Good health is a balance between social, spiritual, mental and physical wellbeing. Mental and emotional health depend upon good physical health and nutrition, along with rest and exercise, is a basic foundation of physical health. If the nutritional needs of your body are not met, sleep patterns can become disturbed, the capacity to do physical exercise can become impaired, mental concentration and decision-making can suffer and unwanted changes in mood can occur.
So what are our bodies nutritional needs?
Major health organizations agree that there are six main principles and recommendations for good nutrition:
In practical terms these recommendations translate to;
Regular meals and snacks are important in keeping our bodies energy levels constant. Three meals and two – three snacks per day are recommended. Eating regular meals also stimulates the muscles of the gut (digestive system) to work well. Bowel movements become regular and constipation is prevented. For some individuals recovering from an eating disorder, it may be easier to begin working towards a more normal food intake by eating six smaller meals, rather than three bigger meals. It is very important to eat breakfast since it can help prevent the desire to binge or overeat later in the day. Breakfast is the meal which break(s) the fast of the night’s sleep. It stimulates the body’s metabolic rate and gets you going in the morning.
The body needs a continuous supply of energy in order to survive. Food and drink provide us with energy in the form of carbohydrates, proteins and fats; Vitamins and minerals do not supply energy. However some are needed to help the body utilize energy from food. The energy in food is measured in calories or kilojoules. The amount of energy that each woman needs is affected by a wide range of factors. However, we know that it is difficult to meet your required intake of nutrients if your energy intake is less than 1200 kcal (5040 kJ) per day. Most women need approximately 2000 kcal (8400 kJ) daily.
Two main types of carbohydrates exist in food. The complex carbohydrates include starch and fiber-containing foods such as breads, pasta, potatoes, kumara, corn, legumes, rice and cereals. Foods containing simple carbohydrates include fruits, honey, sugar and sugar-containing foods (desserts, cakes etc). The major function of carbohydrates is to provide a steady supply of energy to all cells in the body. Complex carbohydrates are also crucial for the healthy functioning of the digestive tract and contribute to feeling full after a meal. Ideally approximately 50 to 55% of an individual’s total energy intake will come from carbohydrates. Included in this will be 25-30 grams of fiber per day. This can be met by eating at least six servings of food from the bread and cereal group, plus five servings or more from the fruit and vegetable group each day.
Foods supplying high quality protein include meats, eggs, dairy products and seafood. Proteins of a lesser quality and concentration are found in nuts, legumes, grains and other vegetables. The major function of protein is to build and repair the body and to maintain an effective immune system so that you can fight off infections and stay healthy. Ideally, about 12 to 20% of total energy intake will be derived from protein. This can be met by eating at least two servings of food from the milk, milk products group, plus one or more servings from the meat, fish, chicken, dried beans, nuts or eggs group daily.
The most common sources of fat are butter, margarine, oil, fatty meats, high fat dairy products and rich desserts and cakes. Fat is an essential part of meals.
Fat in food contains important fat soluble vitamins, such as A, D, E & K.
Vitamin A is needed for vision in dim light. It is also put in skincare products as it keeps skin strong and elastic, and helps resist infection.
Vitamin D is essential for strong bones. It protects the skeleton from fractures.
Vitamin E is protective against aging. It has also been proven to reduce the risk of cancer.
Vitamin K is needed for blood clotting.
Fat also contains essential fatty acids. Essential fatty acids are the building blocks of many hormones and of the substances in the body that help fight infection. All body cell membranes contain fat to give them elasticity. Women store more fat in their bodies than men. Body fat gives us the curves which make us female. A healthy body fat percentage is approximately 25% for women. This fat insulates the body and prevents excessive loss of body heat. It also cushions our bones and decreases the risk of bone fractures. Current New Zealand recommendations are for people to cut down on fat intake. This does not mean “cut out”. A target of 30 – 33% of total energy in food coming from fat has been set. This means having a moderate amount of fat with each meal.
Thinking traps may also be referred to as ‘thinking errors’ or ‘cognitive distortions’. Most people use thinking traps from time to time, however they tend to be more common in people who experience psychological distress such as anxiety or depression. They are also very common in people with disordered eating. Often people will use these thinking traps so often they they will not be aware that they are using them. However, awareness of these thinking styles can be an important stop in understanding and changing unwanted moods and behaviours.
Here are eleven of the most common thinking traps that you might have experienced:
1. Mental Filter
Mental filtering is when we focus exclusively on the most negative and upsetting features of a situation, filtering out all of the more positive aspects.
Example: You undertake a performance review at work which is ninety-five percent positive and complimentary – but you dwell and focus exclusively on the five percent of the review that mentioned ways in which you could have performed better. This leaves you feeling that you are a failure, that you haven’t done well enough and that your boss sees you in a negative way. The impact of this mental filter may be that you not only don’t recognise the praise that you were given but that you start to feel anxious or low when thinking about your job.
2. Disqualifying the Positive
Disqualifying the positive is when we continually discount and dismiss the positive experiences we encounter, by deciding they are unimportant or ‘don’t count’. Positive information or experiences may be seen as a fluke.
Example 1: A friend compliments you on a dinner you made, but you decide that “they are just saying that to be nice” or “they are trying to get something out of me”.
Example 2: “I know I wear a size 10-12, but my thighs are too big”, “He only asked me out because he was lonely or feels sorry for me, he doesn’t really like me”.
3. ‘Black and White’ or ‘All or Nothing’ Thinking
This involves thinking in extremes, with no middle ground. These types of thoughts are characterised by terms such as or ‘every’, ‘always’, or ‘never’ . Everything is seen as good or bad or a success or failure. It is generally the negative perspective that is endorsed, discounting all the shades of grey that lie in between the two focussed on choices.
Example 1: If you get eighty per cent on a test, you feel like a failure that you didn’t get a perfect score.
Example 2: People with eating disorders often believe that if they can’t be ultra-thin, they will be obese, and that they must be completely in control of their eating or there will be chaos. You may believe that if you begin eating normally you will lose all control and end up extremely overweight. When you think this way you are thinking in extremes; ultra thinness and obesity are not the only alternatives, in fact your body functions best within a natural weight range, which is somewhere between these two extremes.
To avoid black and white thinking it is often helpful to look for the grey area in between. Look for all the possible alternatives. For example “Getting a mix of As, Bs and Cs for my exams is fine and does not mean I am a failure” or “Obesity is not the only alternative to thinness, it is more likely that I will be in a healthy weight range”.
Thinking in an over-generalising way means we will often see a single unpleasant incident or event as evidence of everything being awful and negative, and a sign that now everything will go wrong.
Example 1: If you fail to get a job you interview for, you decide you are never going to get a job.
Example 2: If you go on one unsuccessful date, you decide you are never going to find a partner.
Example 3: Believing that if something turns out badly once, then it will always happen that way. For example, failing your driving test and believing you are totally inadequate in all areas of your life.
For people with eating disorders a common generalisation is thinking that because I have put on some weight, I am just going to continue to put on weight forever. However, the facts show us that initial weight gain following re-introduction of regular eating is your body counteracting effects of past deprivation or starvation.
5. Jumping to Conclusions
This thinking trap involves making a negative interpretation or prediction even though there is no evidence to support this conclusion. This type of thinking is often made when thinking about how others feel towards us. It can show up as either ‘mind reading’ (assuming the thoughts and intentions of others) or ‘fortune-telling’ (anticipating the worse ad taking it as fact).assuming the worst even when there is no reason to.
Example 1: “People are staring at me because I am so fat” (mind reading).
Example 2: “My boss wants to speak to me – I must have made a massive mistake and I’ll get the sack” (fortune telling).
Example 3: “Sarah didn’t call – I must have done something to upset her” (mind reading).
Example 4: You are at a party and you don’t like what you are wearing and you decide ‘everyone is laughing at me’ (mind reading).
Example 5: You are going to take your drivers test and ‘know’ that you are going to fail (fortune-telling).
6. Magnifying or Minimising (Also referred to as “Catastrophisation”)
Thinking in a magnifying or minimising manner is when we exaggerate the importance of negative events and minimize or downplay the importance of positive events. In depressed individuals, it is often the positive characteristics of other people that are exaggerated and the negatives that are understated (and then when thinking of oneself, this is reversed).
Catastrophising is only paying attention to the negative side of things or overestimating the chances of disaster. When we think catastrophically we are unable to see any other outcome other than the worse one, however unlikely this result may turn out to be.
Example 1: “I had one binge – I am back to square 1 – I’m never going to get better”. “Nothing ever works for me – I may as well give up now”.
Example 2: You send out the wrong letter to a client at work, and this turns into “I will now lose my job, and then I won’t be able to pay my bills, and then I will lose my house.”
A person engaging in personalisation will automatically assume responsibility and blame for negative events that are not under their control. This is also called ‘the mother of guilt’ because of the feelings of guilt, shame, and inadequacy it leads to.
Example: You feel it’s all your fault that your dog injured his foot even though you weren’t at home when it happened but were out shopping. Your thoughts might be ‘if only I didn’t go out’ or even ‘maybe when I came home I accidentally stepped on the dog and hurt him’ even though this is entirely unrealistic.
8. Shoulds and Oughts
Individuals thinking in ‘shoulds’, ‘oughts; or ‘musts’ have an ironclad view of how they and others ‘should’ and ‘ought’ to be. These rigid views or rules can generate feels of anger, frustration, resentment, disappointment and guilt if not followed.
Example: You don’t like playing tennis but take lessons as you feel you ‘should’, and that you ‘shouldn’t’ make so many mistakes on the court, and that your coach ‘ought to’ be stricter on you. You also feel that you ‘must’ please him by trying harder.
9. Emotional Reasoning
Emotional reasoning is when we assume feelings reflect fact, regardless of the evidence. The idea here is “I feel it, therefore it must be true”. Such thinking can lead to self-fulfilling prophecies whereby our thoughts can end up eliciting the very behaviour we predicted, just because we changed our behaviour in accordance with that thought.
Example 1: if you think “I feel ugly and stupid, so then I must actually be ugly and stupid” you might then stop buying yourself new clothes and start doing poorly at the course you are taking at university, even though you look fine and were doing very well at school.
Example 2: Taking your emotions as an accurate reflection of what is happening. For example, “I feel fat therefore I am fat”, even when you are actually underweight.
Labelling is an extreme form of ‘all or nothing’ thinking and overgeneralisation. Rather than describing a specific behaviour, an individual instead assigns a negative and highly emotive label to themselves or others that leaves no room for change.
Example: You make a mistake on a form you filled out and it’s sent back to you in the post. So you decide “I’m such a loser” or “I’m so stupid” rather than thinking “I made a mistake as I had a busy day when I was filling this out”.
11. Expecting perfectionism and having double standards
These two often go together. People with eating disorders often expect themselves to be perfect and anything less than excellence equals failure. They judge themselves by what they achieve and expect others to judge them in the same way.
Additionally, they may have double standards, for example, thinking it is OK for other women to be a normal weight, but that they will only look good at X weight. It may be OK for other people to make mistakes but unacceptable for them.
We praise the recognition among schools that encouraging pupils to strive for perfection in all areas can increase the risk of mental health conditions including depression and eating disorders.
Unrelenting standards and a core sense of failure or not being good enough are common difficulties among people who present to us for treatment. Targeting these issues at a younger age and encouraging people to resist the urge to need to be perfect at all times is crucial to good mental health. We hope to see more schools following this example.