As seen in Psychology Today.
Keeping a wellness regimen during a time of crisis is obviously difficult. Although many of us find ourselves with an abundance of free time, trying to remain healthy and active is a struggle because we are still trying to acclimate ourselves to a new reality that is defined by social distancing and shelter at home orders. Add to the innumerable minor stressors of radically altering how one lives their life the constant updates from 24-hour news outlets, social media channels, and even friends and family, and it’s no surprise that many people have cut down on the amount they exercise, increased the amount of time in which they are sedentary, or started eating far more heavily processed foods than they did in the past.
Unfortunately, such changes may exacerbate symptoms of anxiety. This is especially the case with diet. Far more than just providing us with the necessary calories to survive, our diets should ideally supply us with all the nutrients that we need to keep our body’s many systems working properly. Conversely, when we fail to consume a sufficient amount of certain nutrients, this can lead to specific conditions that can be extremely serious. Deficiencies in vitamin D can lead to rickets in children; deficiencies in vitamin C can cause scurvy; and deficiencies in calcium can lead to the development of osteoporosis.
While just about everyone is accustomed to the notion that a failure to eat certain nutrients may make them more vulnerable to these kinds of diseases, there is a far greater amount of skepticism directed at those who suggest that deficiencies in some nutrients may have an impact on one’s mental health, particularly with regards to anxiety disorders. Some like to hold tight the belief that they have complete control over their emotional or psychological wellbeing, and that neither diet nor genetics nor neurochemical imbalances have as great an influence as willpower. This is simply not true. There are several factors that contribute to one’s mental health, and an increasing amount of data suggests that diet plays a crucial role in regulating everything from our sleep cycles to our mood, and that an unhealthy diet may impact brain performance and could even accelerate the progress of neurodegenerative disorders like Alzheimer’s disease.
A causal relation between diet and anxiety may also exist, but the mechanisms that link the two are not entirely understood. Researchers have found that a diet that is high in empty calories, saturated fats, and processed sugars and low in unprocessed foods like whole grains, raw fruits, and vegetables may lead to increased oxidative stress in the body. Increased oxidative stress then leads to inflammation, including in the brain, which then begins a cascade of effects that may give rise to symptoms of anxiety. Given that many people are already feeling increasingly anxious because of the coronavirus pandemic, we should be doing everything in our power to mitigate these symptoms and avoid making them worse.
What Is Oxidative Stress?
To understand oxidative stress, one must go back to high school chemistry and the image of the atom as described by Niels Bohr. It looks a bit like a miniature solar system. At the center is the nucleus, which contains the atom’s protons and neutrons. Orbiting around the nucleus one finds one or more rings of electrons—though it is more accurate to think of these as shells rather than rings.
Any electron that gets added to the atom will be absorbed into its most distant shell, provided that shell is not full. Once one shell is full or closed, any additional electrons will begin to fill out a more distant shell. When all shells are full or closed, an atom is considered stable. When an atom’s outermost shell can accommodate additional electrons, the shell is considered open and less stable. To become more stable, these atoms may bond with other atoms by using the other atom’s electron or electrons to close their outermost shell. This kind of bond is known as a covalent bond.
Unstable atoms without full shells are known as free radicals. One of the most common is oxygen that has been split (oxygen typically exists as a bound molecule of two oxygen atoms, O2). These single atoms of oxygen then bond to other atoms. Oxygen atoms are just one example; there are several other reactive molecules that contain oxygen, which are known as reactive oxygen species (ROS).
When ROS repeatedly bond with molecules found within the body, it can cause what is known as oxidative stress. Many have theorized that, over time, oxidative stress can break down cells within the body, and that the process of aging—from the development of wrinkles to irregularities in organ function—is due to oxidative stress.
However, it should be noted that this is still a theoretical model. A great deal of data to support the free radical theory of aging has been accumulated, but a great deal of data has been accumulated that contradicts it. It seems at the very least likely that oxidative stress contributes to aging and to cell damage, but that it is not the full story.
How Does the Body Defend Against Oxidative Stress?
Oxidative stress in the body is mitigated by antioxidants. Some antioxidants are produced in the body. Others come from compounds that we consume in our diet. Antioxidants effectively donate electrons to the free radicals, thereby neutralizing their potentially deleterious effects.
Unfortunately, there will always be free radicals in the body, and no diet, no matter how high it is in antioxidant-rich foods, will eliminate them. Your body will always endure some degree of oxidative stress. One can only mitigate the damage done by these molecules, which becomes more severe the greater the imbalance between antioxidants and free radicals like ROS.
Studies have been mixed about how effective diets that are high in antioxidants are in defending against oxidative stress. As mentioned above, the same is not true for the reverse. Studies have repeatedly found that a diet high in processed foods and low in whole foods leads to more oxidative stress in the body, including the brain.
The Vicious Loop: Oxidative Stress, Chronic Inflammation, and Anxiety
When the body experiences cell damage related to oxidative stress, it may trigger various types of inflammation. Inflammation occurs when the body’s immune system responds to injury and infection. Ordinarily, inflammation is not problematic, but when a part of the body faces chronic inflammation, this can lead to other issues, as the immune system’s response may injure otherwise healthy cells in the vicinity.
This brings us back to diet. Poor diet and obesity have been linked not only to increases in oxidative stress, but also increases in the occurrence of hypertension, insulin resistance, dyslipidemia, and chronic inflammation. Chronic inflammation has been detected by observing elevations in proinflammatory markers, including c-reactive protein (CRP), tumor necrosis factor-α, and interleukin-6. Increases in oxidative stress have also been linked to reduced levels of glyoxalase (GLO1), glutathione reductase (GSR1), and brain derived neurotrophic factor (BDNF), which have all been shown to possess both antioxidative and anxiolytic (anti-anxiety) properties. Finally, the activation of inflammatory pathways in the brain manifests in behavioral changes, one of which is an increase in the prevalence of anxiety symptoms.
Perhaps even more intriguing, increases in the stress hormone cortisol, which is released during periods of anxiety, seem to correlate not only with “stress eating,” but poor food choices. In other words, a diet consisting of a high percentage of saturated fats and processed sugars may lead to oxidative stress, which leads to neural inflammation in the amygdala and hippocampus, which leads to anxiety, which leads to increased levels of cortisol, which leads to the “stress eating” of more foods that are high in saturated fats and processed sugars.
More research is needed to confirm these findings, but it seems extremely likely that there is a strong correlation between a diet that lacking in antioxidant-rich foods and symptoms of anxiety. Given the current atmosphere of extreme apprehension due to the coronavirus, it is more important than ever to avoid coping with anxiety by attempting to comfort oneself with unhealthy foods. This may only exacerbate the anxiety instead of alleviating it. Rather, one should adopt a diet that is high in fruits, vegetables, nuts, and whole grains.
More than just mitigating some of these symptoms, this change in diet will improve overall health, too.
Dr. Ahmad reports no conflict of interest. He is not a speaker, advisor, or consultant and has no financial or commercial relationship with any biopharmaceutical entity whose product/device may have been mentioned in this article.