Roughly 40 million Americans suffer from an anxiety disorder. And nearly all of us have felt anxiety as a natural response to certain situations.

If you live with chronic stress or anxiety, you might spend much of your daily life managing it with tools like therapy, mindfulness, exercise, and anti-anxiety medication.

But did you know that anxiety can be triggered by certain foods we put in our bodies?

This isn’t to say that these tools and approaches aren’t necessary for tackling anxiety — they are often healthy options for any person’s lifestyle. But if anxiety is still impacting your life, it might be worth it to a glance down at your plate.

Read on for five foods that trigger anxiety and suggestions for what to eat instead.

1. Alcohol

Believe it or not, that beverage you’re drinking to quell your social anxiety is actually making it worse.

“Although it may seem like it calms your nerves, alcohol can have a negative impact on hydration and sleep, both of which can trigger anxiety symptoms when suppressed,” says Erin Palinski-Wade, RD, CDE, author of “Belly Fat for Dummies.”

Alcohol changes levels of serotonin and the neurotransmitters in the brain, which makes anxiety worse. And when the alcohol wears off, you may feel even more anxious.

Drinking in moderation — or about two servings of alcohol a day — is typically safe, as long as your doctor gives you the okay.

Try Instead: There’s no real substitute for alcohol. If you like the flavor, but don’t need the side effects, consider nonalcoholic beer. Drinks that feel special, like mocktails or sparkling water with fancy bitters, can also be good replacements in social situations.

2. Caffeine

First, they want to take away your booze and now coffee? Sadly, yes.

According to the National Coffee Association, 62 percent of Americans drink coffee on a daily basis, and the average amount per day is slightly over 3 cups per coffee drinker. But our favorite morning ritual might actually be doing more harm than good.

“High levels of caffeine can not only increase anxiety and nervousness, but an also decrease the production of the feel-good chemical serotonin in the body, causing a depressed mood,” says Palinski-Wade.

Typically, caffeine is safe in low doses. But high doses can cause unpleasant effects, namely anxiety and nervousness.

A study found that participants who drank 300 milligrams of caffeine a day reported nearly twice as much stress. In Starbucks terms, a large (“grande”) coffee contains about 330 milligrams of caffeine.

Also keep in mind that several supplements and medications include caffeine and can contribute to anxious feelings, including St. John’s Wort, ginseng, and certain headache medications.

Try Instead: Matcha tea is an excellent alternative to coffee for a clean buzz minus the jitters. This is thanks to the L-theanine, which is known for its relaxing effects, without the drowsiness.

3. Aged, fermented, and cultured foods

A meat-and-cheese plate with a glass of red wine sounds incredibly relaxing, right?

In theory, yes, but according to science, not so much.

Whole foods like beef, milk, and grapes go gourmet when they’re cured, fermented, and cultured (see: steak, cheese, and wine).

But during the process, bacteria break down the food proteins into biogenic amines, one of which is histamine. Histamine is a neurotransmitter that aggravates digestion, hormones, and the cardiovascular and nervous systems. In susceptible individuals, it can trigger anxiety and insomnia.

Try Instead: To minimize histamine intolerance, always pick fresh, whole foods. Look for the “packed on” date of meat and fish. The less time it takes for it to get from where it was created to your table, the better.

4. Sneaky added sugar

There’s no way to avoid sugar 100 percent of the time, as it naturally occurs in many of the foods we love to eat, like fruit.

But added sugar is a contributor to overall anxiety.

“Added sugars cause your blood sugar to go on a roller coaster ride of spikes and crashes and with it, your energy also goes up and down,” says Palinski-Wade. “When blood sugar crashes, your mood sours and anxiety levels can spike.”

The body releases insulin to help absorb the excess glucose and stabilize blood sugar levels, but a sugar rush makes the body work too hard to get back to normal, causing the highs and lows.

Consuming large amounts of processed sugar can trigger feelings of worry, irritability, and sadness.

Foods that fall into the added sugar category that you should consider avoiding or minimizing don’t all look like desserts. Condiments like ketchup, certain salad dressings, pastas, and white bread can all contain high levels of added sugar.

Try Instead: Luckily, you don’t have to deny your sweet tooth if you give up processed sugar. Stevia, erythritol, and Yacon syrup are natural substitutes for sugar. Fill up your plate with fruits and naturally sweet vegetables, like sweet potatoes.

5. Conventional nondairy creamer

If you’re cutting the coffee, might as well cut the creamer, too. Many people these days are trying to monitor the amount of dairy they consume.

Switching to a conventional nondairy creamer might seem like one solution, but these replacements are sources of hydrogenated oils, also known as trans fats, which are packed with LDL cholesterol and can lower HDL cholesterol. These fats have been linked to depression, anxiety, and other mental health issues.

Try Instead: If you’re drinking decaf and still want a splash of something creamy, whole foods are always the better choice. Milk and cream are better than conventional nondairy creamer. If you’re cutting dairy, consider almond milk or soy milk.