The Connection Between Burnout and Nutrition
Jennifer Harrington, DMS, PA-C, DFAAPA
Assistant Dean and Program Director, Lincoln Memorial University School of Medical Sciences Tampa PA Program
PA Foundation Nutrition Outreach Fellow
Burnout is a significant issue, both in the medical community and within the general U.S. population. It is defined as “a state of emotional, physical, and mental exhaustion accompanied by decreased motivation, lowered performance, and negative attitudes toward oneself and others.” 1 While some believe burnout is based solely on stress levels, science suggests the foods we eat have a huge impact on our emotional health as well. A poor diet, marked by lack of nutrients, high glycemic index, and high sugar consumption, is linked to increased incidence of memory impairment, feelings of disconnectedness, lack of energy, depression, anxiety, and mood disorders. Conversely, foods with high vitamin and nutrient content are linked to balanced mood, stronger immunity, longer lifespan, and increased capability to combat stress that frequently leads to burnout.
Evidence-based nutritional science supports the following recommendations to promote balanced mood and decreased stress levels:
- Consume a high-fiber diet (e.g., beans or legumes). This balances mood levels.
- Consume omega 3 fatty acids on a daily basis (e.g., nuts and seeds). This decreases cortisol levels.
- Make plant-based foods about 80% of the diet. This decreases incidence of anxiety and depression.
- Avoid low-carbohydrate diets (e.g., paleo or keto diets). These diets have been shown to increase all-cause mortality as well as mood cycling, anxiety, and depression.
- Adopt the “Blue Zone” diet. Those who consume more than 80% of calories from vegetables, fruits, legumes, nuts, seeds, and whole grains, and eat limited amounts of animal products, are shown to experience lower rates of depression, psychological stress, and mood disorders and improved incidence of perceived mental health. 2
Using nutrition to combat stress can seem like an overwhelming task when starting from a standard American diet. Small steps can make a big difference in boosting perceived mood and reducing the potential for burnout. Following one recommendation at a time, for example, or swapping a nutrient-deficient meal for a healthy alternative, can have an impact. Studies show that participants who replaced as little as 20% of unhealthy food choices with healthier options saw a difference in their mood and stress level as well as overall health.3 Incorporating mood-balancing and stress-reducing nutritional science into the daily diet doesn’t need to be difficult – here are a few practical discussion points to use when counseling patients to help them get started.
- Request that patients focus on adding delicious nutrient-filled foods rather than restricting foods: The initial goal should be to add 1-2 nutrient dense foods per meal. For example, add a serving of berries and walnuts to breakfast, a serving of raw vegetables and hummus to lunch, and a serving of steamed vegetables and beans to dinner. Patients should be advised to keep a food diary to log their nutritional choices and keep track of the progress they have made.
- Ask patients to make simple food swaps to promote nutritional excellence, for example,
- Choose healthier sources of calcium: Drink unsweetened almond milk instead of cow’s milk.
- Choose healthier sources of protein: Eat a serving of beans, lentils, quinoa, or amaranth instead of red meat. Swapping beans for meat just four times a week reduces cortisol and stress.
- Choose healthier sources of fat: Eat veggies with hummus, a handful of walnuts, or an avocado instead of a fatty prepackaged snack. Healthy fats reduce stress hormones and depression.
- Choose low-glycemic dinner foods: Eat quinoa, farro, buckwheat, or amaranth instead of white rice or white potatoes. This will decrease tiredness, increase energy, and reduce cortisol levels.
- Choose low-glycemic dessert foods: Eat 70% dark chocolate, berries, or an apple instead of a candy bar. This will balance mood and decrease perceived levels of stress.
Ask patients to select at least one category above, find an option that is palatable to them, and start with making 1-3 swaps a week. It is helpful for patients to keep a food swap diary to log the progress they have made in this area.
- Encourage patients to reimagine what meals look like: Healthier meal options include power bowls, vegetable based stews, and roasted vegetable main dishes instead of the traditional meat and potatoes meal. Patients should try to incorporate one reimagined, nutrient-filled meal into their weekly rotation. They should keep a list of the meals and the recipes that were the most delicious for future use.
- Tell patients that preparation enhances success: The most successful patients dedicate a 1-2 hours to meal preparation each week. During this time they can cut vegetables, make a vegetable bean stew, and/or create serving-sized portions of healthy, mood-balancing snacks for use throughout the week. Patients should pick a day and schedule a time for this food preparation each week. If they commit to doing this, they will often have something healthy ready to eat when temptation strikes.
- Aid patients in developing a support network: Being surrounded by friends, family, or an online community who will encourage them and share healthy recipes will patients to gain perspective and increase their chances of success. Patients should select at least one person who will partner with them and help to motivate them on their healthy lifestyle journey.
Nutrition is a key component of health – both physical and emotional. Help empower your patients to make optimal nutrition choices that will improve their emotional health and well-being.
Resources for you and your patients:
- Improved Cardiovascular Parameter With a Nutrient-Dense, Plant-Rich Diet-Style.
Joel Fuhrman, MD and Michael Singer, BS; Vol 11, Issue 3, pp. 264 – 273, First Published October 15, 2015
- Jenkins DJ, Kendall CW, Popovich DG, et al. Effect of a very-high-fiber vegetable, fruit, and nut diet on serum lipids and colonic function. Metabolism 2001;50:494-503.
- Shlisky J, Bloom DE, Beaudreault AR, et al. Nutritional Considerations for Healthy Aging and Reduction in Age-Related Chronic Disease. Adv Nutr. 2017;8(1):17-26. Published 2017 Jan 17. doi:10.3945/an.116.013474
- U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th Edition. December 2020. Available at DietaryGuidelines.gov.
- National Weight Control Registry. Research Findings. [online] Available at: <http://www.nwcr.ws/Research/default.htm> [Accessed 14 June 2022].
- Molade, O. Combating Burnout with Nutrition. Nutritionist Resource. May 4, 2021. Accessed March 30, 2023. https://www.nutritionist-resource.org.uk/memberarticles/combating-burnout-with-nutrition
- American Psychological Association. Burnout. APA Dictionary of Psychology. https://dictionary.apa.org/burnout.
- Buettner D, Skemp S. Blue Zones: Lessons From the World’s Longest Lived. American Journal of Lifestyle Medicine. 2016;10(5):318-321. doi:10.1177/1559827616637066
- Frates B, Bonnet JP, Joseph R, Peterson JA. The nutrition-health connection. In: Frates B, ed. Lifestyle Medicine Handbook: An Introduction to the Power of Healthy Habits. Monterey, CA: Healthy Learning; 2019:167-241.