Nutrition

By Susanne Pettit-Crossman

(In Part One of this series, we looked at the basics of good nutrition for Canadians with and without disabilities. This time,we will address the issues of weight control and dieting.)

Just like proper nutrition, being overweight is not an exclusive state of being. You can be fat whether or not you have a disability.

Over the last few decades, Canadians have become preoccupied with weight and body image. Billions of dollars are spent each year on losing weight. On an average day we spend $1,095,890 on weight loss clinics and on the special food products they sell. Canadians buy $273,973 worth of other specialty foods in that same day. Weight loss programs are seldom successful, and weight remains a problem for many. Yet, on an average day, 28,493 Canadians begina new diet or weight loss program. This relentless and unrealistic pursuit of thinness in our society is taking its toll on the physical and mental health of those who struggle with weight in unhealthy ways.

Certainly, how we feel about our weight is an important component in how we feel generally about ourselves. Maintaining an acceptable body weight is a plus in how others view us, too. Our weight is more about overall well-being, and not just whether we are too fat or too thin. This is particularly true when it comes to those of us with disabilities. Dealing with the day-to-day issues of our disability can be difficult at times, without adding a weight problem to the agenda. Unfortunately, sometimes the disability we live with can predispose us to a weight problem.

What is often exclusive to a person with a disability in this ongoing battle of fat-fighting is the exercise and mobility component in the total equation of weight control. More often than not for people with disabilities, we simply cannot get enough exercise, if any at all.

So, with that in mind, let’s focus on controlling and maintaining good weight status with caloric intake when caloric output is limited.

To begin with, let’s shift the current focus of body weight to a more positive approach: health --eating well, being active and feeling good about ourselves. We should view our own weight and the weight of others more realistically by positioning body weight within a range of healthy weights, rather than striving for the "ideal" weight. There really isn’t one. Healthy bodies come in a variety of shapes and sizes. Weight naturally varies due to body shapes and builds, height, sex, age, activity level and other physical factors including pregnancy, illness and even disabilities.

The key component to weight control is not the diet, rather the ability to make a psychological, social and cultural shift in our "lifestyle."

Let’s face it. Some diets do help you lose weight; however, they don’t teach you to eat properly. They merely restrict your food intake on a temporary basis. So, when the diet is over, so is your weight loss. True determination is necessary, as is an understanding of the importance of lifestyle modification.

There really is no need to deprive yourself of the foods you love in order to lose weight. Times have changed from the days when not eating was the only way. Current thinking leans more towards personalizing your meals and food intake, which will allow you to choose and enjoy any of your favourite foods.
A successful weight control program consists of several components:

- Realistic goals for overall loss and rate of loss
- Calories lowered according to need: Calories must be lowered in relation to expenditure levels to effect a gradual weight loss. Usually, one to two pounds per week is recommended.
- Nutritional adequacy: The diet must be nutritionally adequate. Lower caloric levels may need supplementation. A weight loss program should follow the general outline of Canada’s food guide: high in complex carbohydrates (fruits, vegetables, pasta, bread and cereals), reduced in proteins (meat, fish and milk products), and low in fatty substances (oil and butter).
- Culturally desirable: The food plan must be enough like the cultural eating pattern of the individual to form the basis for permanent re-education of eating habits. In other words, an individual must be able to live with it.
- Calorie readjustment: To maintain the desired weight level once it has been achieved, calories should be readjusted accordingly. Once you have achieved your weight loss goal, you need to learn how to maintain it. Why lose weight, only to gain it back?

Now that some goals for a weight control program have been established, let’s apply these to an action plan.

The most important thing in a program for weight control is to be realistic with yourself, and that includes the short-and long-term goals of your diet.

Ask yourself some questions:

- What foods do you love/hate?
- Which of these are good/bad for you? For example, do you crave potato chips and snack foods high in salt and fat, or are you more the veggie-and-pasta type?
- What is your usual daily eating pattern? Do you eat breakfast? Snack a lot? Skip meals altogether? Do you often eat out or order in?
- What kind of physical exercise do you get each day? If you use a wheelchair, is it electric, or do you "work out" when mobile? If you try to get some exercise, what kind (e.g. cardiovascular) is it?
- What is your "ideal" image for yourself?
- What is your current weight? What weight have you been at the most consistently? What weight would you like to be? Are you gaining/maintaining/losing weight with your current lifestyle?

Once you have answered these questions honestly, you are better equipped to embark on a weight control program. But keep reminding yourself that these answers and goals are yours, and yours alone. Do not compare yourself with anyone else’s successes or failures. Usually, if people are really honest with themselves, they will know where they are failing when it comes to diet and calorie control.

Let’s move on to calories -- culprits and otherwise. In Part One of this series, we reviewed the basics of a good, healthy diet. Included in that article were tips on reducing fats, sugars and salt, and being conscious of "other" foods. These are all the food substances that can be the calorie culprits in a diet program. It doesn’t mean you can’t eat them at all, but they should be incorporated with caution.

As far as basic calorie counting goes, here are some guidelines:
- 1 cup homogenized milk has 170 calories;
- 1 slice of bread has 70 calories;
- 1 ounce of meat has 75 calories; but
- 1 teaspoon of fat (butter/margarine) has 45 calories!
- Most vegetables are considered "free" foods; one-cup servings of beets, carrots or peas, for example, each have 35 calories. Fruit is similar; a medium-size apple has 40 calories.
- As a comparison, did you know that one ounce of liquor equals one regular beer which equals three ounces of wine? And each of those equals 110 calories!
- Did you also know that 12 "light" potato chips have 108 calories?

An average Canadian diet can range from 1,000 to 3,000 calories per day. The daily intake of most adults with average exercise regimens is about 2,000 calories per day.

To figure out your ideal intake, list the foods you are currently including in your daily diet. Total your intake (calorie charts are available through many sources) or consult a professional to help you get started. Once you know what you are consuming, then you can begin to eliminate or reduce foods and patterns which are causing you to gain weight. It’s that simple!

Just a few other pointers:
- Don’t become an obsessive calorie-counter. Simply become familiar with the foods in your diet and know where to cut back or substitute to achieve your goals.
- Anticipate plateaus. They happen to everyone.
- Don’t become discouraged when you break down and "binge." This, too, happens to most people. And don’t forget to plan ahead for special occasions like Christmas -- then you won’t be upset with yourself.

One final pointer when it comes to dieting and foods: Learn to read labels on foods and understand what they mean. For example:
- Calorie-reduced -- means it contains 50 per cent fewer calories than the same food when not calorie-reduced; it’s suitable for dietary use.
- Low-calorie -- means it is calorie-reduced and contains 15 calories or less per serving.
- Calorie-free -- means it contains no more than one calorie per 100 grams.
- Low in fat -- means it has no more than three grams of fat per serving.
- Fat-free -- means it has no more than 0.1 gram of fat per 100 grams.
- Light or Lite -- is a popular claim. If it is on a label, read further to find out what feature of the product is "light." The word could be describing a food that is reduced in fat and calories, but not always. Sometimes, it describes the taste or texture of the food.

Finally, in a diet program, we come back to the other half of the equation, which is caloric output, or exercise. Research has proven that a little physical activity accelerates your metabolism, helping to reduce fat and improving your cardiovascular system. Once again, set realistic goals for yourself when it comes to activity, exercise tolerance and ability. If you use a wheelchair and have good upper body movement, why not try some weights, or wheeling yourself to work? A simple routine with a mixture of daily physical or recreational activities is important. Being active means making physical activity a part of your everyday life. It helps you manage your weight and strengthen your heart, lungs and muscles. Find fun ways to be active in your own way!

Once we have established a healthier self image and body image, we will automatically have a stronger sense of ourselves and consequently have more control over our lives. We will learn to like, accept and respect ourselves at a weight that is realistic.

Feeling good about yourself means believing in yourself. The best way to do that is to accept who you are and how you look. So treat yourself well!

(Contributing columnist Susanne Pettit-Crossman is the host of CBC’s Disability Network. Susanne has a nutrition degree from Ryerson Polytechnic University and is a dietitian. She did her internship at Sunnybrook Medical Centre. Susanne manages special dietary needs for both diabetes and cystic fibrosis. She is also an avid gourmet cook and has appeared in T.V. Guide’s Celebrity Chef feature.)