One in ten Americans takes antidepressants, and females are more likely than males to take them, according to data collected by the Centers for Disease Control. In addition to pharmaceuticals, integrative medicine incorporates nutrition, mindfulness-based stress reduction and breath work, botanicals and supplements, exercise and yoga, biofeedback, acupuncture and energy medicine and other modalities for dealing with anxiety and depression. Eating certain foods and overall good nutritional habits can have a very positive influence on your mood. Here are a few nutrition tips for better mental health.

Reduce processed and refined carbohydrates and eat more complex carbohydrates. Carbohydrate-rich foods trigger the production of tryptophan, the amino acid precursor to the calming neurotransmitter serotonin. However, experts like Mayo Clinic’s Dr. Daniel Hall-Flavin advise that healthier carbohydrates with a lower glycemic index (GI), such as vegetables, whole grains and some fruits, are more likely to provide a moderate but lasting effect on brain chemistry, mood and energy level than the high GI foods, primarily sweets, that provide immediate but temporary relief. Berries, brown rice, beans, broccoli, spinach and kale are good sources of low GI carbohydrates.

Don’t skip meals. Eating regular meals that include sources of protein, healthy fats and complex carbohydrates helps us maintain balanced blood sugar and avoid surges of glucose and insulin and the release of stress hormones that can lead to feelings of jitteriness, irritability and anxiety. Examples include a meal of fish with brown rice and steamed vegetables or a snack of sprouted wheat bread with nut butter.

Increase omega-3 fatty acid intake to control depressive symptoms. Research consistently shows that omega-3 fatty acids offer protection against depression. The results of a study on nearly 22,000 Norwegian subjects, published in the Journal of Affective Disorders, revealed that regular users of cod liver oil, rich in omega-3 fatty acids, were significantly less likely (about 30 percent) to have symptoms of depression than non-users. Get more omega-3 fatty acids by consuming nuts and seeds daily and cold-water, fatty fish biweekly.

Avoid caffeine. Coffee, tea and some types of soda all contain caffeine that is known to affect the nervous system and activate stress hormones, which can worsen irritability and anxiety. Drink more water throughout the day, and instead of drinking regular coffee, choose decaffeinated or herbal teas that are naturally caffeine-free.

Reduce alcohol intake. While small amounts may be good for your health, too much may worsen depression and deplete your body of important vitamins and minerals.

Ensure adequate magnesium intake. An analysis published in 2009 using data from the large Norwegian Hordaland Health Study showed that low levels of magnesium can trigger symptoms of anxiety and depression. Almonds, cashews, leafy greens, and soybeans are good dietary sources.

Ensure proper levels of vitamins B12 and D. Deficiencies in these may increase the risk of depression; ask you healthcare practitioner about testing for vitamins B12 and D. Vitamin D can be obtained through exposure to 10 minutes of sunshine (without sunscreen) two to three times per week. Shellfish, beef liver, mackerel, herring, salmon and sardines are good sources of vitamin B12; fortified soy products are a vegan source. Supplementation may be indicated.

Mary Ellen Francescani, a family nurse practitioner at General Internal Medicine of Lancaster, is enrolled in her final semester of Dr. Andrew Weil’s Integrative Medicine Fellowship through The University of Arizona. She leads community wellness programs including mindfulness meditation. Contact her at [email protected].