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The Role of Nutrition in Anxiety

Anxiety disorders include generalised anxiety disorder (GAD), phobias, post-traumatic stress disorder, adult separation anxiety disorder, panic disorder, and obsessive-compulsive disorder. GAD is defined as anxiety about many different things, occurring on most days for six months or more . Panic disorder is described as sudden events of anxiety or fear happening without any rational cause. A panic attack can last around five to ten minutes as individual panic attacks but can occur in ‘waves’ for periods of up to two hours.

Anxiety disorders usually occur as a result of interaction among many factors, such as: family background, genetics, stress, personal beliefs and personal image, the ability to express feelings. People who suffer from anxiety disorders may have been exposed to trauma, continued stress, specific triggering situation or events. Otherwise, anxiety may have started suddenly, seemingly without specific reasons. If anxiety is not treated, it could become chronic causing prolonged suffering.

In the last hundred years, we experienced increase in technological advancement, material wealth and social growth, levels of comfort and convenience. However, the benefits are not shared equally among cultural and ethnic groups, where lower socio-economic groups and ethnic minorities are still deprived. There is a contrast between social and material progress and declining of mental health in all developed countries of the world.

It is expected that social and economic progress improve mental health and wellbeing. However, modern ways of living, job demands, lack of employment, reduced interaction with family and friends, isolation, increased divorced rate, rise in domestic and sexual violence, all increased stress and mental health issues. Other factors that influence the rise in anxiety and other mental disorders are; loneliness, increased unrealistic expectations about life, sedentary lifestyle, and lack of exercise that causes disconnection from the nature.

Nutritional aspects related to anxiety

Technological advancement in the last one hundred years that was driven by increased population, change of lifestyle, requirement for cheaper and more convenient food, brought so many changes in food production resulting in variety of processed foods. The food that we are consuming now is different in quality and quantity from foods consumed by our ancestors. It is lacking in fresh, nutritious, locally produced fruit, vegetables, legumes and grains, and dominated with processed foods high in additives, sugar, sodium and trans fats. This is the result of decades of trying to manufacture convenient, packaged, ready to eat foods for busy people in western countries.

Food that the poultry and cattle are fed has changed over time. They are not feeding on seeds, plants, grass, and insects but commercially grown and modified cereals which reduce omega 3 fatty acids and increase omega 6 fatty acids in the animal meat. Chicken carcass in the past contained 2% of fat, now contains 22%. Farm animal’s carcass contain 30% fat, while wide animals contain only 5% of fat. When fish farming was developed in 1960, essential fatty acids ratio in fish meat changed because of diet that farmed fish was fed.

In the brain, neurotransmitters as messengers have a vital role for communication between neurons. Four neurotransmitters that play crucial role for the thoughts and general mood are: acetylcholine, serotonin, dopamine/adrenaline/noradrenaline and 4-aminobutyrate (GABA). Imbalance in the levels of those neurotransmitters in the brain may cause anxiety, impair sleep and cognitive function. The connection between anxiety and deficiencies in macronutrient (especially protein), minerals and vitamins are attributed to minerals and vitamin's role in the brain’s conversion of amino acids.

A deficiency in particular amino acids will cause low mood and motivation, and inability to relax. For example, the amino acid tryptophan is precursor to serotonin. Inadequate intake of tryptophan dietary sources like red meat, eggs, fish, poultry, beans, and dairy products will lead to low levels of neurotransmitter serotonin. Other important amino acids that are found in same foods stated above is phenylalanine precursor for neurotransmitters adrenaline and dopamine, that help with motivation. Amino acid tyrosine converts to dopamine, noradrenaline and adrenaline, which is known to improve mental and physical performance under stress and effectively mitigate anxiety symptoms.

Low intake of complex carbohydrates, folate, zinc, selenium, iodine, omega 3 fatty acids vitamins B1, B2 and C are also linked to high prevalence of anxiety and depression (National Health and Medical Research Council [NHMRC], 2006). The fats that we consume influence directly the structure of the brain cells because the brain is consisting of approximately 60% of fat. Increased consumption of trans fats is damaging to the brain cells as trans fats steels positions of essential fatty acids (EFAs), blocking the brain’s conversion of EFAs into docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). A New Zealand study showed that fish consumption was associated with improved mental health status, supporting the belief that omega 3 poly-unsaturated fatty acids help with the mood balance. Various studies, parents and teachers proposed that the changes in nutrition over the last twenty years possible influenced the increase of mental health problems in childhood and adolescence over that period.

Societal influences on food and nutrients

Evidence demonstrates the connection between risk of mental health illnesses and economic, social and psychological disadvantage. Usually, people with mental health problems are those who also eat less nourishing foods like fresh fruits and vegetables and more processed foods, high in trans fats and sugars (chips, cakes, packaged foods). Vegetables and fruit are important for its high content of antioxidants, vitamins A, E and C, which may act as antioxidants stabilising free radicals from the body cells including the neurons.

Social isolation is related to low wellbeing and prevalence of anxiety and depression. Anxiety and depression are not common in early age but occurrence increases in adolescents, and by end of adolescent stage equals to the percentage occurring in adults. Different factors cause anxiety and depression in adolescence including; low confidence, family dysfunction, and family history of mental illness.

Psychosocial changes include the development of body image and an increased awareness of sexuality. Those important life stage changes can cause lots of uncertainties and anxieties, triggering the development of poor body image and eating disorders. High prevalence of anxieties and depression in adolescents could be explained by major psychological, biological and social transitions (new school, new peer group and other interpersonal changes) that occur in this stage of life. Stressors or life events that usually trigger adjustment disorders range from redundancy, re-entry culture shock (e.g. returning to the home country after a long period of absence, immigrating to the new country), or life-cycle changes (e. g. starting new school, leaving home, marriage).

Peer influence is very powerful during early adolescence as kids try to fit into social norms established by their peer group. The nutritional intake and food choices are usually dictated by peer group. Early adolescence enjoys the newly found independence and freedom of eating on the go and when convenient for them. Increased social and sports activities reduce their time spent at home and with family and they start skipping meals, eating out, and consuming more take away foods.

Teenagers tend to select food preferences and choices based on peer influence: convenient, ‘cool’ food, highly processed and full of sugar and trans fats. Increased social independence in adolescence negatively influence food choices and nutrient intake which may cause increase of frequency of anxiety and other mental health conditions. As a result they will become deficient in many micronutrients and macronutrients including fibre and essential fatty acids, which are vital for prevention of hormonal imbalances that leads to psychological disorders like anxieties and depression. Teenagers are usually not able to link how their current health choices and behaviour can affect their health in the future.

Having family meals teaches adolescents healthy eating behaviour and reduce the risk for chronic diseases (St-Onge & Keller, 2014). Adolescence that eat often with their families eat more fruit, vegetables and grains and have lower consumption of processed foods and soft drinks than teens who do not have regular meals with family.

Processed foods are high in damaging trans, hydrogenated fat that has no nutritional benefit. Processed foods contain many additional substances added to improve tastes or prevent decay of foods (salt, alcohol, spices and vinegar). In the last 100 year there have been increase in manufacturing and use of chemical additives to food with 2,500 varieties of chemicals being used in food production. Additives can distract normal body chemistry causing physical and mental disorders, like behavioural changes, hyperactivity, anxiety and depression.

For children below 18 years old is suggested that 30% of total energy originates from fat, where with saturated fat is below 10%. There is an association between the dietary intakes of poly saturated fatty acids (PUFAs) and clinically diagnosed anxiety disorders, where anxiety reduced by 50% with highest increase of PUFA. Recommended source of PUFAs, especially omega 3 fatty acids are; fish, nuts, and seeds.

Magnesium deficiencies may be implicated in depression and anxiety as magnesium regulates neuronal nitic oxide levels. The highest demand for iron is during teenage years because of growth requirements for the increase in blood volume and lean body mass and start of menarche in girls. Zinc is also critical mineral for physical growth, bone formation, and sexual maturation. Fish, red meat and pumpkin seeds are good sources of iron and zinc.

Evidence demonstrates that B vitamins have a protective action against anxiety and depression as they lower homocysteine levels and support brain function. Yeast based spreads like marmite, vegemite improves anxiety and stress symptoms because they are high in B vitamins.

Teenagers love snacking and consume snacks food, high in sugar, fats and low in minerals and vitamins. However, if fruits, nuts, and vegetables are encouraged for snacks, intake of dietary fibre, vitamins and minerals will increase. 25% of vitamin E and C, 23% of magnesium and 20% of daily calcium requirements can be achieved through snaking. Therefore, it would be beneficial having available snacks that includes fruits, vegetables, nuts, and seeds.

The food that we consume has direct effects on our thoughts and feelings. Deficiencies in protein, complex carbohydrates, essential fatty acids, vitamins, and minerals is linked to the development of anxiety disorders. To reduce anxiety symptoms increased intake of fish, olive oil, fruit and vegetables, and increase activity level, social connections, and time spend in the nature are recommended.

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