Nutrition, Anxiety & Teenagers
Nearly 1 in 3 of all adolescence aged between 13 and 18 will experience an anxiety disorder according to the National Institutes of Health and these figures are rising steadily. Anxiety disorders cut across all demographics suburban, urban, and rural. They affect those who are planning on college and those who are not.
Anxiety leads to physical problems such as headaches, chronic pain, digestive problems, and later heart disease. It can interfere with the ability to focus and learn at school, potentially causing lifelong problems. In its most extreme, chronic anxiety can lead to serious mental health problems including depression, substance abuse and even suicide.
Alarmingly hospital admissions for suicidal children and teenagers have also doubled over the past ten years.
These combined statistics leave us with many questions.
What is causing the rise in teenage anxiety?
What are the signs of anxiety?
What can we do about it?
There are a number of factors that could be contributing to the rise in anxiety in teenagers. In addition to genetics, brain chemistry, personality and life events, there are some specific factors we need to take into consideration.
Pressure to succeed
Today’s young people feel pressure to succeed in ways previous generations did not. With standardised testing and a culture of achievement, expectations are high, not only from educational settings but from parents and the adolescent themselves. This pressure starts earlier than ever before with the introduction of the new Primary curriculum, 11 plus exams, endless testing, GCSE’s and then A’level’s. A yearly survey by Higher Education Research asked incoming university students if they felt overwhelmed by all they had to do and 41% said yes.
World influences
Nowadays, teenagers are often subjected to scary, threatening world events. They see and hear about bombings, refugees, homelessness, shootings in schools, terror attacks, extreme violence, election fears and climate issues. Not to mention the COVID-19 pandemic isolating them from their normal lives. The psychological scars and trauma caused by viewing horrifying images and by the memories are pervasive and do not heal easily. It is reasonable for anyone to feel afraid in public spaces that previously would have felt safe.
Social media
This inevitable and constant connection on the one hand creates endorphins that can be creative, insightful and give a sense of belonging. They may be necessary for connection in today’s lockdown. However, as we are all aware, it is likely to be destructive and divisive especially for immature minds. The dangers can not be ignored from being exposed to inappropriate content and advertising that your child can never un-see to cyberbullying, phishing, scams, imposter accounts, sexting, and grooming.
Teenager’s self-esteem, and worldview, unsurprisingly becomes connected to responses to social media posts. They begin to compare their life and connections to what they see others posting on social media. The importance of image becomes exaggerated and if a child’s image is not ‘perfect’ self loathing and other health issues may increase.
Exaggerated responses
There are also some children who have unexpected and disproportionate reactions to normal developmental experiences like going to school, going to a party, having a sleepover; children who worry excessively about everyday life activities.
Importance of Food for Brain Health
Many people still tend to think that anxiety is merely a psychological or even emotional problem, but as nutritionists, we help clients understand the biochemical and nutritional connection with anxiety and depression. Food and nutrients are critical for the stress response and brains ability to function well.
A systematic review in 2019 by Q Haung et al. found that a poor diet high in saturated fat, refined carbohydrates and processed food products was linked to poorer mental health in children and adolescents. While a rich nutrient dense Mediterranean diet improved risks of depression.
What’s going on physically?
The body and mind react to any stressor automatically, be it, perceived like worry, or physical pain. We are likely to feel physical sensations, like dizziness, a rapid heartbeat, difficulty breathing, sweatiness or shaky hands and feet even when the cause is emotional.
These sensations, are due to the fight or flight response, when adrenaline and other stress hormones are triggered to prepare the body to run from danger. Another hormone called Cortisol produced by our adrenal glands increases blood and releases energy stores. This gives the fuel to cope with stress or danger. However, if stress is prolonged and cortisol is produced for a sustained period without a break, it can increase various health issues including mental illness, weakened immune system and susceptibility to viruses, weight gain, poor sleep, and a restricted production of serotonin (the happy hormone). This can lead to overwhelm, anxiety and a sad, tired teenager. This, in turn, can increase craving of foods high in sugar and refined carbohydrates which only exacerbate the situation. But this poor diet in turn feeds the body and brains inability to function well.
How can we support our anxious teenagers?
1. Recognise Signs of Anxiety
Recurring or persistent fears and worries about routine parts of every day life
Changes in behaviour, such as irritability
Avoiding activities, school, or social interactions
Lower than usual school marks or avoiding school
Difficultly sleeping or concentrating
Substance use or other risky behaviours
Chronic physical complaints such as fatigue, headaches, or stomach-aches.
Feeling overwhelmed
Phobias
Trouble concentrating
Gut issues including pain, constipation or diarrhoea
Dizziness
Trouble breathing
Separation anxiety
Obsessions and compulsions
Self-harming
Over-achievement
Tics and involuntary movements
2. Nutrition to Support Anxious Adolescents
A modifiable and arguably most effective change is diet and exercise.
Avoid high sugar foods and white carbohydrates. Ideally always combine carbohydrate with protein and healthy fats like an apple and cheese or oatcakes with peanut butter. It is important to increase good quality protein-rich foods as well as healthy essential fatty acids, dietary fibre, fruit & vegetables, zinc, B vitamins, magnesium, vitamin D, licorice, lemon balm and chamomile.
An imbalance in the gut microbiota directly influences stress-related and psychiatric issues including anxiety, depression, and OCD. Gut bacteria affects brain activity and behaviour via the microbiota-gut-brain axis which includes the immune, neuroendocrine, and neural pathways. Adding fermented food or a probiotic has been seen to improve chronic-stress and anxiety. The use of lactobacillus reuteri has shown in several studies to have the ability to change brain activity and ease anxiety.
B vitamins and iron can play a key role in supporting teenage health. Vegetarians and those with pernicious anaemia or coeliac disease in the family could be deficient in vitamin B12 and iron. Those with a family history of cardio-vascular disease, diabetes or cancer may have more problems absorbing folate which can be found in green leafy vegetables.
Low levels of vitamin B12, B6 and folate are associated with some neurological diseases and psychiatric disorders. They also inhibit the production of monoamine neurotransmitters such as serotonin, dopamine, noradrenaline and adrenaline all crucial for stable mood, a sense of well-being and the ability to feel happy.
Magnesium is essential for the central nervous system, muscle relaxation, energy production and it is depleted during stress. It has been used for centuries as a remedy for anxiety, apathy, depression, insecurities, and headaches. It has also been shown to help calm and aid with sleep and magnesium taurate may be used to reduce palpitations. Epsom salt baths are a wonderful source for relaxation. To increase magnesium levels add nuts, seeds, oily fish, dark leafy greens, bananas and strawberries.
Omega-3 essential fatty acids have had more research about mood and brain health than any other nutrient. Oily fish is the best way to get enough omega-3, which in turn may calm anxiety and many other mental health problems. Rough dry skin at the top of the arm and dry skin and hair may be signs of omega-3 deficiency. You can also find it in flax seed, chia seed, walnuts, omega-3 rich eggs and organic milk.
Vitamin D is a fat soluble vitamin that the body synthesises from the sun. Known as the good mood vitamin, vitamin D is one of the most important vitamins to support an anxious child. There is a gene called VDR which can block your ability to absorb vitamin D; and in this case, vitamin D levels will need ongoing support, sunshine or not.
Moderate exercise can also reduce cortisol levels and increase endorphins, relieving stress and anxiety. A good run around a park, kicking a ball, riding a bike or a simple walk in countryside can make a big difference. Deep breathing, mindfulness and yoga are also great stress relievers.
3. Motivational tips
Start with a small step
Do not be overwhelmed or feel like you need to do everything in one day.
1. Add a fruit or vegetable to every meal
2. Slowly throw high-sugar and processed foods away. Refrain from buying high sugar and processed foods.
3. Buy more (and, eventually, mostly) real, unprocessed foods—fruits, vegetables, whole grains, lean meats and dairy—and read labels to find healthier alternatives for your teenager’s favourite processed items. Offer a selection of alternatives.
Hint: Shop the perimeter of the supermarket, where most unprocessed food is located.
Focus on what you can control.
Even though you can not control your teen’s intake at every meal, you are still providing the majority of food they will consume. Start with those after-school snacks.
1. Teenagers want to grab and go - Have stuff in the fridge, so they can open the door and grab something healthy. This could be, apples and peanut butter, carrots and humus, wholemeal pita filled, cut-up fruit and Greek yogurt.
2. Stock less-than-nutritious snacks on lower shelves. Children are unlikely to look down – it is a trick on the eye.
Stay calm
1. Teens will eat some junk food, but if you provide them with nutritious foods most of the time, they will get the message. Let their not-so-great food choices slide, unless it becomes a pattern.
2. Say your teenager routinely eats fast food with his friends during lunch. Say ‘I’m not doing this right. What can I do to help, you have a good lunch?
3. Just be wary of the hard and fast—no sugar ever!—when it comes to food. Sugar is a treat and should not be the norm so make sure they know it is an occasional thing. Even adults find it difficult to stop themselves. Sugar addiction is a real thing.
Role Model
1. Remember: When it comes to raising healthy teens, they will follow the model, not the rule. You need to show your teens what a healthy relationship with food looks like.
2. Actions speak a lot louder than words – Do not stand at the counter eating salad, while your teenagers eat dinner at the table.
3. Do not skip meals, binge on junk food or talk relentlessly about dieting. You are more likely to create a teenager who does the same thing.
4. If you are incorporating healthier eating and exercise habits into their daily routine, add them to your daily routine too. Being a supportive parent will be a much more effective tactic than simply telling your teen when to exercise and what to eat.
Teach with purpose
1. Providing teenagers with the right kinds of foods is only half the battle; raising healthy teens means showing them how to feed themselves when they go to college. Teach them about food in a way that is relevant to them.
2. Link conversations about nutrition with a teenager’s goals or interests, but never with appearance! For example, protein helps your muscles grow, vegetables support your immune system, low sugar prevents bad skin, and you are helping the environment by eating more plants.
3. Do the wheel of life – ascertain what order things should be in and what is important to them.
4. Science suggests teenagers need to feel like a socially conscious, autonomous person worthy of approval from one’s peers. They need to feel as if they are standing against manipulative and unfair practices of the food industry, such as engineering junk food to make it addictive and marketing it to young children. If healthy eating is portrayed as a way to take a stand against injustice, they are more likely to buy into it.
Eat together
Yes, we are busy. We are often so busy that it seems overwhelming to get healthy food on the table most nights. Here is the bottom line, though:
1. Eating as a family, 3-5 times a week, is a luxury to keep. Benefits include: consuming healthy foods in the right amounts, improved academic performance, improved communication skills and lower rates of risk taking. It does not need to be dinner; Saturday breakfast works just as well. And, only one parent needs to be present to make an impact.
2. Do not single out your teen’s behaviour in a negative manner, this is only more likely to make them feel victimised or cause resentment. As a family, all strive to make healthier changes in your day-to-day activities; come up with a healthy recipe calendar and take turns cooking, enjoy being active as a group and let them have a say in deciding on the choice of activities.
3. When you eat together, consider eating family style, with all the dishes in the centre of the table. Put a meal on the table. Then, just watch – do not talk about the food, do not reflect on who is eating what, just observe.
4. Over time, tweak the food you serve—maybe add an extra piece of fruit, a salad, or brown rice instead of white. Again, this does not have to be from one meal to the next. Take your time
We can teach our children techniques in how to be resilient and cope with stressors but they will inevitably always be there. How well they cope with the changing world and stress can be modifiable with nutrition and lifestyle choices. Do not be afraid to make changes support an anxious teenager.
Kate Black
Bespoke Nutritional Therapy