Gut Health, Anxiety, and the Holidays Made Simple

by | Nov 24, 2019 | Anxiety | 14 comments

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.

Dianne Rishikof, MS, RDN, LDN, IFNCP, is a holistic registered dietitian and licensed nutritionist for people who are desperate to get rid of the pain, discomfort, or unwanted symptoms in their body, but just don’t know how. Their issues may be in the gut (IBS, IBD, gluten sensitivity), the brain (ADHD/ADD, anxiety, depression) or somewhere else (fatigue, inflammation, joint pain, high cholesterol, weight gain, headaches, skin issues). Using integrative and functional medicine nutrition therapy, she gets to the underlying cause of the problem and heals the body from the inside out.

Dianne is president of Health Takes Guts Inc. and has been in private practice for almost 15 years in MetroWest Boston. She and her team see clients in person and also do video or phone sessions as a convenience for distance clients. Dianne is a national speaker and published authorFind more information at



  1. This was so eye-opening for me. Throughout my entire life with anxiety, it has ALWAYS shown up in my gut. Even when I was a child, mornings before school where I “didn’t feel good,” mornings before high school where I was absolutely convinced I was sick because the morning nausea was debilitating – even as an adult where a trigger of anxiety will shortly send me to the ladies room. I knew they were connected, but I had no idea how closely. This article has seriously inspired me to commit to taking my probiotics every day again and take more steps to protect my microbiome. Future husband will be getting on the gut train as well. 😉

    • I’m so glad the article inspired you. Yes, for so many of my anxious clients their anxiety showed up first in their gut. And apparently our gut has more nerve endings than any other part of our body! That’s why it’s called the “second brain.”

  2. I’ve often thought that your work, Sheryl, is very connected to diet and nutrition. Several books that I have read regarding food and nutrition echo many of the same themes in your work. Many people use food as a way to distract them from their anxiety. I am also a dietitian and am very interested in GI health. Thanks for sharing this post.

    • Diet and nutrition have been very important to me my entire life, so I’m not surprised that you’ve seen the connection to my work ;).

  3. My gut health has certainly played a huge role in my anxiety over the years. In short, my gut has been a mess for as long as I can remember. I also had PANDAS as a little girl which didn’t help. I have an excellent functional medicine doctor I’ve been seeing for about a year now, and we’re gradually getting to the bottom of a lot of my health issues. It’s such a relief to have a doctor listen to you and address root causes.

    • I’m so glad you’re working with an excellent doctor! Receiving the right care is life-changing. x

  4. Wonderful discussion. I learned a LOT. I have been trying, successfully, to improve my situation by using Dianne’s tips, but it is admittedly hard to be perfect during holiday season, especially if there are guests. Fortunately, there is allowance for imperfection, and I am happy with the improvements I could make with whole foods (not processed) and various supplements.

    • Yes, SO MUCH allowance for imperfection! When we don’t allow for being human, we create even more anxiety, which doesn’t help gut health at all (as Dianne shares in the article).

  5. It took me a long, long time to realize my acid reflux and indigestion were caused by anxiety, not certain foods! And I am just now, finally, after years of trying, reducing my sugar consumption and tracking the effects on my mood. I used to rely heavily on sugar for a “happy bump” during the day. It made me feel good in the moment, but I’ve long suffered mood swings, irritability, symptoms of hypoglycemia, depression, anxiety, etc. Now I’m making changes so that my life is sweeter and I don’t rely on food so much to uplift. It’s been transformative. Dr. Cate Shanahan’s book “Deep Nutrition” has been an aid on my path. Thank you for addressing these connections!

    • It’s so good to hear from you and YES the connection between gut issues and anxiety is extraordinary! Thank you for the book recommendation as well.

  6. Thank you for this important article. I can testify that gut and anxiety are superlinked. Since I improved my diet a year ago most of the anxiety is transformed to a deep calm. My breath rate is down from about 20 per minute to about 8-10 in a minute and often I feel a deep pleasure of just being alive. Every breath is a pure pleasure. I realize that this is how one is supposed to feel, and all those 30 years I was probably in a quite deep inflammation, heavily affecting my brain, breath, apart from skin and other things.

    I had great help from the York test to identify my intolerances, and also by the free app Cara to track my reactions to food.

    I feel as I have wakened up to my life. Suddenly I am in charge, no longer am I swept about by my thoughts. I think it’s called Presence.
    I cant believe that this is not more well-known.

    • I meant

  7. This is a great post for me!!! My anxiety has always shown up in my gut and I just thought that was going to be my cross to bear with anxiety. I have used probiotics off and on but always shelf stable and just when I was having some digestive issues, never for a very long or consistent pattern. After reading this and the little I know about gut brain and the connections we’re learning about, I went to Whole Foods and found one that appears well reputed and needs to be refrigerated and it also has about 3 ingredients like ashwagandha to help with mood. It’s only been about a week and may only be coincidental, but I have been feeling so good physically and emotionally the last few days!! I’m going to keep taking them and see how things go for the next month or two. Thank you for this post, even though I’m just now seeing it was written 2 years ago. I think you must have put a link for it in our Break Free From Anxiety course material. 🙂

    • I’m so glad this was helpful, Laurie. I linked to it in both the 9-month course and also in this week’s weekly newsletter :).


Submit a Comment

Your email address will not be published.


Pin It on Pinterest