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National Alliance on Mental Illness
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Healthy Eating

EAT-26

The Eating Attitudes Test (EAT) is a commonly used method used to standardized the measure of symptoms and behaviors that are characteristic of eating disorders.  The original EAT had 40 items, but this is the latest updated and shortened version designed to be self-administered or administered by health-professionals, school counselors, coaches and others.

This test alone does not diagnose an eating disorder and should not be thought of as the sole means of identification.  Only a qualified health care professional can provide a diagnosis.  The EAT-26 is used to assess “eating disorder risk.”  All self-report measures require open and honest responses in order to provide accurate information.  The test usually provides useful information about the eating symptoms and concerns that are common in eating disorders.

http://testing.river-centre.org:591/fmi/iwp/cgi?-db=EAT&-loadframes 

Definition of a Healthy Body Weight

Dieting is not healthy eating.

Close to a third of the population are overweight, and in addition eating disorders are on the rise especially among young women.  The preoccupation of body image and the pursuit to be thin has professionals looking at weight as they affect the physical and mental health of those involved.  The concept of a healthy weight emerged from the recognition that we needed to shift our attention away from only body weight and focus on healthy living in general.  Healthy living involves eating well, being active, and feeling good about oneself.

A healthy body weight is a weight range appropriate for a particular height and body build.  It should not be confused with a thin weight.  A healthy weight is the point at which you feel: fit and flexible, healthy and energetic, and are at a lower risk for weight-related health problems.  The healthiness of your weight can be measured using the Body Mass Index (BMI) calculator Calculate your BMI.   The calculator uses a person’s body weight and in relation of their height to define normal, overweight, and obesity.

To achieve a healthy body weight regular physical activity in combination with healthy eating promises the best hope.  The type of physical activity one chooses can range from walking, riding a bike, dancing, gardening, running with your dog…but joining an expensive gym or sport club is not the only option or an excuse.

Healthy Eating Guidelines

Many people eat for emotional reasons.  It is typically triggered by stress and anxiety too often leads to overeating and/or making poor food choices.  In a study done by the International Journal of Eating Disorders compares the daily journals kept by a group of normal-weight women, half of whom were binge-eaters.  The key influence on emotional eating, however, is not just negative or stressful events, but rather its people’s response to them.  People who are less thrown off by stress tend to focus on how they want to constructively deal with a negative situation or they simply put it aside and move on.  These who tend to experience more disruption due to negative situations are more inclined to stay focused on the problem, mentally replaying a distressing situation over and over again.

Those whose healthy-eating goals, are often disrupted by emotions can benefit from finding new strategies to help them respond more effectively to stressful situations.  A study found that people gave in to eating temptations every time they didn’t have a strategy to deal with stressful situations.  Individuals who respond to a negative situation with both positive and negative thoughts and constructive action are able to avoid emotion-based eating.  Action responses might include attempts to fix a problem by asking a friend, family member, or associate for their advice, or through claming and soothing yourself by taking a walk, listening to music or deep breathing.  Examples of positive thinking include reminding yourself that the problem is not really as big as it seems, or that brainstorming different approaches to the problem to find the most effective solution.

It has been observed that many people use food as a means to distract themselves from emotions ranging from simple boredom to frustration to elevated anxiety.  Differentiating between biological hunger and other urges to eat, and trying to identify the feelings and needs behind non-hunger urges is the baseline for understanding what is behind the hunger.  When a rest or distraction or refreshing relief from routine is needed simply learning to acknowledge it is appropriate to take a break can be freeing.  If you’re not hungry, use breaks to read, nap or take a walk.

It is shown that emotional eating can be a significant source of excess of calories.  This can result in overweight or obesity, which can increase problems.  The American Institute for Cancer Research emphasizes the need to choose portions appropriate to our individual needs and to avoid popular super-sized foods.  Emotional eating is controlled with healthier foods or smaller portions, and by getting whatever help and support you need to learn how to handle non-hunger urges without actually turning to food for temporary solace.

For more information on food and nutrition guidelines visit the American Dietetic Association.

Nutritional Requirements

Men are from Mars and Women are from Venus, but other than origin the genders also see differences in their nutritional requirements.  What does everyone need to be concerned about and what health concerns do men and women specifically need to be aware about?

1. Calcium

Women:  Calcium is important in lowering a woman’s risk of osteoporosis.  A diet high in calcium and Vitamin D has been proven to lower the risk of bone fractures and regulate blood pressure.  Women under 50 years of age the recommended amount of daily calcium is 1,000 milligrams and 1,200 mg for women over 50 years.

Men:  Calcium is important in lowering the risk of osteoporosis in men, but can be harmful in large doses.  Studies have shown that men who consumed high levels of calcium saw an increased risk in prostate cancer.  For all ages the recommended amount is 800mg or 3 servings of dairy per day.

2. Iron

Women:  Women require more iron then men because of their monthly menstrual cycles.  Signs of iron-deficiency anemia include fatigue, inability to concentrate and difficulty breathing.  If these symptoms appear, speak to a doctor.  The recommended amounts of daily iron are 18mg and eight milligrams for postmenopausal women.  The difference is one of the reasons why it’s important to choose an age-appropriate formula if you are taking multi-vitamin supplements.

Men:  The recommended amount is 8mg for men of all ages.  Studies have shown that men with high iron stores were associated with increased risk of heart attacks.  It is important to choose an age-appropriate as well as gender-appropriate formula if taking a multi-vitamin supplement.

3. Omega 3 fatty acids

Women:  Omega 3 fatty acids are a type of polyunsaturated fatty acids, which have been shown to help lower triglycerides and increase the good HDL cholesterol.  They may also act as an anticoagulant to prevent blood from clotting. Omega 3 fatty acids can be found in almost all fish, but they are particularly high in fatty fish such as mackerel, salmon, sardines and herring.  They can also be found in nuts and seeds as well as vegetable cooking oils.  There is no official recommendation on how much omega 3 fatty acids women should eat, but the American Heart Association recommends eating fish at least two times a week.

Men:  Omega 3 fatty acids benefit men, but only the marine kind from fish oil.  Vegetable omega 3, also known as alpha-linolenic acid (ALA) may not be good for men.  Still controversial a high intake of ALA has been linked to higher risk of prostate cancer.  Until more is known, men should avoid taking concentrated ALA supplements such as flaxseed oil pills.

4. Protein

Women:  Protein provides energy and it is also important in growth and repair.  As a result of the high-protein diet hype, many people eat more protein than required.  Excess protein accelerates calcium loss in urine, therefore, women with a high risk of osteoporosis should be careful not to eat too much protein.  The average requirement is based on 0.8 grams of protein per kilogram of body weight.  For example, a 130 pound woman would need 47 grams of protein daily.

Men:  Men weigh more and therefore need more protein.  Excess protein accelerates calcium loss in urine, even in men.  Thus, men with a high risk of kidney stones should watch their intake.  The same calculation is applied to men when determining an individual’s average requirement of daily protein.  Based on 0.8 grams of protein per kg of body weight a 165 pound man would need 60 grams of protein daily.

In general healthy men and women will do fine with a daily 60 grams (8oz) of protein.  If you are an athlete, however, your needs and requirements will increase.

5. Fiber

Women:  Fiber prevents constipation, hemorrhoids, diverticulosis and can help reduce the risk for some chronic diseases such as colon and breast cancer.  In addition, it may help lower bad LDL cholesterol and total cholesterol reducing the risk of heart disease.  Fiber can also help lower the blood sugar to help manage diabetes.  Women under 50 require 25 grams of fiber, while those over 50 require 21 grams.  This is equivalent to at least two cups of vegetables and 1.5 cups of fruit.

Men:  In a brief statement, men require more fiber than women.  Men in general need more calories and in turn they need more fiber.  Fiber requirements are calculated to provide the greatest protection against heart disease and are based on energy intake.  Men under 5 require 38 grams of fiber, while those over 50 require 30 grams of fiber.  This is equivalent to at least three cups of vegetables and two cups of fruit.

Understanding Food Labels and Nutrition Facts

Food labels have become synonymous with cryptic ingredients, hidden macronutrients and undecipherable content amounts.  Grocery shopping for some can be a real headache and stressful experience, but it doesn’t have to be.  Determining whether or not a product fits into your healthy lifestyle has become easier with the addition to listing the amounts of macronutrients and vitamin and mineral contents.  The food label provides good information to help a consumer determine if a particular food product meets his or her nutritional needs.

In 1990, the Nutrition Labeling and Education Act went into effect with the intention that food labels are designed to help consumers make healthy food choices.  The USDA and the FDA developed these guidelines so that consumers would have access to useful nutritional information.  According to this act all packaged food MUST contain the following information:

  • Common name of the product
  • Name and address of the product’s manufacturer
  • Net contents in terms of weight, measure or count, and;
  • Ingredient list and Nutrition Facts

The most frustrating and yet most sought after component is the Nutrition Facts panel.  Required fields include components of common nutrients, such as total fat, cholesterol, and sodium.  Each package must identify the quantities of specified nutrients and food constituents per serving.  Note the following measurements:

  • 1 gram of fat = 9kcal
  • 1g of protein = 4kcal
  • 1g of carbohydrate = 4kcal
  • 1g of alcohol = 7kcal

Nutrients Listed, Serving Size, Calories (kcal)

Total fat, saturated fats, cholesterol, total carbohydrate, protein, vitamins A and C, calcium and iron, are required on the label.  Other nutrients are optional and may be listed at the discretion of the manufacturer.  The percent daily values provide an estimate of the percentage of a nutrient from one serving in a typical 2000kcal diet.  Also included is the daily reference values footnote.  This reminds consumers of the daily intake of different foods depending on their own nutritional needs.  In addition, a few other nutrients relevant to heart health are important to pay attention to when reading a label.  At the beginning of January 2006 all labels will also include trans fatty acids.

Serving sizes are standardized to make for easier comparison among similar products.  They are expresses in common household and metric measures.  It is always important to pay attention to a serving size.  For example, if you eat four pieces and the serving size is two then you need to double the amount of nutrition content listed on the label.

It is important to find out the total amount of calories.  Calories provide a measure of how much energy you obtain after eating a portion of food.  Many consumers are surprised to find out that fat-free is not synonymous with low calorie.  Just as sugar-free is not always low in Calories or fat.  See a comparison of low-fat or fat-free with regular food products.

The Bottom Line: regarding food labels

Food labels and Nutrition Facts enable consumers to compare products based on key ingredients.  When comparing foods, focus on the ingredients that are most important to you.  Tips to consider when comparing food labels.

  • If you are concerned about you weight, compare products based on BOTH their calories and fat.
  • If you have heart disease or high blood pressure, focus on the amount of total fat, saturated fat, trans fat, cholesterol and sodium.  Then choose products that contain less than 20 percent Daily Values for fat, cholesterol and sodium.
  • If you have diabetes, focus on the amount of carbohydrate, sugar added as well as fiber.

Nutrition Myths

Good fats, bad fats, low-fat, fat-free, low-calorie.  These are just some of the many terms that get thrown at us as consumers daily by food manufacturers.  They are enticing and intriguing especially with Americans’ preoccupation with body image.  The fact is that we need fats, and reduced fat items have more sugar added to them to enhance the flavor.  What you may think is a conscious effort to be healthy may result in the unintended outcomes and sabotage.  Fats get a bad reputation and are one of the first nutrients monitored when people begin their quest for health.  It is true that all fats are not equal and some promote health while others increase the risk of heart disease, it is also true that fats help nutrient absorption, nerve transmission, and maintaining cell membrane integrity.  The key is to replace the bad fats with good fats in our diet.

Good fats include monounsaturated fats (MUFAs) and polyunsaturated fats.  They lower total cholesterol and LDL cholesterol (bad cholesterol).  MUFAs aid in increasing HDL cholesterol and have been found to help weight loss, especially in body fat.  Food stuffs that supply MUFAs include nuts such as peanuts, walnuts, almonds, and pistachios, avocado, canola and olive oil.  Polyunsaturated fats include the well-known group omega 3 fatty acids.  Seafood such as salmon and fish oil, corn, soy, safflower and sunflower oils are high of this type of fat.

Bad fats include saturated fats and the highly talked about trans fats.  Saturated fats raise total blood cholesterol and LDL cholesterol. They are mainly found in animal products such as meat, dairy, eggs and seafood. Some plant foods such as coconut oil, palm oil and palm kernel oil are also high in saturated fats.  Trans fats are not found in nature, but were invented as scientists began to "hydrogenate" liquid oils so that they can withstand better in food production process and provide a better shelf life.  Trans fatty acids are found in many commercially packaged foods, commercially fried food, other packaged snacks as well as in vegetable shortening and hard stick margarine.

To reduce your intake of bad fats consider these simple changes.  Avoid using cooking oils that are high in saturated fats and/or trans fats such as coconut oil, palm oil or vegetable shortening. Instead, use oils that are low in saturated fats and high in monounsaturated and polyunsaturated fats such as canola oil, olive oil and flax seed oil.  Minimize using commercially packaged foods which are high in trans fats, and read labels to look for trans-fat free alternatives.  Use lower-fat dairy products such as 1% or skim milk instead of whole milk and trim visible fats and skins from meat products to reduce saturated fats.

The truth about fats and calories is not the only myth surrounding nutrition.  Other common myths seen in the dieting and the nutrition world are brown eggs are more nutritious than white, avoid carbohydrates to lose weight, avoid nuts because they are fattening, eating for two is necessary during pregnancy, and red meat is bad for health.  All of these “truths” can easily be debunked with the knowledge of dietitians and their work.

1. Brown Eggs are more nutritious than White Eggs

This widely believed myth that the color of the eggshell has an affect on the eggs overall nutritional value has no scientific support.  The color has nothing to do with the nutritional value, quality, flavor, cooking characteristics, or shell thickness.  It only tells you what breed of hen produced the egg.  The white shelled eggs are produced by hens with white feathers and white earlobes whereas the brown shelled eggs are produced by hens with red feathers and red earlobes.

2. Avoid carbohydrates to lose weight

Many low-carb diets convey the message that carbohydrates promote insulin production, which in turn results in weight gain.  The problem is many low-carb diets do not provide sufficient carbohydrates to your body for daily maintenance. This means the body will begin to burn stored carbohydrates (glycogen) for energy, and when your body starts burning glycogen, water is released.  This water release is the reason for the initial weight loss of a low-carb diet.  These diets are often calorie-restricted allowing an average of1000 - 1400 calories, compared to 1800 - 2200 calories needed for most people. Carbohydrates are not the pinnacle of successful weight loss.  You can lose weight by healthfully reducing your caloric intake by 500 calories per day in respect to your normal diet.   

3. Avoid Nuts because they are fattening

Nuts are caloric and it is easy to overeat them, but when properly portioned nuts can be part of a healthy diet.  Nuts are high in good fats, monounsaturated and polyunsaturated fats, as well as plant sterols, which have all been shown to lower bad LDL cholesterol. Instead of simply adding nuts to your diet, the best approach is to eat them in replacement of foods high in saturated fats.

4. Eating for two is necessary during pregnancy

The idea that pregnancy allows for women to eat double and ice cream is a free-for-all is a nutrition myth.  Generally it is recommended that pregnant women increase their daily intake by 100 kcal in the first trimester and 300 kcal in the second and third trimesters. A daily prenatal multivitamin supplement is recommended and an extra snack before bedtime such as a piece of fruit, a serving of milk or yogurt, and a few biscuits is enough.

5. Red Meat is bad for health

Some studies have linked red meat with increased risk of heart disease due to the saturated fat content, but even chicken can contain as much saturated fat as a cut of lean pork or beef.  Poultry is naturally lower in saturated fats but only if you do not eat the skin.  Red meat altogether is not bad for your health.  Instead of excluding red meat altogether, choose leaner cuts.  For beef, choose eye of round, top round roast, top sirloin and flank; for pork, choose tenderloin and loin chops.

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