I’m delighted to share this guest post by Dianne Rishikof, a registered dietician and licensed nutritionist, where she shares her extensive knowledge on the connection between anxiety and gut health. I first read Dianne’s incredible book, “Health Takes Guts: Your Comprehensive Guide to Eliminating Digestive Issues, Anxiety, and Fatigue”, last year when I became aware of some of my own untreated gut issues. While there are a plethora of articles and books available on gut health these days, Dianne’s straightforward and accessible language, alongside her depth of knowledge on the subject, grabbed and held my attention. I read the book cover to cover, and asked if she would write a post on the connection between gut health and anxiety for my audience. Here it is.


Anxiety is a signal that you need to attend to your body, mind, heart, or spirit. In the realm of the body, the search begins in the gut.

Why is the Gut so Important?
We have an estimated 100 trillion microbes living in our digestive tract. These microbes are mostly bacteria, but yeast and viruses are present, too. Some of these microbes have health benefits, some cause health problems, and some don’t do either. This ecosystem is called the microbiome, and when our microbiome is out of balance, problems will emerge. In an ideal microbiome, the majority of these microbes are beneficial, there is lots of diversity (different types), and there is no overgrowth of pathogens (really bad bugs). Unfortunately, most of us have too many pathogens, not enough beneficial microbes, and not enough diversity.

What’s important to realize about these microbes – good or bad – is that they run the show. They participate in or control all of our bodily functions, including:

nutrient digestion and absorption
how hungry or full we feel
what foods we crave
how well we utilize calories, carbs, and fat (metabolism)
how much neurotransmitters (brain chemicals) we make
our mood
our behavior
and many others…
The research on how these gut microbes affect illness is overwhelming. It is hard to find a medical condition for which the microbiome is NOT the underlying issue.

The Brain and the Gut, a Two-Way Street
The brain and the gut are connected via the gut-brain axis. Scientists used to believe that the messages were sent only from the brain to the gut. For instance, if you were thinking about a big meeting with your boss and you began to feel butterflies in your stomach, that would be a message from your brain to your gut. We now know that the gut microbiome affects the brain quite significantly as well. In fact, there are actually nine timesas many messages sent from the gut to the brain as there are from the brain to the gut. Those microbes have a tremendous influence on your brain, mood, and behavior.

Microbes produce and/or consume neurotransmitters, the chemicals which influence emotions.
Unhealthy microbes also send signals up through the axis to influence our mood and thoughts.
Signals from the brain travel down and actually FEED the bacteria. So, if you are anxious, that proliferates the unhealthy microbiome.
It is a mutually perpetuating problem, where anxiety can influence the microbiome and the microbiome can influence anxiety.
Anxiety and Depression
Studies done on the microbiomes of mice have found astounding results. By manipulating the microbiomes to increase or decrease the number of good or bad microbes, we can see what effects they have on mood and behavior.

In one study, researchers found that germ-free (lacking in good or bad microbes) mice had higher levels of anxiety compared to mice with healthy microbiomes.
In another study, researchers took the gut bacteria from fearless mice and swapped it with the gut bacteria from anxious mice. The bold mice became timid and the anxious mice became bolder (as evidenced by their behavior in mazes and other tasks).
When normal mice were infected with certain bad bacteria, the mice developed anxiety.
Probiotics (good bacteria) reduced stress, anxiety, and depression as well as increased memory in mice.
There have also been many studies on the human microbiome. These studies tend to be observational and do not involve double-blind control groups (because who would volunteer to have the bad microbes put into their microbiome?). A review of 21 studies showed that probiotics and diet separately were successful at treating anxiety by manipulating the gut microbiome.

How Can We Make our Microbiome Healthier?
There are two main ways to change the microbiome: supplements and diet.

Supplements such as anti-microbials (herbal and food-based antibiotics) and probiotics can rebalance the microbiome. This is an elaborate process, as outlined in greater detail in my eBook. In some cases, having a qualified professional personalize your treatment is the best choice.

There are many changes to your diet that can improve your microbiome and improve anxiety.

Bad microbes feed on alcohol, sugar (added sugar from candy, cookies, and soda), and processed food (refined grains/flours, food from bags and boxes), which can increase anxiety.
Eating real, whole foods is a very healthy diet. Starchy vegetables (ex: sweet potatoes), non-starchy vegetables, fruit, beans, and seeds will improve the environment in your gut to help lessen anxiety.
Good microbes proliferate when they consume fiber. Fiber is found in all whole plant foods such as vegetables, fruits, seeds, and beans. Prebiotics is the word for the particular fibers that cause the good microbes to flourish. Some foods that are high in prebiotics include green banana, apple, onion, garlic, and asparagus.
Polyphenols also come from plants. They are antioxidants that help prevent diseases such as heart disease and cancer. They also improve brain function. Not coincidentally, they have an impact on your gut bacteria. They nourish the good bacteria and increase the diversity and strength of the microbiome. Some foods that are high in polyphenols include cranberry, pomegranate, tea, olive, dark chocolate, and purple potato.
Fermented foods are foods that are prepared or aged in such a way that beneficial bacteria are able to grow. Yogurt, kefir, sauerkraut, and kimchi are all examples.

Holidays, Anxiety, and the Gut
This whole season is filled with large meals, parties, and goodies. There are tons of rituals centered around food, which means more opportunities to consume sugar, alcohol, and processed food. As stated above, these foods can increase anxiety levels.

The holidays bring up many emotions. Family dynamics or tough seasonal feelings will not only cause anxiety but also negatively influence the gut. Additionally, we tend to cope with our loneliness and disappointment with unhealthy food. This will perpetuate anxiety further.

While I recommend sticking to a healthy eating pattern during this time (for the multiple reasons listed above), it is not helpful to expect perfection. Trying to control temptation with too much restricting can backfire. Moreover, perfection need never be part of an eating plan as it only leads to shame, judgement, and guilt (which cause anxiety, which then feeds unhealthy bacteria).

At meals, try sticking to the turkey, potatoes, and green beans and skipping the more processed side dishes. Have only one dessert instead of six. Skip the tray of cookies floating around the office the whole month of December. Hold a glass of sparkling water while enjoying your colleague’s company at the holiday party. These are all good tips, but again it might not be realistic to meet these goals all the time.

Ultimately, it isn’t about practical tips, but about making a commitment to yourself and your wellbeing. Many things will challenge you but keep the end goal in mind. With my clients, they often talk about a fear of judgement from others or a fear of not fitting in if they are not taking part in the eating and drinking. I will tell you what I tell them: It is no one’s concern or business what you are eating and drinking. If someone cares that you are drinking water and not pounding beers, there is something strange going on with them. If Aunt Betty is offended that you aren’t eating six desserts, you can politely tell her why and reassure her that it is no reflection on her delicious food. While disapproval is unpleasant, the alternative is the results of unhealthy eating and drinking. Are the anxiety, self-betrayal, and other detrimental health consequences worth it?

Making wise and caring choices for your physical and emotional health is an act of self-love.

Author's Bio: 

Sheryl Paul, M.A., has counseled thousands of people worldwide through her private practice, her bestselling books, her e-courses and her website. She has appeared several times on "The Oprah Winfrey Show", as well as on "Good Morning America" and other top media shows and publications around the globe. To sign up for her free 78-page eBook, "Conscious Transitions: The 7 Most Common (and Traumatic) Life Changes", visit her website at http://conscious-transitions.com. And if you're suffering from relationship anxiety – whether single, dating, engaged, or married – give yourself the gift of her popular eCourse