FOODS & DIETS

SO, WHAT IS A healthy diet?

A healthy diet is rich in fruits, leafy vegetables, nuts and whole grains (e.g. unprocessed maize, millet, oats, wheat and brown rice), legumes (e.g. lentils and beans), low-fat dairy, and lean proteins.

  • At least 400 g (i.e. five portions) of fruit and vegetables per day, excluding potatoes, sweet potatoes, cassava and other starchy roots.

  • Less than 10% of total energy intake from free sugars, which is equivalent to 50 g (or about 12 level teaspoons) for a person of healthy body weight consuming about 2000 calories per day. Free sugars are all sugars added to foods or drinks by the manufacturer, cook or consumer, as well as sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates.

  • Less than 30% of total energy intake from fats. Unsaturated fats (found in fish, avocado and nuts, and in sunflower, soybean, canola and olive oils) are preferable to saturated fats (found in fatty meat, butter, palm and coconut oil, cream, cheese, ghee and lard) and trans-fats of all kinds, including both industrially-produced trans-fats (found in baked and fried foods, and pre-packaged snacks and foods, such as frozen pizza, pies, cookies, biscuits, wafers, and cooking oils and spreads) and ruminant trans-fats (found in meat and dairy foods from ruminant animals, such as cows, sheep, goats and camels).

  • It is suggested that the intake of saturated fats be reduced to less than 10% of total energy intake and trans-fats to less than 1% of total energy intake . In particular, industrially-produced trans-fats are not part of a healthy diet and should be avoided .

  • Less than 5 g of salt (equivalent to about one teaspoon) per day (8). Salt should be iodized.

reference: https://www.who.int/

image credit: https://lyonsdenfitness.co.uk/


ANXIOLYTIC* FOODS

Nutrition plays a role in the prevention and treatment of mental disorders. A traditional whole-food diet, consisting of higher intakes of foods such as vegetables, fruits, seafood, whole grains, lean meat, nuts, and legumes, with avoidance of processed foods, is more likely to provide the nutrients that promote resiliency against the development of mental disorders.

the brain requires a lot of energy to operate optimally, and as such it relies on amino acids, fats, vitamins, and minerals or trace elements.

the functioning of the immune system is also reliant on dietary intakes. For example, the antioxidant defense system, which is also implicated in mental disorders, operates with the support of nutrient cofactors and phytochemicals

neurotrophic factors found in foods are essential in maintaining healthy brain cells.

Convincing data suggest that select nutrient-based supplements (in isolation, or in combination) might provide many neurochemical modulatory activities that are beneficial in the management of mental disorders.

These are omega-3 fatty acids, S-adenosyl methionine (SAMe), N-acetyl cysteine (NAC), zinc, B vitamins (including folic acid), and vitamin D. Particularly, key nutrients such as B vitamins, vitamin C, magnesium, and zinc regulate stress responses via involvement in the production and metabolism of neurotransmitters, including serotonin, noradrenaline, and dopamine. However, chronic stress may decrease synthesis of neurotransmitters, which in turn may increase the risk of severe anxiety.

In addition, B vitamins, vitamin C, magnesium, and zinc are involved in the conversion of α-linolenic acid to longer-chain n-3 fatty acids; n-3 fatty acids are associated with lower risk of anxiety. For example, several studies support the potential usefulness of omega-3 fatty acids for post-traumatic stress disorder and major depression.

Furthermore, there is an accumulation of evidence in favor of specific diets for the protection and relief of anxiety. Specifically, traditional dietary patterns in Australia (vegetables, fruit, meat, fish, and whole grains), China (gruel, oatmeal, whole grains, fresh yellow or red vegetables, fruit, and soy milk), the Mediterranean and the anti-inflammatory diet have been associated with a lower risk for anxiety disorders.

For example, a diet that includes vegetables, fruit, beef, lamb, fish, and whole-grain foods has been related to a lower risk of a diagnosis of anxiety, while a western-type diet characterized by consumption of foods such as meats and sugar has been associated with more psychiatric symptoms.

In conclusion, there is evidence of an association between healthy eating patterns and reduced anxiety symptoms. As long as there are no food allergies to speak of, interventions focused on diets in the treatment of anxiety are considered low in risk and have beneficial effects beyond anxiety relief. It is important to add that nutritional counseling is not currently part of standard procedure for the treatment of anxiety disorders, and therefore it will be your decision to pursue that option or not.

 

References:

Aucoin M, LaChance L, Naidoo U, Remy D, Shekdar T, Sayar N, Cardozo V, Rawana T, Chan I, Cooley K. Diet and Anxiety: A Scoping Review. Nutrients. 2021 Dec 10;13(12):4418. doi: 10.3390/nu13124418. PMID: 34959972; PMCID: PMC8706568.

Kris-Etherton PM, Petersen KS, Hibbeln JR, Hurley D, Kolick V, Peoples S, Rodriguez N, Woodward-Lopez G. Nutrition and behavioral health disorders: depression and anxiety. Nutr Rev. 2021 Feb 11;79(3):247-260. doi: 10.1093/nutrit/nuaa025. PMID: 32447382; PMCID: PMC8453603.

 Masana MF, Tyrovolas S, Kolia N, Chrysohoou C, Skoumas J, Haro JM, Tousoulis D, Papageorgiou C, Pitsavos C, Panagiotakos DB. Dietary Patterns and Their Association with Anxiety Symptoms among Older Adults: The ATTICA Study. Nutrients. 2019 May 31;11(6):1250. doi: 10.3390/nu11061250. PMID: 31159322; PMCID: PMC6627391.

 Sarris J, Logan AC, Akbaraly TN, Amminger GP, Balanzá-Martínez V, Freeman MP, Hibbeln J, Matsuoka Y, Mischoulon D, Mizoue T, Nanri A, Nishi D, Ramsey D, Rucklidge JJ, Sanchez-Villegas A, Scholey A, Su KP, Jacka FN; International Society for Nutritional Psychiatry Research. Nutritional medicine as mainstream in psychiatry. Lancet Psychiatry. 2015 Mar;2(3):271-4. doi: 10.1016/S2215-0366(14)00051-0. Epub 2015 Feb 25. PMID: 26359904.

 Wang SS, Lay S, Yu HN, Shen SR. Dietary Guidelines for Chinese Residents (2016): comments and comparisons. J Zhejiang Univ Sci B. 2016 Sep;17(9):649-56. doi: 10.1631/jzus.B1600341. PMID: 27604857; PMCID: PMC5018612.

*anxiolytic: reduce anxiety


  • Daily consumption:

    Non-refined cereals and products (whole grain bread, pasta, brown rice, etc.), vegetables (2–3 servings/day), fruits (6 servings/day), olive oil (as the main added lipid) and dairy products (1–2 servings/day)

    Weekly consumption:

    Fish (4–5 servings/week), poultry (3–4 servings/week), olives, pulses, and nuts (3 servings/week), potatoes, eggs and sweets (3–4 servings/week)

    Monthly consumption:

    red meat and meat products (4–5 servings/month


  • Daily consumption:

    50–150 g of whole grains and mixed beans and 50–100 g of potatoes

    300 to 500g of vegetables. Dark vegetables, including spinach, tomato, purple cabbage, pak choy, broccoli, and eggplant, should account for half this amount and should appear in every meal.

    200 to 350g of fruits

    Weekly consumption:

    280 to 525g of fish

    280 to 525 g of poultry

    280 to 350 g of eggs with an accumulated daily intake of 120–200 g on average

    Limited daily consumption:

    6 g of salt and 25–30 g of cooking oil

    less than 50 g, or preferably less than 25 g of daily sugar

    less fat and fewer smoked and cured meat products should be eaten.


  • Vegetables & Fruits

    • Eat plenty of cruciferous vegetables (broccoli, cauliflower, etc.)

    • Consider organic when possible

    • Eat in-season whole fruits

    • Limit Juice intake (1/2 cup per day)

    • All berries are SUPER foods!

    • include all squashes & sweet potatoes

    Other Carbohydrates

    • Whole and cracked grains (you should be able to see the grains—limit foods made from any grain flours)

    • Pastas (Occasional; cook al dente, just until tender)

    • Add vinegar to dishes, it lowers glycemic load.

    • Include soy in the forms of edamame, tofu, and tempeh

    • Beans, lentils, quinoa and barley will help you feel full!

    Fats

    • Omega-3 (from fish, flax or chia seeds)

    • Raw unroasted nuts & seeds & nut butters

    • Extra virgin olive oil or other unrefined oils

    • Avocados

    Proteins (limit servings of animal products)

    • Choose fish rich in omega-3 fats, including wild Alaskan salmon, herring, sardines and black cod

    • Grass fed animals & dairy

    • Legumes (Anasazi beans, adzuki beans, black beans, chickpeas, black-eyed peas & lentils)

    • Almonds and Walnuts (raw is better than roasted)

    • Asian mushrooms (maitake, shitake, wild)

    • High quality dairy & eggs & cheese

    Spices, Beverages, & Sweets

    • Season food with turmeric, curry powder, ginger, garlic, chili peppers, cinnamon, and other herbs & spices.

    • Tea is a great alternative for coffee (green, oolong or black tea)

    • Limited alcohol intake.

    • Dark chocolate (minimum cocoa content of 70%)


LEARN

Diet History Questionnaire III (DHQ III)

The DHQ is a freely available questionnaire created by the national cancer institute for cancer patients to track down their diet. We adapted the very long DHQ III for use here to help you survey your eating habits and hopefully make some healthy changes.

Please keep in mind that the questionnaire below is only a shorter sample of the actual questionnaire that you can find here.

Beverages

What beverages did you drink?

Below is a list of beverages that you could have consumed over the past month.  For each item that applies ask yourself the following 2 questions:

1.Over the past month, how often did you drink _______?

 1 time in the past month

2-3 times in the past month

 1-2 times per week

3-4 times per week

5-6 times per week

1 time per day

2-3 times per day

4-5 times per day

6 or more times per day

2. Each time you drank ____________, how much did you usually drink?

Less than 3⁄4 cup (6 ounces)

3⁄4 to 11⁄2 cups (6 to 12 ounces)

More than 11⁄2 cups (12 ounces)

 

BEVERAGES:

– Tomato juice or vegetable juice

– Orange juice or grapefruit juice

 – Grape juice

 – Other 100% fruit juices or 100% fruit juice mixtures (such as apple, pineapple, or others)

 – Fruit or vegetable smoothies

 – Other fruit drinks, regular or diet (such as Hi-C, fruit punch, lemonade, or cranberry cocktail)

– Milk as a beverage (NOT in coffee, tea, or cereal; including soy, rice, almond, and

– Coconut milk; NOT including chocolate milk, hot chocolate, and milkshake)

– Chocolate milk or hot chocolate

– Milkshakes

– Meal replacement or high-protein beverages (such as Ensure, Boost, Muscle Milk,

– Slimfast, Instant Breakfast, or others; NOT including any added protein powder)

– Soda or pop

– Sports drinks (such as Gatorade, Powerade, or Propel)

– Energy drinks (such as Red Bull or Jolt)

– Water (including tap, bottled, and carbonated water; NOT including vitamin water)

– Vitamin water (such as SoBe, Propel Zero, or Glaceau Water)

– Beer

– Wine or wine cooler

– Liquor or mixed drinks

– Coffee, caffeinated or decaffeinated (including brewed coffee, instant coffee, or

espresso shots; NOT including espresso drinks such as latte, mocha, etc.)

Espresso drink mixtures, caffeinated or decaffeinated (including latte, mocha,

cappuccino, etc.)

– COLD or ICED tea, caffeinated or decaffeinated (NOT including herbal or green tea)

– HOT tea, caffeinated or decaffeinated (NOT including herbal or green tea)

Green tea

– Herbal or fruit tea (including hibiscus, chamomile, licorice, sassafras, etc.)

 

Fruits

What fruits have you eaten?

Below is a list of fruits that you could have consumed over the past month.  For each item that applies ask yourself the following 2 questions:

1. Over the past month, how often did you eat ________?

1 time in the past month

 2-3 times in the past month

1 time per week

2 times per week

3-4 times per week

5-6 times per week

1 time per day

2 or more times per day

2. Each time you ate ___________, how much did you usually eat?

 Less than 1 _____   

 1 _________

 More than 1 _______

 

For canned fruits and melons

Less than 1⁄4 cup or less than 1 medium slice

1⁄4 to 3⁄4 cup or 1 medium slice

More than 3⁄4 cup or more than 1 medium slice

 

FRUITS:

– Applesauce

– Apples

– Bananas

– Pineapple (fresh, canned, or frozen)

– Pears (fresh, canned, or frozen)

– Peaches, nectarines, or plums

– Dried fruit (such as prunes or raisins)

– Grapes

– Cantaloupe

– Melons, other than cantaloupe (such as watermelon or honeydew)

– Strawberries

– Blueberries

– Oranges, tangerines, or clementines

– Grapefruit       

– Avocado or guacamole

– Other kinds of fruit (not listed above)

 

Vegetables, potatoes, beans

What vegetables, potatoes, and beans did you eat?

Below is a list of vegetables, potatoes and beans that you could have consumed over the past month.  For each item that applies ask yourself the following 2 questions:

1- Over the past month, how often did you eat ____________________

1 time in the past month

2-3 times in the past month

1 time per week

2 times per week

3-4 times per week

5-6 times per week

1 time per day

2 or more times per day

2- Each time you ate ___________, how much did you usually eat?

Less than 1⁄4 cup

1⁄4 to 3⁄4 cup

More than 3⁄4 cup

 

VEGETABLES, POTATOES, AND BEANS:

– COOKED greens (such as spinach, turnip, collard, mustard, chard, or kale)

– RAW greens (such as spinach, turnip, collard, chard, kale, watercress, seaweed,

mustard greens, beet greens, or dandelion greens)

 – Coleslaw

– Sauerkraut or cabbage (other than coleslaw)

– COOKED carrots (including frozen, fresh, or canned)

– RAW carrots

– String beans or green beans (fresh, canned, or frozen)

– Peas (fresh, canned, or frozen)

– Corn (fresh, canned, or frozen)

– Broccoli (fresh or frozen)

– Cauliflower or Brussels sprouts (fresh or frozen)

– Sweet peppers (green, red, or yellow)

– Onions

– Garlic

– Mixed vegetables

– Lettuce salads (with or without other vegetables)

– Salad dressing on salads (including low-fat or fat-free)

– Mayonnaise on salads (including low-fat, diet, or light)

– Fresh tomatoes (including those in salads)

– Salsa

– Catsup or ketchup

– Sweet potatoes or yams

–  French fries, home fries, hash browned potatoes, or Tater Tots

– Potato salad

– Baked, boiled, or mashed potatoes

– Cooked dried or canned beans (such as baked beans, pintos, kidney, black-eyed peas, lima, lentils, soybeans, or refried beans; NOT including bean soups or chili)

– Other kinds of vegetables (not listed above)

 

Rice, pasta, pizza

What rice, pasta, and pizza have you eaten?

Below is a list pasta, rice and pizza that you could have consumed over the past month.  For each item that applies ask yourself the following 3 questions:

1. Over the past month, how often did you eat ____________ ?

1 time in the past month

2-3 times in the past month

1 time per week

2 times per week

3-4 times per week

5-6 times per week

1 time per day

2 or more times per day

 

2. Each time you ate ___________, how much did you usually eat?

Less than 1⁄2 cup

1⁄2 to 1 cup

More than 1 cup

 

3. How often was the ___________ you ate whole grain?

Almost never or never

About 1⁄4 of the time

About 1⁄2 of the time

About 3⁄4 of the time

Almost always or always

 

RICE, PASTA, PIZZA:

– Rice or other cooked grains (such as bulgur, cracked wheat, or millet; NOT including

sushi)

– Sushi

Each time you ate sushi, how much did you usually eat?

Fewer than 5 pieces or less than 1 cup

5 to 8 pieces or 1 to 2 cups

More than 8 pieces or more than 2 cups

– Lasagna, stuffed shells, stuffed manicotti, ravioli, or tortellini (including gluten-free; NOTincluding spaghetti or other pasta)

– Macaroni and cheese (including gluten-free)

– Pasta salad or macaroni salad (including gluten-free)

– Pasta, spaghetti, or other noodles (other than those listed above; including gluten-free)

– Pizza (including gluten-free)

 

Cereal, pancakes, breads

What cereal, pancakes, and breads have you eaten?

Below is a list of cereals, pancakes and breads that you could have consumed over the past month.  For each item that applies ask yourself the following 2 questions:

1. Over the past month, how often did you eat ____________ ?

1 time in the past month

2-3 times in the past month

1 time per week

2 times per week

3-4 times per week

5-6 times per week

1 time per day

2 or more times per day

2. Each time you ate ­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­_____________, how much did you usually eat?

Less than 1 medium piece or less than 1 cup

1 to 3 medium pieces or 1 to 2 cups

More than 3 medium pieces or more than 2 cups

CEREALS, PANCAKES AND BREADS

– Oatmeal, grits, or other cooked cereals

– Cold cereal (including gluten-free)

– Pancakes, waffles, or French toast (including gluten-free)

– Bagels or English muffins (including gluten-free)

– Breads or rolls AS PART OF SANDWICHES (including gluten-free)

– Breads or dinner rolls NOT AS PART OF SANDWICHES (including gluten-free)

– Cornbread or corn muffins

– Biscuits

– Jam, jelly, or honey (on bagels, muffins, breads, rolls, crackers, etc.)

– Peanut butter or other nut butter

– Hummus

Source: https://epi.grants.cancer.gov/dhq3/

SELF-TEST