Metabolic health is mental health, too
By
Dr. Jeffrey Alfonsi & Don Bisch
Aug 14, 2026
Far too often, metabolic health and mental health have been treated as separate issues. Diabetes, obesity and insulin resistance were managed on one side. Depression, anxiety and stress were managed on the other
But the science is telling a different story. The body and brain are in constant conversation, and the gut is one of the main places that conversation happens
The gut-brain connection
The gut does far more than digest food. It communicates with the brain through nerves, hormones, immune signals and nutrients carried in the bloodstream. It is also home to trillions of microorganisms, known as the microbiome, that help regulate inflammation, blood sugar and brain chemistry. What we eat helps shape that microbiome, which is why nutrition is so closely tied to both physical and mental health
One of the most striking examples is serotonin, a neurotransmitter closely linked to mood and emotional balance. About 95% of the body’s serotonin is produced in the gut, which means gut health can play an important role in how people feel day to day
When the microbiome is disrupted, that communication can change. Research has linked gut imbalance with depression, anxiety and other mental health concerns. The evidence is still evolving, but the connection is becoming harder to ignore
Metabolic health is mental health, too
Poor metabolic health often shows up long before a formal diagnosis. Insulin resistance, elevated inflammation and unstable blood sugar can affect energy, concentration, sleep and mood
That helps explain why metabolic conditions and mental health challenges often overlap. Insulin resistance has been associated with up to twice the risk of major depression. Among people managing obesity, about 1 in 3 have experienced depression and 1 in 4 have experienced anxiety
These are not separate stories. They are often different expressions of the same underlying biology
Food is one of the most practical levers
Nutrition is not a cure-all, but it is one of the most practical and modifiable ways to support both metabolic and mental health. Unlike many risk factors, food choices can be supported through education, tools, benefits coverage and everyday workplace environments
Protein-rich foods help support mood-related neurotransmitters. High-fibre foods and fermented foods support the microbiome. Omega-3 fats can help reduce inflammation. Eating 30 or more different plant foods each week has also been associated with a significantly more diverse microbiome,7 which may support better mental health. Balanced meals with protein, fibre and healthy fat can help steady blood sugar, energy and mood throughout the day
The goal is not perfection. It is practical, personalized nutrition support that helps people make realistic changes in the context of their lives: small choices that can add up to better physical health, steadier energy and improved mental well-being
Sidebar: How plan sponsors can support healthy nutrition
Group benefits plan sponsors can support their plan members’ health by helping them make everyday choices that support their well-being
Healthy options in the workplace
It’s difficult for plan members to build healthy eating practices if the only choices at the cafeteria counter are burgers, fries and chicken fingers. So, the low-hanging fruit (pun intended), is for plan sponsors to ensure nutritious options are available in the cafeteria, in vending machines and at staff events, such as townhall meetings
Information is key
But offering healthy options isn’t the only critical step. It’s also important to educate members about the benefits of healthy eating and the implications of poor nutrition. “Lunch and learns” or seminars with practical tips can help provide the knowledge and motivation members may need. Offering members access to online rethem make healthy dietary decisions
Coverage for dietitians
Plan sponsors can also include coverage for dietitians under their extended health care plan. Plans typically include an annual maximum of $300-500. Dietitian services are also an eligible expense under a Health Care Spending Account
Dr. Jeffrey Alfonsi is the co-founder and chief product and medical officer at RxFood. Dr. Alfonsi is an engineer and physician specializing in internal medicine, obesity medicine and clinical pharmacology and toxicology. He practices at Trillium Health Partners and Cleveland Clinic Canada
Don Bisch (who wrote the sidebar) is a director, group product and marketing at Equitable. He has 30 years of financial services experience, with a key focus on group benefits. He’s spent the past 16 years helping drive Equitable’s growth in communications, product and marketing leadership roles
