What We’re Getting Wrong About Nutrition and Mental Health

Patel-Dunn is a psychiatrist.

A growing body of evidence links the consumption of unhealthy and ultra-processed foods with an increase in mental health conditions like depression and anxiety. A 2022 study found that the more ultra-processed foods a participant consumed, the more likely they were to report anxiety and depression. Other studies have linked poor diet to conditions like ADHD and dementia.

This research has sparked a broader conversation around nutrition’s impact on mental health and the risks of eating ultra-processed foods, which make up 57% of U.S. adults’ diets and 67% of children and teens’ diets.

The relationship between nutrition and mental health is complex and multifaceted. It’s important to view this relationship in context with other behaviors that can promote mental health, while also being aware of how access to nutritious foods is driven by socioeconomic 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.

Reframe the Relationship Between Nutrition and Mental Health

There is undoubtedly a correlation between diet and mental health. But, there is also a strong correlation between diet and larger socioeconomic 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 acquire.

It’s important to recognize these inequities and avoid casting blame in conversations about nutrition. Instead, mental health clinicians can reframe nutrition as one important part of overall healthy living that can positively impact mental health, along with other critical factors like social connection, good sleep hygiene, and moderate exercise.

Another complicating factor is that a patient’s diet may be impacted by mental health in a variety of ways. For example, some patients experiencing depression 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 symptomatic of mental health conditions.

Ultimately, clinicians must be aware of these factors and how they may impact the relationship between nutrition and mental health. Only then can we start to address the root cause of these conditions.

How to Talk About Nutrition With Patients

There is a full spectrum of eating habits that can impact a patient’s mental health and vice versa, from extremes of overeating to restrictive eating. For this reason, it’s important for clinicians to have honest and ongoing conversations about nutrition with patients.

This can be a very sensitive topic to discuss, especially as it relates to 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 unprompted. Clinicians should ask intentional, open-ended questions to get a better understanding of 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 continually.

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 important thing is to start a conversation. Patients might not realize that, for example, their late-night snacking habit might be impacting their overall mental health. By educating them on this connection, clinicians can help patients find more ways to take control of their overall well-being.

Collaboration With Primary Care Physicians

Nutrition offers 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 on the correlation between nutrition and health.

One way to achieve this is by making 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 impacts. Ideally, every primary care practice would have at least a part-time mental health clinician available as a member of the treatment team or be prepared to make referrals in order to quickly facilitate treatment when needed.

Both mental health clinicians and PCPs can discuss with patients how nutrition impacts overall health, and flag instances where a patient might need more focused care, including for disordered eating. This integrated approach can ensure that no one falls through the cracks and patients are quickly connected with the care they need.

A Holistic Approach to Patient Care

Amid a broader discourse around nutrition’s impact on mental health, clinicians can help to balance these conversations with context at both the industry and individual patient levels to avoid stigmatizing patients. Although it’s tempting to point to a single factor like ultra-processed foods as the cause of anxiety or depression, it is not accurate or useful to do so. Rather, nutrition should be framed as one of a multitude of factors that can impact mental health.

By accounting for the socioeconomic factors that impact nutrition, talking openly with patients about their eating behaviors, and collaborating with primary care physicians, mental health clinicians can take an informed and holistic approach to patient care.

Anisha Patel-Dunn, DO, is a practicing psychiatrist and Chief Medical Officer at LifeStance Health, a mental healthcare company that provides evidence-based outpatient treatment services.