All blog posts from Dr. Allott are provided for educational and informational purposes only. As Dr. Allott is also a licensed medical practitioner, we must make it clear that nothing on the blog is intended to constitute medical advice, consultation, recommendation, diagnosis, or treatment. If you are concerned about your health, please seek appropriate care in your area.


What diet types contribute to depression and anxiety?

I am reluctant to write this post. I’m sure I’m going to make a few people mad. In last month’s Connectors Meeting there were questions about how different diet types contribute to mental health concerns. When a person's diet choice restricts food categories, they can find over time that their diet is contributing to increased anxiety and depression. This is because a diet that limits food groups can lead to nutrient deficiencies if health metrics are not carefully monitored through diagnostic labs.

In this post I’ll review some things to watch out for when eating significant amounts of highly processed foods, following vegetarian or vegan diets, and keto/paleo/Atikins types of diets.

Highly Processed Food Diets

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Diets high in processed foods have been shown to increase depression and anxiety. These are diets with lots of white foods (bread, rice, potatoes, pasta, muffins, bagels, chips, sweets, fast food). With this diet, when I look at an individual's labs what I typically see are deficiencies in nutrients that help to synthesize dopamine and serotonin. Common deficiencies are protein, B vitamins, magnesium, zinc, omega 3, Vitamin D3, and fiber. Additionally, there is increased inflammation as indicated by elevated C-reactive protein (CRP) levels. Inflammation contributes to depression, fatigue, bipolar, cardiovascular disease, dementia, and diabetes, to name a few concerns. Dr. Felice Jacka provides a whole body of research about the impact of diet on mental health. Here is her seminal paper: Association of Western and traditional diets with depression and anxiety in women.

Vegetarian/Vegan

When I see vegetarians and vegans in my office, they tend to be very anxious individuals and the anxiety often leads to depression. I’m not saying that all vegetarians and vegans struggle with anxiety and depression. Rather, that individuals who are anxious and depressed and vegetarian tend to have higher levels of anxiety and depression due to nutrient deficiencies. Their anxiety is often caused by fluctuations in blood sugar levels because of the low carbohydrate to protein ratio in many of the foods they typically consume.

For example, let’s consider a bean burger. Beans have some protein and some carbohydrates. The bread is all carbohydrates. So this bean burgers contain a lot of carbs and not a lot of protein

Clinically, I have seen anxiety decrease significantly when we assure that they are getting enough protein throughout the day (8 grams per 20 pounds of body weight or at least 65 grams divided throughout the day for anyone over 140 lbs.)

There is a large body of research that suggests vegetarians have better physical health then omnivores. Vegetarians tend to have lower body mass index and cardiovascular disease. However, an Australian study with 9113 participants indicated that vegetarians and vegans have more anxiety and depression then omnivores.

Here are two more studies that may be of interest:

For vegetarians, the labs that I carefully look at are total protein, Omega 3, ferritin (iron stores), B vitamins, and Vitamin D3. In my client base, vegetarians and vegans tend to carry less muscle mass and more fat mass.

For vegans, I will also look to see what their primary sources of fats are. The addition of coconut milk and oil can help with fatigue caused by a lack of cholesterol in their diet; consuming enough cholesterol is important because it helps synthesize hormones.

Keto/Paleo/Atkins

I am going to make a “no duh” statement… But it’s one we often forget: Weight does not determine health.

High-fat mass can impact health, but it’s not everything. I’m far more concerned about an individual's ability to be self-compassionate, eat primarily health-sustaining foods, engage in some level of regular movement or exercise, sleep well, and have healthy labs.

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I have seen a number of individuals who started on a keto diet (low carbohydrate with high protein and high fat) to lose weight. However, after the initiation phase of just meat and fat, they did not add fruits or veggies back into their diets for years. They explain that primary reason for staying with this phase is because adding back fruits and veggies caused them to gain back the weight they had lost. This is true, because when we do quick weight loss programs it’s hard to not do quick weight gain as well. However, there are some serious health consequences not eating fruits and vegetables.

One of the consequences is that they became very low in B vitamins and Vitamin K. For women following this type of dietary restrictions, they started having heavy menses because their blood was not clotting well. This then also led to iron deficiency, which contributed to their story of depression/fatigue.

Check out these articles:

In conclusion

Diets that support physical health do not always support mental health. Diets that are low in nutrient dense foods can contribute to mental health concerns through presentation of depression/fatigue and hypoglycemia/anxiety. When someone is considering medications or has tried medicines without the expected positive impact, it’s worth suggesting that they ask their primary care providers for a laboratory workup for fatigue. Going to a naturopathic physician, nutritionist, or acupuncturist to have their diet evaluated for deficiencies that could be contributing to their mental health status is also a good option.

Here are some additional resources:

What's impacting your anxiety?

In July's Connectors Group we reviewed the Snapshot of Anxiety Assessment handout introduced in June's webinar, , hearing stories of how Connectors have used this tool and answering questions. 

We then discussed my new handout, What Impacts Anxiety (WIA),  a worksheet that captures information about anxiety in a format that helps us see the daily pattern of how the symptoms of anxiety show up in our lives.

The focus of this handout is on learning how meeting the needs of your body, which is the power supply for your brain, impacts energy, anxiety and mental clarity. Since food, sleep, exercise, and our environment impact your body’s ability to create a stable platform for your brain and mind to work, they can be significant drivers to improve fatigue and anxiety.

Further, WIA can be used with other interventions to track improvement of the symptoms of anxiety, such as the introduction of medications, mindfulness, exposure therapy, and observing anxiety levels in different environments or around different people.

The WIA Handout can help you with the people you connect with understand their anxiety better, may they be clients, family members, teenagers and most importantly out selves. 

Connectors Group Discussion: What Impacts Anxiety July 2017

  • Introduction: 0-0:21 minutes
  • Review of the Snapshot of Anxiety Assessment and Q&A: 0:21-20:28 minutes
  • Introduction of the new tool, What Impacts Anxiety: 20:28-34:17 minutes

This webinar is also available as a Podcast.

If you find this blog helpful, please tap on "Like", post comments or consider sharing it. Thank you. 

Snapshot of Anxiety Assessment

In June, the Connectors Group discussed one of the assessments I developed for the book I am writing on Addressing the Physical Causes of Anxiety. The handout Snapshot of Anxiety Assessment reviews how to distinguish anxiety from functional hypoglycemia.

As I discuss different chapters from my book with Connectors, I am very interested in getting your feedback. As you watch the 22 minute excerpt from June's Connectors Group webinar, please let me know what you think, reply to the following questions in the comments section below, or email me.

  • How is the Snapshot of Anxiety Assessment helpful?
  • What new perspective will this Assessment offer your clients?
  • What type of client would this help? Are there clients you would not use this with?
  • What are the obstacles to integrating this into your practice?
  • How likely are you to use and share the Snapshot of Anxiety Assessment?

Dr. Kristen Allott, June 9, 2017 (22.30 minutes)

  1. Introduction: 0-1.11 minutes
  2. Part 1: GAD-7: 1.11-3.19 minutes
  3. Part 2: Mind – Brain – Body Symptoms: 3.19-6.30 minutes
  4. Part 3: Global Symptoms: 6.30-13.00 minutes
  5. Part 4: Functional Hypoglycemia Score or the “It’s not in your head – it’s in your body” Score: 13.00-17.37 minutes
  6. Identify what’s most important to you about reducing anxiety: 17.37-22.28 minutes

This webinar is also available as a Podcast.

If you find this blog helpful, please tap on "Like", share your comments or consider sharing it. Thank you. 

Addressing the Physical Causes of Anxiety

In February-March of this year I held a live online 3-part training Addressing the Physical Causes of Anxiety. We work with our anxiety and other people’s anxiety all the time. Anxiety can create challenges at work or within our family. We know what questions to ask about what makes us emotionally anxious; but what if part of the cause of our anxiety or the anxiety of the people around us is physical?

The recorded webinars and handouts from the three sessions is now available:

  1. Naming and Taming Anxiety
  2. Eating to Reduce Anxiety
  3. What to Ask Your Doctor

Everyone who purchases this program will receive updated materials and will be able to interact with me about this content, by email, through 2017.

Based on the key educational points that I review with my individual clients, this content represents a value over $700. Your cost for the full online training package: $150

Dealing with Fatigue or Depression

In the United States, 33.7 million people live with some type of mental health issue. Studies show that prolonged fatigue is linked with anxiety and depression and all too often we assume that these symptoms emotionally driven without taking the time to rule out potential physical triggers, such as hypoglycemia, anemia or even possible drug interactions.

In part, this is because differentiating fatigue from anxiety and depression is hard to do and those suffering often don’t know what questions to ask.

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I always recommend that people begin by describing their symptoms to their primary healthcare providers as fatigue rather than anxiety or depression.  The medical questions around fatigue can be answered with a number of blood tests. Be sure to ask for the following labs:

  • CBC rules out overt anemia.
  • Comprehensive metabolic panel rules out liver and kidney problems and identifies issues with glucose regulation (prediabetes and diabetes directly affect brain function).
  • CRP is a metabolic marker implicated in cardiovascular disease, diabetes, obesity, and depression.
  • Ferritin levels below 50 correlate with increased fatigue, especially in women.
  • Hemoglobin A-1 C is a marker for diabetes. Studies have shown that diabetes predicts depression and depression predicts diabetes. A1C should be below 5.7 to be considered normal.
  • Homocysteine levels (a Vitamin B marker) greater than 12 indicate a 70% increase in risk of depression.
  • Lipid panel is important in diagnosing cardiovascular disease. Additionally, when total cholesterol is below 120, suicidal ideation increases.
  • TSH rules out hypothyroidism or hyperthyroidism.

While there is a cost for running these labs, the cost of treating fatigue strictly as an emotional symptom is even higher. A recent article in Money magazine states that the treatment costs for mental disorders is more expensive than treatment of diabetes or hypertension– and that the cost falls mostly to the patients. Insurance companies put up road blocks for receiving mental health treatment, finding in-network care can be challenging and, if you do, the cost of prescribed medications is high. Very often, mental healthcare is a budget buster. Particularly if the primary care provider, prescriber, or therapist have not addressed the true problem – Fatigue. Nutritional studies are showing that poor nutrition and dysfunctional physiology cause 50% of the symptoms of fatigue.

I've created a sample letter requesting the above blood work from your primary care physician that you can use to help start this discussion.

In addition to asking your healthcare provider for the lab work, I have seen the following self-care steps help in relieving fatigue:

  1. Walk outside everyday – move your body for at least 10 minutes.
  2. Be in bed for 8 hours a night – even if you’re not sleeping, the rest is helpful.
  3. Eat protein with every meal.

If these steps feel hard, ask yourself what you can do to make it happen. Don’t think of it as a lifestyle change, but consider it an experiment. Start with one of the above steps and commit to doing it for at least 3 days to see if it helps.

If there was one solution for fatigue, everyone would be doing it. Ask your provider to rule out the most common causes of fatigue/depression. It may not be all in your head ─ it may be that your body needs help.

References:

Home Treatments for Colds and Flus

In the January Connectors Group we discussed how to prevent colds and flus and how to feel better quicker if you do get sick.

Winter is the season of stuffy noses, aching muscles, coughs and headaches. Common daily interactions, no matter how careful we are, lead to sharing viruses and bacteria. These invaders slow us down and can even wipe us out.  After the Connectors Group, Natasha and I recorded a podcast on the same topic. The game changers for me when I am treating my own colds are hot baths and rest. 

This accompanying free 4-page handout for you covers:

  • 6 simple steps to feeling better quicker,
  • 5 steps for prevention,
  • A worksheet for a Plan to Get Better Faster, and
  • Guidelines for when to see a Doctor and how to get the most out of that visit.

Remember to share it with the people in your life to help them feel better. 

In the the podcast,  I recommend some supplements (in addition to rest and hot baths) that help in preventing colds and flus:

  • Carlson's 2000 IU of Vitamin D3 daily for adults and 400IU/day for children 6 years old or up to 140 pounds of weight. Vitamin D boosts the immune system and helps prevent autoimmune diseases
  • Emergen-C is a great way to get 1000 mg of Vitamin C as a drink mix or chewables
  • Airborne, or similar products, can also help boost the immune system and prevent a cold