KRISTIN MCNEALUS, PT, DPT

NOW YOU'RE COOKING: "Your disability may make it difficult to prepare healthy meals. However, it is better to take longer to prepare your meals because you have to adjust to a different way of doing it, than to deal with the complications brought on by an unhealthy diet."

Pay Attention to Nutrition

Studies have shown that people with disabilities are more likely to be overweight, and also obese. Carrying extra weight not only increases your risk for health complications such as heart disease and diabetes, but it can impact your mobility.

When you have a disability, you may be prone to having increased inflammation in your system. This impacts your digestion and can contribute to a number of secondary conditions. Many people then take more medications to address the symptoms from these other complications. The good news is that the way we eat can address this increased inflammation naturally! Nutrition is using food to nourish your body with the essential elements it needs to live, grow and heal.

People who have disabilities commonly have poor diets, for a number of reasons. It may seem like a healthy diet is more expensive than eating junk food. We will address this in future articles to show how you can eat healthy foods on a budget.

Getting to the super market may be difficult. If you don't drive, and rely on a family member or friend to drive you, you may not go as often as necessary to have fresh food. It may also be inconvenient to take a dial-aride service, especially if you live in a more rural area. If this sounds like your situation, consider a delivery service that can bring you good, healthy foods.

Your disability may also make it difficult to prepare healthy meals. I often hear people who have limited tolerance to standing say this gets in the way of cook ing. You can certainly prepare food sitting down! You can cut up foods, you can mix bowls, you can even (carefully) cook on a stove! It is better to take longer to prepare your meals because you have to adjust to a different way of doing it, than to deal with the complications brought on by an unhealthy diet.

A poor diet can lead to nutritional deficiencies. Depending on your primary condition, there may be other reasons why your body is not absorbing all of the good nutrients from food. Or you may be on medications that impact the absorption of nutrients in the digestive tract. All of these reasons are why you should consider following a better diet.

There are a number of complications that are associated with disability, but many can be prevented with a good diet. Common complications include:

• Digestive dysfunction • Constipation • Diarrhea • UTI's • Obesity • Osteoporosis • Arthritis • Type II diabetes • Heart disease • Pain • Sleep disorders • Skin issues

By improving your diet to have better nutrition, you can improve sleep and increase your energy! Everyone can use this. It will also help to maintain weight. While losing weight is a nice goal, assuring you do not put on more weight is a good first step. This can be challenging, and losing weight could be a bonus benefit.

You could have skin improved health. Many people do not equate skin issues with diet, but skin is the largest organ we have. Protecting it important! 

Improved diet can improve your bowel function. If you have loose stools, or go frequently, your intestines may not have the time to absorb nutrients. A good diet will help to slow this process. On the flip side, if you experience constipation, which is a common side effect of many medications, this can increase the number of toxins in your body. Stool carries all of the toxins out of the body, and letting it sit in the colon can affect your body negatively. It is healthy to move that along regularly.

A good diet can improve your mood, as well as decrease pain that you experience. An improved mood, and also improved nutrition, can decrease the pain experienced, especially if you are decreasing inflammation. By decreasing pain, you may be able to lower the amount of pain medication you take. These medications also carry a number of uncomfortable side effects. Decreasing the amount of medication you take is always a good goal. Our bodies were not designed to have all of those chemicals pumping through the body.

Studies have shown that people with dis abilities are more likely to be overweight, and also obese. Carrying extra weight not only increases your risk for health complications such as heart disease and diabetes, but it can impact your mobility. It is difficult to move more weight, especially if you have weakness or impaired functional mobility, added weight could even impact your independence. Additionally, it has been shown that people with disabilities have higher percentages of body fat.

Why is weight gain more common in people with mobility impairments? There are a number of reasons. First, having that increased percentage of body fat, and lower lean body mass, means that your metabolism slows down. Metabolism is the number of calories that your body needs to function.

Remember that weight maintenance is having a balance between calories out and calories in. A higher fat percentage means less calories out. Remember that a disability also means that you are burning less calories from moving around less to complete basic activities. You will need to adjust your intake from pre-disability days. Exercise will help increase the calories out! While a good diet is important, it only works with consistent exercise. There are plenty of previous posts about the importance and benefits of exercise.

Medications can contribute to weight gain. There can be multiple reasons as to why this is, and you should not stop any medications without consulting your physician. However, if you are able to safely decrease any medications, that will help your overall health. Because of this side effect, understand that medications may make weight loss more difficult, or slow it down. Do not get frustrated! The weight gain did not come on over night, so be patient and keep up the hard work!

You may notice that your finances are tighter when you have a disability. This is unfortunately common. This is also a reason many give for following a poor diet and not exercising. While it may seem pricy to lead a healthy lifestyle, it does not need to be. It may take more planning and more time, but that will contribute to less illness and less hospitalizations. That time is invaluable, right? Put in that extra time and effort now to earn it back later.

As mentioned earlier, a disability may predispose you to having more inflammation in your system. This can contribute to weight gain. Additionally, you may have hormonal changes that can make weight loss more difficult. Again, do not get discouraged. Forgive your body, and continue the hard work. It will pay off!

You may also have poor carbohydrate metabolism, and insulin resistance. This can lead to diabetes, or make diabetes more difficult to control. This can be dangerous. Diabetes can affect your whole body, and lead to a plethora of additional complications. Prevent it if you can! Good diet and regular exercise are key.

This information, and information about an anti-inflammatory diet, can be found in Eat Well, Live Well with SCI by Kylie James and Joanne Smith. •

PAYING ATTENTION : MAKING SIMPLE CHANGES

Do not think about dieting. That often fails because you feel like you are depriving yourself and then you return to your normal eating habits, if not worse, and gain back any lost weight. Try to make simple changes. Here are a couple to start with:

1. Restrict fruit intake to only 1 per day. This does not sound like a common recommendation, however, while fruit has a number of good nutrients, it also has fructose. This is a natural sugar, and high amounts have been shown to increase inflammation in the system. The best fruits to have for your one serving are berries, orchid fruits, and citrus fruits.

2. Consume lots of vegetables! Veggies help to slow the release of glucose, and decrease the risk of insulin resistance. They are low in calorie and high in fiber, which will help you feel fuller faster . Vegetables are also high in vitamins and minerals, which, as mentioned previously, are important due to the impaired nutrient absorption. They also help to rid the body of toxins. It is recommended that you eat at least 8 servings a day! So if you need a snack, consider some cucumber slices.

3. Reduce sugars. Sugar is linked to a number of health complications, and really offers no benefit. It leads to increased obesity, inflammation, hormone imbalances, insulin resistance, and higher cholesterol. Skip dessert, but also limit sugar containing products such as cereals, cookies, muffins, and white rice/pasta/bread.

4. Avoid artificial sweeteners! Just because something says "diet" does not mean it is healthy! It often means that it has artificial sweetener in it, and these compounds have been shown to actually stimulate appetite. Artificial sweeteners also increases the cravings for carbohydrates and stimulate fat storage. This can all contribute to weight gain even when you think you are choosing healthy alternatives.

5. Eat good fats. Fat got a bad reputation over the years because each gram has higher calories than each gram of carbohydrate or protein. However, fat helps suppress appetite and curb cravings. By limiting fat in your food, you'll likely be more hungry more often. Fat also adds taste – we want to enjoy the food we eat or we won't eat it, right? Good fat is in fish, nuts, olives and avocado. Oils from these foods are also healthier than butter or lard for cooking.

THE FITNESS PRIORITY My name is Kristin McNealus, DPT, MBA, and I received my Masters in Physical Therapy from Boston University and went on to earn my Doctorate in Physical Therapy from MGH Institute of Health Professions. I received my MBA from Pepperdine University in 2016. I started Every Body Fitness, an online fitness program for people with physical limitations to workout anywhere. We have a video-ondemand program that offers cardiovascular workouts, boot camp style strengthening workouts, balance classes, and adapted yoga programs. I started this because I know that it is important to get exercise, but there can be challenges getting out to some of the activities discussed in this article. I wanted to design an option with as few barriers as possible. This can be a primary workout program, or complement any other activities. You can check this program out at ebfitnessonline.com