February 12, 2024
There’s been a rise in mental health issues for teens over the past decade and parents are looking for ways to help their teens feel better. In this episode, our dietitians will discuss a couple reasons why teens might be experiencing anxiety and depression while offering ideas on things to do nutritionally to help support their mental health during challenging times. We’ll cover specific examples of how food can affect mood and what habits can create a more balanced baseline for the brain during times of growth and stress.
Similar Podcast Episodes:
Welcome to Dishing Up Nutrition, brought to you by Nutritional Weight and Wellness, a nutrition company educating you and thousands of others about the health benefits of eating real food. I'm Teresa Wagner. I'm a Registered and Licensed Dietitian. And today, I'm here with Monica Hoss, also a Registered and Licensed Dietitian.
You may have noticed that the mental health of teens has been in the news almost daily. In fact, we'd like to talk about a topic from the New York Times podcast by Ezra Klein that caught our attention from May of 2023, titled, “Why Are Teens in Crisis?” If you are a parent, like I am, this two-part episode topic had some very concerning information. As a dietitian, my first thought went to I wonder what these teens in crisis are eating. Monica, I don't know about you, but I feel like I look at everything through a nutrition lens.
MONICA: Yeah, absolutely.
TERESA: Sometimes there is a nutrition component. Sometimes there's not, but I always look there first.
TERESA: So as I was listening to this podcast, I was thinking, well, how might nutrition contribute to this conversation that they were having on that podcast? So let's dig into some of the reasons teens are experiencing so much anxiety. What are some of the whys and more important as parents, what can we do to help our teens experience less stress and anxiety?
Before we get into it though, we are going to mention some suicide rate statistics. So we want to mention if you or someone you love is struggling or having thoughts of suicide, please reach out for help. You are not alone and there is help available. Call or text 988 to reach the Suicide and Crisis Lifeline. Or, go to speakingofsuicide.com/resources for additional resources.
MONICA: Yeah, and you know, Teresa, the other thing I want to mention is if this topic hits too close to home, take good care of yourself. You're welcome to skip ahead into the episode to hear our real food tips, or join us in a different topic altogether if this is triggering for you. So with that disclaimer, to start, let's dig in.
According to this New York Times piece, we are in the middle of a very serious mental health crisis. Looking at the numbers, teens and young adults with clinical depression more than doubled in the past 10 years. Even more serious, suicide rates doubled from 2007 to 2019. And that rate actually tripled for 10 to 14 year olds.
That means kids in 4th, 5th, 6th, and 7th grade are struggling. And honestly, this statistic is terrifying to me as a mom of a 10-year-old in fifth grade. And Teresa, I know you have kids in this age range too.
TERESA: Yes, Monica. I agree. I have kids all in that age range as well. I can't imagine the pain for everyone involved. First for the child themselves, and then for the parents. I mean, I can't imagine a worse pain than losing a child. Especially in a way that is just so unnecessary and preventable. And then of course, I feel for all the extended family and the friends.
With that said, a CDC survey done in 2021 found that almost 60 percent of high schoolers were feeling sadness or hopelessness in the last year. It is shocking to learn that 25 percent of teenage girls, a quarter of teenage girls, made a suicide plan in 2021. This New York Times podcast interviewed two different people to discuss possible theories and reasons for why this is.
One thing to note is that the additional stress of the pandemic was going on at this time. This survey was done in 2021, and that was a time when teens were doing a hybrid model of school, were maybe anxious about going back to school, or maybe worried that they would start back to school just to be told that they had to go back to distance learning. Despite the impacts of COVID in those early days, teens were already starting to struggle prior to the pandemic.
MONICA: Yeah, and COVID was obviously a huge stressor for everyone. But the study suggests that something else was going on before that too to really start kids on this decline in their mental health.
Jean Twenge, a research psychologist and author of the books iGen and Generations, believes that teenage mental health crisis is the direct product of the increased use in smartphones and social media. Jean works with large national studies and looks for patterns in the data to try to pinpoint trends and reasons why these trends might be happening.
What she saw was an uptick in teens reporting feelings of loneliness, being left out, and not enjoying life starting back in 2012. Clinicals of depression, interestingly, started to increase between 2011 and 2019.
TERESA: Looking back at the history of smartphones, Jean found a poll from the Pew Center for research that showed smartphones were owned by the majority of Americans by the end of 2012, and 80 percent of teens were using social media every day around 2016.
The other trends happening around the same time that are important to mention are that teens were spending more time online than outside in nature or with friends in person and they were sleeping less, which is an important point we want to talk about nutritionally in a little bit.
MONICA: In part two of the New York Times podcast, the host interviews Lisa Damour, a clinical psychologist and author of the book, and Under Pressure: Confronting the Epidemic of Stress and Anxiety in Girls. And she brings a really interesting perspective to the landscape of being a teenager. So she says, “Change equals stress.” And if you look at an 11-year-old, this is typically when we mark the beginning of adolescence. And then you look at, say, a 17 or 18 year old.
So, someone that has gone through adolescence and is on the other end of it. You're looking at six, seven years, and that is so much change. An 11-year-old next to an 18 year old, they're, there's just so much going on during those years and they're hardly the same person. And we see this in clinic and also in our personal lives as parents.
My kids aren't teenagers yet, but we, we all know the teenage years are such a tremendous growth. Kids are going through this big period of development where hormones start to change when puberty hits, they're navigating emotions, discovering who they are as a person and where they might see themselves in the future.
Maybe they develop a love interest or a crush. They have more responsibilities, whether it be in school academics or sports, extracurriculars, first jobs. Just saying that makes me tired. There's a lot going on during those years. I remember being a teen and definitely challenging.
TERESA: It's a tough time in life.
MONICA: Yeah. I'm glad to be on the other side, but…
TERESA: I was just going to say…
MONICA: Maybe not as a parent. Well, and then you add in the addition to, of social media and smartphones and just all the positives and negatives that can come from the digital world.
TERESA: Yeah, there is a benefit to social media where there can be access to a wealth of information. I mean, it's funny when I'm hanging out with my kids, if we don't know something, it's just, hey Google, or Alexa. And we get the answer. We don't even have to move a lot of times.
MONICA: Right. My kids do that all the time. “Hey, Alexa.”
TERESA: And it provides a way to be connected to people all over the globe. My daughter has a friend in Canada that she keeps in contact with because we met on vacation in Mexico. It is a fun tool that we have that can connect us where we wouldn't be connected otherwise.
But there's also the aspect of only seeing what people post, their highlight reel, and comparing how you measure up to what you see posted. Lisa also shared that developmentally, the brain starts to remodel and get faster.
So I think this is a great place to bring in the nutrition component to the conversation of teens’ mental health. How can we support these growing and developing brains of our kids? So we first think about what the brain is. The brain is made up of over 60 percent fat. So it makes sense that we should feed it good fats like omega-three fatty acids, particularly DHA fatty acid, which supports good mood, memory, and focus.
So 60 percent of your brain is made up of fat. So it's important to eat healthy fats such as olive oil, butter, nuts, seeds, avocados, coconut oil, and heavy cream to support the brain. When you think about your teen, is your teen eating healthy fats? Are they drinking lots of water?
We talk a lot on Dishing Up Nutrition about the old messaging of low fat or fat free. That was the wrong message. My clients now realize it isn't the amount of fat, but it's the quality of fat that makes the difference in their health. Most of my clients realize that we need healthy, natural fat for a good functioning brain. This is true for teens too.
MONICA: Yeah, and as dietitians, we know that what you eat is critical to how well we function as a person and not just for physical health, like weight loss and blood pressure, but really for our mental health as well. In fact, our Nutrition for Weight Loss Foundations class, we teach people how to have good moods.
So we're actually teaching people to eat certain foods to have good moods, and this is something that I'm constantly talking to my kids about already, from an early age, because I know what a difference it makes.
TERESA: That's a good mom.
MONICA: Well, thanks. For example, to have a good mood, a good memory, focus, something you could eat would be two to three eggs cooked in butter, and maybe you're going to have a side of broccoli and sweet potato for breakfast. Yes, vegetables for breakfast with butter for good moods.
And for my kids, they are on board with the eggs cooked in butter. Usually for them, it is a side of fruit versus veggies, but you know, I think that's a great breakfast to set them up for school. We did a podcast episode interviewing Dr. Mary Newport back in July of 2023, where she talks all about fat being a great source of fuel for the brain. So if you're interested in learning more about how healthy fat supports the brain, give that episode a listen.
TERESA: We really like healthy fat for good moods because it's an anchor for our blood sugar. Leah and I talked about this in a recent episode we did in January called All About Fat. Most people know what low blood sugar feels like; hunger or hangry, sugar and salt cravings, low energy or fatigue, especially around three in the afternoon;
Might feel like irritability, impatience. You might feel overwhelmed, have anxiety, maybe depression, even panic attacks. Low blood sugar feels like anxiety, and that's a feeling that so many young people struggle with, is that anxiety feeling. So what might cause low blood sugar? Often low blood sugar follows a blood sugar spike from a high sugar meal or snack.
It can also come from not eating enough or skipping meals. Imagine your teen running out of the house for school and either skipping breakfast or eating something ultra processed, high sugar, like cereal or Pop Tarts. A few hours later, their blood sugar comes crashing down and they feel anxious, irritable, shaky, and have brain fog. And that is not a good recipe for being a good student.
MONICA: No. And we call that the blood sugar rollercoaster, right, that so many of us are on day in and day out. And we want to keep blood sugar steady. We think of it more as a rolling hill versus that rollercoaster. And in addition to making sure that we're including a lot of good healthy fat into meals and snacks because that's going to promote healthy blood sugar levels, we also recommend that teens, kids and adults as well, eat frequently throughout the day.
That's also going to help keep our blood sugar steady. And I know this can really be a challenge when kids are on a strict school schedule. So what are things we can do to support them? I know that my kids start school really early. They have lunch early. When my daughter comes home from school, she raids our pantry for sugar. She asks for ice cream after school almost every single day.
And I just, it's such a textbook example of low blood sugar. So I talked to her a lot about, making sure we're choosing a balanced snack instead of the sugar, but it really starts from early morning. So making sure that they're having a balanced breakfast before they leave the house, a balanced lunch if you're able to, and sending them good snacks to keep in their backpack.
My daughter, she really likes beef sticks. We had to find a couple brands until she found the one she liked, but that's her morning snack because I know that's going to hold her over well until her lunchtime. And then we want to make sure that they end the day with a solid dinner.
TERESA: Yeah. And speaking of dinner, that's just a really important thing to think about with teens at home. From information that I found through the familydinnerproject.org, the information that they have is based off of three decades worth of research.
They found that regular family meals which can be any meal by the way, it doesn't have to be dinner because maybe for your family, due to extracurricular activities, school, work schedules, breakfast might actually be the meal that works best for your family to eat together.
Family meals, nonetheless, whether that be breakfast or dinner or lunch, offer a wide variety of physical, social, emotional, and academic benefits. They go on to say, and what I found to be really interesting is that while some of these benefits can be gained through other activities, eating together is the only single activity that is known to provide all of them: physical, social, emotional, and academic benefits at the same time.
MONICA: That is so interesting. And so that website and well, us at Nutritional Weight and Wellness do too, we recommend combining food, fun, and conversation at mealtimes because those three ingredients are the recipe for a warm, positive family dinner. This type of environment makes these scientifically proven benefits possible.
Some of the specific benefits of family dinners, especially when it comes to mental health, that, those are the benefits I'm going to focus on, are better academic performance, higher self-esteem, a greater sense of resiliency, lower risk of depression, a lower likelihood of developing eating disorders, and overall healthier eating patterns in young adults. I mean, I think that it's really hard to argue with that kind of research and those benefits.
TERESA: And you're going to eat anyway. So you might as well eat together.
TERESA: All right. Well, it's time to take a short break. As you've been listening, you may have decided that it is time to make nutrition counseling appointments for you or your teen. Let me suggest you call this number, 651-699-3438 and ask your questions. Prior to the appointment, we will ask that you and your teen fill out a health history form.
We can do in person appointments for those who are local to the Twin Cities, or we can do video or phone appointments for those of you who prefer virtual. You can check to see if your insurance plan includes nutrition counseling, and it's best to set up several appointments so you and your teen can continue to have support. Since all of this takes time, I suggest setting up six appointments and take small steps so that your teen is on the path of recovery from depression and anxiety.
MONICA: Welcome back to Dishing Up Nutrition, and we are continuing our discussion about teens and the mental health crisis. We were just talking about the importance of family dinners and how that can help their mental health. What are some other things, Teresa, that might help?
TERESA: Well, so far we've talked about healthy fat, hydrating with water, eating enough food throughout the day. So now let's talk about another macronutrient to focus on for good mental health: protein. Protein provides the building blocks for our brain chemicals that regulate appetite and emotions, helping us better cope with stress.
Best sources of protein come from animal sources, such as beef, chicken, turkey, fish, and eggs. Because social media can be addicting because of the way it activates the brain's reward center by releasing dopamine, one of those feel good brain chemicals, we can help to balance those brain chemicals through food.
For example, chicken, it's a great source of L-tyrosine, which is an amino acid in the body that the body uses to produce dopamine; poultry, fish, dairy, nuts: these all contain the amino acid L-tryptophan, which produces serotonin and melatonin, which are both helpful for sleep. You don't have to really worry about the specifics with neurotransmitters and amino acids, those details. Just know that when you eat natural whole foods in variety, you are getting all the building blocks needed for a healthy functioning brain.
MONICA: On the flip side, and we talk about this all the time, but if your teen is eating ultra processed foods, which are lacking in key nutrients and filled with ingredients and chemicals most people can't pronounce, the body and brain aren't getting the nutrients needed for energy and development.
What might some of those processed foods be? Well, let's think of all the foods teens love: cereal, bagels, chips, cookies, fast food. These foods are loaded with sugar and usually gluten. Why is sugar and gluten bad for the brain? We often mention Dr. David Perlmutter on this podcast. He's a neurologist and author of several brain books including The Better Brain Book and Raise a Smarter Child.
I think one of the best books to pick up, especially if you have a teen who might be sensitive to gluten, is Grain Brain. Grain Brain says that sugar and gluten can trigger changes in behavior, seize control of focus and concentration, and induce some mood conditions like depression. So, when a teen eats sugar and gluten, they might lose their focus, get more depressed, and have more anxiety. That breakfast cereal containing gluten and sugar can mess with the brain in teens, and in older adults, it can increase the risk for dementia.
People with celiac disease, a genetic gluten problem, may be at risk for developmental delays, learning difficulties, and ADHD. Depression and anxiety are often severe in patients with gluten sensitivity. This is primarily due to the development of cytokines that block production of those critical brain neurotransmitters like serotonin, which is essential in regulating our mood. Like we mentioned already, low levels of serotonin often lead to anxiety and depression.
TERESA: If you are a parent with a teen who is experiencing anxiety or depression, Dr. Perlmutter found that these symptoms can be reversed simply by going gluten free. Is going gluten free an easy fix for anxiety? No. It's really difficult, actually. So it takes buy in from that teen and a desire to want to feel better. We as dietitians and nutritionists usually can help get that buy in from a teen, but I do encourage you to pick up that book and read Grain Brain. by Dr. Perlmutter. Dr. Perlmutter quoted research, but he also put in real case studies; case studies of children and teens he has helped overcome mental health issues.
Today, with the wide array of certified gluten free labeling and products that are available to us, gluten free is so much easier than it was 20 years ago when we first recommended it on Dishing Up Nutrition. One thing I would say, though, what we encourage when people are going gluten free is to stay away from foods that are labeled or made as gluten free and just eat the foods that are naturally gluten free. Proteins are naturally gluten free. Fruits and vegetables: naturally gluten free. Healthy fats: naturally gluten free.
MONICA: Yeah, a lot of the real whole foods that we talk about all the time aren't actually gluten free. So, it's not a simple swap for just, you know, the gluten free Oreos.
TERESA: Right, yeah. It's still, if it's an unhealthy food, it's still unhealthy, even if it's gluten free. That being said, though, it does make it easier in the case of teenagers when, if they're going out with friends and there is a gluten free pizza option available, they can maintain their gluten free plan while still being able to socialize with their friends. So there are ways to make this work.
We just would say, save that for the special times and try to focus on real food the rest of the time. It can be difficult. So for more help and education, Cassie Weness, a Registered and Licensed Dietitian, recorded a class called Going Gluten-Free the Real Food Way.
Cassie discovered through medical tests that she is gluten sensitive and her children have celiac disease.
MONICA: The New York Times piece, “Why Are Teens in Crisis?”, discussed the increased use and availability of smartphones and social media with a connection to mental health. When teens eat poor quality foods, especially when they're eating too much sugar and gluten foods, you know, these ultra processed foods like cereal, cookies, cake, crackers, the brain becomes inflamed.
And then it lacks the ability to function well. And then you add in the stress of small dopamine hits from social media. And we're using that as well to compare ourselves. And we're watching the highlight reels of peers. You can see why there's a big challenge. Helping teens decrease some of the inflammatory foods and feeding their growing brains with nutrient dense foods can give them a better baseline.
They'll have more energy to play sports, exercise, dance, play outside with friends, and all of these activities ultimately end up boosting their mood and then they feel like they're connecting and belonging, which we know are great things for their mental health.
TERESA: Right, I think it's so important that our kids have actual person to person connection versus just digital connection with other people. I guess it could be their peers, but it could be older people too. And then there's the lack of sleep that may come along with being a teenager. How many hours should a teen sleep? When I first read the research for the amount of sleep a teen needs to detox their brain, frankly, I was a little surprised.
It's nine hours, not six hours, not seven hours. I knew it wasn't going to be those, but I thought it might be closer to what an adult would need, which is eight hours, but it's actually nine hours most nights. Lack of sleep sets teens up to be sleep deprived. And that sleep deprived brain triggers the reactive and negative emotional center of the brain.
You may be living with a crabby, irritable teen, which isn't much fun. Lack of sleep could be directly impacted by being attached to their phone. How often does that happen to you too? You're scrolling instead of going to bed or being exposed to the blue light of TV and devices. It can be a real challenge to set up those boundaries for good quality sleep, even for us as adults.
Teens may also be worried about what's going on around the world, which may be interfering with their sleep, or maybe they have a heavy academic load and are up late studying. Maybe they have busy schedules with extracurriculars or jobs. No matter the reason, we do have some sleep tips that you can share with your teens for better quality and quantity of sleep, which will also provide a baseline for their moods.
MONICA: Sleep is really so important. That's something I notice with my son who struggles with anxiety. We can tell when he's not sleeping well because he is just so irritable. His emotions are all over the place. We just, it's such a clear difference when he's not getting that quality sleep.
And as dietitians and nutritionists, we understand how to help clients with sleep problems. We have lots of clients with sleep problems. Often when clients make appointments, they're only sleeping six hours a night. They feel exhausted, their body aches. They feel exhausted, their bodies ache, they crave sugar all the time.
And to overcome a sleep problem, it really takes some time and commitment because usually it's changing certain habits. And that takes time. So, rather than recommending a sleep medication or even a sleep supplement to start, we often just start with having a healthy, balanced snack at bedtime. One thing you can try with your teen, it might be some apple slices with good natural peanut butter or almond butter.
The fat in the peanut butter is going to help calm the brain and anchor our blood sugar and that helps promote better quality sleep. My kids like the peanut butter protein balls on our website. I make those a lot, so sometimes those are a great snack, especially after evening sports and activities. I want to make sure they go to bed with a good snack. My daughter also loves frozen blueberries with cream.
TERESA: So good. I don't blame her.
MONICA: I introduced that to her recently and she's obsessed and wants it every day, but you know, many teens are so deficient in nutrients and we need to add some minerals sometimes that can help promote sleep. So one of those things might be Magnesium Glycinate or even calcium can help.
TERESA: Yeah. Those minerals are so important for teens because number one, our foods aren't really rich sources of those anymore depending on what your child is eating or your teen is eating, may not be eating rich sources of those particular minerals, which are so beneficial for sleep.
So sometimes having some of those extra minerals can be really beneficial, and after your teen has had a few days of being gluten free, they're eating enough balanced, real food throughout the day and getting seven and a half to nine hours of sleep, the teen's mood, it should improve. We know changing some of these lifestyle habits takes time.
I usually, like I had said earlier, suggest setting up several appointments to help keep the teen on the path to recovery. One by one, we can help teens feel calm, peaceful, and comfortable in this world. And we just want to work together to help achieve this.
MONICA: Absolutely. And as a mom, I'm also realistic about what teens are willing to eat. We know there are a lot of likes and dislikes when it comes to food, and this is an age, too, where they're kind of wanting to set their own rules, right, about what they're going to eat. So we can help. I mean, my kids are picky eaters, so I know the struggle. The good news is, you can usually find some real foods that your teens and kids will eat.
TERESA: I've found that most teens will drink a protein shake. For a teen and their taste, I like to add half a banana, some frozen strawberries, a good tasting whey protein powder, and a half a cup of heavy cream. It tastes great. It tastes like like a strawberry banana milkshake, quite honestly, and it's high in nutrients. It's got a great source of protein and it's a great breakfast.
As a dietitian, I love to add nutrients, especially protein, good fat and a variety of vegetables. So I will often suggest that teens add the Key Fruits and Greens for taste and a good source of nutrients. We need to take small steps to make lasting changes.
The goal is to reduce inflammation and help teens think better and feel better. Sometimes it's challenging, but it's so worth the effort. Let's get started with your teen and get them on the road of good mental health. Digital technology isn't going away. So whether or not that is the main cause of mental health issues for teens, giving them the tools of how to feed their bodies and get enough sleep as self care that they can do throughout their lives is really empowering. It might lessen just a little bit of the stress they go through during the big changes that happen during adolescence.
MONICA: That's right. We really want parents to know there is hope if your teen is struggling. We know parents just want to help their teens feel better and sometimes you can feel really desperate.
So, to recap some of the nutritional suggestions we mentioned today, one: incorporating healthy fat into meals and snacks can help fuel the brain. Healthy fats look like guacamole, avocados, nuts, nut butters, butter, cream, coconut oil.
Two: hydrate the brain by drinking plenty of filtered water. Maybe get your kids a new favorite water bottle that can make drinking water more fun. I know my daughter has been drinking way more water ever since getting one of those popular Stanley cups.
TERESA: My daughter too. It's the magical water drinking cup.
MONICA: Yeah, and she asks me to refill it all the time, so I know she's drinking more water.
TERESA: We also want to help our teens eat enough food and eat in balance with protein, fat, and carbohydrates at meals and snacks throughout the day to balance blood sugar. Incorporate foods like enough animal protein to get the amino acids for neurotransmitters, the feel-good brain chemicals.
MONICA: Also decrease the amount of high sugar in processed foods that can cause blood sugar spikes and inflammation. Try eliminating gluten if you suspect your teen is sensitive to gluten. Add in a bedtime snack of a little carbohydrate and some fat to help your teen sleep.
TERESA: One of the things I would say is remove devices and screens from bedrooms or regulate the usage. There are many apps and options to control when and how much the phone, gaming, social media apps can be used. And know you're not alone. We are here for you and your kids. There's a lot out there on social media about nutrition, and we can help teach your teen what works for them and their body to reach their goals, whether that's to feel better mentally, have more energy, perform better at their sport or activity, or just feel more comfortable in their growing bodies while their hormones are changing.
Our goal at Nutritional Weight and Wellness is to help each and every person experience better health through eating real food. It's a simple yet powerful message. Eating real food is life changing. Thank you for listening and have a wonderful day.