Phase 2: Low-Glycemic Protocol, falls within a more liberal approach of less than 90 grams of carbohydrates.

  Portions are noted to distribute macronutrients within their given category of protein, carbs, and fats; however, based on individual need you may increase or reduce these portions for your body weight, physical activity, true hunger, and need.

  Phase 1: Ketogenic Protocol (7 Days)

  Day 1

  7:30 a.m. 2 eggs, ½ cup bell peppers, ¼ cup sautéed onion, 1 cup baby spinach, cooked in 1 to 2 teaspoons coconut oil, topped with ½ avocado

  10 a.m. 10 roasted macadamia nuts with 2 tablespoons shredded coconut flakes. (Try freezing the nuts for a creamy indulgence that slows down the crunching!)

  2 p.m. 4 to 5 ounces roasted chicken pulled from rotisserie, 5 olives, ½ cucumber, sliced, 3 tablespoons Cashew Cheeze Dip (page 120), 6 flax crackers

  7 p.m. 5 ounces wild salmon cooked with 1 to 2 teaspoons avocado oil and topped with tarragon, served with 1 cup Asian Braised Bok Choy (page 119)

  Day 2

  7:45 a.m. 2 Caramelized Onion, Turkey, and Kale Egg Muffins (page 100)

  12 p.m. 1 cup Whole Roasted Cauliflower (page 116) served over 2 cups greens tossed in 2 teaspoons each of lemon and olive oil, with one 4–7 ounces roasted chicken thigh

  3 p.m. 1 ounce prosciutto with 13 Marcona almonds

  7 p.m. 5 ounces sirloin steak with Bacteria-Battling Chimichurri (page 139), with 1 cup roasted yellow summer squash sautéed in 2 teaspoons olive oil and sprinkled with sea salt

  Day 3

  7:30 a.m. Morning shake: ½ cup water, ½ cup full-fat coconut milk, 1 tablespoon almond butter, 2 teaspoons cacao powder, pinch of sea salt, 1 to 2 cups of greens, 2 scoops of collagen, and ice (optional)

  10 a.m. 2 to 3 Walnut Maca Caramels (page 147)

  1 p.m. 6 ounces grass-fed burger patty on lettuce wrap, with ½ avocado, ⅛ cup kimchi, and 1 cup kale chips

  4 p.m. 6 ounces Gut-Restoring Chicken Bone Broth (page 125) with 1 tablespoon chopped mint or basil

  7:30 p.m. 2 grilled wild shrimp kabobs with zucchini and red onion, ½ cup cauliflower rice served with ½ cup Roasted Colored Peppers (page 122)

  Day 4

  7:30 a.m. 3 ounces chicken sausage link, ¼ cup sautéed onion, ½ cup kale sautéed in 1 teaspoon coconut oil, served with ¼ cup live active sauerkraut

  11:30 a.m. 8 ounces Grass-Fed Beef Knuckle Bone Broth (page 123) with 3 ounces wild cod, ½ small avocado, cubed, and 2 tablespoons scallions

  3 p.m. 1 serving Matcha Coconut Gummies (page 149) + 5 to 6 raspberries

  7:30 p.m. 1 serving Warming Chicken Thighs with Braised Greens (page 129)

  Day 5

  7:30 a.m. 2 pasture-raised eggs, 2 slices bacon, cherry tomatoes tossed in 1 teaspoon olive oil with basil, coarse salt, and black pepper

  12 p.m. 1 serving Creamy Green Chile Chicken Soup (page 126) over 2 cups baby spinach

  3 p.m. 2 to 3 Lime in the Coconut Fat Bomb (page 144) and 6 ounces low-sugar kombucha

  7:30 p.m. ½ cup purple cabbage slaw with 4 to 6 ounces white fish broiled with chili powder seasoning and 2 teaspoons avocado oil, topped with crushed almonds, 2 teaspoons herbs, served in lettuce cups

  Day 6

  7:30 a.m. 1 serving Stress-Stabilizing Steamer (page 109) with 1 scoop protein (grass-fed whey or collagen)

  12 p.m. 2 to 3 Greek Deviled Eggs (page 114) over 2 cups spinach and arugula, with ¼ cup cultured probiotic vegetables

  4 p.m. 3 stalks celery cut
into 3- to 4-inch pieces, with 1 to 2 tablespoons tahini nut butter spread and ½ cup cherry tomatoes

  7 p.m. 5 to 6 ounces Herb-Crusted Pork Tenderloin (page 134) with 1 cup roasted Brussels sprouts

  9 p.m. 6 ounces bone broth plus 2 tablespoons cultured veggies such as kimchi, added after soup is removed from heat to retain probiotic cultures

  Day 7

  7:30 a.m. 2 Prosciutto Egg Cups (page 102) served with a simple arugula salad, seasoned with 1 teaspoon lemon, 1 teaspoon olive oil, coarse black pepper, and truffle salt

  12 p.m. 1 to 2 servings Seaweed Turkey Roll-Ups (page 130) with 1 Pumpkin Nut and Seed Bar (page 106)

  4 p.m. ½ avocado with juice of ½ lemon, pinch of sea salt, red pepper flakes (optional), and ½ orange bell pepper

  7:30 p.m. 4 to 6 ounces Simple Salt and Pepper Scallops (page 140) over 1 cup spiralized zucchini “noodles” with pesto and ¼ cup blistered cherry tomatoes

  Phase 2: Low-Glycemic Protocol (7 Days)

  Day 1

  7:30 a.m. 1 serving Coconut Chia Seed Pudding (page 145) with 1 scoop of protein (collagen or grass-fed whey) or 1 soft-boiled egg

  11:45 a.m. 1 serving Truffled Egg Salad (page 133) in lettuce cups with 1 small piece fruit

  4 p.m. 1 to 2 Mango Zen Fuego Nutballz (page 115), plus 6 ounces low-sugar kombucha