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DIET AND NUTRITION

"Always remember that aged men should eat often, But little at a time for fareth by them, As it doth by a lamp the light whereof is Almost extinct, which by pouring in of oil Little and Little, is long kept burning; And with much oil poured in at once, It is clean putou

t."

Nutrition is essential consideration when working with a patient who has a mental illness.Because psychiatric illnesses affect the whole person, it is not surprisingly that patientswith mental illnesses frequently have inadequate diets. Often, either their diets aredeficient in the proper nutrients, or they eat too much or too little. Research demonstratesthe intimate connection between nutrition and behavioral issues. For instance, anemia,which is the most common deficiency disease, often cause depression. Scientists at theUniversity of California, Davis, reported that omitting breakfast can interfere withcognition and learning in the classroom.The value of nutrition in the healing process has long been underrated. Lutz andPrzyulski (1994) state:Today many diseases are linked to lifestyle behaviors such as smoking, lack of adequate physical activity and poor nutritional habits. Health care providers, in their role aseducators, emphasize the relationship between lifestyle and risk contracting diseases.People are increasingly managing their health problems and making personalcommitments to lead healthier lives.Individuals select the foods they eat based on a number of factors, not the least of whichis enjoyment. Eating must serve social and cultural as well as nutritional needs.

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EAT A VARIETY OF FOODS

No single food can supply all nutrients in the amounts needed for good health. A varietyof foods should be selected from the USDA’s food pyramid. Most of the daily servingshould be selected from the food groups that are closest to the base of the pyramid. Arange of servings is suggested for each group of foods. Smaller, sedentary persons shouldselect the lower number of servings. The higher numbers of servings are meant for larger,more active individuals.

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BALANCE THE FOOD YOU EAT WITH PHYSICAL ACTIVITY

Many individuals gain weight with age, which increases their chance of developing anumber of health problems associated with excess weight. These problems include high blood pressure, heart disease, stroke, diabetes, certain types of cancer, arthritis, breathing problems and other illnesses. Thirty minutes or more of moderate physical activity, suchas walking, 3-5 days each week can help to increase calorie expenditure and assist inmaintaining a healthy weight.

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CHOOSE A DIET WITH PLENTY OF GRAIN PRODUCTS, VEGETABLES AND FRUITS

Consumptions of grains, vegetables and fruit is associated with a substantial lower risk for many chronic diseases, including certain types of cancer. These foods areemphasized in this guideline because they are an excellent source of vitamins,minerals, complex carbohydrates(starch and dietary fiber); they are also low in fat,depending on how they are prepared.

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CHOOSE A DIET LOW IN FAT, SATURATED FAT, ANDCHOLESTEROL

Heart disease and some types of cancer (e.g. breast and colon) have been linked to highfat diets. Some dietary fat is required for good health. Fats supply energy and essentialfatty acids, and they promote absorption of the fat soluble vitamins A, D, E and K.However, fats should comprise no more than 30 percent of the total daily calorie intake.Individuals should choose foods with monounsaturated and polyunsaturated fat sourcesand should keep daily cholesterol intake below 300mg.

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CHOOSE A DIET MODERATE IN SUGARS

Many foods that contain sugars supply unnecessary calories and few nutrients. Toothdecay is a significant health problem from eating too much sugar. Scientific evidenceindicates that diets high in sugar do not cause hyperactivity or diabetes. A recent study bydr.W.B. Grant of the Atmospheric Sciences division of NASA’s Langley Research center reports that sugar may be the highest dietary risk factor for heart disease in women ages35 and older. He states,”Fructose metabolizes into triglycerides, then is incorporated intovery low density lipoprotein cholesterol.

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CHOOSE A DIET MODERATE IN SALT AND SODIUM

Sodium and sodium chloride occur naturally in foods, usually in small amounts. Mostfoods are prepared with some salts, and some has already been added during processing.Studies with many diverse populations have established that a high intake of salt isassociated with high blood pressure. It is therefore important for individuals at risk for high blood pressure to consume less salt in their diets.

Nutritional Therapy:

Many nutritional deficiencies may produce symptoms of psychiatric disorders. Fatigue,apathy and depression are caused by deficiencies in iron, folic acid, magnesium, vitaminC, or biotin. Logically treating these deficiencies with nutrition supplements shouldimprove the psychiatric symptoms.In 1967, Linus Pauling espoused the theory that ascorbic acid deficiency produced many psychiatric disorders. He implemented a treatment for schizophrenia that included largedoses of ascorbic acid and other vitamins. This treatment was referred to as megavitamintherapy or orthomolecular therapy. Many psychiatric shows interest in Pauling’s proposal but his research could never be substantiated and most researchers and clinicians becamehighly skeptical of this hypothesis.Over the last two decades, several theories and diets have been developed based on the belief that food controls behavior. High sugar intake was once thought to producehyperactivity in children and Benjamin Feingold developed a diet to eliminate foodadditives that he believed increased hyperactivity. Neither claim was substantiated butfurther research has determined that tartrazine, sodium benzoate, milk, chocolate, eggs,wheat, corn, oats and fish may produce behavioral problems for some children (Podell,

1985). An elimination diet was implemented for some children but was difficult andtendious to follow.More recently advances in technology have led research to new investigations regardingdietary precursors for the bioamines. E.g. tryptophan, the dietary precursor for serotoninhas been most extensively investigated as it relates to low serotonin levels and increasedaggression. Individuals given tryptophan-deficient amino acid mixtures have shownlower levels of serotonin in the brain, resulting in depressed mood and aggressive behavior (Young, 1990)Medications also influence the development of nutritional deficiencies, which mayworsen psychiatric symptoms. E.g. drugs with strong anticholinergic activity often produce impaired or enhanced gastric motility which may lead to generalizedmalabsorption of vitamins and minerals.

Nutrition Chart, Guide : Nutrition Requirement / Needs

NutritionMen over 24 YearWomen 25-50 YearWomen over 50 Year Calories

290022001900 maximum

Fat

96g maximum73g maximum63g maximum

Saturated Fat

32g maximum24g maximum21g maximum

Cholesterol

300mg maximum300mg maximum300mg maximum

Protein

63g50g50g maximum

Carbohydrates

446g335g283g

Fiber

20 - 30g20 - 30g20 - 30g

Sodium

2400mg maximum2400mg maximum2400mg maximum

Medication and food:

One important area of nutrition to consider is the interaction of foods and medications.For instance some medications such as antidepressants classified as monoamine oxidaseinhibitors involve dietary restrictions. Patients taking MAOIs are instructed to avoideating foods that contain a substance called tyramine. These foods taken with MAOI,could cause a hypertensive crisis, in which the patient’s BP soars to dangerous levels.

Caffeine and other Stimulants

:Another important area of nutrition to consider is the ingestion of foods or substances that produce or exacerbate psychiatric symptoms. For instance, patients with anxiety disordersshould avoid stimulants such as those found in over-the counter diet and cold preparations as well as caffeine. These substances can intensify anxiety in patientsalready struggling with anxiety disorders.For instance, caffeine triggers increased activity of the sympathetic nervous system,which causes the fight-or-flight physiological responses typical of an anxiety attack.