Recipe For Success

1
Recipe For Success

• Pamela Piotrowski, BASc, RD
• May 31, 2008

2

• No specific diet for the treatment of lupus
  exists
• A well balanced diet will help promote day to
  day wellbeing
• Dietary modifications can help manage symptoms
  associated with side effects of the condition or
  treatment

3
Start with the Main Ingredients

• Energy as fuel source for body
• Protein for muscle synthesis/tissue repair
• Micronutrients for cellular health / protection
  from other conditions
• Fluids to avoid dehydration

4
Fold In Potential Beneficial Ingredients

• Food sources of
• Vitamin E
• Vitamin A/Beta-carotene
• Selenium
• Omega-3 fatty acids
• Magnesium
• B vitamins

5
Be Careful with These Ingredients

• Too many calories
• Excess protein
• High amount of fat (especially saturated and
  polyunsaturated omega-6 fatty acids)
• Food sources of
• Zinc
• Iron

6
What About Food Sensitivities

• Keep a record of foods consumed during a flare up
• Avoid suspects for 2 weeks and gradually
  re-introduce, one at a time
• Find substitutes for key nutrients that may be
  missed

7
Add in Drug-Dietary Interactions

• NSAIDs
• Aspirin
• Ibuprofen
• Celecoxib

• DMARDs
• Steroids
• Anti-malarials
• Immunosuppressants

Nausea/vomiting, Gastrointestinal problems,
Appetite changes, Weight fluctuations
8
Other Nutrition Side Effects

• Pain medications constipation, nausea
• Antibiotics - diarrhea
• Diuretics fluid levels, excess nutrient
  excretion
• Various medications - changes in nutrient
  digestion/absorption/excretion

9
Needing to Substitute Ingredients

• Side effects of medications
• Side effects of the disease
• No energy/no time
• Be PREPARED

10
Too Fatigued to Eat

• Choose nutrient-dense foods
• Eat small, frequent meals
• Add snacks/supplements between meals
• Use nutritious smoothies or soups

11
Nausea, Vomiting

• Try light foods, cold/cool temps, bland tastes
• Avoid mixing hot and cold temperatures
• Include adequate fluids (ice chips, broth,
  juices, frozen grapes, popsicles)
• Pick nutrient-dense fluids instead of solids

12
Avoiding Weight Gain

• Watch portion sizes
• Avoid empty calories (fat, sugar, alcohol)
• Adequate water intake
• Include more fibre
• Be aware of mindless eating

13
To Keep Bones Strong

• Calcium
• Vitamin D
• Avoid excess caffeine, protein, sodium,
  phosphates (from carbonated beverages), alcohol,
  as well large amounts of aluminum-containing
  antacids.

14
Mood Boosting Foods

• Water
• Vegetables and Fruit
• Omega-3 Fats (salmon, tuna, mackerel, sardines,
  canola oil, walnuts, flaxseed)
• Complex Carbohydrates (whole grains cereals,
  whole wheat pasta, brown rice, fruit and
  vegetables)

15
Reflux/Heartburn

• Avoid fat, chocolate, spices, acidic foods and
  alcohol
• Eat small, frequent meals
• Separate liquids and solids
• Sit up after meals

16
Constipation

• Add insoluble fibre wheat bran, dried fruits,
  fruits and vegetables with skin on, nuts,
  seeds
• Include adequate fluids including bowel
  cathartics (prune juice, warm water)
• Increase activity level as tolerated

17
Abdominal Bloating, Cramps, Diarrhea

• Add soluble fibre oatmeal, barley, applesauce
• Limit intake of gassy foods
• Avoid foods with lactose, use lactase drops or
  tablets.
• Use probiotics (in yogurt or as live culture
  supplements)

18
Keep Hydrated

• 25 - 30 ml FLUIDS/ kg body weight (more if
  hot weather, increased body temperature,
  increased perspiration, vomiting, diarrhea,
  constipation)
• Use ice chips, popsicles/juice bars, gelatin, ice
  cream, sherbet, soup, broth, fruit/veggie juices,
  lemonade and flavoured water
• Avoid caffeine-containing drinks

19
How To Keep Your Heart Healthy

• Avoid animal fats
• Include beans, legumes and fish
• Add more vegetables and fruit to diet
• Use extra soluble fibre - oatmeal, applesauce,
  barley, oranges, legumes

20
Fluid Retention/? Blood Pressure

• Limit sodium to 1500-2000 mg /day
• No added table salt
• One salty food per day
• Avoid too many packaged / canned / prepared foods
  that may have added salt

21
Difficulty Swallowing

• Eat when not fatigued
• Small, frequent amounts
• Liquids easier than solids
• Keep consistency of food smooth
• Room or cool temperature
• Adequate pain management

22
Reducing nutrition-related infections

• Eat a well-balanced diet
• Switch to more omega-3 fats in the diet
• Boost anti-oxidant rich foods
• Eat sources of probiotics/prebiotics
• Prepare foods using proper handling and cooking
  procedures

23
Immune Boosting Fats

• Alpha-linolenic acid ALA
• Plant sources flaxseed/oil, canola oil, chia
  seeds, walnuts/oil, purslane, dark green leafy
  vegetables
• Eicosapentaenoic acid EPA Docosahexaenoic acid
  DHA
• Aquatic plants and seafood herring, mackerel,
  sardines, salmon, trout, tuna, seaweed
• Most readily absorbed by the body

24
Grams of Omega-3s

• per 100 g fish
• Tuna 1. 6
• Salmon 2. 3
• Anchovy 1. 4
• Sardine 2. 2
• Crab 1. 2
• Mackerel 2. 0
• Trout 1. 2

• Per serving
• Omega-3 Egg 0.4 g
• 1 Tsp Flax Oil 2.3 g
• 1 oz ground flax 1.8 g
• 14 walnut halves 2.6 g
• 1 Tsp canola oil 0.4 g

25
Adding Anti-oxidants
26
Finding Probiotics

• Probiotics bacteria similar to those naturally
  found in the intestinal tract
• foods containing probiotics yogurt, fermented
  milk, miso, tempeh, some juices and soy beverages
  
• dietary supplements capsules, liquids, powders

27
Dont Forget to add the Prebiotic

• Prebiotics nondigestible fibre in food
  (oligosaccharides) that stimulates the growth
  and/or activity of probiotics
• Food sources include fruits, legumes, and whole
  grains.
• Also found in various fibre supplements (inulin,
  chicory root, FOS)

28
Mixing It All Together
29
Healthier Eating Habits

• Variety and moderation
• Eat 3 out of 4 food groups
• Small frequent meals or snacks
• Pick bright coloured fruit and vegetables
• Cut back (not out) fat intake
• more omega 3, less omega 6 and saturated

30
Healthier Eating Habits

• Keep hydrated
• Limit simple sugars and refined starchy foods
• Avoid excessive doses of supplements

31
Healthy Eating At Home and Away

• Start with a good breakfast
• Plan meals around vegetables
• Choose fish (at least twice per week) and use
  meat alternatives such as dried beans, peas and
  lentils more often
• Make extras of your favourite recipes and freeze
  them

32

• Take time to plan meals
• Keep healthy snack and meal choices handy at
  work, in the car and at home to avoid settling
  for something less nutritious
• Ask for healthy alternatives when eating out
• Take It One Meal At A Time!

33
Quick ,Tasty (and good for you)

• Stuffed vegetables
• Fruit/veggie kebobs with yogurt dips
• Pita pizza
• Fruit smoothies
• Bean/yogurt dips with baked tortilla/pita crisps

• Chilled fruit soups
• Couscous with lentils and dried fruit
• Bake sweet potato fries
• Grilled vegetables
• Phyllo nests with fruit

34
Healthier Comfort Foods

• Frozen yogurt/fruit smoothie
• Oatmeal raisin cookie, flavoured rice cakes
• Warmed low fat milk with cocoa powder
• Chocolate syrup drizzled over fruit,
• Veggie pizza (no cheese)

35
What Other Utensils Are Available?
dietitians.ca eatracker.ca msss.gouv.qc
.ca/sujets/santepub/nutrition extenso.org eatright
ontario.ca dialadietitian.org eatright.org

36
The Finished Product