*4.5. Vitamins and Minerals*

There is significant animal data suggesting an anxiolytic effect of several vitamins and minerals as well as supplemental formulas which deliver a combination or broad range of micronutrients. Given the presence of micronutrients in whole, unprocessed foods such as vegetables, fruit, and whole grains, these findings add evidence to the importance of eating a healthy diet containing a variety of unprocessed foods. Intake of foods that provide a rich source of zinc (oysters, crustaceans, meat, organ meat, leafy and root vegetables [95]), and selenium (Brazil nuts, seafood, meat, beans, and lentils [85]) could be prioritized.

Micronutrients such as zinc and selenium are necessary as coenzymes in the synthesis and regulation of neurotransmitters and neurotrophic factors [96] which may explain their importance in maintaining mental wellbeing. Additionally, B vitamins and folic acid contribute to the methylation balance which is hypothesized to be relevant to the pathophysiology of psychiatric illnesses [97].

#### *4.6. Vegetables, Fruits, and Phytochemicals*

There is fairly consistent evidence that vegetables, fruit, and plant constituents may exert anti-anxiety actions; however, the majority of the evidence comes from animal studies. Caffeine on its own or added to energy drinks appears to be associated with increased anxiety. Whole foods containing caffeine such as coffee, teas and cacao may have beneficial or equivocal impacts on anxiety, likely due to the co-occurrence of caffeine with other beneficial phytochemicals. Vegetables and fruit contribute to lower levels of inflammation and oxidative stress through their phytochemical and antioxidant constituents [98].

#### *4.7. Food Allergy and Intolerance*

The body of evidence related to the connection between food allergies and anxiety symptoms is limited and the majority of the evidence pertains to the presence of elevated anxiety symptoms among individuals with celiac disease and the anti-anxiety effects of implementing a gluten-free diet in this population. The presence of neuropsychiatric symptoms in celiac disease is established, with hypothesized mechanisms including micronutrient deficiency due to malabsorption and hyperhomocysteinemia [99]; however, it is unclear how the findings of these studies may apply to anxious individuals unaffected by celiac disease.
