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two scrumptious salads on a farm-style table

Self Care

Nutrition

A healthy diet and weight have many benefits for patients with PASC by reducing

  • Depressive symptoms
  • Sleep problems
  • Fatigue
  • Pain
  • Declines in brain function and memory

Filling Your Plate with a Healthy Diet

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Based on many years of studies the United States Department of Agriculture (USDA) has defined what makes up a healthy diet.

How to Fill Your Plate with A Healthy Diet

Food Group How Much Per Meal
Fruits and vegetables 50% of every meal
Whole grains 25% of every meal
Legumes & animal proteins 25% of every meal
Water Primary beverage
Nuts Small handful daily
Oils/fats Use healthy oils like olive oil for cooking and do not eat trans fat
Salt 2,500 mg daily (1 teaspoon)

Diagram of a healthy eating plate

Here are some general healthy diet guidelines:

Incorporate these foods into your diet as much as possible:

  • Fruits
  • Vegetables
  • Whole Grains (e.g., brown rice, oatmeal)
  • Nuts
  • Seeds
  • Seafood
  • Legumes (e.g., black beans, garbanzo beans, and lentils) Healthy oils and fats from vegetables and fish (e.g., olive oil, omega-3 fatty acids)

Check the ingredients in your food and reduce or avoid:

  • Salt
  • Red or processed meat (e.g., bacon and luncheon meat)
  • Foods that include added sugars (e.g., sucrose, maltose, cane syrup, molasses, cane sugar, corn sweetener, raw sugar, syrup, honey, or fruit juice concentrates)
  • Coconut oil and animal fats like butter

Calculate Your BMI to Inform Your Health Risk

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BMI Calculator

Units

The calculated BMI is:

(Very low body fat)

(Low body fat)

(Medium body fat)

(High body fat)

(Very high body fat)

If you have a BMI that indicates a low, high, very high body fat % then you may want to consider talking to your doctor and making changes to your diet. The amount a person eats is one of the most important factors in how much a person weighs, even more so than exercise.

BMI should be used as a guide but is not the only indicator of who is healthy - BMI is good for indicating body fat percentage, although there are limitations. For example:

  • Women generally have a higher body fat % compared to men at the same BMI.
  • People who are Black or African American tend to have lower body fat % compared to those who are White at the same BMI.
  • People who are Asian tend to have higher body fat % than Whites at the same BMI.
  • Age also plays a role. Younger adults generally have a lower body fat % compared to older adults at the same BMI.
  • Having high lean body mass, including muscle and bone, can result in a higher BMI, although athletes and other individuals with high lean generally have less body fat compared to non-athletes at the same BMI.

How Can I Afford a Healthy Diet?

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Many people have a hard time paying for enough food to feed themselves and their families. Do you need assistance having enough money to buy groceries and add high quality food such as vegetables, fruits, nuts, and fish? Review the following resources below that can increase your access to healthy foods and help you save money at the grocery store.

Resources for Healthy Eating on a Budget:

  • The Supplemental Nutrition Assistance Program (SNAP): This program provides food assistance to eligible low-income individuals and families via an electronic benefits card. To apply, contact the DHS in the state in which you currently live. To learn more about eligibility related to resource and income limits, click here.
  • The Women, Infants and Children Program (WIC): Provides supplemental nutrition support for low-income pregnant, breastfeeding, non-breastfeeding postpartum women, infants, and children up to five years of age who are at nutritional risk. To determine if you are eligible and to apply for benefits visit - https://www.fns.usda.gov/wic
  • Feeding America: This organization has a mobile food pantry program that can be accessed by anyone. With this program, a truckload of food is distributed to clients in pre-packed boxes or through a farmers’ market-style distribution where clients choose to take what they need. Not all Feeding America food banks operate the Mobile Pantry program; contact your local food bank here and find out what it is doing in your community.
  • The United Way: This program is dependent on the county but offers assistance with locating neighborhood food pantries. Learn more here.
  • Meals on Wheels: Some Meals on Wheels programs have restrictions based on age, income, or homebound status. Click here to find a Meals on Wheels provider near you.
  • Needymeds.org: This website provides a national database of low-cost medical, dental, and vision clinics as well as transportation services by state. Needymeds.org also provides applications for free or discounted medication through the respective pharmaceutical companies.
  • 211 Helpline Center: 211 works a bit like 911. Calls to 211 are routed by the local telephone company to a local or regional calling center. The 211 center’s referral specialists match the callers’ needs to available resources and refer them directly to an agency or organization that can help. 211 covers all 50 states, the District of Columbia, and Puerto Rico. Referrals offered by 211 include basic human needs (food pantries, rental assistance, etc.), physical/mental health (health insurance, Medicaid, Medicare, etc.), work support (financial assistance, job training, etc.), and several others. To find out whether 211 services are offered in your area and to obtain more information, visit 211.org.

How to Save Money at the Grocery Store:

  • Ask about discounts. Ask your local grocery stores if they have a senior discount or a loyalty or discount card. Besides getting items at a lower price, you may also get store coupons.
  • Use coupons when you can. Coupons are only helpful if they are for items you need. Also, at times other brands will cost less than using a coupon.
  • Consider store brands because they usually cost less. These products are made under a special label, sometimes with the store name. You might have to look on shelves that are higher or lower than eye level to find them.
  • Be aware that convenience costs more. You can often save money if you are willing to do a little work. For example, buy whole chickens and cut them into parts, shred or grate your own cheese, and avoid instant rice or instant oatmeal. Bagged salad mixes cost more and may spoil before a head of lettuce.
  • Look at unit prices. Those small stickers on the shelves tell you the price but also the unit price – how much the item costs per ounce or per pound. Compare unit prices to see which brand is the best value.
  • Try to buy in bulk, but only buy a size you can use before it goes bad. If you buy meat in bulk, decide what you need to use that day and freeze the rest in portion-sized packages right away.
  • Focus on economical fruits and vegetables like bananas, apples, oranges, cabbage, sweet potatoes, dark-green leafy vegetables, green peppers, and regular carrots. Frozen fruits and vegetables have the same nutritional content as fresh foods and are often cheaper. Another option is canned fruits and vegetables—however, avoid canned foods with added salt or sugars.
  • Think about the foods you throw away. For less waste, buy or cook only what you need.
  • Resist temptations at the check-out. Those snack foods and candy are put there for impulse buying. Save money and avoid empty calories!

Understand and Use the Nutrition Facts Label

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The first step to eating nutritious foods is being able to tell if a food is good or bad for your health. The easiest way to do this is by reading the nutrition labels on food items. Important things to look for when reading food labels are serving size, calories, nutrients, and daily value percentages.

Review the figure below to get started.

Diagram annotating a nutrition facts label

Calories are important when reading a food label, as they tell you how much energy that specific food or drink will give you. Generally, it’s recommended that people consume 2,000 calories per day, but this value varies from person to person depending on your age, gender, and activity level. It is important to consume the correct number of calories for your body, as there are health consequences for consuming too few or too many calories. When looking at calories, remember that the number of calories represents how many calories are in one serving, so if you are eating two servings you are consuming double the number of calories.

Nutrients on the label generally include carbohydrates, proteins, fats, sodium, cholesterol, vitamins, and minerals. When choosing what foods to eat, you should look for foods with more of the nutrients that are healthy and less of the nutrients that you want to limit. Sodium, added sugars, saturated fat, and trans-fat are all nutrients that may contribute to adverse health effects, so these should be limited whenever possible. On the other hand, nutrients to get more of include fiber, vitamins, and minerals. These nutrients are known to improve overall health and may help prevent certain health conditions, like osteoporosis and anemia, making them an important part of eating a healthy diet.

Daily value percentages (%DV): Most nutrients on food labels will have a percentage next to them, telling you what percent of the recommended daily amount of that nutrient is contained in one serving of the food or drink. This is helpful in determining whether there is a high or low amount of each nutrient in one serving. The general rule for a food or drink being low in a nutrient is a daily value less than 5%, and the rule for a food or drink being high in a nutrient is a daily value above 20%.

Serving sizes refer to the amount of food or drink that people typically consume. All nutrients included on the label are measured by how much is in one serving. To know how much of these nutrients you are getting, you should compare how much of the food or drink you consumed to the serving size. For example, if you eat two servings of a food, then you are getting double the nutrients on the food label.

The figure below shows you how to use your hand to calculate serving sizes.

Figure showing how to use your hand to calculate serving sizes

What about Special Diets and Allergies?

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  1. Do I need to eat a special diet such as ketogenic, Mediterranean, or Paleolithic to have a healthy diet? Focus first on eating a healthy and balanced diet. Studies have shown that people can eat a variety of diets and be healthy. There is no single diet recommended for managing PASC symptoms.
  2. What about food allergies and intolerances to foods such as dairy or gluten and their impact on chronic pain? Some people may have unique or allergic reactions to certain foods and nutrients. If you choose to cut foods out of your diet, just make sure you are also eating a wide variety of healthy foods.
  3. What about anti-inflammatory diets? A healthy diet with a wide variety of foods will help your body make anti-inflammatory chemicals. Your diet will be naturally anti-inflammatory if you eat:
  • Berries (fresh or frozen)
  • Vegetables like kale or broccoli (fresh or frozen)
  • Whole grains without added sugars or sweeteners
  • Foods rich in healthy fats like nuts, seeds, and salmon or other fatty fish

A Video on the Benefits of Eating a Nutritious Diet

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[insert video on nutrition -get revised copy from Michigan Media]

Further Reading and Other Resources

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Healthy Recipe Resources:

  • Harvard University Nutrition Source: Recipes
  • OldWays: Traditional Diets: Recipes
  • American Institute for Cancer Research: Recipes

Resources if Your Goals Include Weight Loss:

Mobile Food Tracker Apps:

There are several apps available for iPhone and Android that can support your nutrition and caloric goals. Many can be downloaded for free or a small fee. Some examples include:

Other Resources:

References:

  1. Grimstvedt ME, Woolf K, Milliron BJ, Manore MM. Lower Healthy Eating Index-2005 dietary quality scores in older women with rheumatoid arthritis v. healthy controls. Public Health Nutr. 2010;13(8):1170-1177.
  2. Berube LT, Kiely M, Yazici Y, Woolf K. Diet quality of individuals with rheumatoid arthritis using the Healthy Eating Index (HEI)-2010. Nutr Health. 2017;23(1):17-24.
  3. Barebring L, Winkvist A, Gjertsson I, Lindqvist HM. Poor Dietary Quality Is Associated with Increased Inflammation in Swedish Patients with Rheumatoid Arthritis. Nutrients. 2018;10(10).
  4. Fitzgerald KC, Tyry T, Salter A, et al. Diet quality is associated with disability and symptom severity in multiple sclerosis. Neurology. 2018;90(1):e1-e11.
  5. Perry MC, Straker LM, Oddy WH, O'Sullivan PB, Smith AJ. Spinal pain and nutrition in adolescents–an exploratory cross-sectional study. BMC Musculoskelet Disord. 2010;11:138.
  6. O'Loughlin I, Newton-John TRO. 'Dis-comfort eating': An investigation into the use of food as a coping strategy for the management of chronic pain. Appetite. 2019;140:288-297.

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