The multidirectional links between diet, mental health, and heart health

At the meal

We humans are amazing, complex creatures, and part of that complexity comes from the interaction of our minds and bodies. On any given day, you may notice how mental stress causes tension in your back or shoulders, how worry ties your stomach “in knots,” or how happiness seems to make you feel cheerful. But the mind-body interactions go even deeper, with research revealing the links between mental health and heart health, and how what we eat affects both.

“I can’t talk to my patients about their cardiovascular health without addressing their mental health,” said Dr. Erin Michos, director of the Women’s Cardiovascular Health Study at the Johns Hopkins School of Medicine. Speaking at the annual meeting of the Academy of Nutrition and Dietetics in Denver last month, she noted that over the past 10 years, there has been an increase in people with mental health disorders — especially anxiety disorder and major depression — being admitted to hospital after a heart attack.

Michos said both negative and positive psychological factors affect cardiovascular health. Take stress for example. “Not all stress is bad. Stress is what helps us meet deadlines, but chronic stress can change some processes in the body.” She said chronic stress – as well as anxiety, anger and depression – can directly trigger the release of stress hormones, yes increase heart rate and blood pressure, increase inflammation, harden arteries, increase the risk of blood clots, and constrict blood vessels on the surface of the heart.

A 2019 study found that people who sleep less than six hours or more than nine hours a night are more likely to have a heart attack. Michos said this could be because short or long sleepers are more likely to struggle with depression, other mental health issues or a chronic physical illness. In other words, is the sleep pattern affecting the heart or is it a physical or mental illness that affects sleep and the heart? For example, a 2021 study found that female veterans with PTSD had a 44 percent increased risk of developing heart disease, possibly because brain trauma leads to both mental disorders and cardiovascular disease.

Chronic stress and poor mental health can also indirectly contribute to heart disease by affecting how we take care of ourselves. For example, some people may try to cope with stress, anxiety, or depressed mood by smoking, excessive alcohol use, or stress eating. And when you’re in trouble, you’re less likely to take prescribed medications or seek preventive health care. On the other hand, positive psychological health—think happiness, emotional vitality, optimism, a sense of purpose, gratitude, mindfulness—is associated with healthier blood pressure and blood sugar levels, but also with behaviors that support health, including increased physical activity, heart-healthy eating and other basic forms of self-care.

Being optimistic—expecting that good things will happen to you in the future—and having a purpose in life are associated with better survival from cardiovascular disease. The same goes for positive social connections. “Those who are more socially isolated have a greater cardiovascular risk,” Michos said, citing a 2023 UK study that followed 18,509 people with diabetes for more than 10 years and found that loneliness is associated with a 20% increased risk of cardiovascular disease. This makes it a greater risk factor than depression and some “traditional” risk factors, such as high blood pressure and blood sugar, smoking, low physical activity and poor diet.

Michos pointed out that some stressors are very difficult to change because they can be related to socioeconomic status. For example, discrimination or living in an unsafe neighborhood. “I think too much blame is put on the individual when they’re in a toxic environment, but having tools to buffer stress is still important,” she said. Sleep, physical activity, and a nutritious diet help us build personal resilience against stress, but other factors include learning healthy ways to cope, connecting with family and friends, practicing mindfulness (perhaps through mindfulness meditation), engaging in genuine laughter, and reframing failures as opportunities. Cultivating gratitude (perhaps with a gratitude journal), feeling optimistic, and self-compassion are also key. “I think we’re harder on ourselves than we are on others,” she said.

The American Heart Association has tips for managing and finding relief from stress, as well as more information about how stress affects the body and the connections between stress, mental health and your heart at

Now let’s talk about the food. A heart-healthy diet recommended by the AHA is based on:

  • Plenty of fruits and vegetables
  • Whole grains (choose them more often than refined grains)
  • Healthy sources of protein such as legumes (beans and lentils), nuts, avocados, fish and seafood, and unsweetened dairy products
  • Healthy fats from olive oil and other liquid oils (plus those in nuts and fish)

He also limits animal fats, foods high in sodium, and foods and beverages with added sugars. It also keeps alcohol at moderate levels — one drink a day for women or two for men — if you choose to drink at all.

“We know that diet quality at every stage of life affects health and well-being,” said Christina Petersen, associate professor of nutritional sciences at Penn State University, who presented with Michos. Poor diet—along with poor sleep and reduced physical activity—are linked to major depressive disorder in what could be a chicken-or-egg scenario. However, at least 150 minutes of moderate-intensity physical activity per week can help protect against stress, anxiety and depression, while directly benefiting heart health. Peterson said a healthy eating pattern is associated with lower odds of depression, possibly because vitamins, minerals, phytochemicals, fiber and healthy fats have a positive effect on gut microbiota while helping to reduce levels of stress hormones, inflammation and oxidative stress in the body. . All this, in turn, can have a positive effect on the brain and, oh yes, the heart.

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