The holiday season is an important time of connection and celebration, but can also be associated with increased stress, disrupted routines, and health challenges.^1-3 Patients may experience changes in eating patterns, tension headaches, overconsumption and weight gain, and increases in emotional challenges.^1,2 Studies indicate that eating habits shift with the winter season due to a mix of cultural traditions, psychological cues, social events, and marketing, more than actual nutritional needs. Increases in energy intake are commonly seen in winter, driven by colder temperatures, shorter daylight hours, holiday gatherings, and changes in physical activity and mood.^4,5

Studies have shown that the last week of November through early January is a time of high-calorie food consumption in Canada, the US, and many European countries. An increase in alcoholic beverages and foods high in added sugar leads to an average of one pound of weight gain that is not generally lost after the holiday season.¹ The most common holiday hospital emergency visits include digestive and heart problems. Cardiac deaths peak during the December holiday and New Year period, making it the most dangerous time of year for heart-related events.³

Healthcare providers can offer practical strategies to help clients manage nutrition and lifestyle support as they address late fall and winter season challenges holistically.

Stress and Nutrition During the Holidays 

Common holiday stressors include irregular schedules, travel, financial pressures, and social obligations.¹ This change in routine can lead to disrupted sleep, inconsistent meals, and greater reliance on caffeine, alcohol, or food high in added sugar and/or saturated fat.¹ Patients frequently report tension headaches, gastrointestinal upset, and fatigue during this time of the year.²

Nutrition counseling can help clients learn how to stabilize energy levels and ways to reduce symptom burden. Balanced meals spaced throughout the day, with adequate protein (aim for 0.8-1.8g/kg per day for the average client, depending on lifestyle and needs), fiber (25-28g/d for females, 31-34g/d for males), and hydration (11.5 cups/d for females and 15.5 cups/day for males), help regulate blood glucose and energy levels.^6-8 Note that needs change depending on body size, health status and medical conditions, and with activity levels. Personalization is critical.

Providers can remind patients that skipping meals followed by overeating may worsen fatigue and stress reactivity, while consistent eating patterns improve both mental focus and energy. Counseling can focus on maintaining structure without restriction. Providers should encourage regular meals containing both protein and fiber to support satiety and blood sugar balance. Strategies could include eating a light, balanced snack, such as a yogurt and berries, nuts or trail mix, or hummus with vegetables or crackers, before attending parties to stabilize hunger levels. Thanksgiving and Christmas are specific days which studies have shown that people have unusual consumption patterns. Some people skip meals with the plan to overindulge later in the day. For example, one study showed that individuals may consume up to 6000 calories on Christmas day.^1,9 Emotional and situational eating are common during the holidays.^1,5

Physical activity also has been shown to decrease between November and January, further contributing to challenges with emotional and physical health during the holidays.¹ A study by Stevenson et al (N=148 adults ages 18–65, average BMI 25.1 ± 0.5 kg/m²) assessed whether regular exercise through the winter holiday months affected body weight. They analyzed body weight, body fat percentage, blood pressure, and self-reported exercise from mid-November to early January. Participants were categorized as “athletes” (≥150 minutes/week of moderate exercise) or “non-athletes” (<150 minutes/week) and gained an average of 0.78 kg and 0.5% body fat during the holiday period, with no significant differences in weight or fat gain between the two groups. Non-athletes showed a greater rise in systolic blood pressure, and obese individuals experienced the most significant increases in body fat and blood pressure, suggesting initial body weight had a more substantial impact than exercise on holiday weight gain.¹⁰ 

Supplements and Stress Support

Certain nutrients and supplements may support patients experiencing increased stress or headaches during the holidays. Practitioners can work with their clients to assess whether some of these nutrients could help, especially if dietary intake is lacking. 

Magnesium: This mineral supports muscle relaxation and may reduce headache frequency or severity.¹¹ Magnesium deficiency is linked to tension headaches and low dietary intake is common.¹¹ Supplementation (200–400 mg/day) can be discussed as a potential prevention strategy.¹² The Recommended dietary allowance (RDA) is 320g/d for adult females and 420g/d for adult males. Top food sources include pumpkin seeds, chia seeds, almonds, spinach, cashews, and soymilk.¹²

Omega-3 fatty acids: These heart-healthy fats are shown to have anti-inflammatory properties, reducing neuroinflammation, and potential mood benefits, especially when dietary intake from fatty fish is low.¹³ Some studies have shown that 1250 mg omega-3 per day, in supplement form, is helpful in people with migraines.¹³ Adequate intakes for alpha linolenic acid (ALA) are 1.1g/d for females and 1.6g/d for males.¹⁴ ALA, found in plant sources such as flaxseed oil, chia seeds, and walnuts, can be partially converted in the body to the long-chain omega-3s eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), though conversion can be limited. Top dietary sources of DHA and EPA include salmon, herring, sardines, and mackerel.¹⁴

B vitamins: Critical for energy metabolism and stress regulation, deficiencies in b-vitamins can contribute to fatigue or low mood in some people.¹¹ Some studies have shown that taking 400 mg of riboflavin (B2) daily for three months reduced migraine frequency by more than half.¹³ B vitamins are widely found in whole grains, meat, poultry, fish, eggs, dairy, legumes, nuts, seeds, leafy greens, and fortified foods.¹⁵

Adaptogenic herbs: Botanicals such as ashwagandha, holy basil, rhodiola, and various types of ginseng may help modulate the body’s stress response and reduce perceived stress in some patients. Adaptogens are compounds that may help the body manage stress by supporting balance in the hypothalamic–pituitary–adrenal (HPA) axis, potentially through modulating cortisol (a stress hormone) levels via glucocorticoid receptors (proteins inside cells that bind to stress hormones like cortisol to help regulate inflammation, metabolism, and the stress response).¹⁶ There are no standard doses for these herbs and many are given in blends. Providers should work with trained herbalists or other qualified health care providers to assess if adaptogens would be safe and effective for their clients. 

Many of these supplements have been studied together for their stress-relieving, sleep promoting, relaxing properties. A randomized, placebo-controlled trial evaluated the effects of a daily combination supplement (magnesium, vitamins B6, B9, B12, rhodiola, and green tea/L-theanine) vs placebo in 100 adults with chronic stress. Participants took the supplement for 28 days saw significantly reduced stress scores at Day 14, Day 28 (p = 0.04), and Day 56 when compared to a placebo group. Improvements in daytime dysfunction from poor sleep were observed by Day 28 and became significant by Day 56 (p < 0.001).¹⁷ Sleep quality should be a key focus during the holiday season and counseling should also include behavioral strategies such as consistent bedtime routines, limited alcohol or caffeine after noon, and reduced screen time before bed.¹⁸

Providers should reinforce that supplements serve as adjuncts, not replacements, for foundational habits like balanced nutrition, hydration, physical activity, and restorative rest. Some patients should be referred out directly to mental health counselors if they are struggling with stress and need specific mental health therapeutic support.²

Key Takeaways for Providers
The holidays can intensify stress and disrupt health habits. Studies show that schedule disruption and altered eating habits can cause headaches, weight gain, and even cardiovascular issues. Providers should normalize these seasonal dietary challenges, help patients focus on regular eating, protein, fiber, hydration, and sleep, and suggest simple food and supplement strategies when appropriate. Counseling should emphasize realistic, sustainable approaches that reduce pressure during what is a difficult season for some.

References

1. Abdulan IM, Popescu G, Maștaleru A, et al. Winter holidays and their impact on eating behavior—a systematic review. Nutrients. 2023;15(19):4201.
2. Rushendran R, Chitra V. Exploring infodemiology: unraveling the intricate relationships among stress, headaches, migraines, and suicide through Google Trends analysis. Front Big Data. 2025;7:1365417.
3. Schneider E, Liwinski T, Imfeld L, Lang UE, Brühl AB. Who is afraid of Christmas? The effect of Christmas and Easter holidays on psychiatric hospitalizations and emergencies – Systematic review and single center experience from 2012 to 2021. Front Psychiatry. 2023;13:1049935.
4. Spence C. Explaining seasonal patterns of food consumption. Int J Gastronomy Food Sci. 2021;24:100332.
5. Fujihira K, Takahashi M, Wang C, Hayashi N. Factors explaining seasonal variation in energy intake: a review. Front Nutr. 2023;10:1192223.
6. Wolfe RR, Cifelli AM, Kostas G, Kim IY. Optimizing protein intake in adults: interpretation and application of the Recommended Dietary Allowance compared with the Acceptable Macronutrient Distribution Range. Adv Nutr. 2017;8(2):266–275.
7. U.S. Department of Agriculture; U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020–2025. 9th ed. Published December 2020. Accessed November 8, 2025. https://www.dietaryguidelines.gov
8. Gordon B. How Much Water Do You Need? EatRight.org. Academy of Nutrition and Dietetics; June 23, 2022. Updated May 17, 2024. Accessed November 8, 2025. https://www.eatright.org/health/essential-nutrients/water/how-much-water-do-you-need
9. Mason F, Farley A, Pallan M, et al. Effectiveness of a brief behavioural intervention to prevent weight gain over the Christmas holiday period: randomised controlled trial. BMJ. 2018;363:k4867.
10. Stevenson JL, Krishnan S, Stoner MA, Goktas Z, Cooper JA. Effects of exercise during the holiday season on changes in body weight, body composition and blood pressure. Eur J Clin Nutr. 2013;67:944–949.
11. Curatolo P, Moavero R. Use of nutraceutical ingredient combinations in the management of tension-type headaches with or without sleep disorders. Nutrients. 2021;13(5):1631.
12. Office of Dietary Supplements. Magnesium—Health Professional Fact Sheet. National Institutes of Health. Published June 2, 2022. Accessed November 8, 2025. https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/
13. Ariyanfar S, Razeghi Jahromi S, Togha M, Ghorbani Z. Review on headache related to dietary supplements. Curr Pain Headache Rep. 2022;26(3):193–218.
14. Office of Dietary Supplements. Omega-3 fatty acids—Health Professional Fact Sheet. National Institutes of Health. Published August 22, 2025. Accessed November 8, 2025. https://ods.od.nih.gov/factsheets/Omega3FattyAcids-HealthProfessional/
15. Hanna M, Jaqua E, Nguyen V, Clay J. B vitamins: functions and uses in medicine. Perm J. 2022;26(2):89–97.
16. Tóth-Mészáros A, Garmaa G, Hegyi P, et al. The effect of adaptogenic plants on stress: a systematic review and meta-analysis. J Funct Foods. 2023;108:105695.
17. Noah L, Morel V, Bertin C, et al. Effect of a combination of magnesium, B vitamins, Rhodiola, and green tea (L-theanine) on chronically stressed healthy individuals—a randomized, placebo-controlled study. Nutrients. 2022;14(9):1863.
18. Baranwal N, Yu PK, Siegel NS. Sleep physiology, pathophysiology, and sleep hygiene. Prog Cardiovasc Dis. 2023;77:59–69.