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10/20/2016 Nutrition for Healing and Recovery Courtney Slater, RD, LD, CDE Hy‐Vee dietitian and diabetes educator Power Nutrients to Help Healing – Calories – Protein – Vitamin C – Vitamin A – Zinc Image credit: Crossfit Thames http://12z7i52euxl02ta498gb08o8dx.wpengine.netdna‐cdn.com/wp‐content/uploads/2013/06/recovery3.jpg Image credit: Inspired Wellness Solutions http://www.inspiredwellnesssolutions.com/uploads/9/0/6/4/9064049/1389369710.jpg Power Nutrients: Calories – During recovery, the body requires more energy to fuel healing – Normal calorie requirements: roughly 25 calories per kilogram body weight – Calorie requirements during recovery/healing: roughly 35 calories per kilogram body weight – Extra calories should come from healthy sources – lean proteins, whole grains, fruits and vegetables, omega‐3 fats – A person who weighs 100 kg (220 lbs) would normally require 2,500 calories per day to maintain body weight – During recovery/healing, a 100 kg person may need more than 3,500 calories per day to maintain body weight and rebuild damaged tissue Image credit: Can Stock Photos http://cdn.xl.thumbs.canstockphoto.com/canstock31262619.jpg 1 10/20/2016 Power Nutrients: Protein – Protein is the building block of muscles and tissues – Protein should come from high quality sources – Lean meat and seafood, eggs, beans, nuts, low‐fat dairy foods, soy, whole grains – To properly fuel healing and recovery, we need to increase our protein intake to allow for rebuilding of broken down tissue – Protein needs for normal person: 0.8 grams of protein per kilogram body weight – Protein needs for healing recovery: 1.2 grams of protein per kilogram body weight (or more) – 100 kg person needs approx. 80 g protein per day – 100 kg person needs approx. 120 g protein per day during healing/recovery Image credit: Can Stock Photos http://cdn.xl.thumbs.canstockphoto.com/canstock23191161.jpg Power Nutrients: Vitamin A – Vitamin A is needed for skin, eye and immune system health – Vitamin A is a fat‐soluble vitamin – Fat soluble means it attaches to fatty tissue for absorption – It also means we store extra vitamin A in our liver and adipose tissue – Because of this, there is a potential for toxicity with over consumption/supplementation – Found mainly in brightly colored foods that are red, orange and yellow – Brightly colored fruits and vegetables: sweet potatoes, butternut squash, cantaloupe, apricots, pumpkin and carrots – Also found in dark leafy green vegetables, bell peppers of all colors and foods with omega‐3 fats Image credit: Coupon Code Top https://www.couponcodetop.com/wp‐content/uploads/2016/08/vitamin‐a‐01.jpg Power Nutrients: Vitamin C – Vitamin C is vital to healing injuries both inside (damaged tissue) and outside (cuts, burns, scrapes) the body – It helps fortify the immune system to prevent infection and reduce inflammation and also aids in protein metabolism – Vitamin C is water‐soluble – It is excreted through the kidneys every day – Vitamin C is not stored in the body because it is eliminated in the urine – It can be hard to “overdose” on vitamin C, but our body can only absorb up to 1,250 mg per day – Best sources of vitamin C are fruits and vegetables Image credit: Pur Xpressions https://purxpressions.com/images/Adderall‐and‐vitamin‐C.png 2 10/20/2016 Power Nutrients: Zinc – Zinc is a mineral needed for wound healing, protein synthesis and immune function – Zinc is NOT stored in the body, so daily consumption is necessary – Normal eating habits provide enough zinc for the body (97%‐98%) and supplementation is not usually necessary – Over supplementation and chronic use of zinc or zinc‐containing products can cause toxicity, resulting in neurologic diseases – Good sources of zinc include lean meat and poultry, oysters, beans nuts, dairy products, whole grains Image credit: A2ua https://a2ua.com/zinc.html 5 Tips to Eating Well – Eat 5 to 6 small meals per day – Focus on nutrient‐dense foods – Eat a variety of foods including a variety of texture, color, odor and temperature – Use nutritional supplements (drinks, powders, pills) only as needed for poor appetite – If appetite and eating still isn’t optimal, include a multivitamin in daily routine Image credit: Woodward Chiropractic https://cdn.vortala.com/childsites/uploads/1384/files/eat‐well‐fruit‐face.jpg Image credit: Eating Well magazine http://bed56888308e93972c04‐0dfc23b7b97881dee012a129d9518bae.r34.cf1.rackcdn.com/sites/default/files/veggie‐heart_0.jpg Eating Well: Small Meals – If your appetite is decreased, don’t try to force yourself to eat 3 meals a day – Break your eating up into 5 to 6 different eating sessions with small meals or large snacks or some combination of both – You are better off to try to fuel your body with small amounts of food every couple of hours than to force yourself to eat a meal and then have long stretches with no nourishment – During healing/recovery, our body is using more energy, so frequent nourishment helps replenish the food stores used Image credit: SuppVersity Nutrition and Exercise Science for Everyone 3 10/20/2016 Eating Well: Nutrient-Dense Foods – Because good nutrition helps heal the body, it becomes more important to choose foods that give you the most nutrients for your calories – Fruits and vegetables top the list of nutrient‐dense foods – Lean protein, low‐fat dairy foods and whole grains are also nutrient‐dense – Search for foods with less than 300 mg of sodium per serving (140 mg or less is ideal) – Less saturated fats and more omega‐3 fats can help reduce pain and inflammation in damaged tissue Image credit: Choose My Plate www.choosemyplate.gov Eating Well: Variety – Put a rainbow of colors on your plate; different colors are high in different nutrients. A variety of colors means a variety of nutrients. – If your senses are altered or more sensitive, you can try varying odor and temperature. – Foods with strong odors can increase nausea and/or decrease appetite for people who are experiencing upset stomach during recovery and healing – Cooking with fewer spices or preparing bland foods may be helpful – Some medications can alter our palate and make us feel more sensitive to food temperatures. Experimenting with cold, cool, room temperature, warm and hot foods may help increase appetite and calorie consumption Image credit: My NutraTek Health and Wellness Platform http://mynutratek.com/blog/tag/eat‐a‐rainbow Image credit: iStock photo http://media.istockphoto.com/vectors/cute‐thermometers‐vector‐id453154993?k=6&m=453154993&s=170667a&w=0&h=2Un5GXwzMLX9JTBGddUFEKZTUAmBxD2xqJ_zrdjlncw= Eating Well: Nutritional Supplements – If you still are eating poorly, nutrition supplements can be included in the diet. – Thrive, Ensure, Enlive, Boost, Juven, Arginaid, Carnation Instant Breakfast, protein powders, nutrient supplements – Come in several different flavors (plain, vanilla, strawberry, chocolate, cherry, orange, etc) – Come in various forms: powders, drinks, pills – Can be mixed with milk, ice cream, lemon‐lime soda, yogurt, fruit smoothies or other liquids to improve taste and palatability. – Supplements should be used as a last resort. Nutrition through food is always most absorbable nutrition for the body. Supplements don’t always have 100% absorption into the bloodstream. Image credit: Amazon https://www.amazon.com/Ensure‐Bottles‐Chocolate‐8‐Ounces‐Count/dp/B0033NWGZ8 Image credit: Direct Patient https://www.directpatient.com/nutrition Image credit: Healthable http://www.healthable.org/pros‐and‐cons‐of‐vitamins/ 4 10/20/2016 Eating Well: Multivitamins – During periods of decreased appetite or insufficient nutrient intake, take a multivitamin regularly to avoid any nutrient deficiencies and promote healing and immune sufficiency – Once nutrition through food is adequate, discontinue using a multivitamin, unless it has been directed by a doctor to continue Image credit: Can Stock photo http://cdn.xl.thumbs.canstockphoto.com/canstock6951281.jpg Diabetes and Healing – Diabetes is a chronic disease in which blood sugars are higher than normal and is marked by chronic inflammation – Elevated blood sugars and inflammation can slow down healing – People with diabetes are at an increased rate of infection because infections are fed by sugar – Important to work with the patient’s diabetes doctor and a diabetes educator to closely monitor and manage blood sugars – Check blood sugars before and after physical therapy to prevent low blood sugar from occurring Image credit: Natural News Natural Health News and Scientific Discoveries http://www.naturalnews.com/diabetes.html If you have diabetes… – Monitor BGs very closely to avoid blood sugar extremes – Both highs and lows can interfere with recovery and increase healing time – Follow up with diabetes doctor – If a patient is struggling with blood sugar management, a doctor can help identify patterns and reduce out‐of‐range blood sugar time – Make an appointment with dietitian – Food and nutrition play a vital role in diabetes management and healing – See a CDE – Certified diabetes educators are experts in diabetes and can help manage diabetes during times of illness – CDEs can also be easier to schedule an appointment with than a doctor Image credit: American Association of Diabetes Educators www.diabeteseducator.org Image credit: American Association of Diabetes Educators www.diabeteseducator.org 5 10/20/2016 Sources used for information Cleveland Clinic Nutrition Guidelines http://my.clevelandclinic.org/services/heart/home‐ recovery/home‐recovery‐instructions/nutrition‐guidelines National Institutes of Health Office of Dietary Supplements https://ods.od.nih.gov/factsheets/VitaminC‐HealthProfessional/ https://ods.od.nih.gov/factsheets/Zinc‐HealthProfessional/ Questions? Thank you very much for having me today! Please feel free to contact me at: : Cslater@hy‐vee.com Des Moines Drugstore 4100 University Avenue Des Moines, IA 50311 West Des Moines Drugstore 1010 60th Street West Des Moines, IA 50266 515.633.8603 515.440.1481 6