Living for the Health of It Adaptations for Amputees

Transcription

1 Living for the Health of It Adaptations for Amputees 1

2 Task Force Dagger is dedicated to providing assistance to wounded or injured veterans of U.S. Special Operations. Many veteran members of Task Force Dagger have undergone amputations and are not sure how to adjust to their new lifestyle. You may worry that having an amputation means your life is over. This is not true. What is true is that you need to change some things about your daily routine. Luckily, there s a lot that you can do to keep yourself healthy. The purpose of this nutrition pamphlet is to educate Task Force Dagger recipients on healthy eating, heart-healthy diets, weight maintenance, and adapted exercise routines for amputees. For many, learning how to adjust to their new lifestyle is the first step towards feeling better and living a longer, healthier life. Here's what you need to get started on the path toward improved health and wellbeing. 2

3 Choose My Plate Tell me what you eat, and I will tell you what you are. -Anthelme Brillat-Savarin 3

4 Choose My Plate A balanced diet is essential to maintaining good health. Choose My Plate has replaced the Food Pyramid and is a tool that helps to illustrate the five main food groups in proportion to each other. Before you eat, think about what goes on your plate, cup or bowl. What are some things you notice about the plate below? For instance, notice how half the plate consists of fruits and vegetables. 4

5 Grains How much grains should you have? Adults should eat about 7 oz of grain every day. What is 1 oz of Grain? 1 slice bread 1 cup ready-to-eat cereal ½ cup cooked pasta, rice, or oats What are the benefits of grains? Grains are a great source of energy. They also provide folate, niacin, and iron. Whole grains are a great source of fiber. Make half your grains whole grains Try whole grain bread Try rolled oats or other whole grain cereals Try brown rice or whole wheat pasta Try substituting whole wheat or oat flour Think of the foods you ate yesterday, how much grains did you eat? oz. 5

6 Fruits How much fruit should you have? Adults should eat about 2 cups* of fruit every day to achieve health benefits. What counts as ½ cup fruit? 1 medium fruit (about the size of a tennis ball) ½ cup fresh, frozen, or canned fruit ¼ cup dried fruit What are the benefits of eating fruit? Fruit provides essential nutrients such as antioxidants, folate, potassium, fiber, vitamin A and vitamin C. Tips to increase daily intake of fruit Keep a bowl of fruit on the table Try frozen, dried or canned fruit Pre-cut your fruit Buy fruit when it is in season Think of the foods you ate yesterday. How much fruit did you eat? cups. 6

7 Vegetables How much vegetables should you have? Adults should eat about 3 cups* of vegetables every day. What counts as ½ cup Vegetables? ½ cup cooked or raw vegetables 1 cup leafy greens 6 oz vegetable juice What are the benefits of vegetables? Vegetables, like fruit, provide needed nutrients such as antioxidants, folate, potassium, fiber, and vitamins A, C, and K. Tips to increase daily intake of vegetables Try a variety of veggies Try frozen or canned veggies Pick pre-washed veggies or those packed in microwavable bags Buy veggies when they are in season Think of the foods you ate yesterday, how much vegetables did you eat? cups. 7

8 Protein How much protein should you have? Adults should eat about 6 oz of protein every day. What is one serving of Protein? 1 Serving of Protein is 3 oz of meat, fish or poultry. 3 oz is about the size of one deck of cards What are the benefits of protein? Protein foods provide niacin, thiamin, vitamin B12, iron and zinc. They also help regulate your body s functions and structures such as muscle. Tips to choosing good protein sources Try leaner meats such as round steaks, roasts, pork loin, tenderloin, and lean ground beef Broil, grill, roast, poach, or boil meat, poultry, or fish instead of frying Take off skin and cut extra fat Think of the foods you ate yesterday, how much protein did you eat? oz. 8

9 Dairy How much dairy should you have? Adults should eat about 3 cups of dairy every day. What is one serving of Protein? 1 Serving of Protein is 3 oz of meat, fish or poultry. 3 oz is about the size of one deck of cards What are the benefits of dairy? Dairy provides vitamin B12, calcium, riboflavin, and vitamin D. It is also a great source of protein! Tips to choosing good dairy sources Drink low-fat or fat-free milk at meals Use low-fat or fat-free milk when cooking Try low-fat yogurt and cheese Try replacing source cream with low-fat yogurt Think of the foods you ate/drank yesterday, how much dairy did you get? cups. 9

10 Getting Nutrients from the Source By eating a balanced diet, you will receive all the necessary nutrients that your body needs to function properly. It is best to get these nutrients from food instead of supplements if possible to get the other beneficial substances from foods that work to prevent disease and promote health. The following section will further discuss ways to prevent disease. Goals to improve your diet:

11 Heart Healthy Diets A wise man should consider that health is the greatest of human blessings, and learn how by his own though to derive benefit from his illnesses. -Hippocrates 11

12 Heart Healthy Diets Many factors affect heart health. Hypertension, diabetes, obesity, and atherosclerosis are all conditions that can eventually lead to cardio-vascular disease, the leading cause of death in the United States. Through diet and exercise much can be done to lower risk of heart disease and its accompanying conditions. This section will discuss dietary changes that can positively affect heart health. 12

13 Hypertension Hypertension: High Blood Pressure Hypertension often exists without symptoms or discomfort. However, this disease puts constant pressure on the heart and arteries. It is important to have your blood pressure taken regularly. How does your blood pressure compare? Status Healthy Blood Pressure 120/80 or less Pre-Hypertension 120/80-139/89 Hypertension 140/90 or more The DASH eating plan is a clinically proven diet to reduce high blood pressure by decreasing saturated fat and salt while increasing fruit and vegetable consumption. 13

14 DASH Eating Plan Food Group # of Servings Serving Sizes Grains slice bread 1 cup ready-to-eat cereal ½ cup cooked pasta, rice, or oats Vegetables 4-5 ½ cup cooked or raw vegetables 1 cup leafy greens 6 oz vegetable juice Fruits medium fruit ½ cup fresh, frozen, or canned fruit ¼ cup dried fruit Lowfat Dairy cup milk or yogurt 1 ½ oz Cheese Lean Meats 2 or less 3 oz cooked lean meats, skinless poultry or fish Fats & Oils tsp vegetable oil or margerine 1 Tbsp lowfat Mayonnaise 2 Tbsp oil-based salad dressings Legumes 4-5 per week 1/3 cup or 1 ½ oz nuts 1 Tbsp or ½ oz seeds ½ cup cooked dry beans Sweets 5 per week 1 Tbsp Sugar or Jam 14

15 Atherosclerosis Atherosclerosis: Buildup of Plaque Atherosclerosis is a condition caused mainly by fat intake. The following three steps are simple diet changes that can reduce your risk for this disease. 1. Decrease Saturated and Trans Fats Eat less fatty meat and hydrogenated oils. Buy Trans-Fat Free Products. 2. Increase Healthy Fats Eat more monounsaturated fats such as olive oil, canola oil, and peanut oil. 3. Increase Exercise These changes will decrease bad cholesterol (LDL) and increase good cholesterol (HDL). 15

16 Diabetes & Obesity Diabetes and obesity are both conditions that can lead to heart disease. For both of these conditions moderate weight loss of 5-10% body weight can significantly improve heart health. The following section will discuss ideal body weight and weight maintenance strategies. Goals to improve heart health:

17 Weight Maintenance You must begin to think of yourself as becoming the person you want to be. -David Viscott 17

18 Weight Maintenance Many members of Task Force Dagger have struggled with weight maintenance after their amputation. They are often unsure of what their new weight should be, and how to maintain a healthy weight. This section will show you how to calculate your adjusted ideal body weight. It s important to note that these calculations are estimates because body proportions vary in individuals. 18

19 Adjustment of Ideal Body Weight for Amputees Research has determined the percentage of body weight that is associated with each limb, and therefore how much weight should be deducted from the typical ideal body weight (IBW) calculations in the case of amputations. Body Segment Weight Average % of Total Lower arm and hand 2.3 Trunk without extremities 50.0 Entire arm 5.0 Hand 0.7 Entire lower leg 16.0 Below knee including foot 5.9 Foot 1.5 5% to 10% should be subtracted from IBW for a paraplegic. 10% to 15% should be subtracted from IBW for a quadriplegic. 19

20 Adjustment of Ideal Body Weight for Amputees In order to calculate your adjusted ideal body weight you need to: 1. Calculate your typical IBW before adjusting for amputations. A commonly used method of calculating IBW is the Hamwi Equation: Men: 106 lbs for first 5 feet of height and 6 lbs per inch over 5 feet. Women: 100 lbs for first 5 feet of height and 6 lbs per inch over 5 feet. 2. Calculate your estimated IBW by subtracting the percentage of body fat that is associated with each missing limb from your IBW. (100 - % amputation) Estimated IBW = (100) x IBW for original height 20

21 Adjustment of Ideal Body Weight for Amputees EXAMPLE To determine the adjusted ideal body weight for a 5 10 male with a below-the-knee amputation: 1. Calculate the ideal body weight for a 5 10 male. ( 5 = 106 lb ) + ( 10 x 6 lb = 60 lb ) = 166 lb 2. Calculate your estimated IBW by subtracting the percentage of body fat that is associated with each missing limb from your IBW (~ 6.0%). Estimated IBW = (100 6%) (100) x 166 lb = 156 lb 21

22 Adjustment of Ideal Body Weight for Amputees Now it s time to calculate your adjust ideal body weight: 1. Calculate your ideal body weight. ( = lb ) + ( x 6 lb = lb ) = lb 2. Calculate your estimated IBW by subtracting the percentage of body fat that is associated with each missing limb from your IBW. Estimated IBW = (100 - %) (100) x (IBW) 22

23 Weight Loss Steady weight loss over a longer period favors reduction of fat stores, limits the loss of vital protein tissues, and avoids the sharp decline in metabolic rate that accompanies rapid weight loss. Calorie deficits that result in a loss of approximately 0.5 to 1 lb per week should continue for approximately 6 months for a reduction of 10% of body weight. 23

24 Evaluation of Wight Loss For the next 6 months the focus changes from weight loss to weight maintenance. Following this phase, further weight loss may be considered. It s important to avoid rapid weight loss. Significant weight loss can lead to health complications. weight change % Weight Change = x 100 usual weight TIME SIGNIFICANT WEIGHT LOSS 1 week 1-2% 1 month 5% 3 months 7.5% 6 months 10% 24

25 Weight Loss A lot of people who try to lose weight experience a weight plateau, when weight remains the same for a long period. The plateau may reflect metabolic adjustment and weight maintenance. If you want to maintain weight loss you need to make changes to your diet or physical activity. Here are some tips to help maintain weight loss: The best diet is don t buy it. Easy does it use moderation at all meals. Don t drink your calories. Keep the extras to no more than 200 kcal per day (about 5 Thin Mint cookies). 25

26 Weight Loss Programs Weight loss programs with any degree of success integrate food-choice changes with exercise, behavior modification, nutrition education, and psychological support. If you decide to join any kind of weight-control program, here are some questions to ask before you join. Does the program provide counseling? Is the staff made up of a variety of qualified counselors and health professionals such as nutritionists, registered dietitians, doctors, nurses, psychologists, and exercise physiologists? Is training available on how to deal with times when you may feel stressed and slip back to old habits? Is attention paid to keeping the weight off? How long is this phase? Are food choices flexible and suitable? Does the client set the weight goal or does the health professional? 26

27 Behavior Modification Behaviors that will help you lose weight and maintain it: Set short-term and long-term goals Goals should be: 1. Specific 2. Attainable (doable) 3. Forgiving (less than perfect) Reward your success (but not with food) Frequent small rewards, earned for meeting smaller goals, are more effective than bigger rewards that require a long, difficult effort. 27

28 Weight Maintenance Goals Short-term goals: Long-term goals:

29 Adaptive Exercise We will not waver; we will not tire; we will not falter, and we will not fail. Peace and Freedom will prevail. -George W. Bush 29

30 Benefits There is an increased energy cost of ambulation with a prosthesis. With exercise you can improve cardiorespiratory endurance so that you have more energy throughout the day. In addition may experience some of the other benefits of exercise such as: Overcome Depression Avoid Contracture Improve Balance Lose Weight Build Strength Build Endurance 30

31 Adaptive Exercises Core Strengthening Techniques Fitness ab ball sit ups (use a weight on your missing limbs side for balance) Half-Turkish get ups Bosu ball stands Bosu ball plank with ab twist Upper Body Workouts Wheel chair push ups Resistance bands Dumbell weights Push presses/dips Arm exercise bike 31

32 Adaptive Exercises Lower Body Workouts Fitness ab ball sit ups (use a weight on your missing limbs side for balance) Half-Turkish get ups Bosu ball stands Bosu ball plank with ab twist Cardiovascular Training Wheel chair push ups Resistance bands Dumbbell weights Push presses/dips Arm exercise bike 32

33 There s a lot that you can do to keep yourself healthy by eating right and being physically active. However, every person learns to adjust to his or her new lifestyle differently. It s important to find out what works for you. Talk with other people who have undergone amputations to see what worked for them. It's not easy to adjust your lifestyle, but there are resources available and support groups to join to help you feel better and improve your health and wellbeing. Task Force Dagger honors the wounded or injured veterans of U.S. Special Operations. Thank you for your bravery and the service you rendered for your country. Valor is stability, not of legs and arms, but of courage and the soul. -Michel de Montaigne 33

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