For some
people, the phrase healthful diet
is enough to send their mood tumbling. "Guess I'll have to give up everything I
enjoy, like chocolate and hamburgers and french fries," sighed one patient.
"That's enough to make me even more depressed!" But healthful need not be
equated with unappetizing or boring. Different, perhaps, and for some people a change to a
more healthful diet requires big adjustments -- in the foods they buy, where they eat out,
and how they prepare their choices. The rewards, however, are many, including improved
mood, more energy, enhanced immune system, better concentration, and invigorated sex
drive, to name but a few.
I've found that laying down a few basic but
critical guidelines for a healthful diet, and then tweaking them for individual patients,
works much better than expecting people to follow a complicated program that involves
counting grams of carbohydrates or protein, weighing foods, referring to charts, or
combining certain items in complicated ratios. That being said, here are my lists of
"Positive Foods" and "Foods to Avoid."
Positive Foods
Sweets. In moderation, natural sugars such as rice
syrup, date sugar, pure Vermont syrup, unsulfured blackstrap molasses, and unfiltered
honey are all acceptable. An herbal sweetener -- that has nearly no calories -- is stevia,
which can be found in health food stores and increasingly in mainstream grocery stores.
Fats. Some fats are healthy and instrumental in
maintaining mental health, especially omega-3 fatty acids. When you choose oil for
cooking, your best choice is probably cold-pressed olive oil. Butter and other saturated
fats (like coconut oil, but not margarine that contains transfatty acids) may be used in
moderate amounts. I suggest you avoid fried foods (especially deep-fried).
Whole fruits and
vegetables. Whenever
possible, choose fresh, organic fruits and vegetables and eat at least five to seven
servings daily. To derive the most benefit from these rich sources of vitamins, minerals,
fiber, and carbohydrates, eat them in as pure a state as possible, preferably raw or
lightly steamed. (Sorry, deep-fried potatoes and onion rings don't count as servings of
whole vegetables.) Fruit and vegetable juices are good as well, and if you have a juicer,
please learn how to make your own fresh juices, remembering to drink the pulp as well!
Whole grains and cereals.
Whole grains and cereals
(organic if possible) are excellent sources of complex carbohydrates. These foods include
whole grains, brown rice, and unprocessed cereals. Complex carbohydrates break down
gradually and provide a more steady supply of glucose -- brain fuel -- thus helping
maintain an even or calmer mood. Simple carbohydrates, however, such as those found
in sugary foods or those made with white flour, metabolize rapidly, contributing to and
causing mood swings and energy highs and lows. Also, be aware that some grains and even
other whole-food starches may be problematic for some people.
Beans, legumes, nuts, and
seeds. Choose organic foods
in this important category as well. Foods in this group are excellent sources of protein,
especially for people who want to reduce or eliminate animal protein. Beans, legumes,
nuts, and seeds are also high in fiber and many nutrients. Also in this category are tofu
and other forms of fermented soybeans (miso, tempeh) and flaxseed.
Eggs and dairy. Eggs and dairy foods -- milk, cheese,
butter, cream, and yogurt -- are good sources of protein, calcium, and other important
nutrients. They are also rich sources of saturated fat, which may be fine for many people.
The major concern I have about eggs and dairy relates to whether hormones were used in
raising the animals; whether or not they were given foods containing pesticides,
antibiotics, toxic minerals, or other chemicals; and whether the animals were confined to
inhumane cages. Soft-boiled eggs are best because heat is applied without exposure to
oxygen, thus reducing free radical damage. I recommend organic eggs and dairy products and
prefer nonhomogenized milk. Although pasteurization of milk products is the norm today in
order to eliminate harmful bacteria, certified raw milk is preferred in areas where it is
available, provided the cows are clean and hygienic principles are used in caring for
them. If you are lactose-intolerant because of a deficiency of the enzyme lactase, or you
choose not to consume dairy items, nondairy foods may be used. These include products
made from soy, rice, or nuts, such as soy milk, rice milk, and almond milk; cheese made
from these "milks"; and nondairy desserts. These "dairy" foods are
also good sources of protein.
Organic meats and
poultry. Despite a push for
people to eat more fish, meat and poultry continue to be major sources of animal protein
for many people. For patients who eat meat, I recommend organically raised products, which
are virtually free of hormones, pesticides, antibiotics, and other unnatural additives,
all of which can have a detrimental effect on mood and general health. Such meat and
poultry choices are slowly becoming more accessible and typically are available in natural
and whole-food stores. Meats and poultry are sources of methionine, which is critical for
methylation; this amino acid is difficult to get from plant-based sources.
Fish and shellfish. Fish and shellfish can be excellent sources
of protein and omega-3 fatty acids, if you make judicious choices. I'm calling for
"judicious choices" because of the persistent and very real problem of mercury,
pesticides, PCBs, and other contamination of the fish supply. Fish that I tend to
recommend that are high in omega-3 fatty acids, but relatively low in mercury, are wild
Alaskan salmon and sardines. I am wary about farm-raised fish because some studies
indicate that they are high in PCBs and other contaminants. The smaller the fish (say,
sardines), the less likely they are to accumulate mercury. But if you eat fish fairly
frequently, I recommend that you have your blood mercury levels checked, because there is
no way to guarantee the fish you eat regularly is not contaminated. Everyone whom I have
checked for mercury who eats sushi more than once a week is quite high in it.
Swordfish, king mackerel, shark, and most tuna tend to be quite high in mercury.
I would like you to consider two factors
when choosing foods from this list. One, do you have any reactions to these foods that may
be contributing to or causing your depression? Two, do you have any specific food
preferences based on religious, ethical, and/or moral beliefs? If you are a vegetarian,
for example, you will not select meat, poultry, or fish, so you will need to choose other
protein-rich foods such as soy products, legumes, beans, seeds, and, depending on the type
of vegetarian diet you follow, eggs and/or dairy.
Foods to Avoid
Most of the foods included in this list
should come as no surprise to you. In most cases, foods on the "Avoid" list have
been highly refined and processed. Fortunately, for every food you should avoid, there is
a healthy alternative on the "Positive Foods" list. You may find that the
"Avoid" list reads like your current grocery list; or you may discover that only
one or two categories apply to you. Next time you're in the grocery store, here are the
items you want to skip:
Sugar. Avoid all foods that contain added sugar,
such as soda, candy, cakes, ketchup, some breakfast cereals, and so on. Become a label
reader. If sugar (or one of its companions, such as corn syrup) is one of the first few
ingredients, put the item back on the shelf! Sugar can give you a burst of energy, but in
the long run it can leave you depressed and tired.
White-flour products. Just say no to white bread, white pasta,
and other products that use white flour, including many crackers, rolls and bagels,
refrigerator biscuits, pizza dough, and baked goods. Also avoid white rice. These overly
processed food products have been stripped of their nutritional value, and then they are
"enriched" with some nutrients, along with synthetic additives.
Alcohol. This includes beer, wine, and liquor.
People often forget that alcohol is a depressant, even though it provides an initial kick.
Drinking alcohol can also disturb your sleep, which is a problem with many people who are
depressed.
Caffeine. Avoid coffee, tea, colas, and chocolate.
(Okay, you can have a limited amount of
organic dark chocolate on occasion.) If you must have coffee, choose an organic coffee,
since most coffees are high in pesticides. Decaffeinated coffee is fine for most people,
provided that it is organic and does not use toxic chemicals in processing.
Hydrogenated fats. Hydrogenated fats are oils to which
hydrogen atoms have been added in the factory in order to harden them and improve shelf
life. These hydrogenated oils or fats contain high concentrations of trans-fatty acids,
which have recently been clearly shown to disrupt fatty acid metabolism in the body and
cause serious disease. Hydrogenated fats are found primarily in margarines, snack foods
(potato chips, corn chips), crackers and cookies, baked products, and fast foods. When you
read ingredient labels, look for the words hydrogenated,
partially hydrogenated, margarine, or shortening,
which indicate the presence of trans-fatty acids, or look at the nutritional panel for the
percentage of trans-fat in the product. Beginning January 2006, food manufacturers were
required to list trans-fat content on labels.
Chemical food additives. To avoid artificial preservatives,
flavorings, colors, and sweeteners, you need to read labels. Not all labels list all
the chemicals in the food item, but the general rule is: If the product has been
processed, it probably contains chemicals. For example, artificial preservatives such as
BHA, BHT, nitrites, monosodium glutamate, and nitrates are often seen in cereals, breads,
frozen dinners, boxed meals, and crackers. All foods containing artificial colors (such as
red dye 40) or artificial flavorings should be avoided. Artificial additives can cause
various adverse reactions, including mood swings, depression, fatigue, headache, rash,
aggression, irritability, and attention difficulties, among others. I believe all
artificial sweeteners, including saccharine, aspartame, and sucralose, should be avoided.
In particular, avoid diet sodas containing aspartame.
Fluoride. Do not drink fluoridated water or tap water
(unless filtered) or use fluoridated toothpaste. Despite the popularity of fluoride dental
treatments for both adults and children, I strongly recommend you not get them. Also,
avoid fluoridated vitamins for children. There are a number of excellent books and
websites that clearly document the lack of efficacy and dangers of fluoride ingestion and
fluoride use. If you live in an area where the tap water is fluoridated and you want to
drink the tap water but not the fluoride, you need to use a water filter with a reverse
osmosis component; carbon filters will not remove fluoride.
Chloride. Do not drink chlorinated water (unless the
chlorine has been filtered out), as chlorine is toxic. A simple carbon filter will remove
chlorine from tap water.
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