Transcript Our clients diets and eating patterns following an MVA can become

Nutrition
The Missing Link
The role of nutrition in
rehabilitation and long term care
Presenter:
Kylie James, B.Sc., O.T., CNP
Why is nutrition so important?
Common Nutrient Deficiencies
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Vitamin A
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Calcium
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B2 (riboflavin)
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Chromium
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B9 (folic acid)
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Magnesium
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B12
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Zinc
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Vitamin D
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Fiber
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Vitamin E
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EFA’s
*Walters JL 2009
*Tomey 2005
Average:
Average - 7 secondary health
7 healthcomplication
complications
per
year
per
year
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Digestive dysfunction
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Osteoporosis
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Constipation/
bowel obstruction
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Arthritis
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Diarrhea
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Type 2 diabetes
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UTI’s
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Heart disease
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Obesity
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Pain
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Pressure sores
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Sleep disorders
Benefits of Nutrition for SCI
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Enhances natural healing potential
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Restores balance
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Boosts overall health
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Helps target causes – not just symptoms
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Fulfills higher need for nutrients
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Replenishes nutrients depleted by medication
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Helps prevent development of secondary health conditions
Why use Supplements?
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Digestive dysfunction deceases nutrient absorption
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Body has an increased demand for specific nutrients to address health
conditions
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Food alone may not be able to provide the nutrient levels required for
therapeutic effect

Addresses clients compliance & preference
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Certain medications deplete nutrients
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Processed foods limited in nutrients
Addressing
Bowel Dysfunction/
Constipation
Nutrition &
Spinal Cord Injury
SCI FACTS:
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Main gastrointestinal
complaint/frustration following injury
Abdominal pain/bloating
Increased risk of involuntaries
Increased risk of bowel obstruction
Contributes to other health issues/concerns:
Increased risk of hemorrhoids, spasticity,
autonomic dysreflexia and diverticulitis
 Negatively impacts overall lifestyle

Client Case:
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26 years old
T12-L1 incomplete paraplegic
3 yrs. post injury;
Diet-pizza, pasta, subs, cakes,
processed cereal, energy drinks
 1 BM every 3 days (difficult, time-consuming,
often incomplete bowel routines)
 Low energy/often fatigued
 Abdominal pain/chronic gas/bloating

• social embarrassment/isolation
1. Support Digestive Function
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Consume enzyme rich foods:
fresh vegetables
 pineapple
 avocado
 papaya
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Digestive enzyme supplements
(1-2 every main meal)
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betaine hydrochloride
bile salts
enzymes
2. Help Stimulate Peristalsis
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Eat small frequent meals
Reduce/eliminate sugar and high
glycemic foods
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Donuts
Cookies
Cakes
Processed muffins
Pizza
Refined pasta
3. Increase Fiber
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Absorbs water and adds bulk in stool creating softer
consistency and easier evacuation
19-30 grams of fiber per day
Healthy Sources
Legumes (i.e. chick peas or black beans)
 Whole grains (i.e. spelt)
 Fruits and vegetables
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Supplements
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1 tbsp whole husk psyllium /day
*Cameron, Nyulasi, Collier & Brown, 1996
4. Other
Take probiotic
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1/day – minimum 8 billion microorganisms
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Lactobacillus acidophilus & bifidobacterium
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Yogurt, pickled foods, kefir
Increase intake of good fats
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Fish oils, olive oil, Flax seed oil
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2-4, 1000 mg capsule/day
Increase water
Outcome
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BM every day
Faster and more efficient bowel routines
Reduced incidents of gas
Elimination of abdominal pain
Increased energy
Increased self-esteem
•
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Decreased social isolation
Medal winning Paralympic athlete!
Nutrition &
Brain Injury
Case study - Kyle
Kyle’s injuries
MVA in 2001- 16 years old

lacerated perforated duodenum

Surgery to remove part of his intestines

L1-L2 fracture

Brain injury

Catastrophic
Kyle’s nutritional problems
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Nausea and vomiting 2/7
Dizziness
Lost weight - 160 lbs. to 93 lbs. Currently 143lbs.
Skips a couple of meals a day
Diet consists of energy drinks, refined carbohydrates, chocolate, and pop
Bowels vary btw diarrhea/constipation and are infrequent
Major sleeping problems and getting up at 10:30am
Major stress and anxiety
Easily distracted, unable to remain focused
Mood swings, major depression slumps
Kyle’s nutrition goals and plan
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Stabilize blood sugars
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Increase protein and complex carbohydrates
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Increase vegetable and fruit intake
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Eliminate sugar and caffeine
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Improve hydration
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Improve digestion
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Provide nutrients for brain health and function
Supplement program
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Digestive Enzymes
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High Potency multi-vitamin
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Probiotics
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Fish oils
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Adrenal support (adaptogen herbs)
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Magnesium
Results on completion of nutrition plan
Before plan
After plan
1.
Depression 9/10
Depression 6/10
2.
Irritability 8-9/10
Irritability 4-5/10
3.
Stress 7-8/10
Stress 5-6/10
4.
Smoke a pack of smokes in 3-4 days
Given up smoking
5.
Energy drinks 2x a day
Energy drinks 2x a week
6.
Bowel movts. every other day vary
from loose to constipation
Daily and well formed
7.
Studying - poor focus/mind wanders
Increased focus and less mind
wandering/Increased retention of info
8.
Pain pill 3-4x a week
Pain pill 1x a week at most
9.
Wakes up at 10:30-11:00am with
cueing in a “bad” mood
Wakes up at 8:30am without cueing in
a “good” mood
10.
Dizziness, nausea and vomiting
All resolved
Nutrition is…
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An integral part of rehabilitation process
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Important for helping prevent and reduce
secondary health complications
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Key in optimizing long term health
& well-being
So what are you eating?
Thank you!