Food as Medicine: Meals for Mental Health

Ever eat your feelings? Or feel low after a few too many nutrition-poor meals? A newer area of practice called nutritional psychology looks at this intersection of nutrition and mental health. Read on for more on nutrition and mental health, nutrition strategies to optimize mental health, and practical tips to share with clients.

Why We Need to Address Mental Health Now

One in five U.S. adults experiences mental illness each year (NAMI 2004). Stress, anxiety and depression are the most widespread mental health concerns. The COVID-19 pandemic worsened rates of both depression and anxiety by 25% worldwide, affecting females and younger people more than others (COVID-19 Mental Disorders Collaborators 2021). Unfortunately, antidepressant medication only helps about a third of patients. For all these reasons, we need to find better ways to address mental health now.

The World Health Organization agrees, and has said “the promotion, protection and restoration of mental health can be regarded as a vital concern of individuals, communities and societies throughout the world” (WHO 2024).

The Nutrition-Mental Health Connection

It’s easy to think of the brain as an abstract place where thoughts and emotions live. That’s why it’s helpful to remind clients that the brain is a physical organ in need of nourishment. Imbalances at the point of chemical synapse—connections between neurons—lead to changes in emotions, moods, thoughts and behaviors.

All told, the brain is home to about 171 billion cells, including 86 billion neurons, and each and every one of those cells require a steady flow of oxygen, glucose, and other nutrients to function optimally. That’s why, though the brain is only 2% of body weight, it consumes up to 20% of daily calories and oxygen.

We know deficiencies in certain nutrients are associated with greater anxiety and depression. Conversely, other nutrients, foods, and traditional eating patterns are associated with better mental health.

The complex relationship between the food we eat and mental health intersects at the gut-brain axis. In fact, the gut is often called the second brain since it’s the largest collection of neurons outside the brain. The gut even produces 95% of our serotonin; a chemical messenger that boosts mood, inhibits pain, and regulates appetite and sleep.

Imbalances in the gut microbiome—for example, by eating a diet high in added sugar—leads to systemic inflammation, including neuroinflammation. This neuroinflammation alters the blood brain barrier, which lowers its defenses, making the brain more susceptible to dysfunction (Wieckowska-Gacek et al. 2021).

Nutrition Strategies to Optimize Mental Health

Simple nutrition strategies can put clients in a better position to support their mental health.

Stay Hydrated

About 75% of the brain is water, which is why even mild dehydration of 1 to 3% of body weight can negatively impact mood and anxiety. Hydrating choices are water, tea, and high-water fruits and vegetables, such as cucumbers, lettuce, grapes, citrus, and watermelon; the latter of which is 92% water (and as a bonus it also offers potassium!).

Fall in Love with Healthy Fats

The other 25% of the brain is ‘brain matter’, most of which is fat. The brain is picky and prefers omega-3 fatty acids, which are a mood stabilizer with anti-inflammatory qualities. Research shows that consumption of omega-3s may help reduce risk of, and help improve existing, depression (Sanchez-Villegas et al. 2018).

EPA, DHA, and ALA are the abbreviated names for the most important omega-3 fatty acids. Recommended intakes are below.

ALA: Alpha-Linolenic Acid	1.1 g/day for women 1.6g/day for men
EPA: Eicosapentaenoic Acid DHA: Docosahexaenic Acid	0.25 – 0.5 g/day combined EPA + DHA for adults

An observational study of 6,587 adults found that consuming 0.5 to 1 g of omega-3 fats (EPA + DHA) from seafood lowered the odds of depression (Sanchez-Villegas et al. 2018). Smart seafood choices include trout, sardines, and arctic char. Clients will want to aim for one-to-two seafood meals per week.

Omega-3 ALA is a plant-based omega-3, which is helpful to know since some clients may be looking for plant-based sources. A clinical trial found that ALA reduced stress and improved mood in young adults, as evidenced by lower levels of stress-hormone cortisol and better mood ratings (Yehuda Rabinovitz & Mostofsky 2005). Among adults 18-80, eating about an ounce of walnuts a day, which provides an excellent source of omega-3 ALA, was associated with fewer symptoms of depression (Arab Guo & Elashoff 2019).

In contrast to omega-3s—which are a type of polyunsaturated fat—saturated fat is pro-inflammatory, which can damage the blood-brain barrier when consumed in excess.

You Need Carbs

Carbs break down into glucose, the brain’s preferred fuel source. Stress diverts glucose to muscles, which can put the brain in an energy crisis and compromise the hippocampus’ ability to create new memories (Osborne Pearson-Leary & McNay 2015). This may be why short-term memory is a common casualty of chronic stress. Carbs are found in many wholesome foods such as beans, whole grains, fruits, vegetables, and dairy foods.

In contrast to natural sugars found in wholesome foods, too much added sugar diminishes the nutritional value of foods and negatively impacts how the body regulates insulin, promotes inflammation and oxidative stress, and feeds harmful bacteria in the gut. Research shows that a high-in-refined-sugar diet may worsen depression (Zhang et al. 2024).

It’s important to help clients understand that not all carbs are created equal. Help them see the value of wholesome foods that contain carbohydrates vs foods high in added sugars.

Eat Your Vitamins & Minerals

In foods, nutrients work in concert with each other and are generally present in safe amounts. Data is sometimes mixed on supplements, and too much of a single nutrient can be harmful. If a client needs to fill gaps, a humble multivitamin may be reasonable. Otherwise, encourage clients to eat their nutrition; there’s no substitute for a balanced diet.

B vitamins, often together in foods, are involved in neurotransmitter production, and deficiencies are associated with depression. Food sources include leafy greens, yogurt, chicken, asparagus, brussels sprouts, shellfish, eggs, tofu and fortified foods.

Choline is a precursor to the neurotransmitter acetylcholine that is involved in memory and mood. Food sources of choline include eggs, soybeans, poultry, pork, fish, kidney beans and quinoa.

Vitamin D is involved in the production of the feel-good neurotransmitter serotonin. Food sources include UV-treated mushrooms, sardines, egg yolks, salmon, and fortified plant and animal milks.

The antioxidant lutein significantly reduced psychological stress and the stress marker cortisol, and improved emotional health, according to a randomized controlled study (Stringham Holmes & Stringham 2018). Lutein is found in eggs, collard greens, kale, bok choy, and carrots.

Low levels of zinc are associated with depressive symptoms. Zinc is in chickpeas, mushrooms, oysters, and whole grains. Low potassium intake can lead to anxiety, worry, and restlessness. Find it in fruits and vegetables such as avocado, tomatoes, and potatoes. Low iron is associated with anxiety and depression. Foods rich in iron include meat, poultry, seafood, beans, dark green leafy vegetables, fortified breads and cereals.

Magnesium and calcium work together to ensure that N-methyl-D-aspartate (NMDA) receptors function normally. NMDA receptors are concentrated at the synapses where information jumps from one neuron to the next. Dysfunction here causes mood disorders, lack of motivation, emotional distress and cognitive deficits. These two minerals are often in fortified plant milks, spinach and dark green leafy vegetables.

A meta-analysis found that high intake of the antioxidant mineral selenium helps reduce symptoms of depression in general and may be protective against postpartum depression specifically (Sajjadi et al. 2022). Food sources include seafood, beans, lentils, dates, and whole grains.
Favor Flavonoids
Flavonoids are compounds that improve blood flow to the brain and keep mood-boosting neurotransmitters in circulation for longer. Increased blood flow to the prefrontal cortex, aka the emotional regulation center, may strengthen neural circuitry and inhibit rumination, which is associated with depression.

A well-known flavonoid is anthocyanin. A study found that wild blueberries—an especially potent source of anthocyanins—improved same-day mood in children and young adults after just one morning drink that contained the equivalent of a cup and a half of wild blueberries (Khalid et al. 2017).

Anthocyanins protect mood-regulating monoamine neurotransmitters like serotonin, dopamine and noradrenaline, by inhibiting monoamine oxidase (MAO); an enzyme that breaks down monoamines. Additional food sources include prunes, elderberry and black beans.
Psychological Safety & Nostalgia
Clients should not be discouraged from enjoying their heritage foods. Research suggests heritage foods helped immigrants in Western cultures with their mental health, perhaps due to psychological safety, according to a review that incorporated culture and economics (Elshahat et al. 2023). The study by Elshahat and colleagues (2023) found that hunger and food insecurity led to more anxiety and depression among immigrants. Better mental health was related to eating fruits, vegetables, unsaturated fats, vitamin D-rich foods and whole grains.

In another study, when people felt nostalgic, they ate more healthful foods, decreased intake of less healthy foods, and had better attitudes about healthy eating (Lasaleta Werle & Yamim 2021). Researchers concluded that nostalgia helped people feel more socially supported, leading to feelings of security and empowerment to make better choices.

Meals for Mental Health

The following are a few specific examples of meals for mental health from around the world.

Meal	Origin	Description
Chicken Soup	Various	Chicken and vegetable soup (Pennsylvania Dutch), soupa avgolemono (Greek), Ajiaco (Colombian), caldo de pollo (Mexico), and samgyetang (Korean)
Ceviche	Peru	Peru is famous for its ceviche, but variations are popular in many other countries.
Bibimbap	Korean	This is a Korean one-bowl mixed rice and vegetable dish, with optional smaller amounts of meat or seafood. Blanched and seasoned spinach, carrots, mushrooms, sprouts and stems are common components.
Thali	India	This is a Korean one-bowl mixed rice and vegetable dish, with optional smaller amounts of meat or seafood. Blanched and seasoned spinach, carrots, mushrooms, sprouts and stems are common components.
Meze	Various	A meze plate could be a snack, course, or full meal. It may include vegetable and bean-based spreads like muhammara or hummus, fruits, vegetables, fish, eggs, and pickles. It’s enjoyed in Armenia, Egypt, Greece, Iran, Palestine and more.

Practical Nutrition Tips to Share with Clients

Below are dietitian-approved tips you can feel confident in sharing with clients to help them eat more meals for mental health.

General

• SAD leads to SAD. That is, the Standard American Diet is associated with Stress, Anxiety, and Depression.
• Your cultural foods are healthy.
• No single food is the answer. It’s a variety of foods, eaten in a pattern, over time, that helps or hurts.

Save Time

• Canned beans are always ready.
• Frozen fruits and veggies are always in season.
• 10-minute whole grains are a weeknight game changer.

Eat your hydration

• If it’s crisp, there’s water inside. Go for cucumbers, bell peppers and celery.
• If it’s juicy, there’s water inside. Enjoy citrus, zucchini and tomatoes.

Meal Prep

• Batch-cook whole grains and beans to use all week—they also freeze well.
• Pack smoothie ingredients, except the liquid, into freezer-safe containers to enjoy any time.
• Prep make-ahead frittatas, hard-boiled eggs or breakfast sandwiches.

Basic, but good

• Pack healthy snacks so you’re never without.
• Eat colorful fruits and veggies daily to benefit from a range of antioxidants.
• Drink water in the morning to make up for overnight fluid losses.

Bottom line

Nutrition is a low-risk line of therapy to support mental health. Nutrition alone is not enough to solve the problem, but it may be an essential part of the answer. Fitness professionals should feel confident to pass along dietitian-approved nutrition tips to support client success.

See also: Nutritional Deficiency and Depression