Patient Information About Healthy Eating and Drinking
This information is relevant to everyone aiming to eat healthily, particularly those who feel their mental health condition or its treatment has affected their eating habits.
This leaflet provides information, not advice. The content is intended for general information purposes only and should not be relied upon as specific advice. It is not a substitute for professional or specialist guidance. Before taking or refraining from any action based on the information in this leaflet, you must seek relevant professional or specialist advice. Consult your doctor or healthcare provider promptly if you have questions about any medical matter or suspect a medical condition. No Representation, Warranties, or Guarantees:
While reasonable efforts are made to compile accurate and up-to-date information, we make no representations, warranties, or guarantees, whether express or implied, about the accuracy, completeness, or currency of the content in this leaflet.
Section 1: Why Eat Better?
Your food choices have a significant impact on your well-being and overall health. Eating the right foods in appropriate quantities is crucial for your overall well-being. Taking your health seriously means finding ways to incorporate a balanced diet that works for you. Healthy eating can be enjoyable, simple, and doesn't have to be time-consuming. It involves making gradual, long-term changes and savoring the food you consume.
Some key points to consider:
- Eating well helps prevent various diseases associated with excess weight, such as high blood sugar, high blood pressure, heart problems, stroke, cancer, joint issues, and sleep difficulties.
- Eating well contributes to emotional well-being.
- The importance of healthy eating for individuals with mental health problems:
- Individuals with mental health problems often face weight-related challenges. The reasons behind this are not fully understood. Some individuals constantly feel fatigued and lack the energy for physical activity, while others struggle with persistent hunger.
These factors may be related to the mental health problem itself. However, it has become apparent that weight issues can also be a side effect of certain treatments. This does not imply that one should discontinue treatment, as it may result in a relapse of mental illness. Instead, alternatives such as switching to different medications or increasing physical activity and adopting better eating habits can be explored.
Section 2: Getting the Balance Right
Foods can be categorized into three groups:
- Carbohydrates or sugar-based foods
Please note that the information provided is general and may not address individual cases. If you have doubts or questions, consult with your nurse, doctor, or a dietician regarding your specific diet. Additionally, the guidance in this leaflet is intended for adults and may not apply to children, as their dietary needs differ. If you are pregnant or have certain physical health conditions, your dietary requirements may also vary.
What are carbohydrates?
Carbohydrates are essentially composed of sugar. They can be classified into two categories: simple carbohydrates, which consist of one or a few sugar units like glucose or fructose, and complex carbohydrates, which are made up of long chains of sugars.
Simple carbohydrates are quickly broken down in the body, providing instant but short-term effects. On the other hand, complex carbohydrates take longer to break down but provide sustained energy. Each gram of carbohydrate provides approximately four calories of energy.
What are carbohydrates used for?
Carbohydrates serve as the primary fuel source for the body. Muscles, for example, work most efficiently when fueled by glucose, although they can also utilize fat.
Under normal conditions, the brain primarily relies on glucose as its main fuel.
Types of Foods
Simple carbohydrates can be found in foods such as glucose, sugar, jam, honey, and sweets. They are also present in many carbonated and sports drinks. Complex carbohydrates are found in foods like fruits, root vegetables, beans, potatoes, grain products such as bread, pasta, rice, and couscous. Breakfast cereals also contain complex carbohydrates, although some brands may have significant amounts of added sugar.
What is the glycemic index?
The glycemic index measures how quickly a food is broken down into single sugar units, specifically glucose. Foods with a longer breakdown time have a lower glycemic index (GI).
The glycemic index is not solely determined by the length of the sugar chain but also by the fiber content. For example, white rice and white bread, which have the outer layer removed, have a much higher glycemic index than brown rice and brown bread.
Foods with a low glycemic index are often referred to as "good carbs," while those with a high glycemic index are called "bad carbs."
However, it's important to note that the glycemic index only measures glucose and does not account for fructose. As a result, it may underestimate the sugar content of foods that contain a lot of fructose or table sugar (a combination of glucose and fructose). Pastries, fruits, soft drinks, and fruit juices, for instance, may have lower glycemic indexes than expected. Additionally, the glycemic index does not provide information about calorie content. High-fat snacks like peanuts may have a low glycemic index but are still high in calories.
What happens if I eat too many carbohydrates?
Consuming more carbohydrates than your body needs for energy will result in the excess being converted into fat and stored.
Which carbohydrates should I eat?
It is advisable to choose "good carbs" with a low glycemic index. Good carb options include fruits, vegetables, legumes such as beans, pasta, brown rice, basmati rice, whole wheat bread, and potatoes.
It's worth noting that the sugar content can vary significantly among fruits. For example, bananas may contain up to 21% of free sugar, while oranges tend to have about 9%, and strawberries only 6%.
Let's move on to fats.
What are fats?
Fats consist of chains of fatty acids. There are three types of fatty acids defined by their chemical structure and their ability to accept additional hydrogen atoms.
This classification has important health implications as different fatty acids have varying effects on bad (LDL) and good (HDL) cholesterol levels. One gram of fat provides approximately eight calories.
Unsaturated fats are composed of fatty acids that can accept additional hydrogen atoms. If they can accept only one hydrogen atom, they are called monounsaturated; if they can accept multiple hydrogen atoms, they are called polyunsaturated.
Unsaturated fats are typically in liquid form, such as oils, and can help lower blood cholesterol levels.
Saturated fats cannot accept additional hydrogen atoms. They are already fully saturated, which makes them solid at room temperature. Saturated fats tend to raise cholesterol levels.
Trans fats are unsaturated fats that have been chemically modified to become solid and more resistant to spoilage. They are commonly used in industrial food production. Trans fats have been linked to an increased risk of heart disease, although not everyone agrees on this association.
What are fats used for?
Fats serve several purposes. They are an important energy store that the body taps into when glucose levels are depleted.
Fat deposits also provide insulation against cold temperatures. Fatty acids play a crucial role in cell membranes and hormone production and may contribute to maintaining mental stability. Fats are necessary for the absorption and utilization of certain vitamins such as A, D, E, and K.
Types of Food
Unsaturated fats are found in foods like vegetable oils (e.g., sunflower oil, olive oil), olives, nuts, seeds, and avocados.
Saturated fats are mainly present in animal products like meat, fish, poultry, butter, cheese, cream, and dairy products like yogurt, pudding, and ice cream. It's important to note that coconut products, including coconut paste or milk, are also high in saturated fats.
Trans fats are found in hydrogenated vegetable oils used in margarine, spreads, instant soups, sauces, cake mixes, and many processed foods like cakes, biscuits, and chips.
What happens if I eat too many fats?
Consuming an excessive amount of fats can lead to an expansion of fat deposits in the body.
Which fats should I eat?
It is recommended to consume unsaturated fats such as vegetable oils, seeds, and nuts. However, it's important to remember that even "good fats" are calorie-dense, so moderation is key. Using skimmed or semi-skimmed milk and dairy products instead of whole milk is also advised.
Next, let's discuss omega-3 fatty acids.
Omega-3 fatty acids
Omega-3 fatty acids are unsaturated fatty acids that are considered essential because the body cannot produce them on its own. They are called "essential" fatty acids. Omega-3 fatty acids are believed to provide various health benefits, including reducing cholesterol levels, preventing heart and joint diseases, and improving cognitive function.
Omega-3 fatty acids may also play a role in promoting mental stability and have been tried as supplements for individuals with mood disorders and schizophrenia. They may help prevent relapses in bipolar disorder. However, there is insufficient evidence to recommend them as alternatives to antidepressants or mood stabilizers.
Note: Omega-3 fatty acid supplements can interact with blood thinning medications.
Which foods contain omega-3 fatty acids?
Omega-3 fatty acids can be found in oily fish such as cod, salmon, and mackerel. They are also present in plant sources like flaxseed and walnuts.
How safe is omega-3 from fish sources?
For most individuals, the benefits of consuming omega-3 fatty acids from fish outweigh any concerns about potential contamination. However, women of childbearing age, pregnant women, and breastfeeding mothers should not consume more than two portions of oily fish per week.
As recommendations can change, pregnant individuals should consult a healthcare professional to determine the appropriate amount of fish they can safely consume in a week.
Moving on to proteins.
What are proteins?
Proteins are composed of amino acids. They can be classified into essential amino acids, which the body cannot produce on its own, and non-essential amino acids, which the body can synthesize.
Complete proteins contain all the essential amino acids, while incomplete proteins lack one or more essential amino acids. One gram of protein provides approximately four calories.
What are proteins used for?
Proteins are the fundamental building blocks of the body and are crucial for muscle development. They also form enzymes and hormones
Taking Steps Towards a Healthier Lifestyle
Improving your diet starts now. The consumption of excessive sugar, salt, saturated fat, and alcohol can have adverse effects on your health. Learn how to make better choices and gradually reduce your intake of these substances.
Adopting a Balanced Diet
A balanced diet, according to the UK Food Standards Agency, consists of a variety of foods. Refer to the respective sections above to find examples of recommended carbohydrates, fats, and proteins.
The Agency recommends the following:
- Base your diet on starchy foods like potatoes, cereals, pasta, rice, couscous, and bread.
- Consume at least five portions of fruits and vegetables daily.
- Include meat, poultry, fish, eggs, nuts, and pulses as good sources of protein.
- Incorporate milk and dairy products for protein and calcium.
- Aim for at least two portions of fish per week.
- Reduce your intake of saturated fat and sugar.
- Limit your salt consumption to no more than 6 grams per day for adults and children over 11 years.
Managing Your Weight
When aiming to lose weight, some of the recommended foods may not be the best options. For example, foods with a low glycemic index, such as avocados and nuts, are calorie-dense. A medium-sized avocado contains approximately 230 calories, equivalent to consuming 12 tomatoes.
Avoid processed foods whenever possible and opt for whole, unprocessed alternatives. For instance, a serving of French fries (100g) contains around 360 calories, equivalent to consuming ten medium-sized boiled potatoes (500g).
Choosing Beverages Wisely
Many individuals with mental health issues often experience excessive thirst, which may be caused by medications leading to a dry mouth. It's important to note that drinks can also contribute to calorie intake.
Low-calorie beverage choices include:
- Unsweetened tea and coffee
- Skimmed milk (in moderation)
- "Lite" or diet soft drinks
Avoid the following:
- Sugar-sweetened fizzy drinks
- Fruit juices
- Fruit Juice Considerations
Opting to consume whole fruits rather than fruit juice is generally recommended. Eating fruits can help you feel more satiated compared to consuming fruit juice alone.
A large glass of apple juice (300 ml) contains as many calories as three apples.
Alcohol and Calorie Content
It may come as a surprise, but alcohol is high in calories. Each gram of alcohol contains about seven calories, nearly as much as one gram of fat. In contrast, one gram of carbohydrate or protein contains about four calories.
Vitamins, Trace Elements, and Supplements
While some individuals may choose to use supplements, it's important to note that they are typically unnecessary unless there is a clear deficiency causing poor health.
Most people take supplements with the hope of gaining significant health benefits, such as protection against cancer, improved immune system function, or better mental health support. However, scientific evidence regarding the benefits of supplements remains mostly inconclusive, with a few exceptions.
Remember that supplements cannot replace a healthy and balanced diet. If you decide to take supplements, do not exceed the recommended daily intake considered safe. If you are a smoker, avoid taking beta-carotene supplements, as the combination may increase your risk of cancer.
Oxygen is necessary for many bodily processes, but it can also cause damage to body cells. Antioxidants are substances that neutralize these harmful compounds.
Many vitamins, such as vitamin A, C, and E, and some trace elements like selenium, contain antioxidants. You can find antioxidants in various fruits and vegetables, including oranges, strawberries, spinach.
Developing Healthy Habits and Understanding Special Diets
Diets for Mental Health Conditions
There isn't a specific diet recommended for schizophrenia or mood disorders. It's important to follow a balanced and varied diet as mentioned in the previous sections. However, ensuring an adequate intake of foods rich in omega-3 fatty acids can be beneficial. If weight gain is a concern due to medication, focus on consuming "good carbs," which have a low glycemic index and are not rapidly broken down into glucose. Including calcium in your diet is also important, and you can achieve this by incorporating dairy products, preferably based on skimmed milk to limit fat intake.
For epilepsy, a ketogenic diet high in fat and low in carbohydrates may be helpful, particularly in children with uncontrolled epilepsy. This diet aims to shift the brain's main fuel source from glucose to ketones, which are produced when fat is broken down. However, maintaining a ketogenic diet long-term can be challenging, and it is essential to seek specialist advice before embarking on this diet.
There are no clear dietary recommendations for ADHD, as research in this area is still developing. Some studies have suggested that individuals with ADHD may have lower levels of omega-3 fatty acids or may be sensitive to gluten, a protein found in wheat, rye, and barley. Elimination diets, which exclude specific foods believed to trigger ADHD symptoms, have been explored but may be difficult to follow long-term. It's best to consult with a healthcare professional before considering any dietary changes for ADHD.
Understanding Grapefruits and Grapefruit Juice
Grapefruits and grapefruit juice can significantly affect the way the body metabolizes certain medications. They can increase the concentration of various medications, including certain antidepressants, antipsychotics, and sedatives. These changes are more likely to occur when consuming large amounts of grapefruit or grapefruit juice, but occasional use can also have an impact. It's important to be cautious and check with your healthcare provider if you are taking medications that may interact with grapefruit.
Orthomolecular medicine involves the use of supplements and vitamins to treat or prevent health problems, including mental health conditions. It often recommends high doses of vitamins, known as megavitamins. However, orthomolecular medicine remains controversial, and there is limited scientific evidence supporting its effectiveness. In some cases, high doses of vitamins and supplements can be harmful or even toxic. The Food Standards Agency has established recommended daily intake levels for most vitamins and supplements to ensure safe and appropriate use.
Tips for Eating Well on a Budget
Eating well doesn't have to be expensive. Here are ten tips to help you eat healthily while being mindful of your budget:
- Avoid ready meals and takeaways as they can be high in fat, sugar, and cost.
- Limit the purchase of snacks like crisps, ice cream, and sweets to occasional treats.
- Buy seasonal fruits and vegetables to save money. Out-of-season produce tends to be more expensive.
- Purchase fresh foods in small amounts and more frequently to reduce waste.
- Opt for dried beans and pasta instead of canned varieties to save money.
- Replace sugar-sweetened fizzy drinks and fruit juices with water and whole fruits.
- Compare prices in different shops and supermarkets and take advantage of special offers.
- Consider using generic supermarket brands instead of more expensive branded products.
- Cook and share meals with others to divide the costs and enjoy social interaction.
- Make a shopping list and plan your food budget weekly. Seek assistance from a key worker or support professional if needed.
For further information, you can visit the NHS Eat Well website (www.nhs.uk) or reach out to our Mental Health Support Team for additional support.