How nutrition can help manage stress and anxiety

Stephanie is an experienced Clinical Nutritionist as well as a member of SATCC Advisory Board. Discussing how we can use nutrition to help manage stress and anxiety, here she talks about the correlation and gives invaluable advice, with information that’s suitable for anyone, including those at all stages of their cancer journey.

Any cancer diagnosis is a stressful situation, but one of the key aspects of being well across the board is to have a healthy gut microbiome. This is because it affects our levels of nutrition, our immune responses, our stress response, our inflammatory markers and more – all of which are critical to how well we feel and how well we heal.

In our bodies we have this huge organism made up of an estimated 39 trillion microbial cells, all communicating with one another. However, when we’re stressed and anxious those microbial cells can’t work properly, which impacts inflammation, immune response and so forth.

As creatures we’re only designed to be in a state of stress and anxiety for short periods of time, which is critical when we look at our evolution compared to modern life. It’s not to denigrate modern life, but it means we need to be aware so we can manage better.

It’s estimated that the body is designed to be stressed for about 10% of our lives as a means for protecting us from danger. It brings a state of awareness – a warning that something isn’t well and we need to do something about it, thereby activating a stress reaction so we do something about it. This manifests in either a fight, flight or freeze response, all of which are powerful hormonal responses to a perceived threat. In that moment the body isn’t worried about mending, healing and recovery – it’s about life or death. It’s an acute stress and anxiety response, which is good and necessary.

The modern world throws so many challenges at us; some are obvious and some are subtle, from sleep that’s disturbed by light pollution to environmental toxins, things in our food that shouldn’t be there and so forth. They’re all little stabs of stress all the time that keep us in a state of stress for longer than our bodies are designed for. That stops the opposite response which we should be in most of time, which is rest, relax and digest – when the immune system is more functional and the body mends.

The three Fs

However, we can manage those processes better by looking after our gut microbes, which help us to manage stress and be more resilient. Helpfully, there are simple things we can all do to help improve our gut microbiome, which I categorise as the three Fs. These are things that we should be doing regularly, where possible, to support our wellbeing whatever we’re currently experiencing.

Fibre

The first F is for fibre. This is because fibre, found in plant foods, is the main fuel for gut microbes, all living in our lower digestive tract. They feed on and ferment fibre to thrive. Lots of people under eat fibre and are therefore not optimising gut microbes or are even losing them.

Broadly speaking fibre is found in fruit, vegetables, nuts, seeds, beans and legumes like lentils. It’s very clear from science that diversity is key, so it’s not about having a plate of broccoli everyday, but some broccoli, some spinach, carrots, peppers – lots of different colours, textures, etc.

By doing that you get lots of different structures of fibre and that’s why we hear experts talk about having 30 different plant based foods a week. I encourage people to have 10 to15 different ingredients on their plate at each meal, so that includes the olive oil you cook in or the spices that you add because all these things mean we’re constantly drip feeding our gut microbes with super fuel so they can work at their best.

Fermented food

The second F is for fermented food, because as a result of the impact of modern life we also want to top up our microbes.

Fermented foods are an ancient concept because it’s how we used to preserve food before refrigeration so that it lasted throughout the winter. However, the process of fermenting also means that foods contain lots of great microbes, which add to and also stimulate our gut microbes. It means we store foods as live, functional ingredients. For example, cabbage becomes sauerkraut when it’s fermented.

As with fibre, the goal is to have lots of variety of fermented foods. There are vegetable ferments such as sauerkraut and kimchi, and variations range from beetroot to onion and plenty of others. You only need a tablespoon a day and will get millions of microbes. There are lots available in good supermarkets but it’s also easy and cheap to make your own.

There are also dairy ferments, which range from basic live yoghurt (unflavoured), which usually has about four strains of microbes. Then there’s kefir, which is much more complex and can be very useful. Good, mature cheeses like a mature cheddar and brie can also be good sources – you can get microbes from very ordinary foods.

Another popular group are fermented drinks, such as kombucha and water kefir. Soy ferments are also an option, such as good soy sauce and nattō, which are very distinctive and are eaten a lot in Japan. Tofu can be fermented, and apple cider vinegar is great added to dressing or as a digestive tonic.

Incorporating a combination of these is extremely nourishing.

Fasting

The third F is for fasting, which shouldn’t be taken to an extreme unless you’re under medical supervision. This is to give the microbes a chance to reboot. Fasting simply means having a break from eating for about 12 hours after your last meal. Sometimes you can extend that to 14 or 16 hours, but not every day and it doesn’t suit everyone.

When we take into account that about 70% of our immune system lies in our gut and these many microbes are talking to one another all the time, it makes sense that by looking after the microbes we help to manage the immune system and inflammation systems well. That allows healing to occur and in turn helps us to manage stress.

Research has shown that some people find that fasting before their chemotherapy treatment offers relief from many of the uncomfortable side effects, especially nausea and post-chemo fatigue. A study conducted on 106 women going through chemotherapy for breast cancer found significant improvement in side effects with short-term fasting. If you are going through chemotherapy and are interested in trying this, you can read more about the study here. It is recommended you get some professional nutritional therapy support before trying this.

Things to include in your diet

Stress is highly inflammatory and the whole idea of taking pressure off means that we allow all the amazing systems in the body to rebalance so we can help stop that inflammatory process. Some foods are especially helpful when it comes to stress and anxiety as we use up their nutrients while in that state. For example, these are some of the key things to focus on including in your diet:

Vitamin C

Our adrenal glands are our stress glands,  and they use more vitamin C than any other part of the body, so when we’re stressed we need more of it to bring balance. Things to look out for include brightly coloured, fresh fruit and vegetables. Kiwis, red peppers and citrus fruits are great.

B vitamins

There are eight B vitamins as things like lentils, beans, fresh fruit and vegetables and eggs are really nice sources. One thing I see a lot is people who are deficient in B12, especially if they are on a plant based diet.  B12 is hugely important for energy, the immune system, brain health and managing stress. I know there’s a lot of scare mongering around animal products at the moment, but it isn’t always beneficial to avoid animal-based foods. Eggs are fantastic and are a high source of protein which is very healing. Quality is important though.

Vitamin D

I work a lot with cancer patients and other people with immune issues, and in general Vitamin D levels are always low. We know we can get it from the sun, but most of us don’t have enough exposure to it to get what we need. It’s excellent for reducing inflammation and foods that are rich in it include oily fish like sardines and mackerel, liver, and there’s a little in egg yolks. It’s quite hard to get enough Vitamin D, so for many people supplementing is necessary, but you should check your levels first.

Omega 3 fatty acids

Omega 3 fatty acids are wonderful for calming inflammation, and supporting the immune system as well as the adrenal glands. They calm cell damage and are used by the brain – without it we’re more likely to be stressed and anxious. In general they help the body to feel well looked after and we mostly find them in oily fish, wild salmon, sardines – similar foods to where we find Vitamin D. It’s also one of most common supplements I recommend

Things to stop doing or reduce

In addition to things that we can start doing nutritionally, there are also some things we can stop doing or reduce in our diets.

We know that sugar can cause an imbalance in good and bad microbes. By feeding the bad microbes it can overwhelm the good ones, and increasingly research shows that emulsifiers – usually in processed foods are unhelpful. These don’t need to be in the ingredients list on products so they can be hard to spot, but the rule of thumb is generally to reduce your intake of highly processed foods where possible.

Read more expert advice from Stephanie here.