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C H A P T E R
11
Back to Basics: We Are What We Eat

Your Mother Was Right After All
Remember how your mother used to tell you to eat your fruits and vegetables so that you could grow up big and strong? What seemed like nagging to many broccoli-hating children is now an accepted fact: eating good foods can help you to be healthier-maybe even live longer and prevent diseases such as cancer. Just look in any bookstore: it seems like new books are coming out every week to tell of the wonders of this vegetable, or that vitamin, or some special diet. How do you know which is true? Which is a fad? How to you become a well-informed consumer?

     Let me start by saying that this is not a text on in nutrition; there is a wealth of information which  does not fit within the scope of this topic. Also, there are many differing  opinions among members of the health care community regarding optimal nutrition, the use of vitamin supplements, etc. What I am going to do is to synthesize information from a variety of current sources to give you some working knowledge of nutrition—with specific emphasis on the connection between nutrition and stress management.

     Before starting any radical diet program, please check with your health care practitioner. This book will not advocate any radical diet regimens; it will look at how you can modify your diet to make improvements which will affect your overall physical and psychological well-being. Please refer to the sources listed in the bibliography for further information.

Awareness Exercise: Food Diary
    
Each chapter in this book has in chided some exercises to increase your awareness of yourself and how stress affects you. Awareness is also an important part of optimal nutrition: awareness of how you are eating now, awareness of basic principles of a good diet, and awareness of your relationship with food.

     We often take eating for granted. Many of us eat on the run, eat at our desks, buy fast food, etc. We may not realize how we place food within an emotional context sometimes. Most people do not think about how what they eat contributes to their stress level. This chapter is designed to help you find insights into these issues.
One of the more enlightening things I have done is to keep a 'food diary" for one week. What this means is that you write down everything that you eat. Everything! A bite of chocolate, a can of beer, a banana, etc. If you eat it, you record it in your diary. We often don't realize exactly what we eat because we reach for food so unconsciously-it becomes like a reflex. Only by writing it down can you gain a greater awareness, and awareness becomes the key to change whatever needs changing.

     OK, a diary is only going to help you if you will do the exercise faithfully. So, now is the time to make a contract with yourself: Decide that it is important to you to know what type of "fuel" you are putting into your body, and to explore how you can improve your diet. If you are a health care professional, you can teach your clients to do the same thing. Designate a seven day period during which time you will keep a food diary, get yourself a small notebook and a pen, and get started!

     My entry from today would look something like this:

            Breakfast:           Apricot-apple juice
                                           Herbal tea with milk and 1 tsp honey
                                           Broccoli-potato soup
                                           (I know, I eat very unusually-but it will make more sense later in this chapter.)
             Lunch:                   More soup
                                            Low-fat blueberry yogurt
                                            Low-fat string cheese

            Snacks:                More herbal tea, no honey
                                            A banana, some sunflower seeds and raisins

             Dinner:                 Lamb/broccoli/tabouli stir try (no salt or oil)
                                            Home-made no salt hummus
                                            A few low-salt, reduced-fat potato chips
           (I admit chips are a vice, but I'm working on it!)

     Looks pretty weird, huh? What makes this diary so enlightening is that food doesn't seem weird at the time you are eating it; you need to look at your eating patterns objectively to get a better understanding of what you are doing and why you are doing it. You may be working against yourself and your own stress management without even knowing it!

     For example, if you are having a really hideous day at work, drinking five cups of coffee will seem like a reasonable thing to do, until you try to go to sleep that night and find yourself too wired to close your eyes. Or you may not realize caffeine is increasing your anxiety until your doctor tells you to cut down on coffee to lower your blood pressure. Remember, many things which we eat and drink will continue to affect us for hours after we consume them. Keeping the diary will help us see the connections between our activities, our diets, and how we feel. This brings us to the next question:

Does What We Eat Affect How We Feel?
     As you set up your food diary, leave room on each page to write how you feel at various times of the day. For example,

Time     Foods eaten                  Activity                        How did I feel?

8:00       Orange juice                  in the                            felt 'wired' at first,
               Scrambled egg            office                            got sluggish and
               3 cups of coffee                                                   sleepy mid-morning.
               Sweet roll with jam                                              Had more coffee.


     You may find some clear connections, or you may not. The important thing is to become aware of what you eat and how it makes you feel. To get you started, a sample form is included for you on the next page.

     Please experiment with making your own form or diary system. It doesn't matter what it looks like as long as it works for you. This diary will not help you unless you make a commitment to do it. Start with a week, and you may find it valuable enought to continue over an entire month.

     [Hint: if you are a female, I strongly suggest keeping a food diary for an entire menstrual cycle so that you can discover any cyclical food patterns. More about this later] 

     You may find that eating dairy products in the morning helps you feel energized, or you may feel sleepy. Each of us is different; the food diary will give you the clues you need to improve how you eat. Part of your overall commitment to stress management and wellness promotion is increasing your awareness of yourself


The Meaning of Food in Modern Society

     Food is more than just survival fuel. Over the ages, we have imbued food with cultural meanings and emotional overlays. Chicken soup means motherly nurturing and healing. Chocolate means a treat. What is considered a gourmet selection in one culture may be taboo in another. Eating is often a social experience. All of these issues are important as we look at how to improve our nutrition for optimal stress management.

     Our culture gives us a lot of confusing messages about food. We can find recipes overflowing from the pages of many magazines and books. TV commercials bombard us with ads for fast foods and restaurants. We teach our daughters that "the way to a man's heart is through his stomach."

     Yet these "pro-food" images are countered with the preoccupation with being thin.

     Thin=Beautiful/ sexy/ smart/ rich, etc.

     Fashion models are unnaturally thin and angular. Overweight people are the object of discrimination and teasing. Young women, taking the dictates of fashion to the extreme, damage their health and risk their lives due to anorexia and other eating disorders.

     Next we will complete another exercise to explore our own emotional connections with food.

Awareness Exercise: Comfort Foods
     When you are feeling stressed at work or at home, do you ever turn to food for comfort? When you are depressed, do you ever reach for a candy bar? If you said 'yes' to these questions, you are in good company. Most of us have developed emotional attachments to certain foods over the years, foods which can help us feel better when we are sad, relax when anxious, etc. These are what I call our 'comfort foods.'

     For example, if I have a cold, I know that a pot of home-made chicken soup will make me feel better. This is not just folklore; the fresh vegetables and spices in the soup are healing. If I am having a bad day at work, I want frozen yogurt and a cappuccino. Neither of these foods will help me solve my problems or actually improve my performance; they just make me feel better emotionally. (At least until the sugar rush wears off!)

      What are your comfort foods? Take a few minutes to think about this and make some notes to yourself Don't be shy; whatever unusual thing you really like to eat on bad days is probably not unique-nothing to be ashamed of.

Awareness Exercise-Comfort Foods

When I am feeling depressed, I like to eat:
_____________________________________________________________________
_____________________________________________________________________

If I am feeling a lot of stress, I want to eat:
_____________________________________________________________________
_____________________________________________________________________

What is my favorite snack when I am:
At work______________________________________________________________
At home_____________________________________________________________
Happy______________________________________________________________ 
Sad_________________________________________________________________ 
Angry_______________________________________________________________

My favorite beverage in the morning is:
     Coffee? Tea? Milk? Juice? Other??????
_____________________________________________________________________

Are there any foods which have special emotional meaning for you? Please explain.
_____________________________________________________________________
_____________________________________________________________________

     Any surprises? We may not realize that what we eat is actually working against us. For example, coffee contains caffeine. Some authors and researchers have linked moderate intake of caffeine to an increased risk of heart disease. Caffeine is a stimulant, as we all know. It works by increasing the circulation of adrenalin and other stress hormones within the body. It also has been implicated in aggravating fibrocystic breast conditions, and in depletion of vitamins such as C and B, and some minerals. .Any coffee drinker knows what happens when you drink too much-can't sleep, feel shaky, have diarrhea, palpitations, etc. If a breast-feeding mother drinks too much coffee, the infant often gets jittery.

     Given this information, it seems logical that reaching for a cup of coffee when you are already feeling tense and 'hyper' is not the best idea in the world. Many stress management and nutrition books advocate avoiding or limiting your intake of caffeine by limiting in take of coffee, regular tea, colas, and chocolate. You may want to substitute herbal teas, or decaffeinated varieties as part of your improvement program.

     Once again speaking from personal experience, getting off the "coffee habit" can be very difficult. Caffeine is addictive for many of us, and giving it up "cold turkey" may cause headaches. Tapering down the amount you drink may be a better alternative if you find that you do get headaches, or switching to drinks with a lower caffeine content (tea, cocoa, etc.) Since "decaffeinating" myself, I find that I can handle stress more effectively and have a more consistent energy level, rather than having the highs and lows which I used to get from coffee.

     As with most things in life, moderation is the key. An occasional cup of coffee will not harm most people. Be aware of your intake patterns, how your body reacts, what the research says, and make your decision accordingly.

     Another common comfort food is sweets, candy bars, sodas, ice cream, etc. Sugar gives us a rapid burst of energy as our blood sugar skyrockets, but this peak is followed by an equally rapid decline, resulting in sleepiness and fatigue we all experience after lunch. Although many health food writers advocate using honey or brown sugar instead of refined sugar, the body will react similarly to all.

     Once again, moderation is the key. If you are a heavy sugar eater, particularly during times of stress, you probably need to alter your diet to reduce sugar in take. Rather than reaching for the candy bar, try a piece of fruit—there is a natural type of sugar in it, but your body will react more slowly to it than refined sugar. Another choice would be to reach for a complex carbohydrate food, such as a potato or some whole-grain bread These types of foods give you energy for longer periods of time.

Food For Stressful Times
     OK, we have talked about some of the things you shouldn't eat. What about the foods that are good for you during times of stress? High nutrient intake is important, because stress speeds up the cellular activities within our body, which in turn results in a faster rate of using up nutrients.

     The Surgeon General of the U. S. and the National Cancer Institute have also told us that what we eat is very important to our overall wellness. Americans tend to eat too much fat and protein, both of which may contribute to less than optimal health.

     Some basic guidelines to help you improve your nutrition are:

  •  reduce fats so that less than 30% of your daily calories come from fat;

  •  reduce intake of cholesterol;

  •  eat less high-fat meat and high-fat dairy products; switch to lean meats, fish, poultry, low-fat dairy foods.

  • increase intake of complex carbohydrates and fiber by eating more whole grains, cereals (preferably with no added sugar), leafy vegetables, dried legumes, and fruit. Pasta with a low-fat sauce is a good example.

  •  if you buy processed foods, look for low-salt items and minimize added salt.

  • drink 8-10 glasses of water a day;

  •  if you drink, drink no more than 2 alcoholic beverages a day.

     Some foods that relieve anxiety include vegetables, which provide us with minerals and vitamins needed to promote stamina and maintain the body's biochemical balance. Vegetables rich in vitamin C, such as broccoli, parsley, and tomatoes, are particularly important because stress speeds up the body's consumption and elimination of this vitamin.

     Fruits also provide vitamin C and other nutrients which assist the body to tolerate stress. Eating the whole fruit is a better choice than drinking fruit juice because you also get the benefit of the fiber.

     Starches, such as potatoes, are excellent, easy-to-digest foods which calm your mood by helping to regulate the blood sugar. One of my favorite breakfasts is a baked potato or yam, along with some lentils to get a good mix of proteins and carbohydrates.

     Beans and peas are excellent sources of mineral and B vitamins— all of which are needed to help the body cope with stress. As you cut down on meat intake, mixing beans with other food such as rice can provide you with a healthy, economical source of protein.

     In regards to meat, your body only needs small amounts—3 ounces a day or less is adequate for most people. Meat is difficult to digest, and may give you more fat and cholesterol than is desirable. In order to stretch your meat dollar and calories farther, try using it in low-cal stir fry dishes or soups. Some people may want to make the change to vegetarianism, which involves learning more about food combining and nutrition than is needed at this time.

     The key for stress management is to build a well-balanced diet out of fresh fruits and vegetables, lean meats and dairy products, and complex carbohydrates. Minimize or eliminate intake of caffeine, sugar or alcohol as' anxiety adjusters.' While some of these changes may not seem pleasant, you should consider and try them--let your body tell you how it reacts. Most bodies will resond positively to better nutrition once you get through the initial change or 'detox' phase; I know that mine has.

Other Ideas: Nutritional Supplements and Herbs
     It is a well-known fact that stress takes a toll on the body's resources, including nutritional resources. The major nutrients which are depleted during times of stress are vitamins A, E, C and B vitamins, and minerals 
such as zinc, selenium, calcium, magnesium, iron, potassium, and some others. If you read the labels of anti-stress formula vitamins in the market, you will see an emphasis on these vitamins and minerals.

     Some health care professionals recommend high-doses of these key nutrients to prevent the negative effects of stress. Physician Elson Haas, for example, suggests that we take at least 4-8 grams of vitamin C daily during times of stress. The Food and Drug Administration (FDA) has published its Recommended Daily Allowances (RDAs) of vitamins which are believed to provide for the daily nutritional needs of most people. The RDA for vitamin C is 60 mg. per day. The American Dietetic Association advocates the use of supervised supplementation with specific nutrients for certain populations who cannot obtain adequate nutrients from dietary sources, such as the need for folic acid in women of childbearing age. The ADA has voiced concern over the recent publicity over the use of antioxidants (such as vitamins A, C, E, and beta-carotene) as prevention against diseases ranging from cancer to heart disease. The research into the safety and effectiveness of nutritional supplements is still evolving, and the ADA continues to advocate obtaining adequate nutrients from food sources. By eating a balanced diet with ample supply of fresh fruits and vegetables, it is possible to obtain the desired RDAs of the major nutrients in most healthy people.

     The controversy lies in the differing opinions of the professional and governmental agencies and those of the holistic health community and some researchers. Kahn and Saulo state this difference quite clearly:

The Recommended Daily Allowances (RDAs) are the levels of intake of essential nutrients considered by the Food and Nutrition Board of the National Academy of Sciences and the Food and Drug Administration (FDA) to be adequate to meet the nutritional needs of the average healthy person. Ideally, you should be able to obtain all the nutrients you need by eating a balanced and healthful diet. Unfortunately, the food we eat may not be as nourishing as they should be. Grown on depleted soil with toxic fertilizers and pest repellents, much of the food in super markets lacks important nutrients. Considerable loss of nutrients also takes place during the processing and preparation of foods. Lifestyle factors such as stress, pollution, strenuous exercise, pregnancy, coffee and alcohol consumption, illness, and prescription medications may all increase an individual's nutritional requirements. Based on the factors just described, it is advisable to support your daily diet with a nutritional supplement containing ample proportions of the antioxidants, vitamins A, C, and E, the B-complex vitamins, beta-carotene, and minerals.

[Sherry Kahn and Mileva Saulo. Healing Yourself: A Nurse's Guide to Self-Care and Renewal . (Albany: Delmar Publishers, 1994), 185.]

     My opinion is that each person must decide for himself what advice to folio win reference to nutritional supplementation. It is unarguable that a well-balanced diet is essential to health. Fruits and vegetables need to be a major part of every person's daily food intake. Whole grains, low fat meats and dairy products, and low levels of dietary fat are also important. Minimizing or avoiding caffeine and other potentially harmful sub stances is also important.

    Personally, I do take nutritional supplements, including extra doses of vitamin C if I feel a cold coming on. I cannot prove 100 percent if these help or not, but I do feel better when I take them compared to when I don't. It is impossible to say whether this is a purely physical reaction to a much-needed substance, or if it is a mixture of the physical plus the psychoneuroimmunological effect of my belief in what I am doing. Basically, this is not a major issue for me as an individual. I tell all of my health care providers what I am doing, and continue to read about nutritional theories in both the medical and lay literature.

     You must make your own decision. If you are a health care provider, you must assist your clients make well-informed choices. This chapter is the beginning of what can become a long, fascinating search for information on nutrition. Do not be persuaded by all the advertisements you see, yet do not ignore them. Look around, stay open, and learn.

     Another area of controversy is the place of herbs in the management of stress and other physical conditions. In recent years, there has been an explosion of herbal teas and preparations on the market, each claiming some health benefit. Many remedies we learned at our grandmothers' knees have come back, such as the use of chamomile tea to calm us, peppermint tea to soothe an upset tummy, etc. We now know that chamomile really does work to calm us because it contain stryptophan, an amino acid which has relaxing properties. Valerian root, easily prepared as a tea, is an effective herbal remedy to help people sleep.

         The use of herbs is much more common in European and Oriental medicine than in American. If you are interested in learning more about herbs, I suggest that you do some research before launching into a heavy-duty use of any products. Go to the local library or bookstore and look through the ever-growing library of herbal encyclopedias. Herbs are powerful substances; many modem drugs such as digitalis and aspirin come from herbal or botanical sources. Learn about what you are thinking of taking.

        In general, most of the tea preparations available in the supermarkets are pleasant and well-tolerated. Many different tea companies make chamomile tea and other herbal teas. They taste good, have no caffeine, and are a delightful addition to our diets. I find many of them helpful for a variety of conditions, and suggest that you explore what is available.

     To summarize the role of herbs in stress management, I refer to the writings of Susan Lark:

Many herbs can help relieve the symptoms and treat the causes of anxiety and stress. I have used anxiety- and stress-relieving herbs in my practice for many years, and many women have found them to be effective remedies. I use them to extend the nutrition of a healthy diet. Herbs can balance and expand the diet while optimizing nutritional intake. Some herbs provide an additional source of nutrients that can relax tension and ease anxiety.

[Susan M. Lark, M.D. Anxiety and Stress: A Self-Help Program . (Los Altos: Westchester Publishing Company, 1993), 137.]

      As you can see, there is a lot to learn. Do some exploring. See what works for you or your clients, and enjoy. Use you common sense, your sense of reason, and read a variety of sources so that you can make an informed decision about how to use nutritional remedies as part of your stress management program.

      Nutrition, combined with exercise and other modalities of stress management described in this book can help you develop a holistic approach to wellness. Remember, stress management is part of an overall commitment to life management. Do it .

The Food-Stress Link
If we are what we eat, then from 9 to 5 many of us are either bottomless cups of coffee or the F9 button on the candy machine. Joan Horbiak believe that's no way to work. Horbiak, president and founder of Health & Nutrition Network, consultant to Scott Paper, Johnson & Johnson and Bristol-Meyers Squibb, among others, says that a change in diet can help keep stress under control. She and her staff make on-site visits to over 40 companies to help employees manage stress and increase productivity through nutrition and behavior. Horbiak talked with Working Woman  about the food-stress connection.

How does stress affect eating habits? People usually react to stress in one of two ways: Some eat excessively to distract themselves from work; others suffer stomach upset and skip meals. Both situations decrease productivity. The overeater's blood is diverted from the brain to the stomach, and the under eater deprives her brain of essential nutrients.

How should you eat to be at your best? People should either eat three small meals a day, supplemented by two "power snacks", as I call them, or five minimeals. Eating smaller meals throughout the day helps people think more clearly by keeping their blood sugar-the brain's major fuel-at a constant level. This also allows the overeater to eat fairly frequently and gives the under eater smaller, easier-to-digest portions. Also, it's hard for someone under a lot of stress to digest a large meal-the' 'flight or fight" response to anxiety-provoking situations diverts blood from the digestive tract to the arms and legs.

What are power snacks?
They're complex carbohydrates-breads, cereals, fruits and vegetables-that are easy to digest and give you the most fuel within the least amount of time. Breads take just one to three hours to digest, and fruits take less than an hour. Bagels, low-fat muffins or fig bars are great snacks because you can eat them on the run. I sometimes freeze a container of low-fat yogurt so that by the time mid-afternoon rolls around, it's ready to eat.

Which foods can cause stress? Listen to your body to determine which foods you're sensitive to. In general, it's good to avoid fatty foods when you have important work to do because they take five to seven hours to digest. You don't want your blood leaving your brain to sit in your stomach. Most people have trouble with gas-producing foods like Brussels sprouts, broccoli, kidney beans and lima beans. And watch out for spices, MSG and salt-they can up set your stomach, too.

Which can help your performance? Recent reports show foods that are high in carbohydrates release a calming chemical called scrotonin, while proteins contain the amino acid tyro sine, which increases alertness. But one important nutrient that's often overlooked when it comes to performance is water. The brain is 75 percent fluid, and it is the first thing to be affected by dehydration. In addition, every chemical reaction that transforms food into energy uses water, so you're probably just dehydrated during those midday snack attacks. The average office worker loses 10 cups of water a day. And because caffeine is a diuretic, coffee drinkers get more dehydrated. Replacing lost fluids requires a minimum  of eight 8-ounce glasses of caffeine-free liquids a day.

We always hear that, but how do we do it? The key is not to drink all 64 ounces at once or to wait until you're thirsty. Have two cups of non-caffeinated fluids before you go to work. Then cue yourself to drink during the day by placing a glass and a pitcher of water with lemon by your desk. Instead of taking coffee break, walk to the water cooler. You can also substitute juice, milk or caffeine-free soda. Cool liquids are best-they're absorbed faster into the blood.

Should you avoid coffee altogether? I'm not for caffeine, but it's important to put coffee drinking in perspective. The morning cup of coffee is not the problem. Studies even show that two cup s of coffee can temporarily increase alertness. If I were a coffee drinker and hadn't had my morning cup, I would definitely not perform at my best. It's the four-cup coffee drinker who needs to cut down because it's at least dehydrating and will cause stomach-acid secretion.

      If you want to cut out coffee, do it gradually. A report in the October [1993] New England Journal of Medicine  warns that quitting cold turkey can contribute to insomnia and stomach upset. Try cutting your daily intake by one cup of coffee every two weeks, mixing regular with decaf, drinking instant, which has less caffeine, or using a smaller mug. Also, pay attention to the caffeine content in soft drinks, teas and medications.

What's the best way to change your eating habits? Think about progress in stead of perfection. Any move that you make in the right direction will decrease the physiological effects of stress. Pick one area to start-fluids, minimeals, or caffeine-and stick to it for one or two weeks. If you have one day when you eat something that' s high in fat or you drink too much caffeine, don't think you've blown away your whole diet. Make trade-offs with yourself Have something better for your next meal.

First Appeared in Working Woman in May 1993.
Written by Francine Hermelin.
Reprinted with the permission of Working Woman Magazine.
Copyright cl993 by Working Woman, Inc.