Health tips for amputees: Part 1

Health

Health tips for amputees: Part 1
In part one of this article, we look at healthy eating tips for people with limb loss and how what you eat can affect you.

As an amputee, maintaining your health can sometimes be a challenge, especially when it comes to keeping a balance between food intake and physical activity. The benefits of managing your food intake may include reducing the need for prosthetic adjustments (due to changes in your body weight), lowering your risk of disease, and feeling your best emotionally and physically.

Think about the size of your meals

It is important to think about portion sizes, or ‘how much’ you are eating at meals. When planning your meals, start with a small 25cm (10 inch) diameter dinner plate and imagine it is divided into quarters. Aim to fill one quarter of the plate with lean meat such as beef, chicken, pork tenderloin, or fish or meat alternatives like beans, lentils, eggs and tofu. Fill another quarter with wholegrains like brown rice, quinoa, cous cous, wholegrain pasta or starchy vegetables such as potato or pumpkin. Fill the rest (half your plate) with different, colourful vegetables like broccoli, cabbage, zucchini, green beans, spinach, capsicum, carrots, sweet potatoes or tomatoes. Don’t forget to include small amounts of heart-healthy fats such as those in fish, olive oil, avocado, and nuts and seeds. In terms of fruit, aim for two serves per day. One serve of fruit is one medium piece, such as an apple or a banana, or one cup (about the size of your fist) of cut fruit.

Limit your juice intake to 125ml (half a glass) per day, as juice is high in sugar but doesn’t have the fibre of whole fruit. Make sure you drink plenty of water throughout the day as well. And don’t forget, if you are eating out at restaurants or ordering takeaway meals it can be hard to stick to recommended portion sizes as restaurant portions tend to be much larger than recommended. You can try to stick to smaller portions by planning how much you want to eat in advance and packaging the rest up right away to have as leftovers. You can also consider ordering a side salad, a side of vegetables, or a meal with vegetables in it like a curry or casserole to make your meal more nutritious. You can also consider swapping your plates, bowls, and cups to smaller sizes. Your plate will look just as full with less food.

Eat more veggies

Many of us don’t eat the recommended 5-6 servings of vegetables each day. We often wait for lunch or dinner to get our ‘vegetable-fix’. Think about ways that you can include vegetables throughout the day to ensure you eat enough. They are a major source of fibre, which is important for digestive health and helping to keep you feeling full for longer. For those with diabetes, eat starchy vegetables in moderation as they will raise your blood sugars. These include potatoes, pumpkin, corn, peas and other root vegetables such as parsnips and carrots. Instead, choose non-starchy vegetables such as broccoli, cabbage, cucumber, mushrooms, capsicum, salad greens, tomatoes, and zucchini, which can be eaten in abundance as they have little impact on blood sugar levels. Try adding vegetables sticks as a mid-afternoon snack, adding a side salad or salad vegetables to a sandwich at lunch, adding pre-cut frozen vegetables to a curry or stir-fry, or using convenience options like a pre-mixed salad or microwavable frozen veggies (e.g. Steam Fresh) as a side dish. You can even add veggies to breakfast, try scrambled eggs with sauteed mushrooms and tomato, baked beans on toast, or add some sauteed spinach to your eggs on toast.

Choose your snacks wisely

We all tend to reach for high energy snacks to get a quick boost of energy during the day. However, these snacks tend to be higher in saturated fats and sugar and lower in the vitamins and minerals that our bodies need. While it’s okay to have these snacks occasionally, if we eat them more than a few times per week it is likely to result in weight gain. Choose healthier snacks including fresh fruit, apple slices with peanut butter, vegetable sticks with dips such as hummus, beetroot dip, or tzatziki, a handful of unsalted mixed nuts or nut bars, a hard-boiled egg, reduced fat, plain, fruit, or reduced sugar yoghurt, a glass of low fat milk or a small latte or cappuccino, a slice of wholemeal or multigrain bread with peanut butter, avocado, or cheese, or wholegrain crackers and cheese.

Stock your freezer with healthy foods including vegetables, and protein such as chicken, fish, and lean beef. Fill your pantry with nutrient-rich foods such as tinned tuna, nuts, dried fruit, whole wheat pasta, canned beans, and whole grains such as brown rice. Lastly, cook in batches so you can freeze individual portions. This avoids cooking every day, and an easy way of heating and eating a quick and healthy meal regularly.

If you find that cooking is too difficult, or you are not sure how to cook, you can also use healthier convenience meal options. For vegetables try prepared salad packs, chopped fresh or frozen veggies, or Steam Fresh frozen vegetables. Choose lean proteins, such as tinned tuna or salmon, eggs, smoked salmon, cottage cheese, cooked shredded chicken, or a pre-cooked roasted chicken from the supermarket. For complex carbohydrates opt for tinned beans and lentils, quick cook rice cups, or frozen falafels. Many pre-made frozen meals are also quite nutritious, although reading the label is important because some are high in fat, salt, and sugar. Look for frozen meals with 1700kJ or less per serve, 30-50g of carbohydrates per serve, 2g of saturated fat or less per 100g, 400mg of sodium or less per 100g, and at least 2 serves of vegetables per meal. You can always add some extra frozen veggies to increase the nutrition too!

Watch your weight

As an amputee, being overweight can be a problem. People with a lower limb amputation who gain weight may find that their stump gets bigger, and their prosthesis becomes too tight which can lead to pain, discomfort, skin breakdowns and the need for a replacement socket. Weight gain can also affect the safety of your componentry if you go above the recommended weight limit for your device.

To lose weight, you must burn more calories than you take in. This usually means eating a balanced diet and increasing your activity level. Speak with your doctor, and consider referral to a dietitian, so that a nutritious eating plan can be developed that is appropriate and safe for you. A dietitian can help you to make a practical plan that considers what foods you enjoy and your individual circumstances. Avoid fad diets that require extreme changes or offer a ‘quick fix’ solution, as these can be dangerous for your health and don’t usually help you to make long term, sustainable changes that will keep you healthy for a lifetime.

If you are unsure of the right diet for you, speak to your healthcare provider/doctor or contact Dietitians Australia on 1800 812 942.

Look out for part two of this feature in the November edition.
Medically reviewed by Chantelle Elson, Clinical Dietician, Austin Health

References:

Erica Oberg, ND, MPH 2019, Type 2 Diabetes Diet Plan, MedicineNet, <www.medicinenet.com/diabetic_diet_for_type_2_diabetes/article.htm>

2021, Nutrition Tips For Amputees, Thrive Magazine, <thrivemag.ca/health-fitness/124-nutrition-tips-for-amputees>

Maki, K, Phillips-Eakley, AK, Smith, KN. The effects of Breakfast Consumption and Composition on Metabolic Wellness with a Focus on Carbohydrate Metabolism. Adv Nutr 2016; 7(Suppl): 613S-21S; doi: 10.3945/an.115.010314.

Ahola, A.J., Mutter, S., Forsblom, C. et al. Meal timing, meal frequency, and breakfast skipping in adult individuals with type 1 diabetes – associations with glycaemic control. Sci Rep 9, 20063 (2019). https://doi.org/10.1038/s41598-019-56541-5

Courtney R Chang, Monique E Francois, Jonathan P Little. Restricting carbohydrates at breakfast is sufficient to reduce 24-hour exposure to postprandial hyperglycemia and improve glycemic variability. The American Journal of Clinical Nutrition, 2019; DOI: 10.1093/ajcn/nqy261

Zawn Villines, 2019, Breakfast ideas for people with type 2 diabetes, Medical News Today, <https://www.medicalnewstoday.com/articles/317067#summary>

2020, Healthy snacks, convenience meals, eating out factsheets, Baker Heart & Diabetes Institute

2015, How much do we need each day, Australian Government Department of Health, <https://www.eatforhealth.gov.au/food-essentials/how-much-do-we-need-each-day>

National Diabetes Services Scheme, 2016, Healthy meal idea, eating out, hints for healthy cooking, making healthy food choices factsheets, Diabetes Australia, <https://www.ndss.com.au/about-diabetes/resources/>