Anxiety is defined as “an emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure” by the American Psychological Association (APA) (1). Even though anxiety is generally experienced as an unpleasant emotional state, the underlying responses serve as an adaptive function when facing a threat through the activation of the fight-or-flight reaction. Experiencing anxiety is part of everyone’s life. However, if its intensity and/or duration seem uncontrollable and lead to a disruption of a person’s daily life, an anxiety disorder could be present.
Anxiety – an adaptive response to threats
Anxiety is an emotion everybody is familiar with. Symptoms of anxiety include increased heart rate, rapid breathing, restlessness, trouble concentrating and difficulty falling asleep, among others. Feelings of anxiety are not only normal but beneficial and sometimes even a matter of survival when facing harmful situations. Since the beginning of mankind, the approach of predators and incoming danger has initiated alarm signals in the body which allowed taking protective actions. For most people today, running from large animals and life threatening dangers are of less importance compared to early humans. Nowadays anxieties are often related to financial matters, problems at work, health concerns and other important issues demanding an individual’s attention. However, anxiety can also occur without an obvious cause (2, 3).
Everyone has fears and worries. Anxiety can be of advantage in some situations and is a normal reaction to actual or potential threats. Sometimes, however, anxieties become uncontrollable and take over someone’s life. Anxiety disorders have to be distinguished from normal nervous or anxious feelings. They are characterized by extreme or long-lasting feelings of anxiety which have a strong impact on a person’s well-being. About 30 percent of the population are affected by anxiety disorders at one point throughout their life (4), making anxiety disorders the most prevalent mental health disorders. People with an anxiety disorder try to avoid situations that trigger or worsen their symptoms, like a crowd, dogs, or social situations. There are different types of anxiety disorders, including generalized anxiety disorder, panic disorder, specific phobias, agoraphobia, social anxiety disorder and separation anxiety disorder (5).
How to manage your anxiety?
Remember that anxiety is a normal and common feeling in daily life, and experiencing it does not always indicate the presence of a mental health disorder. However, individuals facing overwhelming and uncontrollable anxiety should seek professional help. Anxiety disorders can be treated effectively through psychotherapy and pharmacological treatment. Talk to your GP to get advice and referral.
Can lifestyle choices help your anxiety?
You may ask yourself what you can change in your daily life to reduce your feelings of anxiety. Lifestyle choices, such as diet and physical activity, are one element which can help manage your anxiety. However, it has to be mentioned that diet and physical activity changes should never be the stand-alone treatment when facing an anxiety disorder. Lifestyle changes can only be an add-on approach in the treatment of pathological anxiety.
Food to help anxiety
So far, the number of relevant studies is too small to draw final conclusions about the relation between food and anxiety. But there is first evidence that certain foods and specific dietary habits may lead to a change of anxiety levels. For example, studies identified an association between processed foods (6), dietary patterns rich in saturated fat and added sugars (7) as well as Western diet (9) and increased anxiety levels. In contrast, an association between greater food diversity (8) as well as the Mediterranean diet (9) and lower levels of anxiety was found. However, these studies do not allow causal conclusions, but give first indication that whole-foods might help improve anxiety symptoms. According to this, anxiety reducing foods are vegetables, fruits, legumes, seeds, nuts and whole grains. Processed foods should be avoided. Following a diverse diet including complex carbohydrates (like whole grains), sufficient dietary fibre, unsaturated fats (e.g. olive oil) and proteins (as in legumes) is recommended – not only for people experiencing feelings of anxiety. Specific foods which seem to reduce anxiety are brazil nuts, fatty fish, eggs, dark chocolate, turmeric (10), chamomile, yogurt and green tea (11). Although these foods might have a positive effect on anxiety, it is important to know that a change in diet alone will never be sufficient to treat an anxiety disorder. If you are suffering from very mild anxiety, these foods might be helpful to alleviate some symptoms.
Find out more about anti-anxiety foods in the book “Anti-Anxiety Food Solution: How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings” by Trudy Scott, a certified nutritionist who was affected by an anxiety disorder herself.
Physical activity to help anxiety
Physical activity plays a key role in staying healthy, physically as well as mentally. Find out more about exercise here. Exercise has been identified to be a useful addition to the treatment of anxiety. However, it stays unclear which kind and which intensity of physical activity is most effective in the reduction of anxiety symptoms. Some studies recommend moderate graded exercise (12), while others suggest high intensity exercise to be more effective than low intensity exercise (13). Though there is a lack of high quality research which would allow final conclusions about the effectiveness of exercise (14).
- Ghinassi, C. W. (2010). Anxiety. Santa Barbara, CA: ABC-CLIO.
- Bandelow, B., & Michaelis, S. (2015). Epidemiology of anxiety disorders in the 21st century. Dialogues in clinical neuroscience, 17(3), 327-335.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
- Bakhtiyari, M., Ehrampoush, E., Enayati, N., Joodi, G., Sadr, S., Delpisheh, A., Homayounfar, R. (2013). Anxiety as a consequence of modern dietary pattern in adults in Tehran—Iran. Eating behaviors, 14(2), 107-112.
- Masana, M. F., Tyrovolas, S., Kolia, N., Chrysohoou, C., Skoumas, J., Haro, J. M., Panagiotakos, D. B. (2019). Dietary Patterns and Their Association with Anxiety Symptoms among Older Adults: The ATTICA Study. Nutrients, 11(6), 1250.
- Poorrezaeian, M., Siassi, F., Qorbani, M., Karimi, J., Koohdani, F., Asayesh, H., & Sotoudeh, G. (2015). Association of dietary diversity score with anxiety in women. Psychiatry research, 230(2), 622-627.
- Kamali, M., Dastsouz, F., Sadeghi, F., Amanat, S., & Akhlaghi, M. (2016).
Associations between Western and Mediterranean-type dietary patterns and anxiety and stress. Acta alimentaria, 45(3), 398-405.
- Esmaily, H., Sahebkar, A., Iranshahi, M., Ganjali, S., Mohammadi, A., Ferns, G., & Ghayour-Mobarhan, M. (2015). An investigation of the effects of curcumin on anxiety and depression in obese individuals: A randomized controlled trial. Chinese journal of integrative medicine, 21(5), 332-338.
- Sarris, J., Moylan, S., Camfield, D. A., Pase, M. P., Mischoulon, D., Berk, M., Schweitzer, I. (2012). Complementary medicine, exercise, meditation, diet, and lifestyle modification for anxiety disorders: a review of current evidence. Evidence based complementary and alternative medicine, 2012(Article ID 809653), 1-20.
- Aylett, E., Small, N., & Bower, P. (2018). Exercise in the treatment of clinical anxiety in general practice–a systematic review and meta-analysis. BMC health services research, 18(559), 1-18.
- Stonerock, G. L., Hoffman, B. M., Smith, P. J., & Blumenthal, J. A. (2015). Exercise as treatment for anxiety: systematic review and analysis. Annals of behavioral medicine, 49(4), 542-556.
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