by A growing body of evidence links the consumption of unhealthy and ultra-processed foods to an increase in mental health conditions such as depression and anxiety. A 2022 study found that the more ultra-processed foods a participant ate, the more likely they were to report anxiety and depression. Other studies have linked poor diet to conditions such as ADHD and dementia.
This research has sparked a broader conversation about the impact of nutrition on mental health and the risks of eating ultra-processed foods, which make up 57% of the diets of US adults and 67% of the diets of children and teenagers.
The relationship between nutrition and mental health is complex and multifaceted. It is important to look at this relationship in context with other behaviors that can promote mental health, and to also be aware of how access to nutritious foods is driven by socio-economic factors.
Mental health clinicians have an important role to play in contextualizing this discussion, educating patients, and collaborating with primary care physicians to better promote both mental and physical health.
Reframing the Relationship between Nutrition and Mental Health
There is undoubtedly a correlation between diet and mental health. But, there is a strong correlation between diet and larger socio-economic factors that limit people’s access to unprocessed foods. More than 54 million Americans live in low-income areas and have limited access to healthy foods; disparities in access to certain foods continue to be driven by race, income and geography. For example, research has found that predominantly Black neighborhoods have more limited access to grocery stores, making certain food products more difficult and expensive to obtain.
It is important to recognize these imbalances and avoid blaming in conversations about nutrition. Instead, mental health clinicians can reframe nutrition as one important part of an overall healthy lifestyle that can positively impact mental health, along with other critical factors such as social connection, good sleep hygiene, and moderate exercise.
Another complicating factor is that mental health can affect a patient’s diet in different ways. For example, some depressed patients may not have the energy to cook a meal from scratch, while others may use food as a way to cope with feelings of anxiety or depression. Disordered eating can also be a symptom of mental health conditions.
Ultimately, clinicians need to be aware of these factors and how they may influence the relationship between nutrition and mental health. Only then can we tackle the root cause of these conditions.
How to Talk Nutrition to Patients
There is a whole spectrum of eating habits that can affect a patient’s mental health and vice versa, from extremes of overeating to restrictive eating. For this reason, it is important that clinicians have honest and ongoing conversations about nutrition with patients.
This can be a very sensitive topic to discuss, especially since it involves behaviors like binge eating or restrictive eating — but it’s an important conversation. In my experience, patients often won’t bring up the topic of eating habits without encouragement. Clinicians should intentionally ask open-ended questions to better understand how this behavior intersects with mental health. For example, ask patients about nutrition and eating habits, as well as sleep, exercise, and substance use as part of an initial evaluation. From there, check in on these habits continuously.
Clinicians can also play a role in educating patients about nutrition and good eating habits while keeping sensitivities in mind. Going back to the basics — like the food pyramid, eating and drinking in moderation, and buying seasonal fruits and vegetables — can go a long way. The most important thing is to start a conversation. Patients may not realize, for example, that their late night snacking habit may be affecting their overall mental health. By educating them about this connection, clinicians can help patients find more ways to take control of their overall well-being.
Collaboration with Primary Care Physicians
Nutrition is a good example of the need for an integrated approach to patient care. Collaboration between mental health clinicians and primary care physicians (PCPs) can help ensure a holistic treatment approach and a unified message to patients regarding the relationship between nutrition and health.
One way to achieve this is to make mental health an extension of primary care. For example, PCPs can check in on factors like nutrition, sleep, and exercise as part of annual wellness visits, and connect the dots between behavior changes and the corresponding mental health consequences. Ideally, each primary care practice would have at least a part-time mental health clinician available as a member of the treatment team or willing to make referrals to facilitate rapid treatment when needed.
Both mental health clinicians and PCPs can discuss with patients how nutrition affects overall health, and demonstrate situations where a patient may need more focused care, including disordered eating. This integrated approach can ensure that no one falls through the cracks and that patients are quickly connected to the care they need.
A Holistic Approach to Patient Care
Amidst a broader discourse on the impact of nutrition on mental health, clinicians can help balance these conversations with context at both the industry and individual patient levels to de-stigmatize patients. While it’s tempting to point to one factor like ultra-processed foods as the cause of anxiety or depression, it’s not accurate or useful to do so. Rather, nutrition should be framed as one of many factors that can influence mental health.
By accounting for socioeconomic factors that influence nutrition, talking openly with patients about their eating behaviors, and collaborating with primary care physicians, mental health clinicians can take an informed, holistic approach to patient care.
Anisha Patel-Dunn, DO, is a practicing psychiatrist and Chief Medical Officer at LifeStance Health, a mental health care company that provides evidence-based outpatient treatment services.
