There’s nothing like a pandemic to throw healthy eating habits out the window.
At the same time, the outbreak also has given us a lot of time to ponder our own health and how we nourish their bodies.
How has it been for you? Did you hit the bonbons hard, or did you grab some carrots and Wasa crackers? More important, how did you feel before, during and after eating?
Modern science is digging deeply these days into the mind-body connection, the brain-gut relationship and how food relates to mood, both in emotional comfort and chemical reactions.
‘Food as medicine’
For Sheri Iodice, the idea of “food as medicine” first captured her fascination while she worked on the business side for Berkshire Health Systems, listening to medical co-workers discuss how healthy eating directly affected people’s physical and emotional well being.
It led her to become a registered dietitian nutritionist; she now has a private practice in Pittsfield.
Eating is much more than the nuts and bolts of food and nutrition, Iodice notes. In interactions with clients, Iodice often finds herself discussing what they eat for nutritional purposes and what they eat to feed their emotions.
“That’s what I work on a lot with my clients, separating emotional eating from nutritional eating,” says Iodice. “We intersect with food on our minds, or physically with food, all day long. If we are more mindful about all of those times that food intersects with us, and we take into consideration our actual needs and emotional states at the moment, we can check-in about being hungry.”
Check-in time and self care
“Checking-in” is being aware of yourself, acknowledging your internal dialogue, thoughts and feelings in any given moment; in the wellness world, it’s a good step to take before contemplation or meditation, as well as part of a healthy diet and eating ethos.
“You need to ask yourself, ‘What do I want, and what’s driving this?’ If you can sit with cravings, sometimes you can learn more than when you go ahead and actually indulge them. Doing nothing is still doing something.”
Eating well is a big part of “self care,” in addition to exercise, mind-calming activities and sleeping well, writes Dr. Monique Tello of Massachusetts General Hospital, an expert on healthy lifestyles. Self care grants us permission to take care of ourselves to ensure we are able to properly help others in our lives; if we’re compromised, whether it’s from too much stress, anxiety, depression or a continually upside-down gut, we can’t properly serve those entrusted to our care, like our children or parents.
What does healthy eating look like?
Both Tello and Iodice recommend research-based diets (not fads) that include lots of whole foods and plants, and that steer clear of foods that cause inflammation or sugar spikes; the former can lead to physical disease and the latter is associated with increased risk of anxiety and depression, according to research.
Health experts like Tello and Iodice recommend a variety of colorful plant-based foods, fruits and vegetables, which carry vital vitamins, minerals and antioxidants. These have the double benefit of boosting brain and cardiac health.
These recommendations are modern, but are based on something ancient: the Mediterranean diet, a building block for many diets, some effective and some trendy, notes Iodice.
The Mediterranean diet itself, however, is based in science, says Iodice. It’s “a way of eating based on the traditional cuisine of countries bordering the Mediterranean Sea,” as the Mayo Clinic describes it. At its most basic, it’s a diet high in fruits and vegetables, whole grains, beans and nuts, as well as olive oil, many of which contain so-called healthy fats.
The diet includes the weekly consumption of fish, poultry, and eggs, too, with moderate dairy intake and limited portions of red meat, says the Mayo Clinic. It’s a sustainable food practice that’s endorsed by the World Health Organization and United Nations Educational, Scientific and Cultural Organization.
The social component of eating
Eating the Mediterranean way, at its core, honors the social aspect of food, of dining with family and friends. For Iodice, this is one of the best and most important ways for food to nourish more than the belly.
“The thing I love about the Mediterranean diet is that the social component of the diet is as equally weighted to the variety of the food you’re eating,” she says. “It recognizes the importance of foods being part of relationships. It also says, ‘Let’s have a healthy, personal relationship with food.’”
Physical activity is another component of the diet, the Mayo Clinic notes.
Iodice, the dietitian, wants you to look closely at your relationship with food. Is it a personal relationship, or strictly business? Do you inhale your food, like it’s a race, or do you chew dozens of times per bite? Do you use all of your senses when eating or preparing food — such as savoring the sizzle of onions and garlic in hot oil — or are you more inclined to just listen for the microwave to beep?
Perhaps more important, are you paying attention to how the food makes you feel after you eat it? Bloated, with your insides sounding like the bubbling of the workplace watercooler? Hungry again 20 minutes after eating, or nauseous?
The food should make you feel good. Iodice notes that food you eat also should fill you in multiple ways, as it is more than food: It is memory, it is tradition, it is connection to your truest self and others. If you’re truly disconnected from yourself, food, or people, for that matter, you’re bound not to feel well in body and mind, experts say.
“When someone eats mindfully, they really are working on skills that appreciate how much they love food,” says Iodice. “ Eating engages all your senses, taking each bite slowly, and putting utensils down in between bites, tasting as it sits in the front and back of your mouth.”
Iodice suggests more conscious eating as medicine for what ails you, especially if you’re someone who’s driven to eat by emotions or stress.
“If gaining weight is a mindless process in checking out, zoning out, not engaging, isolating, if you find emotional eating is keeping you away from enjoying food and life, then adopting mindful eating techniques might bring about a refreshing new approach to weight management,” says Iodice.
She recommends against extremes with food habits, as people will tend to rebound hard. “Yo-yo dieting is a good example. After an unsustainable weight loss, when someone experiences a discouraging regain of all the weight and sometimes more, it reminds me of Newton’s third law: for every reaction there is an equal and opposite reaction,” Iodice says.
“When we're restricting and restricting and restricting, the research shows there will be a counter-balance binge,” says Iodice, who tries to guide people to learning different habits. “When people are referred to me by their doctors for changes in their diet, particularly around losing weight, they expect restrictions are coming. What’s more important is finding ways to replace habits that are no longer helpful with healthy habits. Replacing or modifying, fine tuning, reinventing.”
A middle road
Going to the health food store doesn’t prevent you from being exposed to processed foods, nor is every processed food going to make you ill, notes Iodice.
“Whole and processed foods, they both can work well together,” she says.
That’s great, as some people don’t have an affinity for cooking and will rely on processed foods, she notes. For those who are buying processed food, Iodice says to be wary of the word “natural,” as it can mean almost anything. Her advice is to look for items that have five ingredients or less, which “makes it closer to a whole food than a processed food.”
Often, if it has only five ingredients, the next question Iodice asks is, “‘Can I make this myself?’”
For a healthy diet, another goal that Iodice recommends is to have three or four food groups in a meal.
“It’s easy to get two. The third might be a fruit or vegetable, and that’s where the work begins. For some reason, people don’t always have a comfort level with fruits or vegetables; and I think that means they haven't found a way they like it prepared yet,” she says.
Know where your food comes from
Iodice recommends taking time to prepare food yourself and with your children; it serves many purposes, including teaching and learning experiences about where food comes from. For food cooperatives, it’s part of their mission to develop long-term relationships with local farmers and food producers, in addition to searching out other whole food sources for their owners and shoppers.
“When kids are more involved, they have more ownership and interest. And we should know where our food comes from,” says Iodice. “We can develop a sophisticated palette by giving ourselves time with food, to cook for 30 minutes, instead of waiting for the delivery person for 30 minutes.”
What about comfort foods?
OK, then. What about comfort foods? Pizza? Macaroni and cheese? All those salty, mushy things that somehow must hearken back to our early childhoods?
“There’s always room for everything. Food doesn’t have the ability to be good or bad, yet we place these titles on it,” notes Iodice. “It’s always OK to make a choice that doesn't interfere with your goals. If you’re on a Mediterranean diet, I think that pizza comes in there somewhere. A couple slices with a big salad? Why not?”
Iodice says if you're not reaching your health goals, and you’re also relying on pizza too often for comfort, then there’s probably an opportunity for some self-questioning and also to work on making that pizza healthier.
A buffer against anxiety, depression
During the coronavirus outbreak, we’re all home more often; closer to our refrigerators; battling the daily stress of living alongside an invisible, deadly virus; and many of us have been caught up in the national riptide of discord, anxiety and depression.
Many of the elements of the Mediterranean diet, in addition to being beneficial for brain and cardiac function, also appear to act as a buffer against depressive episodes.
A study from 2019 by research universities across Europe found that “a healthy diet, in particular a traditional Mediterranean diet, or avoiding a pro-inflammatory diet, appears to confer some protection against depression.”
Another study, published in the World Journal of Psychiatry in 2018, found that there were 12 nutrients that aid in the prevention and treatment of depression: Folate, iron, long-chain omega-3 fatty acids, magnesium, potassium, selenium, thiamine, vitamin A, vitamin B6, vitamin B12, vitamin C and zinc.
Animal foods that had the most of these were shellfish such as oysters and mussels, and other seafoods, and organ meats from animals. Plants that had the most were leafy greens, lettuces, peppers and the cruciferous family of vegetables, such as cauliflower, cabbage, kale, garden cress, bok choy, broccoli and Brussels sprouts.
‘People have lost their anchors in life’
Dr. Jennifer Michaels is the medical director at The Brien Center, a nonprofit Berkshire County community-based agency that helps people living with mental health and/or substance use disorders. She says self care and eating properly should be a mainstay for people to seek balance in an uncertain world.
”We all need to think about this because we're in such unprecedented times. A lot of people have lost their anchors in life, or their routine,” Michaels says.
Talking about food and people’s relationship with it is a regular part of counseling and treatment at The Brien Center, she says.
“We’ve done a lot of work talking to the people we serve about food being an opportunity for health, and that it can be quite harmful if the diet includes certain ingredients and certain types of foods,” says Michaels.
She and other clinicians at Brien try to steer their clients away from “white foods,” says Michaels.
“We talk to people about avoiding pure sugar, white rice, potato chips, pretzels, anything overly processed,” says Michaels. “If you want to eat processed meats, put it on salad instead of bread.”
Beware of ‘quick fix’ foods
Unhealthy food is cheap and accessible, Michaels and Iodice note.
“Our food supply is so confusing, because there's a plethora of food. We’re surrounded by food. One hundred years ago, we were worried about deficiencies, and now we’re worried about abundance. It’s a very short history in the theme of evolution,” says Iodice.
It’s a quick fix, Michaels notes, with little positive payback for the body, brain and mind.
“We’ve been on this Earth a long time, and all of these processed foods have not been on Earth a long time. They do things to our brain and our body that we haven’t had a chance to adapt to.”
Stress eating is a part of many people’s lives whether they’re in a pandemic or not, and both Iodice and The Brien Center aim to educate people about that, too.
“People will sometimes engage in eating like they’re engaging with a drug, and therefore need to become cognizant of this behavior and develop a healthier relationship with food,” says Michaels. “Instead of living to eat, we want to help people to eat to live.”
No simple cure, but go with your gut
There is no one food that will cure depression or provide an instant salve for anxiety, nor should anyone jump into a major dietary change without consulting their doctor first. But, there are droves of simple dietary changes that have been shown to have a direct and beneficial effect on our physical and emotional well being, as well as key organ function.
For example, eating plant-based foods helps increase the presence of specific gut microbes that are related to reduced risk for obesity, type 2 diabetes and heart disease, according to an international study that included Massachusetts General Hospital.
Researchers found that certain levels of friendly bacteria in the microbiome — our gut environment — help with lower blood sugar, blood fat and inflammation levels after eating. They reported that their evidence was so consistent, they could use “gut checks” as a way to predict disease or recommend a personalized diet plan.
Emotions and the gut
Moreover, there’s a link between the microbiome and the brain when it comes to emotions, notes Iodice and other researchers.
“You know that gut feeling you get? There’s studies now that show there is a real phenomenon of communication between the gut and the brain,” says Iodice.
Mad, sad, happy or glad? All feelings can trigger symptoms in the gut, according to Harvard Medical School.
Uma Naidoo, a nutritional psychiatrist at Mass. General and faculty at Harvard, notes that 90 percent of serotonin receptors are located in the gut, she writes in an article for Harvard Medical School; serotonin is a chemical that’s also found in our nervous system, and affects everything from motor skills to emotions. It is believed that it regulates mood, but also helps control bowel function.
Immune system function
What’s more, the gateway to your immune system is also in your gut, Iodice, the nutritionist, notes.
“When your gut isn’t healthy, your immune system is susceptible to takeover by foreign bodies because you can’t fight it off,” says Iodice.
Plain yogurt is an ideal balancer for the gut, she and other experts note, but it’s challenging to get Westerners to eat it plain, even though that’s the healthiest option. Yogurt in the U.S. has been processed and marketed as candy, Iodice says, and people need only look at the ingredients to see for themselves. Some yogurts, for example, have as much sugar as a brownie.
Naidoo, the psychiatrist, notes in an article from 2019 that current research advises to adjust your diet before adding probiotics or prebiotics to the mix; probiotics or prebiotics are supplements that help with balancing and feeding the good flora in the gut. Further recommended is a diet of whole foods, while avoiding processed foods that cause inflammation and illness, she writes.
A nice glass of water, maybe some popcorn
Before we eat automatically every time we get up from our desks at work or scoop a bowl of ice cream to watch with the evening news, Iodice and other experts recommend hitting the pause button, and asking ourselves if we’re really hungry or if it’s something else.
“Maybe you’re really thirsty, and should start with water. Sometimes we get a false signal that we’re hungry but are actually thirsty,” says Iodice. “A lot of people say, ‘I just don't like water.’ Give it a try, because your body likes water. You lose it in multiple ways. It needs to be replaced,” she says.
If you truly want to go to bed with something in your stomach but you want it to be a healthier choice, brainstorm a healthy option.
“Sometimes, it’s popcorn made with healthy olive oil and flavored with herbs or spices,” says Iodice, a family favorite in her household.
Try something different
The next time you’ve had a really hard day, and are feeling entitled to X, Y or Z foods, recognize that you’ve been down this road before without the desired effect, and ask yourself, “What other choices do I have?” suggests Iodice.
“See how your body responds to something different, says Iodice.
But, if you must have a Reese’s peanut butter cup before you go to bed, then make it your one-treat-a-day ritual and immerse yourself in it, she says. Have it in a place in your home that’s dedicated to the single purpose of savoring that moment.
“Choose a quiet spot, put it on a plate, have a cup of tea with it. Maybe section up a nice orange, too. That’s three powerful foods, citrus, chocolate and tea. Why wouldn't you embrace that treat for your body and enjoy it mindfully,” says Iodice. “Check out your bird feeder, find your solace, and feed yourself emotionally as well as physically, and enjoy it thoroughly.
How long, she wonders, can you make a peanut butter cup last?