When pregnant with twins, trying to get a balanced diet with enough protein, carbohydrates, calcium and energy is important for your health and your babies’ health.

Protein

Protein helps with babies’ growth and also supports your needs when pregnant. A woman pregnant with twins needs an extra 50 grams of protein each day compared to someone pregnant with one baby. What does that look like? Those extra 50 grams would be equal to 220 grams (8 ounces) of meat or eight large eggs or about two and a half cups of cooked lentils. Keep in mind that this is on top of the usual amount needed for a pregnancy with one baby. A 60 kg (132 pound) woman would need about 66 grams per day if she’s carrying one baby or 116 grams per day for a twin pregnancy. 

Carbohydrates

Your carbohydrate needs are also higher with a twin pregnancy. You should aim for a minimum of 208 grams of carbohydrates daily to help with your babies’ development, your weight gain and to prevent ketones (a chemical you make when you don’t get enough carbohydrates). This is equal to six-and-a-half slices of whole wheat bread or four cups of rice or five cups of cooked pasta or seven-and-a-half chapatis.

Calcium

Getting enough calcium is important to help with growth, as well as maintenance of bones and teeth for you and your babies. It’s also important for helping to control blood pressure during pregnancy. All pregnant women should include three to four servings of calcium daily to meet your needs. Mix and match the calcium-rich foods you enjoy to ensure you receive enough. Each of the following is considered one serving of calcium:

• One cup of milk or fortified milk alternative (e.g. soy beverage, rice beverage, almond beverage)
• 1/3 cup of cubed pasteurized cheese
• One cup of yogurt

I’m feeling really nauseous – what are some tips for eating well?

It can be challenging to eat enough food if you are feeling nauseated or if your babies are not leaving you a lot of room in your stomach to eat. Here’s my advice to help you get enough to eat:

1. Have small, frequent meals and snacks with both carbohydrates and protein, for example:
   • Fruit and cheese
   • Greek yogurt and cereal
   • Hummus and pita
   • Sandwich with a cup of milk
   • Crackers with peanut butter
2. Include protein with every meal. Protein is found in:
   • Eggs
   • Fish – choose low mercury options like salmon, rainbow trout or sardines
   • Poultry (chicken, turkey)
   • Meat
   • Legumes/pulses (beans, lentils, chickpeas)
   • Greek yogurt
   • Cheese, cottage cheese
   • Tofu
   • Textured vegetable protein (e.g., veggie burgers, veggie dogs)
   • Nuts, nut butters (e.g. peanut butter)

We also recommend you take a prenatal vitamin each day. Discuss any other supplements with your health care provider.

What about my weight gain?

Recommended weight gain in twin pregnancies is based on your pre-pregnancy body mass index (BMI). You can calculate your pre-pregnancy BMI here.

If your pre-pregnancy BMI was between 18.5-24.9 it is recommended that you gain between 17-25 kg, or 37-54 pounds, throughout your pregnancy. If it was 25-29.9, the recommended weight gain is 14-23 kg, or 31-50 pounds. If your pre-pregnancy BMI was 30 or more weight gain of 11-19 kg, or 25-42 pounds, is recommended.

As most people with twins deliver before 40 weeks gestation, weight gain earlier in pregnancy is recommended. If you are finding it difficult to gain weight or get enough to eat, ask your care provider for a referral to a registered dietitian. 

The post Eating for three: what to eat when you’re pregnant with twins appeared first on Your Health Matters.

1. Go slowly.

Adding too much fibre too quickly into your diet can cause gas, bloating, cramping and diarrhea. Increase your fibre intake gradually by spreading out high-fibre foods throughout the day. Because fibre absorbs fluid as it passes through our digestive tract, make sure to drink plenty of fluids as you increase your fibre intake, too.

2. Start your day out right.

Start your day with a nutritious and high-fibre breakfast. Give high-fibre cereal or low-fat yogurt an extra boost by adding fresh fruit, ground flax seed or chopped nuts.

3. Choose whole-grain.

Instead of plain white flour products, choose multigrain or whole grain breads, pasta, and crackers. You’ll get more fibre bang for your buck without having to increase the amount of grain products you eat.

4. Balance your plate.

Half of your lunch or dinner plate should be filled with a variety of vegetables. Enjoying a mix of colourful yellow, orange, red and green vegetables is a great way to add fibre, and will also help you get all the different vitamins and minerals that you need.

5. Chew instead of drink.

Eat whole fruits and vegetables instead of drinking juice. If you enjoy juicing, make sure that your juicer retains the pulp in the juice so that you don’t miss out on the fibre.

6. Snack often and wisely.

Munching on high-fibre snacks between meals can help you feel satiated throughout the day, and can also help with portion control at mealtimes. Try some fresh veggies and hummus, roasted chickpeas, or apple slices with some natural almond butter as a dip.

7. Go meatless once or twice a week.

Substituting meat with legumes (beans, chickpeas, lentils) can help increase your fibre intake. Instead of ground meat, use beans, lentils and a variety of mixed vegetables in your chili or pasta sauce. You can also use legumes in soups and salads for some added fibre and protein.

8. Check the label.

Read the Nutrition Facts table and choose products that have 4 grams or more of fibre per serving (or labeled as “high source of fibre”).

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When you have cancer, there are a few reasons why you may not feel hungry. These include:

• cancer itself
• the side effects of cancer treatment
• feeling depressed or anxious
• being put off by the smells of cooking and food
• effects of medications
• digestive upset like constipation or diarrhea
• feelings of pain and fatigue

We are going to look at a few ways to help make sure that you are getting enough food and nutrition, and how to best manage cancer-related loss of appetite.

It is very important to make sure that you continue to eat and drink often to try to keep your weight the same. This will help keep you strong enough for cancer treatments. Since it can be difficult to eat when you aren’t hungry, here are three key ways to make sure you are getting enough food and nutrition into your body:

1. Getting enough protein
2. Getting enough calories
3. Making every bite and every sip count

Getting Enough Protein

Our bodies need protein to help with healing, especially when going through cancer treatments. To make sure you are getting enough protein, try to have some at each meal and snack.

Include foods like meat (chicken, beef, pork, etc), fish, eggs, tofu, nuts and seeds, dairy products, and legumes (beans, lentils, and peas).

Getting Enough Calories

One of the best ways to make sure you are getting enough nutrition is to add in extra calories. Eating small snacks or meals frequently, choosing fluids that are higher calorie and protein drink options, and choosing higher fat foods or adding fat to foods that you eat can help.

This can be done by drizzling oil over soup, putting butter or margarine on toast before adding another topping, choosing high fat dairy and adding it to congee, oatmeal, rice pudding, mashed potatoes, and making sure if having fruit or vegetables that they are dressed up with something (e.g. butter or gravy on steamed vegetables, dip fruit into high fat yogurt or nut butter).

Make Every Bite and Sip Count

With the cancer treatment, sometimes people find they are too tired to make foods and eating large meals can be challenging. Eating more frequent meals and having easy-to-eat snacks on hand are two ways to maximize how much you are eating throughout the day.

Some grab-and-go snack ideas are: prepackaged yogurts or puddings, cheese and crackers, hummus and vegetables or crackers, fruits, trail mix, nuts, mini cans of tuna or salmon.

If eating foods is difficult, another way to make sure you are getting all the calories and protein you need is to drink them. By having enough fluids, you are also keeping yourself hydrated. Remember that anything that melts into a fluid at room temperature counts too.

Some energy fluids are: milk, chocolate milk, soy milk, nutritional supplements, ice cream, popsicles, and cream-based soups.

If you have nutrition questions, speak to your nurse or oncologist who can connect you with more help. At Odette Cancer Centre, pop into the Nutrition Resource Centre to see the nutrition technician or book an appointment with a registered dietitian.

If you are experiencing other signs or symptoms, make sure to tell your nurse or doctor.

Written by Katie Brunke and Maxine Seider, dietetic interns in the Odette Cancer Centre Nutrition Program.

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But, what is fibre?

Fibre is a carbohydrate that’s only found in plant-based foods – fruits, vegetables, legumes, grains, and nuts. But unlike other carbohydrates like sugars that get absorbed into our bloodstream, fibre simply passes through our digestive tracts. Even though our bodies don’t digest fibre, we still get something out of it!

What’s the difference between soluble and insoluble fibre?

Fibre is broken down into two different types: soluble and insoluble. Each of them plays an important role in helping to prevent disease and promote good health.

Soluble fibre

Soluble fibre absorbs water and turns into a gel-like substance as it goes through our digestive systems. This helps slow digestion and softens your stool so it goes through your gastrointestinal tract more easily. But that’s not all: Soluble fibre helps to lower LDL cholesterol, triglycerides, and total cholesterol. It also helps to control your blood pressure and blood sugar levels.

Foods that are rich in soluble fibre include legumes (beans and peas), oat bran, barley, quinoa; vegetables such as artichoke, squash, broccoli, carrots; and fruits that are rich in pectin, like apples, pears, berries, and bananas. It’s also found in psyllium, a common fibre supplement.

Insoluble fibre

Insoluble fibre doesn’t absorb water or dissolve. Instead, it passes through the body in almost the original form it goes in! This added bulk (or “roughage”) helps to keep our bowels regular and prevent or relieve constipation. Insoluble fibre is found in whole-grain foods, brown rice, nuts, seeds, and colourful fruits and veggies (ones that are yellow, orange and red; or have dark leafy greens).

How much fibre do we need?

In Canada, women need 25 grams of fibre per day and men need 38 grams of fibre per day, but most Canadians only get half of that amount. Foods that contain 4 grams or more of fibre per serving are good sources of fibre.

Remember, serving sizes vary based on the foods you eat, so check out the Nutrition Facts table and review the chart below to see how your favourite foods measure up in fibre content.

Source: Canadian Nutrient File Database

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Ingredients are listed by order of weight

This means that the first ingredient weighs the most (i.e. there is more of it in the food product) and the last ingredient weighs the least (i.e. there is less of it in the product).

Choose products that have fewer ingredients

Products with longer ingredient lists are more processed, especially if many of the ingredients listed are preservatives or words that you don’t recognize. Look for products that list fewer ingredients, and ones you would normally cook with at home or eat on their own.

Identify the different names for unhealthy ingredients.

Sometimes reading the ingredients list is like reading a foreign language. Knowing how to identify different names for ingredients will help you make healthier food choices. Here are some common (and sometimes tricky) ingredients to avoid:

Trans fat

Trans fats raise your bad cholesterol (LDL) and decrease your good cholesterol (HDL). Sources of trans fat include hydrogenated and partially hydrogenated oils and shortening. Avoid products that have sources of trans fats listed anywhere on the ingredients list.

Sodium

Sodium can increase your blood pressure. Look out for the words “sodium” or “salt” – even if they’re combined with other words, like in monosodium glutamate (MSG), disodium, garlic salt. Other sources of sodium are brine and soy sauce. Avoid products that list sodium within the first five ingredients.

Sugar

Words that end in “ose” are all forms of sugar (glucose, fructose, sucrose, dextrose, etc.). Other sources of added sugar include corn syrup, molasses and honey. Under new food labelling requirements starting soon, sugars-based ingredients will be grouped together in brackets after the name “sugars”, which will make it much easier for you to identify all of the sources of sugars added to food. Sugar can increase your risk of heart disease, so avoid products that have any added sugars listed within the first five ingredients.

Use the ingredients list as a partner to the Nutrition Facts Table

The ingredients list is typically listed close to the Nutrition Facts Table on the food product. This makes it easier to compare the ingredients list and nutritional content of different products. If you see two products with identical or very similar ingredients lists, make sure to compare the Nutrition Facts Table to help you make a healthier choice.

The post What’s in my food? A guide to the ingredients list appeared first on Your Health Matters.

Don’t shy away from warm meals

While you make not feel like something hot, it actually might help to cool you off. A warm meal can make you sweat, which is our bodies’ way of lowering our temperature.

If you opt to leave the oven off and use the barbecue instead, be sure you minimize charring the meat to help prevent cancer, and follow these BBQ safety tips. You can serve the meals with fresh greens or a tomato salad.

Use your slow cooker – it won’t heat up the house the way some ovens do. If you cook, make extra so you can eat that the next day and save yourself from cooking again. You also have an option to freeze these for a later date if you have freezer space.

Eat food that feels fresh

Think green, red, yellow or orange peppers, watermelon, crispy carrots, leafy green salad. Visit your local farmers’ market for fresh produce. Check out what’s in season.

Minimize salty foods

Eating high salt foods can lead to water retention, and can result in more swelling and bloating, particularly noticeable during hot weather. Reach for foods that are lower in salt. There are a number of lower sodium choices available.

Drink lots of water 

This sounds like a cliché, but we are serious. Drink more water when the weather is hot. Not a fan? Slice a cucumber, lemon or strawberries and keep a fruit-infused water jug in the fridge. Unsweetened herbal iced teas, and even cold soups are also refreshing.

But you don’t have to stop drinking hot beverages—they can actually help your body feel cooler. 

Be mindful of caffeine and alcohol

Caffeine and alcohol are diuretics, which means they can make you pee more! More trips to the washroom mean a higher chance you’ll get dehydrated.

A cold beer tastes great on a hot day, but remember to drink responsibly: stick to the recommended daily alcohol limits and alternate with water so you stay hydrated.

And if you are drinking, make sure you’re not drinking, boating, swimming or barbecuing.

Freeze some fruit

Try frozen grapes or strawberries, or chop up some fruit and put it in your freezer. It’s super refreshing, helps with hydration and is more nutritious for you than popsicles or ice cream as there is more fibre and other nutrients from the fruit.

The post What to eat in the heat appeared first on Your Health Matters.

3 tips for better nutrition

1. Plan a menu and stick with it!

Get the whole family involved in planning healthy meals. Be sure to include your kids’ ideas to set good habits early in life.  Making a menu can help save money in groceries, reduce food waste by planning to use up leftovers, and provide a good overview of what you are eating.

2. Shop smarter

Save money on groceries by sticking to your list. Spend most of your time in the perimeter of the store (where the fresh stuff is!) Don’t go to the store hungry! Bring the kids and make shopping a family affair.

3. Sit down to eat

Studies suggest lots of benefits to sitting down and having dinner – happier kids, better food choices and chatting about your days can be great for a family. If you live alone, stopping to prepare a meal and sitting down to enjoy it can have many benefits.

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Safe menu swaps when dining out
The heart-healthy way

Try these swaps and make healthier choices

Choose:

Tomato sauces instead of creamy sauces
Leafy greens, brightly coloured veggies and vinaigrette instead of Caesar, potato or macaroni salad.
Rice or baked potato (with side toppings) instead of fries or mashed potato.
Broths or veggie soup instead of creamy soup
Fruit-based dessert or sherbet instead of cakes or pies
Water or diet pop instead of full pop or fancy dessert coffee

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Cravings on your commute? Don’t get hangry. Plan a healthy snack.

Instead of hitting a drive-thru or battling traffic with a growling tummy (which tends to make anger levels rise) enjoy a healthy snack before you set out on your way home.

7 snacks to try before your commute (not all at once)

Fresh Fruit

Yogurt

Cheese and crackers

Seed or nut bar

Whole grain granola or cereal bar

Plain popcorn

Veggies and dip

Quench Your Thirst

Before you get in the car, on the bus or start your walk home – hydrate! Staying hydrated can help you feel energized! Best picks: water. Green, black or herbal tea. Decaf latte. Don’t add sugar!

Having a healthy snack before your commute home can help you get there in a better mood and also help you avoid overeating when you walk in the door.

Source: dietitians.ca and sunnybrook.ca

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Choose lean cuts of meat, skinless poultry, fish or legumes.

Say YES to veggies!

Ask if a dish can be made lower fat. Ask for sauces, gravies and dressings on the side.

Dos:

Share a large portion, choose a half portion or take leftovers home, store safely and enjoy for lunch tomorrow.

Don’t starve yourself before you go out. Have a healthy snack before you go and you’ll be less likely to overeat.

Don’ts:

Don’t pick menu items described as buttery, buttered, sauteed, fried, crispy, creamed, cheesy, scalloped.

Don’t fill up on pre-meal bread!

Don’t add high-fat things to salads (bye bye bacon and croutons)

Remember – if you have a treat every day, it’s no longer a treat. It’s a habit!
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