As we previously discussed, exercise, food choices, and stress management are crucial in boosting not only your mental health but also your physical health—especially when living with a chronic disease like PAD or diabetes. There are so many diets that are geared toward vascular health. I have written on some diet plans, like the rainbow diet or the DASH diet, yet the common thread amongst healthier food choices is the avoidance of preservatives, ultra-processed foods and snacks, and food dyes.

Whole food choices are always going to be your best bet in trying to keep a healthy lifestyle. When buying foods that are processed or prepared, be mindful of the sodium content. When you have vascular, heart, or kidney disease, you need to proactively manage your sodium intake. Also, you must be careful of potassium in certain foods or spices if you have a disease process that is restrictive of high-potassium foods. Some spices that are advertised as “low sodium” or “sodium-free” may have a higher amount of potassium instead. You do not want to have a diet that is not balanced or high in sodium or contraindicated minerals, because it can have unhealthy side effects.

Sometimes it’s hard to know where to start. If you need a bit of help in planning your meals, a good resource is My Plate from the U.S. Department of Agriculture (USDA). It is an easy way to get tips on wholesome food options and portions. Using apps like My Plate, or working with a nutritionist, can help make planning meals less taxing while optimizing healthy food choices. If you have a chronic disease, consult your doctor or nutritionist on precisely what foods you should be consuming.

There have been studies that have demonstrated a positive effect on mood when a person is consuming the right foods. For example, “The SMILES (Supporting the Modification of lifestyle in Lowered Emotional States) Trial”, which was published in the international journal BMC Medicine, showed that “participants in the dietary intervention group had a much greater reduction in their depressive symptoms over the three-month period, compared to those in the social support group.” 

The SMILES diet utilized the following dietary recommendations:

• Mediterranean, Norwegian, or Japanese diet

• Adding a higher number of fruits, vegetables, legumes, wholegrain cereals, nuts, and seeds

• Increasing foods rich in omega-3 polyunsaturated fatty acids

• Substituting unhealthy foods with wholesome nutritious foods

• Reducing the number of processed foods, “fast” foods, commercial bakery goods, and sweets in your diet

Studies like the SMILES trial show how nutritious food choices can have significant benefits to your mood especially when you are struggling with a chronic disease. Eating healthfully can lead to mental health improvements beyond having a positive impact on your disease process. Another study, published in Frontiers in Psychology, showed while “controlling for covariates, raw fruit and vegetable intake (FVI) predicted reduced depressive symptoms and higher positive mood, life satisfaction, and flourishing; processed FVI only predicted higher positive mood.”

The study also rated the top 10 raw foods related to better mental health:

• Carrots

• Bananas

• Apples

• Dark leafy greens like spinach

• Grapefruit

• Lettuce

• Citrus fruits

• Fresh berries

• Cucumber

• Kiwifruit

Whether you follow the DASH diet, Mediterranean diet, or plant-based diet, a common thread is reducing or eliminating processed foods or fast food from your diet. “The USDA defines a processed food as one that has undergone any changes to its natural state—washing, cleaning, milling, cutting, chopping, heating, pasteurizing, blanching, cooking, canning, freezing, drying, dehydrating, mixing, packaging, or other procedures that alter the food from its natural state. The food may include the addition of other ingredients such as preservatives, flavors, nutrients, and other food additives or substances approved for use in food products, such as salt, sugars, and fats.”

Keep in mind that not all processed foods are bad for you. What we look for is the difference between ultra-processed foods and processed foods. Nutritious processed foods include frozen fruits or vegetables that have no added preservatives or chemicals; they are merely fresh produce that has been flash-frozen to last longer. Ultra-processed foods are usually full of preservatives and chemicals, are high in bad fats, sodium, and sugar, and hold very little nutritional value.

The nonprofit organization Environmental Working Group has a “Dirty Dozen Food Chemicals” that are best to avoid:

• Nitrates and nitrites

• Potassium bromate

• Propylparaben

• BHA (butylated hydroxyanisole)

• BHT (butylated hydroxytoluene)

• TBHQ (tertiary butylhydroquinone)

• Titanium dioxide

• BVO (brominated vegetable oil)

• PFAS (per-and poly-fluoroalkyl substances)

• Artificial colors

• Artificial sweeteners

• Heavy metals

According to the Cleveland Clinic, it is also good to avoid MSG (monosodium glutamate), trans fats found in partially hydrogenated oils, sulfites, and FD&C yellow no. 5 and no. 6 food dyes. Ultra-processed foods are loaded with chemicals, fats, sugars, and sodium. That is why it is imperative to read the labels of the foods you regularly consume.

Learning to make healthy food choices can not only affect your mood, but it can be key to overcoming a chronic disease like PAD (Peripheral Artery Disease) or diabetes. If you are suffering from a chronic disease, consult with your doctor or nutritionist for guidance and insight on making an optimal and healthy dietary choice.