A word about eating disorders:
A healthy diet is a big part of any successful self-care plan. Nutrition has been linked with emotional, physical, and cognitive health. Eating a healthy diet gives your brain and your body the vitamins and minerals needed to stay well. However, healthy eating habits can be difficult to maintain, especially if you have a mental health disorder. You’re not alone if you find yourself experiencing changes in your appetite as a result of your disorder, or find yourself gaining weight as a side effect of your psychiatric medication. Make sure you discuss concerns about medication side effects or significant appetite changes with your healthcare provider.
Your diet affects:
- the brain neurochemistry that controls mood and response to stress
- the way your brain and body interact
- the higher brain functions that control learning, memory and intellectual functioning
Whether deciding what, when or how much to eat, the key is balance. The strategies and tools outlined here will help you develop a more balanced approach to eating, and to incorporate some specific ideas that may lessen your mental health symptoms.
What am I eating now?
Making changes to how you eat is simple, but not easy. Breaking bad habits and establishing new, healthy routines always requires patience. And because eating has both a physical and emotional component (providing comfort, familiarity, and even recreation), developing an achievable eating plan may be a particularly challenging part of your self-care plan.
To make a start, it’s good to first have a clear, honest picture of what you’re currently eating. The best way to see how you’re using food is to keep a food diary for one week, writing down what, when, and how much you’re eating. By also noting how you’re feeling at different points during the day in your food diary, you’ll get an even more complete picture of how your emotions and your eating behaviors may be interacting. See SuperTracker.usda.gov to complete an online food diary.
What should my food plan look like?
The U.S. Department of Agriculture recently moved away from the traditional “food pyramid” in favor of a new icon, called MyPlate. The MyPlate icon is easy to understand and it helps to promote healthy food choices based on the 2010 Dietary Guidelines for Americans.
- The United States Department of Agriculture’s ChooseMyPlate website offers personalized eating plans and interactive tools to help you plan and assess your food choices based on American Dietary Guidelines.
- The U-M Healing Foods Pyramid reflects the University’s latest thinking about the connection between what we eat and how we feel.
Tips for Healthy Eating
If you have a medical condition such as diabetes or food allergies, or other dietary restrictions including those related to taking certain psychiatric medications, you should follow your healthcare provider’s specific dietary recommendations.
Eat small and frequent meals. Small and frequent meals can help prevent you from getting too hungry, which can lead to overeating. This approach also feeds your brain a steady supply of glucose which helps to keep cravings at a minimum.
Keep a regular meal schedule. Eating on a regular schedule can also help prevent you from getting too hungry, help you to plan for healthier meals, and help you get a good nights sleep. Here are some tips for developing a regular eating schedule:
- Schedule your classes so that you allow yourself enough time each day to have lunch and dinner. Rushing between classes can often lead to unhealthy eating options and habits.
- If you are working a long day, make sure you take your lunch or dinner break regardless of how busy you are. You are entitled to these breaks. Breaks can also help relieve stress by giving you some downtime from the busy environment.
- Keep some healthy and easy-to-grab food options on hand for days when you know you will not have time to take a break. This way you can bring the food with you wherever you need to go and can still eat at or near your regular eating time. To avoid spending a lot of money, invite your roommate/s to join in and split the costs with you.
- Schedule a regular time to have dinner with your friends in the residence hall cafeteria. It always helps to have friends supporting these habits.
- Take turns with your friends making inexpensive dinners at each other’s apartments/houses one or two times per week. Students who have busy academic schedules, such as graduate students, may have difficulty finding time to see their friends. This is also a great way to have a set time to catch up with them.
- Late dinners can’t always be avoided. If you do go out to eat late at night, ask your server to wrap up half of your meal before you even get started. This can help to prevent overeating late at night which may affect your quality of sleep.
Did you know? If you are a currently enrolled U-M student, you can make an appointment at the University Health Service Nutrition Clinic for free!
Services include individual food-related counseling with a registered dietitian to discuss diet and disease, weight loss or weight gain, and establishing a healthy diet.
Think ahead. Pack healthy snacks to avoid between-meal cravings.
Don’t skip breakfast. Skipping breakfast is associated with reduced problem solving ability, lower energy and decreased motivation. Eating breakfast may also help you to manage your hunger and food intake throughout the day.
Consider taking a multivitamin*. A standard multivitamin can help ensure an adequate daily intake of vitamins and minerals that may improve mental health, including Vitamin 12 and Folic Acid.
*Make your healthcare provider aware of any dietary supplements you might be considering, as some have been shown to interact negatively with certain medications.
Try to include Omega-3 fatty acids in your diet. Research suggests that Omega-3s play a role in many brain functions, from regulating mood to increasing cognitive abilities. Omega-3s can be found in fish including tuna and salmon, or in fish oil supplements.
If you live in a Residence Hall:
Aim for variety, and let color guide you. Ideally, your daily menu should include a “rainbow” of fresh fruits and vegetables to ensure you’re getting a balanced mix of nutrients. For example, eating plenty of leafy greens can help boost your intake of Folic Acid. Try to find a variety of different colored fruits and vegetables that you enjoy and work them into your diet.
Remember that your beverage choices are as important as your food choices.
- Drinking plenty of water is recommended, to keep the body properly hydrated.
- Limit caffeinated beverages like coffee, soda, or energy drinks, which can have a stimulating effect at first, only to be followed by a drop in energy level and mood. Here are some suggestions for energy boosting snacks that can be better alternatives:
- Fresh fruits like bananas, apples, or berries
- Yogurt with granola
- Low-fat cheeses
- Almonds and walnuts
- Hummus and red peppers
- Half of a sandwich
- A single-serving of popcorn
- Avoid alcohol which can act as a depressant and can interfere with your sleep patterns.
Know that all carbohydrates are not created equal. Processed sugars and refined carbohydrates provide only a temporary feeling of increased energy and fullness. That initial boost may be followed by a desire for more sweets and starches to prop up your mood and energy level. A better choice is complex carbohydrates such as fruits, vegetables and healthy grains to ensure maximum nutritional and digestive benefits with fewer “spikes” that can disrupt brain chemistry.
Limit fast food and junk food. Both high sugar and high fat meals can have a negative effect on mood. Use the list below for some ideas for snacks that taste good and also contain great nutrients to fuel your body:
Learn to listen to your body’s signals to know when to eat, and when to stop.
- Eat when you feel physical hunger.
- Try to eat slowly and mindfully.It takes several minutes for your body to signal fullness. Enjoy each bite and avoid overeating by stopping before you feel full.
Regulate your portion size. Many of us tend to underestimate the amount of food we eat and overestimate recommended portion sizes. Use the following tools for tips on regulating portion sizes:
Don’t give up everything you enjoy. Give yourself permission to indulge on occasion. Remember: everything in moderation.
Pulling it all together
Just as a food journal can help you assess your current eating habits, it can also help you to track your progress as you adopt a “new” nutrition plan. A food diary can even be expanded to include recording physical activity and adherence to your medication plan, and to chart the emotions you experience during the day. All of this information gives you a clearer picture of how your self-care activities are working together to help you manage your mental health disorder.
Next > Sleep
1. Stratton RJ, Green CJ, Elia M. Disease Related Malnutrition: an Evidence Based Approach to Treatment. Oxford: CABI; 2003.
2. Office of National Statistics . Population trends. PT 118, table 14 (population age and sex) London: ONS; 2004.
3. Office of National Statistics . Living in Britain: results from the 2002 General Household Survey. London: ONS; 2004.
4. Morely JE. Anorexia of aging: physiological and pathological. Am J Clin Nutr. 1997;66:760–773.[PubMed]
5. Chapman IM. Nutritional disorders in the elderly. Med Clin North Am. 2006;90:887–907.[PubMed]
6. Saffrey MJ. Aging of the enteric nervous system. Mech Ageing Dev. 2004;125:266–271.[PubMed]
7. Cowen T, Johnson RJ, Soubeyre V, Santer RM. Restricted diet rescues rat enteric motor neurones from age related cell death. Gut. 2000;47:653–660.[PMC free article][PubMed]
8. Santer RM, Baker DM. Enteric neuron numbers and sizes in Auerbach’s plexus in the small and large intestine of adults and aged rats. J Auton Nerv Syst. 1988;25:59–67.[PubMed]
9. Moore JG, Tweedy C, Christian PE, Datz FL. Effect of age on gastric emptying of liquid-solid meal in man. Dig Dis Sci. 1983;28:340–344.[PubMed]
10. Fich A, Camilleri M, Phillips SF. Effect of age on human gastric and small bowel motility. J Clin Gastroenterol. 1989;11:416–420.[PubMed]
11. Bitar Kn, Patel SB. Aging and the gastrointestinal smooth muscle. Mech Ageing Dev. 2004;125:907–910.[PubMed]
12. Elphick H, Elphick D, Sanders D. Small Bowel Overgrowth. An unrecognised cause of malnutrition in older adults. Geriatrics. 2006;61:21–25.[PubMed]
13. McEvoy A, Dutton J, James OF. Bacterial contamination of the small intestine is an important cause of occult malabsorption in the elderly. BMJ. 1983;287:789–793.[PMC free article][PubMed]
14. Parlesak A, Klein, Schecher K, Bode Jc, Bode C. Prevalence of small bowel bacterial overgrowth and its association with nutrition intake in non hospitalized older adults. J Am Geriatr Soc. 2003;51:768–773.[PubMed]
15. Gullo L, Ventucci M, Naldoni P, Pezzilli R. Aging and exocrine pancreatic function. J Am Geriatr Soc. 1986;34:790–792.[PubMed]
16. Laugier R, Benard JP, Berthezene, Dupuy P. Changes in pancreatic exocrine secretion with age: pancreatic exocrine secretion does decrease in the elderly. Digestion. 1991;50:202–211.[PubMed]
17. Dreiling DA, Treibling AT, Koller M. The effect of age on human exocrine pancreatic secretion. Mt Sinai J Med. 1985;52:336–339.[PubMed]
18. Popper H. Aging and the liver. Prog Liver Dis. 1986;8:659–683.[PubMed]
19. Cao SX, Dhabbi JM, Mote PL, Spindler SR. Genomic proliferating of short term and long term effects in the liver of aging mice. Proc Natl Acad Sci U S A. 2001;98:10630–10635.[PMC free article][PubMed]
20. Aging and the intestine. World J Gastroenterol. 2006;12:7578–7584.[PMC free article][PubMed]
21. Marin K, Kirwood TB, Potten CS. Age changes in stem cells of murine small intestinal crypts. Exp Cell Res. 1988;241:316–323.[PubMed]
22. Hohn PR, Pascal RR, Kotler DP. Effect of aging of the rat intestinal mucosa. II. Morphological aspects of the aging of the small intestinal mucosa. Mech Ageing Dev. 1978;7:217–226.[PubMed]
23. Keelan M, Walker K, Thompson AB. Intestinal morphology, markers enzymes and lipid content of brush border membranes from rabbit jejunum and ileum: effect of aging. Mech Ageing Dev. 1985:49–68.[PubMed]
24. Wurtman JJ, Leiberman H, Tsay R, et al. Caloric and nutrient intake of elderly and young subjects measured under identical conditions. J Gerontol. 1988;43:B174–B180.[PubMed]
25. Villareal DT, Apovian CM, Kushner RF. Obesity in older adults: technical review and position statement of the American Society of Nutrition and NAASO. The Obesity Society. Am J Clin Nutr. 2005;82:923–924.[PubMed]
26. Wallace JI, Schwartz RS, LaCroix AZ, et al. Involuntary weight loss in older outpatients: incidence and clinical significance. J Am Geriatr Soc. 1995;43(4):329–337.[PubMed]
27. Newman AB, Arnold AM, Burke GL, et al. Cardiovascular disease and mortality in older adults with small abdominal aortic aneurysms detected by ultrasonography. The Cardiovascular Health Study. Ann Int Med. 2001;134:182–190.[PubMed]
28. Calle EF, Thun MJ, Petrelli JM, et al. Body mass index and mortality in a prospective cohort of US adults. N Engl J Med. 1999;341:1097–1015.[PubMed]
29. Potter JF, Schafer DF, Bohi RL. In hospital mortality as a function of body mass index; an age dependant variable. J Gerontol. 1988;43:M59–M63.[PubMed]
30. Prentice AM, Jebb SA. Beyond body mass index. Obesity Rev. 2001;2:141–147.[PubMed]
31. Cree MG, Newcomer BR, Katsonos CS, et al. Intramuscular and liver triglycerides are increased in the elderly. J Clin Endocrinol Metab. 2004;89:3864–3967.[PubMed]
32. Roubenoff R. The path physiology of wasting in the elderly. J Nutr. 1999;121(Suppl 1):256–259S.
33. Yeh SS, Schuster MW. Geriatric cachexia: the role of cytokines. Am J Clin Nutr. 1999;70:183–197.[PubMed]
34. Evans WJ. Exercise, nutrition and aging. Clin Geriatr Med. 1995;11:725–734.[PubMed]
35. Roubenoff R. Sarcopenia and its implications for the elderly. Eur J Clin Nutr. 2000;54(Suppl 3):S40–S47.[PubMed]
36. Doty RL, Shaman P, Applebaum SL, et al. Smell identification ability: changes with age. Science. 1984;226:1441–1443.[PubMed]
37. Schiffman SS. Taste and smell losses in normal aging and disease. JAMA. 1997;278:1357–1362.[PubMed]
38. Mathey MF, Siebelink E, de Graff, et al. Flavour enhancement of food improves dietary intake and nutritional status of elderly nursing home residents. J Gerontol A Biol Sci Med Sci. 2001;56:M200–M2005.[PubMed]
39. Morley JE. Decreased food intake with aging. J Gerontol A Biol Sci Med Sci. 2001;56:81–88.[PubMed]
40. Roberts SB, Fuss P, Heyman MB, et al. Control of food intake in older men. JAMA. 1994;272:1601–1606.[PubMed]
41. Morton GJ, Cummings DE, Baskin DG, Barsh GS, Schwartz MW. Central nervous system control of food intake and body. Nature. 2006;443:289–295.[PubMed]
42. Strader AD, Woods SC. Gastrointestinal hormones and food intake. Gastroenterology. 2005;128:175–191.[PubMed]
43. Di Francesco V, Zamboni M, Dioli A, et al. Delayed postprandial gastric emptying and impaired gallbladder contraction together with elevated cholecystokinin and peptide YY serum levels sustain satiety and inhibit hunger in healthy elderly persons. J Gerontol A Biol Sci Med Sci. 2005;60:1581–1585.[PubMed]
44. Batterman RL, Cowley MA, Small CJ, et al. Gut hormone PYY physiologically inhibits food intake. Nature. 2002;418:620–653.
45. MacIntosch GC, Andrews JM, Jones KL, et al. Effects of age on concentrations of plasma cholecystokinin, glucagon-like peptide-1 and peptide YY and their relationship to appetite and pyloric motility. Am J Clin Nutr. 1999;69:999–1006.[PubMed]
46. Zamboni M, Zoico E, Fantin F, et al. Relation between leptin an the metabolic syndrome in elderly women. J Gerontol A Biol Sci Med Sci. 2004;59:396–400.[PubMed]
47. Van der Lely AJ, Tschop M, Heiman ML, Ghigo E. Biological, physiological and pharmacological aspects of ghrelin. Endocr Rev. 2004;25:426–427.[PubMed]
48. Doucet E, St-Pierre S, Almeras N, et al. Quebec Family Study: Fasting insulin levels influence plasma leptin levels independently: evidence from both a cross sectional and an intervention study. J Clin Endocrinol Metab. 2000;85:4231–4237.[PubMed]
49. Murdolo G, Lucidi P, Di Loreto C, et al. Insulin is required for prandial gherlin suppression in humans. Diabetes. 2003;52:2923–2927.[PubMed]
50. Pirlich M, Lochs H. Nutrition in the elderly. Best Pract Res Clin Gastroenterol. 2001;15:869–884.[PubMed]
51. Omran ML, Morley JE. Assessment of protein energy malnutrition in older persons, part 1: history examination, body composition and screening tools. Nutrition. 2000;16:50–53.[PubMed]
52. Sullivan DH, Walls RC. The risk of life threatening complications in a select population of geriatric patients: the impact of nutritional status. J Am Coll Nutr. 1995;14:29–36.[PubMed]
53. Ellia M, editor. Screening for Malnutrition. A multidisciplinary Responsibility. Development and use of the ‘Malnutrition Universal Screening Tool’ (‘MUST’) for Adults. British Association of Parenteral and Enteral Nutrition; 2003.
54. Knodrup J, Allison SP, Ellia M, Vellas B, Plautg M. ESPEN guidelines for nutrition screening 2002. Clin Nutr. 2003;22:415–421.[PubMed]
55. Stratton RJ, Hackston A, Longmore D, et al. Malnutrition in hospital outpatients and inpatients: prevalence, concurrent validity and ease of use of the ‘Malnutrition Universal Screening Tool’ (‘MUST’) for adults. Br J Nutr. 2004;92:799–808.[PubMed]
56. Beck Am, Ovesen L, Osler M. The ‘Mini Nutritional Assessment’ (MNA) and the ‘Determine Your Nutritional Health’ Checklist (NSI Checklist) as predictors of morbidity and mortality in an elderly Danish population Br J Nutr199;8131–36. [PubMed]
57. Ek AC, Unosson M, Larsson J, et al. Interrater variability and validity in subjective nutritional assessment of elderly patients. Scand J Caring Sci. 1996;10:163–168.[PubMed]
58. Cena H, Madini N, Zaccardo A, Rondanelli, Roggi C. Nutritional assessment of elderly people. Minerva Gastroenterol Dietol. 2008;54:295–306.[PubMed]
59. WHO Physical status: the use and interpretation of anthropometryReport of a WHO Expert Committee WHO Technical Report Series 854.Geneva: World Health Organization; 1995 [PubMed]
60. Stevens J, Cai J, Pumuk ER, Williamson DF, Thun MJ, Wood JL. The effect of age on the association between body mass index and mortality. N Engl J Med. 1998;338:1–7.[PubMed]
61. Hickson M, Frost G. A comparison of three methods for estimating height in the acutely ill elderly population. J Hum Nutr Diet. 2003;16:13–20.[PubMed]
62. WHO document Measuring obesity – classification and description of anthropometric dateNutrition Unit EUR/ICP/NUT 125.Copenhagen: WHO Regional Office for Europe; 1989
63. Allard JP, Aghdassi E, McArthur M, Mcgeer A, Simor A, Abdolell M, et al. Nutrition risk factors for the survival in elderly living in Canadian long term care facilities. J Am Geriatr Soc. 2004:59–65.[PubMed]
64. Haboubi N, Haboubi H, Kennedy J. Obes Facts. 2009
65. Suttmann U, Selber O, Boker K, et al. Incidence and prognostic value of malnutrition and wasting in human immunodeficiency virus-infected outpatients. Journal of AIDS and Human Retrovirology. 1995;8:239–246.[PubMed]
66. Pritchard C, Kyle Ug, Bracco D, et al. Reference value of fat free masses by bioelectrical impedance analysis in 3393 healthy subjects. Nutrition. 2000;16:245–254.[PubMed]
67. Alpers DH, Klein S. Approach to the patient requiring nutritional supplementation. In: Yamada T, editor. Textbook of Gastroenterology. 4th edition. Baltimore: Lipponcott and Wilkins; 2003.
68. Jeejeebhoy KN, Baker JP, Wolman St, et al. Critical evaluation of the role of clinical assessment and body composition studies in patients with malnutrition and after total parenteral nutrition. Am J Clin Nutr. 1982;35:1117–1127.