Episode 153 | Oct 23, 2025

Nutrition’s Hidden Influence on Your Mind, With Dr. Andrea Cook

Can what you eat shape how you feel and think? This week on Health Coach Talk, Dr. Sandi welcomes licensed clinical psychologist and FMCA-certified health coach Dr. Andrea Cook to explore nutritional psychology, the bi-directional relationship between food and mental health. Dr. Cook shares how this lens is reshaping psychotherapy training, clinical practice, and even college psychology curricula.

“So, it is looking at the bi-directional relationship between nutrition and mental health. Because we know now the research has finally reached a point that we have enough data to show that what you eat directly impacts your mental health.”

Andrea Cook, PhD

In conversation with Dr. Sandi, Dr. Cook maps the landscape of nutritional psychology today. She discusses evidence connecting dietary patterns to anxiety and depression in young people, why some processed foods can hijack reward pathways similar to addictive substances, and how stress, culture, family patterns, and trauma histories influence eating behavior. She addresses scope of practice with practical guardrails, emphasizing education over prescription and collaboration with nutrition professionals and physicians when cases are complex or medications are involved. She also speaks to common pitfalls like orthorexia, offering a flexible mindset built on intuitive eating, joy, and community. Tools such as a continuous glucose monitor can become experiments in curiosity rather than judgment, helping clients notice patterns and make informed choices without all-or-nothing rules.

For health coaches, this episode reinforces the power of root-cause, lifestyle-first support within a clear scope. Dr. Cook models language that invites consent and experimentation, not directives, and shows how coaches can partner with clinicians to address trauma, family systems, and disordered eating signs when they surface. Her approach centers client autonomy, nonjudgmental curiosity, and collaboration, giving coaches a practical framework to talk about food, mood, and behavior change while keeping the joy of eating and the value of community at the heart of care.

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Transcript

Dr. Sandi: If you think of a clinical psychologist as someone who only does psychotherapy, maybe psychological testing, well, I want you to think again because there is a field that is called nutritional psychology. And there’s a critical need for psychologists to not just do talk therapy, but to focus on the whole person, and that includes what they’re eating. And we get into this topic today with my guest. Let me tell you about Dr. Andrea Cook. She is a licensed psychologist and functional medicine certified health coach. Yes, she’s an FMCA graduate who specializes in comorbid medical and mental health disorders in her private practice. Dr. Cook includes nutritional psychology in all of her clinical work and believes this is an essential component of effective psychotherapy.

Dr. Cook also teaches upper division psychology courses at the University of California Santa Cruz, including clinical psychology, health psychology, and nutritional psychology. She recently co-authored a textbook on nutritional psychology in the hopes of popularizing inclusion of this course in college level psychology, counseling, and nutrition degree programs. I know you are going to enjoy this conversation with Dr. Cook.

Dr. Andrea Cook, it has been a pleasure to know you, and you are a clinical psychologist, and you also were associated with FMCA. And as part of that, you trained to become a health coach. So, first of all, I want to welcome you and congratulate you on writing and publishing a textbook.

Dr. Cook: Great. Well, thank you so much, Sandi, for having me on your show.

Dr. Sandi: Thank you. Well, your textbook is “Nutritional Psychology”. How did you come to want to write a textbook, and particularly, on this subject matter?

Dr. Cook: So, as a clinical psychologist, I’ve always been excited about the overlap between mental health issues and medical issues and worked in collaborative care where I was in primary care medicine, working with patients and collaborating with doctors. But I also had a passion around nutrition, and was noticing that nutrition was not being discussed in this medical world or in the mental health side of it. So, it really was leading me down that path. When I started teaching psychology classes at the University of California Santa Cruz, which is where I teach, I was teaching clinical psychology and psychopathology and health psychology. And still there was just not much discussion about nutrition.

And I was finding that in my clinical work, I also have a virtual private practice in California, that as I was developing my client relationships at a deeper level, I was integrating my functional medicine health coaching training and really seeing some dramatic effects that the impact was so significant, it really highlighted that this is missing. This is missing not only in our clinical training, but even at our beginning understanding of psychology. In functional medicine, we focus so much on root cause. And I thought, “Well, here’s a root cause approach to let’s get this information into the hands of our college students as soon as they start getting interested in psychology.” So, that was the thinking that brought me there.

Dr. Sandi: Yeah, well, I love it. And there is such a gap in the world of psychology. And I was a clinical psychologist for many years. And like you, I focused on physical health. I was a health psychologist. So, I was getting a lot of consultations, people who had medical conditions that when so I wasn’t doing psychotherapy, I was doing my body medicine. And I started to focus on asking them questions about, what were they were eating, and were they moving throughout the day? And what we call lifestyle approaches. But for people who don’t know, let’s start off, what is nutritional psychology?

Dr. Cook: So, it is looking at the bi-directional relationship between nutrition and mental health. Because we know now the research has finally reached a point that we have enough data to show that what you eat directly impacts your mental health. And whereas before, often, you were told, well, you need to eat healthy so you don’t die of a heart attack, right? So, you don’t have diabetes or other chronic illness from a more physical, medical side. And so, young people, especially, we’re given the message, “Eh, you’re all right for a while, eat what you want. In your middle age, you’re going to have to start eating healthier.” But now we’re seeing this dramatic increase in depression and anxiety in our young people. And so, part of my message is, if you want to get some relief now from some of that distress, changing your nutrition can really help you on that journey. So, there’s that side of it.

There’s also the other side to really understand what drives some of our eating behavior, right? Because it’s one thing to say, “Okay, I intellectually believe that I shouldn’t eat sugar, but I eat it anyway. Why do I do that?” And so, the book includes things like food addiction and understanding that way of thinking. And that’s a controversial issue. There’s not agreement that food addiction exists, although there’s continuing to gather evidence and research that says, yeah, it does. And we’re not saying that all foods can be addictive, but there are certainly some that have been processed and studied and tweaked in labs to activate our brains in ways similar to drugs, similar to substances of abuse. And so, I think that needs to be part of the conversation, as well as things like stress eating and cultural factors. What did you grow up with around your understanding of food and where it fits? When is food something that nourishes your body, and when is it something that comforts your emotions? And it’s important to know the difference. So, to me, that’s the both directions of nutritional psychology.

Dr. Sandi: Such a good point. And both directions are so, so badly needed. So, if you were working with someone, how would you approach this topic? How would you bring it up? If somebody comes to you because, “I need psychotherapy. I’m going to see a psychologist. It’s all in my head. I’m going to talk it out and find out what happened in my childhood, and how my mother set me up for mental health issues,” for example. So, how do you bridge that gap? And there’s not even thinking about it.

Dr. Cook: Yes. So, of course, it starts with psychoeducation saying, you may not know this, but we are finding that foods can sometimes directly impact how we think about things, how much we worry, how heavy and fatigued we feel. And all of those combined with an understanding of what happened in my childhood and my family of origin, right, are very powerful. But sometimes, the food’s getting in the way of actually making changes in your life, right? Having the strength to say, “I want to get out and walk every day.” Or having the strength to have that difficult conversation with that person who’s important to you. So, building up our reserves in that physical way can be so helpful, too.

Now I also found, I had one client where it was so dramatic that really locked it in for me. Like, I have to talk about this with every client. I have to remember to have this conversation. And this was a young woman who had recently graduated college. And certainly, that can be both an exciting and a stressful time because she was beginning a career. She was looking at moving out of her house for the first time away from her parents. And all of the excitement and fear that comes up with that, as well as, of course, the usual family dynamics that were coming up. And she developed debilitating panic attacks. And it was getting to the point where it was getting harder and harder for her to leave the house, much less she used to like to do short trips. And she couldn’t travel because as they would especially hit her at night with bouts of diarrhea. She ended up in the emergency room twice. And that was a terrifying experience for her. So, it really was getting in her way.

And so, I asked her, because of the diarrhea, that was what caught my attention, and I said, “Oh, have you ever experimented with pulling certain foods out of your diet, otherwise known as an elimination diet, and seeing if that makes a difference for two to three weeks, just noticing.” And so, we got talking and I said, “Are you willing to do an experiment and just see if that makes a difference?” And she said, “Yeah.” And I said, “What do you suspect might be the biggest issue? And where do you feel like you’re ready to start?” She said, “I’d like to start with gluten, to cut out gluten for two to three weeks, see if that makes a difference.” It was astounding. In two weeks, the panic attacks were pretty much gone. She had some mild ones, the diarrhea was gone.

But suddenly she’s like, “Well, I feel it coming on, but then it subsides, and it doesn’t get to the point where I think I’m dying and have to go to the emergency room.” So, for her, that was life changing. And within a few months, she was starting to take short trips. And then eventually, her big like, “Okay, I’ve done it now,” and she went to Hawaii, and from California to Hawaii and spent five days in Hawaii. And like, “Wow, I really feel like I’ve got my life back.” Started her career. Was working on moving out of the home. So, when I saw that kind of rapid change, it really cemented into me that we have to have this conversation.

Dr. Sandi: It’s critical. And what an inspirational story. And it reminds me, brought me back to when I had severe panic attacks, I was in my 20s. And I was feeling like I’m having a heart attack, I can’t breathe, and I also had to go to the emergency room. And at the time, I just thought, “Well, my mother was anxious. Runs in the family.” And what I know now, looking back, was that my lifestyle habits were not really good. In fact, I was binging on sugar. I mean, really binging, or I would skip meals, and I’d have candy bars and pints of ice cream and not believe it, not to the point where I was sick to my stomach, but I would just go a whole day. And I had the sugar diet, lots of bread, lots of pasta, but also, lots of sweets, lots of desserts, and wasn’t working out. And also then, was very stressed. But what I’m realizing was that I was stressed because the sugar was hijacking my brain, and my executive function was out the window.

Dr. Cook: Absolutely.

Dr. Sandi: And that what I finally woke up to that. And actually a physician had prescribed me Inderal, which it’s often used anti-anxiety. And at that time, you couldn’t go online, there was no internet, so no computer. But I looked at the physician desk reference, this big volume. I went to a bookstore and got it out…

Dr. Cook: Library’s desk.

Dr. Sandi: …in the library and found it, “Wait a minute, this is a heart medicine.” I’m only in my 20s. I was like 24, 25, “I got too young for this.” And then started to look at these components, and, yeah, never had a panic attack since. And it was a combination. It was practicing breathing, and it was thought changing that I’m safe, but it’s just my body thinking that there’s an emergency, but also, drastically changing how I was eating and what I was eating. So, it is really critical.

Dr. Cook: You and I share such a similar journey. We’ve always said that, right? Similarly, I struggle with anxiety. Mine would turn more toward irritability and just like, “Oh, everything’s bothering me. This is really hard.” And one of the life-changing things was I met with my first nutritionist and she said, “Eat when you’re hungry.” And it was like, “Okay, that’s amazing, first of all,” because I was always trying to be good, and three meals a day and no snacking, right? But also, I started realizing that I was hungry all day, all the time. I was just always hungry.

And so, she also said, “You need to eat protein and fat throughout the day.” And I’m like, “Yeah, but shouldn’t things be low fat, right?” Because I went through that, right, the 80s and the 90s, right? Broke that low fat. And I was disciplined and hardworking. And boy, did that not work for my body? Because I was just constantly in that, in hindsight, hypoglycemic. And when I start crashing, I’d be shaking, and then I’d be irritable and uncomfortable. And so, once I started adding protein and fat throughout the diet, I was just like, I’m a different person. I call and I’m not hungry all the time. And this is amazing. I didn’t know I could feel like this. So, of course, that made me want to then pay that forward to other people.

Dr. Sandi: Yeah. So, writing a textbook is very ambitious, but wonderful. What were some of the challenges, but also, some of the successes that you experienced in writing this?

Dr. Cook: Yeah. So, well, first of all, getting it approved took a couple of years in my university because they’re like, “This is a new course.” So, I started teaching the class. And luckily, the chair of my department was wonderful. And as I was proposing the idea, he was the one that made the class happen first. And then as I taught, design the class, I realized there was no textbook. So, I was, like, piecing together, “Okay, we’re going to get this book and this reader or these articles,” which worked, but it was disjointed. So, this is co-authored with Dr. Jennifer Champion, who has a doctor in clinical nutrition. So, I wanted to be sure I could partner with someone who had similar thinking to me. And that was a process of going through a couple of different people and going, “Who is a good fit for me, and a good balance ,and brings in information that I don’t necessarily know.” She was wonderful to work with. And we met, of course, at FMCA, right? We both worked there together with you.

So, the first thing we did was sit down in a hotel room for two days and just start writing down what needs to be included. What’s the list because it’s so vast. And then from that started putting together our sort of preliminary table of contents. So, to me, that was hard because it’s like, “What do you include in, what don’t you? And to what depth.” Because each of these, I felt like, “Well, I could write a book on each of these chapters. There’s so much to say.” And I had to keep in mind my audience. And that was helpful that I’ve been teaching at UC Santa Cruz for eight years. So, I had a sense of what my students like, what they can handle, what level of depth? When do I lose them? How much science do I get into? So, that was really important to keep that voice and tone.

And I actually interviewed my students as I was starting to write the book to say, “Well, what do you look for in a good textbook?” And they were very adamant about the language being accessible. And it was interesting that they were saying, “We are so tired of people showing off their knowledge by talking in all this terminology that we don’t understand.” And I was like, “Okay, so I need to get this where it’s something that they can not only understand, but keep their interest.” And students are flooded with so much information that I want mine to get in there a little bit. So, I also needed to figure out how to make it personal.

And that was something that Jennifer and I talked a lot about, which is why we included case studies, why we included little, we call them food for thought boxes, that get them thinking about what works in your own body. What are the things you struggled with? Who do you know that struggles with this type of issue? So that it keeps them engaged. What was hard about it? Being locked in my office, knowing lifestyle as I do and the importance of movement, spending that much time sitting with my hands on a computer was hard on my body. And I did everything I could think of. I have, like, five workstations with different desks, the standing desk, the sitting desk, comfy chair, the treadmill desk, the sit-on-the floor desk, just anything to try to be in different positions to sit and stare at the computer at home.

Dr. Sandi: I do the same. Yeah, I have a standing desk, and I’m standing right now. I have a treadmill desk as well. It helps. And Dr. Jennifer Champion, she was actually our… She was a student of mine when I taught at the University of Western States, having her a student.

Dr. Cook: Really? I didn’t know that.

Dr. Sandi: And then she was in our first beta class at FMCA to be a health coach, and then went on to get her doctorate in nutrition. So, there are so many ways that you can blend these different disciplines. And in the past, I think we’ve all been in our silos. So, it’s been just about 10 years when I founded FMCA, and I stopped working as a clinical psychologist. But the division at that time was very strict boundaries. So, in terms of, I was incorporating nutrition, not as a nutritionist, but I, like you, I was talking about what people were eating, providing education, but this was outside of what a psychologist’s scope of practice. And so, there’s a lot of fear, and I had to document that I had training in this area and I was not prescribing milk lands, for example. But how have you dealt with that in terms of the professions? Because I think in many ways we have psychologists, everybody should be a nutrition psychologist and a lifestyle psychologist in their work, but there are still these boundaries. And often, it’s from the boards, the American Psychological Association, for example.

Dr. Cook: I’m so glad you brought that up because I think it is a careful dance of, what can I talk about? What is in my scope of practice? Where do I have knowledge? And how do I work with that? And so, often, I am referring them to, “Oh, this article or this website.” I’m going to let you know that information is out there and I’m going to encourage you to read more about it. And that’s a way to not be the expert on it, not say, “Well, you should just trust my word on it,” but to let them know that information even exists. And so, yeah.

Dr. Sandi: Yeah, that’s an important point. And that’s just what we teach our health coaches, to refer to research, refer to an article, refer to a book, but it’s always client-centered and they’re making the decision. It’s not the coach, or in this case, a psychologist who’s telling them what to eat.

Dr. Cook: Right, right. Exactly. Yeah, as you said, steering away from any specific meal plan, it’s like, I would say, “Oh, well, this is what a Mediterranean diet is,” or, “This is what a keto diet is.” And then it’s up to you to decide what you want to do with that, right? Other than saying, “Based on your…you should eat.” And so, that’s where I am careful to draw a line.

Dr. Sandi: Yeah, I think that’s really important. And just as you collaborated with Jennifer on the textbook, do you see a role for collaboration where you might have, let’s say, a difficult case, maybe someone’s on multiple medications, would you, at that point, refer them to a nutritionist for an evaluation or consult?

Dr. Cook: Yes, Jennifer has helped me with multiple clients. So, she has been… And I’m starting to work with some other nutritionists as well, because her practice has really blossomed, which is wonderful, but it’s like, “Oh, now, we need other people, too.” So, yeah, and my goal is to collaborate more with functional medicine physicians as well, because I know for so many of them, they absolutely believe in the importance of eating and working with health coaches and working with nutritionists. And sometimes, I think when we have a client who has more significant mental health issues, it can be a stumbling block. We’re providing all this information for this client and they’re still not moving forward.

It’s like, well, they may need to explore their trauma history, right? And that’s really more in the realm of a mental health clinician and not a nutritionist or a health coach, or they may need to really understand how their family of origin is affecting their eating behavior. Or if they’re drifting into an eating disorder style of eating, what signals do we need to be aware of? One of the things we talk about, there’s a chapter on eating disorders in the textbook, and certainly getting into orthorexia, which is that eating perfection becomes its own problem, and is a form of restrictive eating where it becomes unhealthy. And so many foods don’t fit what you think is the okay, perfect food. And it ends up creating more anxiety instead of eating anxiety. So, I think that’s when we start needing to incorporate mental health support more specifically in addition as part of the team.

Dr. Sandi: Yeah, yeah. And it’s so important. I’m glad you brought up orthorexia because you can be paralyzed. And I think it’s getting worse because there are things that were on my radar for those, gluten and dairy and sugars and preservatives and seed oil. Now, we’ve got even more. Now, we’ve got to worry about plasticize and so many other things. So, that list keeps growing, where heavy metals and seafood, and then you end up with nothing to eat. So, one of the things we talk about a lot and focus on and in terms of the joy of eating as we’re sharing meals. So, can you comment on that? Would you say that’s part of, how do you focus on that? And we talk about nutritional psychology, eating in community, or having experiencing those joy of sharing a meal, cooking together.

Dr. Cook: Yes. We also get, in the book, into intuitive eating, where about really reconnecting to what feels good. That is such a good gauge for what to put in your body as your body will give you information. We have to slow down and quiet down enough to listen, so that piece of it too. And I like the terminology they use in intuitive eating where they call it fun foods, because nothing’s off limits. But it’s important to know that some foods are going to affect you in ways that don’t feel good long-term. And if you eat them every day, there may be some consequences. It doesn’t mean don’t ever eat them, but it means, make sure you’re doing it in a way that it’s more special, totally enjoy them. No, you may pay up, and may not feel great for the next day or so, and you can go, “Oh, look, I’m feeling a little depressed. Oh, yeah, yeah, I had that piece of cake. But it was birthday cake and that was a great birthday party. And it was totally worth it.” So, I think keeping that mindset is important.

And part of what I work with too is keeping an attitude of non-judgmental curiosity, that this is a constant exploration about what works for my body. It’s so individual. And so, I just had a client who got a continuous glucose monitor for the first time, and he’s an older adult. And he was worried that he would start obsessing about his glucose monitor and checking it all the time and then feeling bad, feeling that he had somehow failed because he was getting a glucose spike. So, we really worked a lot on, can we just be curious and notice. This is your little clinical experiment with an N-of-1. “Oh, look, I ate that piece of toast and my glucose spike. That’s so interesting. Huh?” Well, if our goal is to limit my spikes, I may only have toast on a special occasion. I may make sure I do it with lots of butter and almond butter and an egg or… Really thinking about the bigger picture of, how does this fit in my life? Instead of just, “Oh, toast is bad. No more toast.”

So, that’s really an attitude that I encourage with my clients, in my class, you know, that this is not about getting it right. This is about continuing to evolve and explore. And our bodies change, especially for someone who has been more insulin resistant and eating a diet of more processed foods after a period of whole foods, you can bring back in a few things and tolerate them better. And so, I’m talking about the healing process as well, that because I know if we say never again, you’ll never eat that food again, right? That deprivation mindset sets in. And I know for me, as soon as anybody tells me I can’t have something, that’s all I want.

Dr. Sandi: That’s right. And I think that’s a perfect example to describe with that continuous glucose monitor of that interaction, that intersection of psychology, what are you thinking about? What are your conclusions? And having a nutritional approach is why it’s so important that we see these together. So, how do your students respond to this course, to this textbook?

Dr. Cook: They love it. So, we have a quarter system, and the last spring was the first time using the textbook. So, my class, my nutritional psychology class is generally about 180 students. So, big lecture class with a couple of three teaching assistants. And we get course evaluations at the end, and they are so excited with this material. They talk about it being one of their favorite classes they’ve ever taken, that it’s one of the ones that’s really life-changing for them and so meaningful and so personal. So, that’s been really exciting.

And part of what I do in my class and all of my classes actually is we do a five minute meditation during every class, in the middle of every class. Because like you and I were saying at the beginning, this idea that this is a full lifestyle. This is not just, eat the right food. It’s also, how do I calm my nervous system in this era of high stress? And so, that’s a skill I want all my students to learn. So, we do a five minute meditation, and they love it. The evaluations always talk about, “Oh, it’s so amazing, just five minutes and I feel so much better.” So, that’s been exciting to incorporate that in.

And it’s been interesting, too. I mean, my students are amazing and I love their courage and their honesty. And so, sometimes too, they’ll say, “I need you to be sensitive in how you talk about this.” And I learned from them, they might say, “I went through treatment for an eating disorder, for anorexia.” And this is the language we use in that. “And some of what you were saying was upsetting.” And so, I really need to be thoughtful when I talk about something like food addiction to say, “This is controversial.” Not everybody agrees with this. In eating disorder treatment for restricted eating disorders, it’s very common, or actually across the board, it’s very common to hear the term all foods fit, and really encouraging people to lose some of their fear that this food is bad or harmful or bad for me, almost like it’s poisonous, and it’s not.

So, to bring it more into a realm of reality about, “How do I function within that,” and then tapping or touching the controversy that we don’t know what works, and the same thing doesn’t work for everybody. For some people, all foods fit is really important and it’s been important part of their recovery. For other people, we’ll see things like over eaters anonymous, where they have no sugar, no flour, abstinence approach. Saying, “Look, for some people, sugar and flour are never a good fit in the same way that for someone who is sensitive to alcoholism, they may need to completely cut out alcohol, to not be pulled back into a lifestyle that makes them feel bad.” So, clearly, controversy exists, and so, it’s very important for me to articulate that so my students don’t feel like I’m choosing an approach that excludes them.

Dr. Sandi: Absolutely. That’s really critical. Well, you are really making a difference in the lives of these college students. So, Andrea, where can people find you and find the book?

Dr. Cook: Yes, my website is drandreacook, and there’s a page about the textbook there, and then you can find the textbook on amazon.com as well. So, it’s easy. And my hope is to inspire other potential instructors. Let’s go start teaching. Let’s go find colleges and universities who accept lecturers to come teach one class. And many of them do. If you show up with a good proposal and say, “Hey, I think your students would like this class.” They’ll say, “Okay, we’ll hire you once and see how it goes.” That’s how I started my college teaching career, was I started with health psychology. So, I would encourage people to get excited and share the information.

Dr. Sandi: So necessary. Well, this has been a delightful conversation. It’s been a pleasure. Thank you so much.

Dr. Cook: Thank you, Sandi. This has been wonderful.