By:  Margaret Tripp, Ph.D.

Nutrition and Anxiety: Practical Techniques to Decrease Anxiety and Panic Attacks

Summary of Teleconference by Dr. Kristen Allott, N.D., L.Ac. As a Licensed Naturopathic Physician and Acupuncturist, Dr. Allott specializes in non-pharmaceutical interventions for anxiety, depression, addictions, and sugar cravings through her private practice in Seattle, Washington.

Dr. Allott’s primary focus of discussion of nutrition and anxiety focuses on neuroglycopenia- the state when the brain is low in glucose. She indicates that this physical state is often missed by general lab work-ups because it does not correspond to measurements of hypoglycemia- low blood sugar. However, she emphasizes the importance of low brain glucose because there are multiple parallels between anxiety/rage and neuroglycopenia/hypoglycemia, including irritability, fatigue, elevations in heart rate, and decreased concentration. It is her belief that food intake can control the physical components of these symptoms and therefore reduce the threshold at which these symptoms might be triggered. She offers the following theory on how food intake can contribute to reduce anxiety symptom thresholds:

Scenario A

            Typical Breakfast of high refined carbohydrates (cereal, bagels, scones, etc.) results in blood glucose increase and makes insulin available for use at cellular level. Then, 2 hours following breakfast, blood glucose starts to drop and the brain waits for the body to make more glucose available.  However, glucose stores are not activated because either the body (unlike the brain) does not perceive the drop in blood glucose or the insulin available is still high. In the meantime, the glucose in the brain continues to drop, making the brain panic over a perceived glucose deficit. This sets off a chain of commands stimulating an adrenaline rush to help convert protein to glucose. As a result, glucose from protein will go to the brain AND to fat cells. And at the brain level this adrenaline rush hits the amygdala (emotional control center) and produces anxiety, irritation, and a Fight OR Flight reactive state. So at this point, the brain is functioning on its most basic primal level and the advanced executive function components are not accessible due to the biological reaction.

Plus, after eating carbohydrates your brain also creates more serotonin, which temporarily creates the euphoric feeling that everything is going to be okay. This can be thought of as a sugar high and develops into an ineffective coping strategy. The only resolution is to go eat yet more carbohydrate, only 2 hours after the first high carbohydrate meal.  

Scenario B

            Choosing protein along with carbohydrates at breakfast allows a 3 to 4 hour window before the brain registers reduced blood glucose. This protein and carbohydrate combination also allows a steady supply of glucose. In addition, the liver will use the protein for fuel instead of competing with the brain for available glucose. So the result is NO panic, no chain reaction or Fight/Flight response, and no sugar cravings.

Based on Dr. Allott’s theory, breakfast choice can in large part determine mood and reaction levels for the remainder of the day.  And it may not surprise you that Dr. Allott emphasizes the importance of choosing high protein meals and snacks all day long. She references the common misconception that Americans eat too much protein but points out that most Americans eat all of their protein at dinner. She stipulates that an individual actually needs 8 grams of protein per 20 pounds of body weight (e.g., 160lb individual requires 65g of protein daily.) Her recommendations do not include eliminating carbohydrates, like many of the current fad diets, because carbohydrates are required to enable glucose to be used by the brain. However, she highlights proteins such as nuts, yogurt, cottage cheese, eggs, beans, and meat as most beneficial.

Benefits of increased protein intake, as outlined by Dr. Allott, include less fatigue, better sleep quality, more energy, more stable moods, and higher metabolic rates. She offers the following general guidelines for gaining these benefits:

1. Protein at every meal
   
2. Protein every 3.5 hours
3. Limit alcohol to less than 5 servings per week
4. Eliminate caffeine.

In addition, Dr. Allott delineates specific recommendations for protein intake as related to anxiety symptoms. She notes that in the majority of panic attack cases she treats, the patient had not eaten in over 4 hours prior to the attack and his last meal was a high carbohydrate meal prior to the attack. She advocates managing anxious physical states by influencing glucose levels; specifically, eating a small quantity of carbohydrate and then immediately following with protein for anxious physical states or middle of the night awakenings.

Still not convinced that you are ready to give up your bagel? Dr. Allott offers an experiment for testing the benefits of increased protein intake. She challenges patients to consume protein rich meals every 3 hours for 3 days to assess the differences in mood, energy, and reactive states with this level of fuel available. By her logic, you can experience it yourself before you have to believe.

More information about Dr. Allott and her nutritional management services can be obtained through her website at www.dynamicpaths.com .