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Managing Mental Illness
Diet, Nutrition and Weight Management

Living a Healthy Lifestyle

Wellness involves choice and action! The choices you make each day and the actions you take on those choices can lead to a healthier lifestyle. Making positive choices in the areas of physical fitness, stress, work, relationships, medication, and nutrition and acting on them promotes a sense of accomplishment and well being.

There are other benefits from these choices too. Making a life-long commitment to a healthy lifestyle can reduce the effect of chronic medical illness, give you more energy, increase your self-esteem and confidence, and reduce the risk of worsening your symptoms of schizophrenia or relapse.

Health Problems Associated With a Poor Diet

The typical American diet can cause significant health problems because it is high in fat, salt, and sugar, and apt to be low in fiber and vital nutrients. Even though most of us have healthy food options available, we tend to make poor food choices. Poor dietary habits, in combination with lack of exercise and high stress, have been connected to such health problems as obesity, coronary heart disease, high blood pressure, and diabetes.

Choosing a Healthy Diet: Dietary Guidelines for Americans

The Dietary Guidelines for Americans were established to help people choose diets that will meet their nutritional requirements, promote health, support active lives, and reduce the risk of chronic disease. These Guidelines are meant to be simple and sensible suggestions for people trying to maintain a healthy lifestyle.

Guideline #1: Eat a Variety of Foods

To be well nourished, each day you need to eat a variety of foods that contain balanced amounts of nutrients. There are over 40 known nutrients that your body needs to stay healthy--no single food can supply all the nutrients you need.

Guideline #2: Balance the Food You Eat With Physical Activity - Maintain or Improve Your Weight

Sometimes, people do not make wise decisions concerning the calories in the foods they eat. A calorie is a unit used to measure the amount of energy produced by the food you eat. If a person eats food containing more calories than the body needs for energy, the extra calories may be stored as fat. In order to lose weight, you must use more calories than you consume. Physical activity is the only way to burn calories.

Guideline #3: Choose a Diet With Plenty of Fruits, Vegetables, and Grain Products

Because fruits, vegetables, and grains are loaded with vitamins and minerals but have little or no fat, they are good dietary choices. Notice that these food groups make up the base of the Food Guide Pyramid, where most of your food choices should come from. By increasing the amount of fruits, vegetables, and grains in your diet, you may be able to:

• Help reduce your risk for heart disease and stroke
• Reduce your chances of getting cancer
• Make your immune system stronger
• Get slimmer and trimmer
• Lower your blood pressure
• Reduce your food costs (these foods are generally cheaper than meat and dairy products)

An additional benefit of eating these foods is that they increase the fiber in your diet. There are two types of fiber -- soluble and insoluble. Soluble fiber absorbs water and swells, forming a gel in the gastrointestinal tract. This gel can give you a full feeling and help you eat less. Insoluble fiber, found in grain cereals, breads, fruits, and vegetables, is sometimes called roughage because of the bulk it adds to the diet. A diet high in fiber may:

• Help alleviate constipation (a common side effect of some medications you may be taking)
• Give you a full feeling, which can help reduce the amount of food you eat
• Reduce blood cholesterol levels
• Reduce the risk for bowel disorders and colon cancer

Guideline #4: Choose a Diet Low in Fat, Saturated Fat, and Cholesterol

Some dietary fat is needed for good health. In fact, fats supply energy and help the body use vitamins A, D, E, and K. However, high-fat diets have been associated with heart disease, high blood pressure, and cancer. Fat also provides twice as many calories as proteins and carbohydrates in the same amounts.

• Carbohydrate = 4 calories per gram
• Protein = 4 calories per gram
• Fat = 9 calories per gram

Saturated fat is any fat that is solid at room temperature-both animal and vegetable fats can be saturated. Too much saturated fat in the diet can cause blood cholesterol levels to rise and may lead to health problems. Some foods high in saturated fat are: bacon, sausage, lard, bologna, coconut oil, peanut butter, ham, butter, whole milk, ice cream, and cream cheese.

When we talk about fat in our diet, many of us immediately think of cholesterol. Cholesterol comes from animals, so only foods from animals contain cholesterol (egg yolks, meat, poultry, high-fat milk products/cheese, shellfish, and pork). Since the body produces all the cholesterol it needs, it is best to limit your cholesterol intake to less than 300 mg per day.

Guideline #5: Choose a Diet Moderate in Sugars

Foods made with simple sugars or carbohydrates contain mostly "empty" calories-those that provide very little vitamins or minerals. Sugar is the #1 food additive and is often listed on labels under names not familiar to most people. Some of these include corn fructose, maltose, dextrose, sucrose, fructose, lactose, and polydextrose. Several problems are caused by eating excess sugars:

• Excess calories from sugars are stored as fat unless they are burned up in exercise
• Simple sugars in the diet can promote tooth decay
• A diet high in sugar may uncover or worsen diabetes

Sugar substitutes should also be used in moderation. Talk to your doctor if you have questions about specific products.

Guideline #6: Choose a Diet Moderate in Salt and Sodium

Sodium is a mineral found in salt that occurs naturally in some foods. Sodium plays an important role in regulating body fluids and blood pressure. Although the body needs 2,400 mg of sodium per day, or the amount in 6 grams of salt, most people consume more than that amount. Foods highest in salt and sodium include snack foods (chips, pretzels, etc.), bologna, bacon, olives, ham, mustard, and ketchup. Ways to reduce sodium intake include:

• Eat more fresh fruits and vegetables
• Use herbs and salt-free spices to flavor foods
• Avoid processed and packaged foods
• Don't add salt at the table

Guideline #7: Avoid Alcohol

Alcohol supplies large amounts of calories and few or no nutrients. Additionally, drinking alcohol can lead to high blood pressure, liver and brain damage, and increased risk for heart disease.

People with schizophrenia should be especially careful about drinking alcohol because it is known to interact with many medications taken to treat schizophrenia. Mixing alcohol and psychiatric medications may cause interactions that can worsen some side effects, like sleepiness and sedation. Mixing medication and alcohol can also cause the symptoms of schizophrenia (eg, hallucinations, delusions, and social isolation) to worsen. It is best to completely avoid the use of alcohol.

The Role of Water in Good Nutrition

The importance of water in the diet cannot be overestimated. Healthy lifestyles that include exercise and a high fiber diet require plenty of water intake. Experts suggest that a person drink 8 additional 8-ounce glasses of water daily. For anyone participating in a regular exercise program, 9 to 13 glasses of water are recommended. The body needs water to perform the following functions:

• Digest food and dissolve nutrients so they can pass through your digestive system
• Carry waste products out of the body
• Send messages between cells so that your muscles can move, your eyes can see, and your brain can think
• Regulate body temperature
• Lubricate moving parts (eg, joints)

Dealing With Weight Management

Excess weight is not healthy for your body. It can cause a strain on your heart, as well as on bones and joints as the body tries to support the excess weight. Although many people look to miracle drugs or crash diets to help them lose weight, these methods can have negative effects on your health, and the results are usually short-term. The most effective long-term treatment for weight management is a commitment to a well-balanced diet and exercise program.

A quick way to determine your healthy weight is as follows:

Women: 100 pounds for the first 5 feet of height. Then add 5 pounds for every inch above 5 feet. For example, if you are 5'4" tall, your target weight would be 120 pounds. If you are large framed, you can add about 10%, which would equal 132 pounds in the example. If you are very small framed, subtract 10%, which would equal 108 pounds.

Men: 106 pounds for the first 5 feet of height. Then add 6 pounds for every inch above 5 feet. For example, if you are 5'11" tall, your target body weight would be 172 pounds. As above, you can add 10% if you are large framed and subtract 10% if you are small framed.

Strategies to Improve Eating Habits

Helpful hints for improving your eating habits include:

Clean out your cupboards at home. Make a decision not to have those foods that are not a part of your new healthy lifestyle in your kitchen.

Avoid eating between meals. This adds extra calories you don't need and slows down the digestive process.

If you snack, choose low-calorie/high-fiber foods such as carrots, celery, and popcorn.

Chew your food well.

Avoid fast foods. When you must eat at a fast food restaurant, choose a salad instead of a hamburger and avoid french fries.

Plan to cook healthy meals with your friends. You can help each other choose the right foods and have fun preparing meals together.

Controlling Your Hunger

Some of the medicines you are taking to treat your schizophrenia may increase your appetite. There are things you can do, however, to decrease your hunger and the desire to eat. Here are some helpful hints on controlling hunger:

• Take a walk when you feel hungry.
• Drink a glass of water or other sugar-free beverage.
• Eat a rice cake or a half-cup of raw vegetables.
• Chew sugar-free gum or suck on sugar-free mints.

Know the difference between "mouth hunger" (the urge to use food to soothe feelings of boredom, nervousness, anger, sadness, or stress) and "stomach hunger" (your body's way of telling you it needs food).

Tips for Eating Wisely on a Limited Budget

In general, a diet that places less emphasis on meat, dairy products, packaged or processed foods, and fast foods will usually be more economical. For persons on a limited or fixed income, budgeting is especially important. Here are some ways to trim your food budget:

Buy fruits and vegetables in season. Look for farmer markets where fresh produce is often sold in bulk and can be offered at reasonable prices.

Buy larger packages of certain foods. Grocers offer "family size" packages of food at discount, but you should purchase these items only if you know you will use them before they spoil or get stale.

Proper food storage. Store foods in airtight containers or in the freezer to protect them from spoilage, moisture, and bugs.

Buy store brands. Store brands or generic products tend to be more affordable than name brands, and their quality is typically the same as name brands.

Watch unit pricing. Some grocery stores place tags near food items that show how much you are paying for a small unit of product. For example, a 10-ounce box of cereal costs $3.60. The unit price per ounce is $0.36. Unit pricing can be used to compare the cost of 2 similar products in different sized packaging. Although larger packages often cost less per ounce than smaller ones, this is not always true. It's important to check the unit price.

Use coupons. Some stores give double value on coupons up to $0.50. Make sure that you compare prices with store brands to ensure that you are getting the best buy.

Have dinner with friends. Sharing the cost of meals with others you know who have to watch their budgets can save everyone money. Another advantage is that the responsibility for preparing meals can be shared with others, so it seems like less work-even fun! Sharing meals can prevent isolation and you can use your friends as a support group to help you maintain your healthier eating habits and lifestyle.

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