You are what you eat

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One of the perks of maximum health (the green level, if you're using the stoplight plan) is eating all the foods you want with the exception of those few that are definite irritants. If you don't feel good very often, it's easy to go overboard when you're well. Keeping some basic nutrition in mind and eating as much variety as possible all of the time can help you maintain the balance between staying healthy and getting sick.

Tips for healthy eating:

The USDA food pyramid is a basic outline of what and how much to eat for general, balanced nutrition. In summary, the food pyramid tells you to:

• Choose a diet rich in whole grains, fruits and vegetables.

• Choose a moderate amount of dairy, lean proteins (fish, poultry, legumes and lean-cut meats) and nuts.

• Eat the least amount of fats, oils and sweets.

• Eat foods with Omega-3 fatty acids, which some studies have found reduce inflammation. Add small amounts of flaxseed oil, canola oil and up to three servings per week of fish such as herring, kipper, mackerel, menhaden, pilchard, salmon, sardines and trout. Choose natural sources over supplements as they are more easily digested.

Add some simple rules:

• Limit saturated or trans-fats and refined sugars as they provide empty calories or calories without nutrition.

• Eat fiber as tolerated when you are well. Fiber can reduce the risk of colon cancer and helps keep you regular. High-fiber foods like whole grains, fruits and vegetables also are good sources of vitamins and minerals.

• Eat many different types of natural foods to get the largest array of nutrients.

• Don’t completely eliminate food groups. If you can’t eat dairy products, find lactose-free dairy products (like Lactaid® milk) or soy products. If you’re bothered by high-fiber fruits and vegetables, choose lower-fiber options and peel or cook them.

• Stay hydrated with lots of fluids such as water, milk and juices. Drink fewer caffeinated drinks and alcohol, which are diuretics that cause more frequent urination.

• Take a complete multivitamin or a women’s vitamin if you’re female (it should have more calcium, zinc and iron). Watch for lactose in some vitamins if you’re intolerant.

• If you have problems with weight loss (as in you're losing too much weight), include more nutrient-dense foods as needed. Check out the high-calorie diet for food options.

• Yogurt with active cultures helps some people in improving digestion and balancing gut bacteria.

• If you're female, you need more calcium and iron than a guy. If you're a guy and losing lots of blood or are on steroids, you also need more calcium and iron. Here's how to get more of both:

  • Choose foods that contain calcium, such as dairy or soy products; calcium-fortified juices; dark, leafy green vegetables; and broccoli.

  • Include iron -- especially if you're anemic or losing lots of blood -- in your diet by choosing meats, seafood and poultry, which contain the most easily absorbed form. You also should include iron-fortified cereals; dark, leafy green vegetables; whole grains; and legumes. These choices contain iron, which is better absorbed when eaten with vitamin C.

Special diets

Your doctor may suggest a special diet based on the symptoms you’re experiencing. List these in your stoplight plan.

Here is some information on the following diets:

Low-fiber diet

Liquid diet

Lactose-free diet

High-calorie diet

Low-fiber diet

When you're going through a medium level of health (yellow on the stoplight plan), you might have looser or more frequent bowel movements (BMs). Eating less fiber can help you feel better by reducing your BMs without sacrificing nutrition. Adjust your fiber intake according to your stool volume and frequency. Keep in mind that fiber is good for you, and this kind of diet should be used temporarily only to help lessen your symptoms.

What to do when you’re looking for low fiber:

• On nutrition labels, look for two or fewer grams of dietary fiber per serving.

• Replace whole grains with refined grains (such as white instead of wheat).

• Remove legumes and beans and eat smooth, not crunchy, nut butters.

• Remove dairy and substitute lactose-free or soy products if you have any lactose-intolerance.

• Eat vegetables and fruits cooked, canned or juiced.

• Eat melons and bananas, and peeled nectarines, peaches or apricots raw or cooked.

• Avoid pears, dried fruits, prunes, rhubarb, berries, corn (popped or not) and raw or cooked coconut.

• Continue with meats, poultry, eggs and seafood.

Extra tips to reduce bowel movements:

• Consume less caffeine (including chocolate) and other stimulants, which activate your colon.

• Avoid spicy foods because they can irritate your insides when you have a lot of inflammation.

• Eat fewer fats and oils (i.e., no fried or greasy foods).

Liquid diet

Use a liquid diet if you simply can’t tolerate any foods or as a supplement if your appetite is low. If you’re at the point that you need a liquid diet, you should see your doctor.

The choices below can take the place of solid foods as much as you need them to, and you should find them in your local grocery or drugstore. Referenced Web sites provide nutritional information and easy recipes.

• Carnation Instant Breakfast® (a good cheap option; not for the lactose-intolerant)

• Ensure®

• Boost®

• Modulen

• Choice DM® (if you’re diabetic or have steroid-induced insulin resistance)

Lactose-free diet

No milk, no ice cream, no cheese and no yogurt? Not necessarily. Lactose intolerance is caused by the absence of the lactase enzyme, which breaks down the milk sugar lactose and varies greatly from person to person. Some people consume all dairy products except milk in its liquid form, while others are irritated by cheeses and cultured yogurt, the products in which most of the lactose already is broken down.

How do you find out where you fit? If you think lactose bothers you (it gives you gas, diarrhea and/or cramping), test your tolerance in clear stages by introducing one new food or drink every few weeks to see how your body reacts. Go slowly and begin with yogurt with live-cultures and lactose-free dairy (such as Lactaid®) and then move to less commonly tolerated foods such as soft cheeses and eventually full-lactose dairy if you've not yet experienced discomfort.
 

High-calorie diet

A good high-calorie diet condenses more calories and nutrients into your normal food volume. It’s not about overeating. If you need to gain pounds or are suffering from a loss of appetite and don’t want to sacrifice your nutrition, follow these guidelines:

• Eat small, frequent meals incorporating these unsaturated fats and nutrient-dense foods:

  • Nuts and nut butters

  • Olive oil

  • Avocado

  • Dried fruit

  • Granola

  • Bananas

• Meal supplements are useful as they’re high in nutrition and calories and can be mixed into solid foods. Try any of the suggestions in the liquid diet section.

• If you have no appetite, eat on a regular schedule even if you aren’t hungry and stay hydrated. Drinking sports drinks like Gatorade® or Powerade® can help — especially if you have diarrhea or are vomiting — as they hydrate you and help maintain the balance of electrolytes (elements like sodium and potassium, which are essential to body function).

To learn more about the amounts of fiber in food, visit http://www.wehealnewyork.org/healthinfo/dietaryfiber/fibercontentchart.html.

If you want a progressively fiber-free diet, start by peeling raw fruits and avoiding salads and beans, then taking out whole grains and finally moving to cooked and canned fruits and vegetables as needed. Remember -- you don’t have to go all out at the first sign of a loose stool.

© 2005 Texas Children's Hospital
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