Diet, Exercise and Wellness for the Patient with IBD

Transcription

1 Diet, Exercise and Wellness for the Patient with IBD Emily Haller, RDN Please consider the environment before printing this PowerPoint

2 Maintaining a Healthy Lifestyle Matters Health benefits Makes us feel good Something we control Division of Gastroenterology & Hepatology

3 How Does Diet Impact IBD? Diet is important to better health, yet little conclusive data on diet & IBD Diet plays an important role During flares After flares to regain muscle Correcting nutrient deficiencies Achieve/maintaining a healthy weight Improving bloating/ibs-like symptoms Preventing malnutrition We want a diet that: Supports energy needs, provides adequate vitamins & minerals, doesn t worsen GI symptoms

4 What or how should I eat?? Vit D: Want >30ng/mL (75 nmol/l) Haskey. Nutrients Mar; 9(3): 259

5 Eating with a Stricture or Adhesions Strictures = narrowed part of intestine Adhesion= fibrous tissue Avoid foods that might get stuck Fibrous, fatty meats Raw veggies Popcorn Nuts Beans Insoluble fiber Skins of fruits

6 Goals for Eating with a Stricture Important to achieve adequate protein and calorie intake Focus on: refined grains, peeled, soft or well-cooked fruits & vegetables, ground or well-cooked leans proteins, dairy, or plant-based alternatives May require temporary liquid diet Oral supplements Shakes/Smoothies Soups Juices

7 Executing a Healthy Diet: The 3 P s Formula Planning Make a shopping List Preparation Shop Portion Store Packing Portability Safety

8 5 Steps to Prep a Power Meal 1. Think food groups. Try to include as many as possible: Vegetable (Peel and cooked if needed) Fruit (Peel and cooked if needed) Whole grain (whole wheat bread/cereal/pasta, brown rice, etc.) (Refined grains if needed, cream of rice, cream of wheat) Lean protein (chicken, turkey, fish, beans, tofu, etc.) Low fat dairy (yogurt, cheese, milk, etc.) 2. Pack the rainbow: More color=more nutrients! 3. Practice proper portion control 4. Buy for convenience & portability 5. Love your leftovers ( and get creative)!

9 Examples

10 EXERCISE

11 Benefits of Exercise: Boosts endorphins Helps curb stress Cardiovascular benefits Rebuilds/maintains muscle mass Can help reduce inflammation Minimize risk of osteoporosis Reduces risk of colon cancer by 50% Can help reduce fatigue

12 Types of Exercise 1. Aerobic 2. Strength 3. Stretching 4. Balance

13 Aerobic Exercise Helps relax blood vessel walls Lowers blood pressure Burn body fat Lower blood sugar levels Raise "good" HDL cholesterol Aim for 150 minutes per week of moderate-intensity activity. Examples: brisk walking, swimming, jogging, cycling, dancing, or classes like step aerobics.

14 Strength Training Builds muscle Stimulates bone growth Lowers blood sugar Assists with weight control Improves balance and posture Reduces stress and pain in the lower back and joints. Examples: Body weight exercises (squats, push-ups, and lunges), and exercises involving resistance from a weight, a band, or a weight machine.

15 Stretching Stretching muscles routinely makes them longer and more flexible Increases range of motion Increase circulation Reduces pain and the risk for injury. Examples: stretches can be done anywhere!, yoga class

16 Balance / Stability Helps prevent falls Improves your ability to maintain body alignment while resisting unwanted bone and joint movements Examples: Standing on one foot, Heel-to-toe walk

17 Where to start Exercise programs should be individualized & based on age, fitness level, exercise goals and preferences. Think about consulting with a physical therapist, personal trainer or exercise physiologist Pick something enjoyable! Motivation and maintenance of exercise is enhanced when group camaraderie is developed, when the activity is enjoyed, when positive changes in QoL are demonstrated Think about group exercise classes with a professional who will provide personalized feedback Moderate exercise intensity AVOID acute, strenuous exercise Could exacerbate an inflammatory response

18 Basics, Where to start..aerobic exercise Walking is a safe, practical, easy-to-do form of aerobic exercise Could begin with: minutes of low-intensity of walking at 60% of your maximal heart rate 3 days/week Progression: Increase to most days of week Stop when feeling fatigued or IBD-related symptoms OR if needed start with walking continuously at your own pace for bouts of 4-5 minutes, work up to 20 minutes J. Bilski et al./pharmacological Reports 68 (2016) C. Perez. Journal of Crohn's and Colitis 3 (2009),

19 Basics, Where to start..resistance training Use elastic bands or free weights Start with a 5 minute warm up - general whole body mobility 2 sets of exercises focused on major muscle groups of trunk and legs Rest seconds after each exercise and for 2-3 minutes in between sets Bands: 8-12 repetitions Weights: 5-8 repetitions at 50% 1-RM, progression: 8-12 reps at 60% 1-RM End with 5 minute cool down muscular stretching J. Bilski et al./pharmacological Reports 68 (2016) C. Perez. Journal of Crohn's and Colitis 3 (2009),

20 AUDIENCE EXPERIENCE: Favorite type(s) of exercise? Classes? Running/walking/hiking/cycling? Weights/resistance training? Yoga/pilates/barre? What motivates you? Alone or with a partner?

21 Tips for Success: You got this! Stay Hydrated Come Prepared Eat well Knowledge of near by bathrooms Bring toilet paper/wipes Choose the right workout/activity Have a Plan B Consistency Listen to your body

22 Wellness Sleep Screen time Time spent outside

23 AUDIENCE QUESTION / POLL How many people scroll through their phone, tablet or watch TV before bed?

24 Screen time may lessen sleep quality Beware of the blue light Boosts alertness & regulates circadian rhythm Decreases melatonin levels (chemical that signals the body for sleep) What to do: Limit screen time Apply screen filters Wear computer glasses that block blue light or antireflective lenses to offset the effects of artificial light at nighttime Use night mode settings that limit blue light exposure L. Ostrin. Ophthalmic and Physiological Optics, 2017; 37 (4): 440

25 Routine No screens Stay active during the day

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27 A new prescription: Nature Getting outside for just 15 minutes is enough to lower your stress & frustration Dose effect the more the better Often overlooked Easy for us all to implement -o

28 Thank