The topic of food is vast and overwhelming. Yet it is critical to our daily life and general well-being. There has been much attention in this site to the role of psychiatry and psychiatrists for people who are experiencing mental or emotional distress. One area that I have chosen to focus on with my patients is food since it is a place where I believe I can have a positive impact on their lives.
In my last blog I wrote about the links between industrial agriculture and the pharmaceutical companies and the importance of food to our overall well being and health. In this blog I will discuss practical approaches to improving the quality of our diets. People vary in their knowledge and sophistication on this topic. I try to keep my message simple. Lest you think I am being the patronizing doctor, I will add that I share with many of my patients a difficulty in eating foods that are optimal for my health. For much of my adult life, I was content to eat highly processed pre-cooked foods. Like so many people, I often ate for reasons that had little to do with how hungry I was. In this regard, I am not a doctor talking at a patient, I am a doctor who shares in the struggle to avoid the temptations of the easily accessible but not terribly nutritious foods that surround us. I just try to use my training to share what I have learned with those who come into my office.
As I mentioned previously, I am heavily indebted to Michael Pollan for my thinking on this topic. One of the things that he talks about is the notion of nutritionism by which he means the search for the secret nutrient(s) that will bring us health. In this regard, I think there is an analogy to what Whitaker described as the search in medicine for the “magic bullet.” In each instance, there is a tendency to form premature conclusions about effective treatments. With food, in particular, we risk not only making premature conclusions about what nutrients are benficial but also loosing the fundamental pleasure that eating and cooking can bring to our lives.
This topic can be overwhelming. I have distilled my recommendations into three main points:
Keep it simple.
One can get lost in reading about what fatty acid or vitamin or other micronutrient is the source of good health or the treatment for a particular disease or symptom. Fortunately, if you keep your plate full of fruits and vegetables, you have a good chance of getting a wide variety of nutrients into your diet. The simple admonition to have a plate full of color will go a long way to providing you with the nutrients you need; it is the vitamins and nutrients that give foods their color. If you add whole grains and minimize your intake of meats, you will make a huge impact on the health of your diet.
Keep it focused on providing energy and not solace.
We eat to get the energy our body needs to keep us functioning. Babies do not over eat. Although some of us may be predisposed to becoming over weight, for most of us, the tendency to eat beyond what our bodies need to sustain us develops over years and is highly influenced by our environment. Being mindful about food is easier said than done but it can be practiced and learned in the same way that we learned to eat without thinking about what we were putting into our bodies. We can remind ourselves that when we eat the foods our body needs, we are honoring our bodies and taking care of ourselves. This can become the positive message that replaces the one that leads us to grab foods that give immediate satisfaction and short term pleasure. Simple measures such as writing down everything we eat, can be a first step to change.
Keep it social.
It is easy to loose the pleasure of eating. This can happen if one is always struggling to deny oneself the “pleasure” foods. It can happen if one is critical about food choices. It can happen if one is stressed about getting food onto the table. By learning some simple cooking techniques and occasionally sharing it with a friend, food can begin to return to its central place as being one of the most pleasurable aspects of life while we still maintain a healthy and nutritious diet.
What we do.
At our clinic, we have tried to bring these concepts into people lives in a few ways. We offer a group called Food Education. This is based on an evidenced based curriculum developed by Boston University’s Center for Psychiatric Rehabilitation. We try to give people some basic information about food and we cook some simple meals together.
I also worked with a group of medical students to develop a simple cook book for our clients. The students came up with meals for a week – 7 breakfasts, lunches and dinner. Their task was to offer a variety of simple meals with healthy ingredients that were affordable on a income that is budgeted for less than $70/week for food. There is one section that provides a weekly meal plan: it gives the shopping lists, and a step by step guide on how to provide the weeks worth of meals. It only requires cooking a couple of times in the week. We have sold the book as a fundraiser so that we could offer it to our cients for free. I have posted this to a Google document for anyone who wants to download here.
This is not an easy process. The influences in our culture to eat processed foods are powerful. They work well! The best cognitive psychology is practiced by advertising agencies. We try to give people the tools that can help them to make healthy choices in their lives. As I know from a lifetime of experience, however, having the knowledge does not always translate into behavioral change. In this regard I sit beside my patients not across from them. In my next blog, I will write about why it can be so hard to make these changes.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.
Another great post!
Duane Sherry, M.S.
Thanks again, Duane. And thanks for the interesting links.
The Mad in America site has become a healing place for me to visit lately, because I’m reading posts from psychiatrists that I never thought I would see… And for you and the others who are out there making changes, I say, “Thank you.”
I watched what people in front of me in the queue were buying at the supermarket the other day. A couple of pensioners had in their shopping trolley mainly raw ingredients: fruit, veg. potatoes, rice,some mince and bread. A young couple with toddler bought a load of frozen ready meals, crisps and fizzy drinks and sliced white bread. I wondered: do both parents in this young family work to pay the mortgage and are they too tired to cook? May be nobody has taught them that one doesn’t need more than half an hour to russle up a healthy meal for three from fresh ingredients
Thank you Duane and Alix for your comments.
I am sympathetic to the young family’s plight since this was such a hard thing for me to manage. Education is key and we are fighting against the stream of education that comes in via advertisements. Schools around here are beginning to have gardens and that is a good trend.
It took me a few years to learn how to cook from scratch all the time. While I was learning, it was overwhelming, because what do I do with the small bits of leftovers? I would dirty every pot and pan in the house to make one recipe.
Now that I have cooked from scratch for over 10 years, it is MUCH easier.
Alix, maybe you grew up doing some cooking with your mom, or maybe I am a slow learner, LOL!
It can be overwhelming and that is why I want to continue to integrate this into the work we do.
Thank you, Sandra. Something else to consider is the role SSRIs play in creating or destroying appetite. At 16, I was prescribed SSRI’s which triggered mania (diagnosed as bipolar), and an insatiable appetite. I never put the two together since I accepted that SSRIs were medicine. My brain chemistry went absolutely haywire (thought i was bipolar) and I was left in constant craving of sweets and carbs. Over the course of 17 years, this did not stop, no matter how much i tried to manage things differently, until I got so desparate for wellness, that I tried the one thing every doctor recommended against—I csme of all psychiatric medication and let me brain regulate itself. After an intense period of adjustment/ recalibration (still happening, though manageable with support), I am healing and among many other improvements, I do NOT crave sweets and carbs like I used to. I know I’m not alone in this as I’ve talked to several other people who have had similar experiences. Please keep this possibility in mind when seeing patients.
There are a number of medications that have an impact on appeitite and this is a serious concern.
In my next blog I will try to address the connection between the brain and other organs systems and the environment – which includes what we eat, what else we take in to our bodies, what we are told to eat, how we eat, etc.