All medications can have potential side effects. For patients taking a certain class of antidepressants known as Monoamine Oxidase Inhibitors (MAOIs), a dangerous spike in blood pressure can happen if they eat foods that are high in a substance called tyramine. Tyramine is an amino acid that is found naturally in many foods are that fermented, says Sunnybrook registered dietitian Karen Fung. Now, a new Sunnybrook recipe book is providing these patients with a safe roadmap through the kitchen.

The MAOI Diet Recipe Book is a collaborative project that Karen worked on with a team of experts at Sunnybrook, led by psychiatrist Dr. Ken Shulman. Importantly, it was also driven by a patient living with depression, Connie Reed.  Here, Connie and Karen share their thoughts on this unique resource and the impact it will have on patients worldwide.

Connie

I’ve been living with depression for the past fifteen years. Taking MAOIs has helped improve my quality of life greatly, making it much more enjoyable. Before I was prescribed these drugs, my doctor explained the importance of following an MAOI diet. There just weren’t many resources available on the subject.

During the pandemic, my friend Carol and I worked together sorting through a variety of recipes and adjusting them to MAOI diet requirements. Carol is very close to me and enjoys making meals for me but they have to be adjusted. For example, when making macaroni and cheese, we used a type of cheese that doesn’t contain tyramine. Carol and her husband taste-tested each recipe we worked on.

Karen

Having Connie and Carol’s input was integral to putting this recipe book together. It’s backed by leading Sunnybrook research and it also comes from an actual patient’s experience. Connie and Carol developed a lot of these recipes and provided many cooking tips. It’s easy for anyone to use and understand.

Dr. Shulman’s research has shown the use of MAOIs has declined significantly over the past 10 years, partly due to other medications being available. But many clinicians also avoid prescribing MAOIs because of this interaction with diet, and they may not be confident in what resources are available for patients to tap into. This is a concern as MAOIs represent the best option for some patients with treatment-resistant depression. As Dr. Shulman has noted, this recipe book is a huge step forward in providing research-based recommendations.

The book is easy to navigate and provides some important background and context. Tyramine is an amino acid that is found in various foods, but in much higher concentrations in foods that are aged or fermented. Some common foods that are high in tyramine include aged cheese, air dried sausages, kimchi, miso, sauerkraut and beer on tap.

On the flip side, the safe foods to eat while taking these MAOIs are all low in tyramine, which include fresh products. So fresh meat, fresh produce and fresh dairy products, like ricotta and feta cheese. Red wine is also safe for patients taking MAOIs.

Connie

As a patient, this recipe book has made me even more aware of the importance of the MAOI diet. It’s so helpful because it provides accessible information for patients as well as friends and families of people on the diet. If they want to cook a meal, they have a huge selection of safe recipes to choose from. In fact, it’s dedicated to the families and friends of those of us on MAOI medications, and their loving efforts to prepare delicious meals that are safe for us to enjoy.

Karen

Because there are so many myths and misconceptions out there, it’s important to rely on the experts to get recommendations, especially when people want to use this on an individual basis. From vegetarian options to hearty mains and salads to desserts, there really is something for everyone to enjoy.

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February is Heart Month, and one way to care for your heart is by eating well. Dr. Rahul Jain, Family Physician at Sunnybrook, and Karen Fung, Registered Dietitian at Sunnybrook, share some ways individuals and families can incorporate heart-healthy eating habits into everyday life.

Have fun with cooking

Dr. Jain says one way to encourage Canadians to stick to their healthy eating goals is to remind them that eating nutritious foods doesn’t have to mean bland, boring meals. That’s why the Canadian Cardiovascular Harmonized National Guideline Endeavour (C-CHANGE), of which Dr. Jain is the co-chair, collaborated with a professional chef from Switzerland, Jaroslav Guzanic, to create a teaching video on how to prepare a delicious, heart-healthy meal (according to Canadian nutrition guidelines). In the video— which you can watch above— Jaroslav prepares a vegetarian version of the Moroccan dish tagine.

“The teaching video aligns with Canadian nutrition guidelines on best practices to prevent and manage cardiovascular disease,” says Dr. Jain. “But it’s about having fun with the food as well. And to pick up culinary skills. [Cooking] can be a fun activity.”

Dr. Jain and Karen say there are some key things Canadians can do to make meals more heart-healthy:

Look for polyunsaturated fats 

One recommendation for heart-healthy eating is for Canadians to reduce the amount of saturated fats they eat and instead opt for unsaturated fats, which include poly- and mono-unsaturated fats.

“Vegetable oils are excellent: sesame, avocado, sunflower seed oil, canola oil, olive oil,” Karen says. “The exception is coconut, which is high in saturated fats.”

Olive oil is likely the most accessible, but some people might be hesitant to cook with it: Karen says not to worry about that.

“The common misconception is that we can’t cook with olive oil, but we can. We just can’t use it at very high heats like barbecuing,” she says. “If you’re making a stir-fry or frying an egg, you can totally use olive oil.”

In addition, nut, seeds and nut/seed butters as well as avocados are sources of unsaturated fats. For Omega-3 fats, people can eat fish such as salmon, rainbow trout, mackerel. Most white fish does not have significant amounts of Omega-3. Karen recommends fresh, not canned or cured versions.

Up the fibre

“There’s a small percentage of Canadians who meet the fibre requirement on a daily basis,” says Karen. The daily recommendation for fibre intake is at least 25 grams for women and 30 grams for men. Karen says Canadians may benefit from focusing on increasing the amount of soluble fibre in their meals because it’s often overlooked.

Soluble fibre is beneficial for heart health, Karen says, and it can be found in whole grains, oats, barley, lentils, chickpeas and beans. The fibre typically found in fruits and vegetables is known as insoluble fibre.

“We know about fruits and vegetables being a fibre source, but we forget about whole grains and legumes possibly being an even better fibre source,” she says. “Because of the low-carbohydrate fads and trends, people have shied away from whole grains and legumes.”

Both are important, but think about upping the amount of soluble fibre specifically.

Watch the sodium

Hypertension Canada recommends Canadians eat less than 2000 mg of sodium per day, which is equal to one teaspoon of salt. Currently, the average Canadian consumes closer to 2800 mg of sodium per day. Too much sodium increases the risk of high blood pressure, which increases the risk of heart disease and stroke.

Dr. Jain says about one in four Canadian adults have high blood pressure, and about 30 per cent of those cases are related to high sodium in the diet.

“Salt attracts and draws water, and if you have more retention of fluid, you have increased blood volume and that results in increased blood pressure,” says Dr. Jain.

Karen says one of the easiest ways to reduce sodium intake is to cook meals at home and limit the use of processed and canned foods such as frozen dinners or canned soups.

“Replace [salt] with other herbs and spices,” says Dr. Jain, adding the cooking video with Jaroslav is a great example of how to use spices and herbs to create flavour without using as much salt. “For example, adding basil and oregano to soups and pasta, or garam masala and cumin to lentil dishes or stews.”

Progress, not perfection

Making small changes will add up, says Karen, so don’t feel as though you have to make sweeping changes to your eating habits immediately.

“It’s about the big picture,” she says.

These are general guidelines, suitable for most Canadians to prevent heart disease, but Dr. Jain says for individuals who have chronic conditions such as diabetes, high blood pressure or heart failure, it’s important to speak with your family physician or a dietitian because they can provide specific recommendations for your situation and needs.

The post How to cook (and eat) with heart health in mind appeared first on Your Health Matters.

Watch the archived webcast video above, and then test your knowledge below by taking our short quiz.

Learn more about upcoming Speaker Series events »

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Drinking enough fluids keeps you hydrated and prevents dehydration. Fluids help your body:

• Digest food and carry nutrients throughout your body
• Get rid of waste and flush out medications (including chemotherapy)
• Keep a normal blood pressure and body temperature
• Protect your organs and joints

Unless told otherwise by your doctor, people with and without cancer should aim for 9 to 12 cups of fluid each day.

It’s important to talk about what to drink because the type of fluids you choose can help you meet your protein and calorie needs. Fluids range in their nutrition content. Some fluids, like water, have no calories or protein, whereas others, like milk or soy milk, have lots. Choosing the right fluids can help you get the right amount of nutrition, depending on your needs.

When you have cancer, getting enough fluid, protein, and calories is an important part of your treatment and healing. If you have lost weight, have problems eating, or have questions about your nutrition, please speak with a registered dietitian. (Patients at the Odette Cancer Centre can stop by or call the Nutrition Resource centre to book an appointment.)

As a registered dietitian in the patient education program at Sunnybrook’s Odette Cancer Centre, I get many questions about what to drink. I answer some of the most common ones below.

As a person with cancer, why is what I drink especially important?

If you have cancer, choosing the right fluids is one of the easiest ways to add more protein and calories to your diet. Side effects from cancer and treatment can make it hard to eat enough. If you find swallowing painful or have a poor appetite, nutritious fluids like soups and smoothies pack a lot of nutrition into each sip and go down easier than a meal. This is important, because getting enough protein and calories can help you:

• Maintain your weight and muscle mass
• Keep your strength and energy
• Cope with treatment-related side effects
• Reduce your risk of infection
• Heal and recover faster

Swapping out low-nutrient fluids for high-nutrient alternatives can make a big difference. If you drink 1 cup of water in the morning but switch to 1 cup of milk, that’s an extra 9 grams of protein and 130 calories added to your day!

Are there any types of fluids I should drink lots of?

If you have lost weight, have problems eating, or need more protein in your diet, drink lots of fluids that are high in protein and calories. Choosing higher fat dairy products, like homogenized milk or cream, can also help you get more calories in each sip.

Examples of high protein and high calorie fluids include:

• Cow, soy, or pea milk
• Smoothies with added protein
• Soups made with cream, meat, fish, poultry, or legumes (dried beans, peas, or lentils)
• Yogurt drinks
• Nutrition supplement drinks like Boost, Ensure, Scandishake, or generic store brands

If your weight is stable, you have a good appetite, and you are eating enough protein, choose low-calorie fluids more often, like:

• Water
• Tea and coffee
• Broth

Are there any types of fluids that should be avoided?

If you have side effects from treatment, avoiding certain fluids might help. If you have diarrhea, for example, sugary drinks like juice or pop can make it worse. If you feel nauseous, high-fat fluids like cream soups might not be appealing. If you have pain when swallowing, avoid fluids with acidic or spicy ingredients, like lemon or cayenne pepper. Speak to a dietitian for more tips on how to manage side effects that are impacting your eating or drinking.

It’s also recommended to limit your caffeine intake to 400 mg each day, to prevent side effects like difficulty sleeping, headaches, and nervousness. That is equal to about 3 cups of coffee.

Finally, the World Cancer Research Fund and American Institute for Cancer Research recommends avoiding alcohol before and after a cancer diagnosis. If you do choose to drink alcohol, drink in moderation – that’s one drink per day for women and no more than two drinks per day for men. One drink is 12 oz. of beer, 5 oz. of wine, or 1.5 oz. of spirits. 

I’m having trouble eating…can what I drink help?

Absolutely! Some people, especially those with head and neck cancer, often only drink fluids throughout their treatment. It is possible to meet all of your nutrition needs this way, as long as you choose your fluids wisely. Smoothies and soups with added protein and nutrition supplement drinks can easily replace a meal or snack.

I’m having trouble even drinking – what should I do?

Most cancer centres have a registered dietitian who can help. Tell your care team about your difficulty with eating and drinking, and ask how to meet with the dietitian.

In the meantime, if you’re having trouble drinking because you don’t feel hungry, try taking small sips throughout the day and choose only high protein, high calorie fluids. Stir in protein or skim milk powder to add even more nutrition. Focus on fluids that you like, even if that means drinking milkshakes every day!

If fluids just don’t taste good, experiment with new flavours. Try soups with beans and lentils if meat tastes metallic. Add citrus, like lemon or orange, to smoothies to wake up your taste buds (unless you have mouth sores). If drinks taste too sweet, dilute with water or plain milk, or add a bit of salt.

If swallowing fluids is painful, avoid acidic and spicy flavours, drink fluids at room temperature, and puree and strain soups and smoothies to remove rough edges.

If the pain continues, speak to your doctor or a pharmacist. They may be able to prescribe a medication that can help.

The post Drink for your health: what should I drink when I have cancer? appeared first on Your Health Matters.

Along with these dietary changes, many also wonder if they should choose lower fat milk, avoid fried foods or opt for margarine over butter. While choosing foods containing lower levels of fats won’t directly improve blood sugar levels, this can help protect and improve heart health. That’s important because people living with diabetes may be at risk of developing heart disease up to 15 years earlier compared to people who don’t have this condition. Here are some of the reasons why:

Gender
In Canada, women with diabetes are 4 times more likely to develop heart disease due to its connection with hormonal levels during menopause, as diabetes cancels out the protective effect that estrogen provided.

Insulin resistance
Insulin resistance plays a role in the development of diabetes and prediabetes. Insulin is the hormone in our bodies that regulates energy or glucose, and resistance happens when the cells in your muscles, fat and liver don’t respond properly. Over time, your blood sugar levels go up because your body isn’t able to use glucose from your body for energy. Insulin resistance plays a role in the development of plaque in the arteries. If plaque builds up too much, it can lead to blocking the blood vessel, significantly increasing the risk of heart attack or stroke.

Unhealthy cholesterol levels
Diabetes can increase the risk of “bad” cholesterol in the body, and lower the “good” cholesterol, which in turn can increase the risk of stroke and heart disease.

High blood pressure
Many people with type 2 diabetes also have high blood pressure, also known as hypertension. There are likely many factors contributing to both conditions including obesity, a diet rich in fat and salt as well as inactivity.

Inactivity
Physical activity is important for overall general health, and may be especially important if you have diabetes. It can help maintain a healthy weight, keep the heart strong and reduce insulin resistance.

Increased body weight
Insulin therapy can lead to weight gain, as insulin promotes fat storage in the body. In turn, being overweight or obese means your heart has to work harder to do its job, increasing the risk of heart disease and other cardiac complications.

Ways to protect your heart

When it comes to diabetes there are many ways to protect your heart, such as having regular check ups with your doctor or endocrinologist to monitor your blood pressure, cholesterol and blood sugar A1C to get these levels into health ranges. The target ranges for blood pressure and cholesterol are much lower for people with diabetes, and similar to targets for someone who has already has had a heart attack or stroke. It’s also important to not smoke, and to take any medications as directed.

Coming back to diet, it plays a critical role. Worldwide, diets low in fruits and vegetable are major contributors to the risk of developing diabetes and heart disease, and nutrition therapy is an integral part of managing both conditions together. Generally, avoid processed foods as they are normally high in salt, sugar and saturated fat. Opt for fresh fruits, vegetables, legumes, beans, lentils, nuts, whole grains and lean proteins, while limiting alcohol intake. Be sure to reach out to your diabetes care team for more information and direction.

View the full Speaker Series event here:

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Did anyone else hear that gem at the dinner table back in the day? Or, perhaps you say it to your kids when they glumly push those carrots around their dinner plate?

Turns out, it’s not exactly the truth. But it’s not quite a lie either, says Dr. Peter Kertes, Chief of Ophthalmology at Sunnybrook.

That’s because what’s good for you is good for your eyes, he says.

“Your eyes are a key to your health – an examination of your eyes can provide a look at your overall systemic health,” Dr. Kertes explains. “High blood pressure and diabetes can both lead to trouble in your eyes. And, eating leafy green vegetables, kale, broccoli, carrots, fish – all that good stuff – can help lower your risk of diabetes and high blood pressure, and in turn, help your eyes.”

Macular degeneration is the most common cause of blindness in the Western world. Studies have found that people with macular degeneration lose less vision if they have a diet rich with green leafy vegetables and fish, Dr. Kertes said.

“That’s been translated into clinical trials that have recommended supplements to obtain the nutrients and vitamins found in those foods to help prevent vision loss due to macular degeneration.”

That doesn’t mean everyone should be on those vitamins, he added.

“There’s no evidence to suggest that eating those things cause everyone to have better vision. The study took place among people with macular degeneration,” he said.

While there’s no evidence that eating a pile of carrots will grant you 20/20 vision, carrots do contain beta-carotene, one class of carotenoids. Beta-carotene is a naturally occurring pigment that gives carrots their orange colour. Healthy eyes do need carotenoids along with other vitamins, Dr. Kertes said.

“Vitamin A, C, zinc and lutein are all important for keeping your eyes healthy,” he said. “You get those in those vegetables I mentioned, along with fish.”

And, if you smoke, consider quitting for your eye health, Dr. Kertes said.

“Smoking cigarettes can increase your risk of macular degeneration and other eye issues,” he said.

So, will eating carrots make you have 20/20 vision? There’s no evidence of that. Is it OK to tell your kids: “Eat your veg. It’s good for your eyes”?

Absolutely.

The post What should you eat for your eyes? appeared first on Your Health Matters.

It’s important we start thinking about food – and snacks – as fuel, says Rebecca Mercer, a clinical dietitian at Sunnybrook. She answered my burning questions about those mid-afternoon munchies and more.

Sometimes I get mixed messages – should we be snacking or not snacking?

As an avid snacker myself, I believe snacking can absolutely be part of a healthy diet – but it comes down to the quality and quantity of the snacks! It’s important that the snacks are just snacks, and not the calorie equivalent of a meal. The way I like to approach snacking is really asking ourselves why are we motivated to munch … Bored? Hungry? Tired? Many different situations and emotions can trigger snacking so being mindful of what and why you are eating is a great place to start. There are different types of hunger and listening to your body can help you decide if you would benefit from a snack. This is called ‘mindful eating’. If everyone in your 11 am meeting can hear your stomach grumble, chances are you are physically hungry and could benefit from a healthy snack. If you find yourself reaching for the potato chips while you watch your favourite TV show shortly after dinner, perhaps the snack is not necessary.

Why should we see snacks as an opportunity to “fuel up”?

Nutritious snacks are a great way to fuel your body to avoid energy slumps that we often experience throughout the day. Having consistent energy levels can help prevent overeating at your next meal. Snacks are also a great way to reach our daily recommendations for different nutrients and should be viewed as an opportunity to fuel, rather than being a ‘treat’ or way to pass time. They are a great opportunity to incorporate more fruits, vegetables and other high nutrient foods into your daily diet. Next time you are reaching for a snack, ask yourself “What in this food will fuel my body and how will it make me feel after?”

What are 3 or 4 go to snacks that can give us a boost?

When I am reaching for a snack I like to look for two things: protein and fibre. Even better if you can pair them together! Protein helps us feel more satisfied after eating it, so it can prevent you from reaching for more food than you need. Fibre provides bulk to the food without adding calories, keeping us feeling fuller longer. Some snacks that provide this dynamic duo include:

• Fruit with nut butter or nuts: i.e. apple and peanut butter, banana and ¼ cup of walnuts
• Greek yogurt with berries: Greek yogurt is packed with protein
• 2 tbsp of hummus and carrot/celery sticks
• Hard-boiled eggs with a few whole grain crackers

Are there certain times when we should reach for a snack?

The first sign that you may benefit from reaching for a healthy snack is physical hunger between meals. If your stomach is growling, chances are you could benefit from a nourishing snack. If you find that you are physically hungry while at work or throughout your day, keep healthy, convenient snacks within reach to avoid purchasing or over-eating a less healthy snack.

If you are planning on hitting the gym or working out a few hours after a meal, you may benefit from having a small strategic snack to fuel your workout. Heading into a workout hungry can leave you feeling light-headed, dizzy, nauseous or sluggish – all things that will limit your physical performance. Reach for a snack that is around 100-200 calories and contains carbohydrates and protein. Some examples include rice cake with nut butter, a healthy granola bar, handful of dried fruit and nut trail mix. When purchasing granola bars, look for one with less than 8 grams of sugar and at least 5 grams of protein and 4 grams of fibre.

Snacking before exercise can provide you with the energy needed to push through, but what you eat after you work out is also important for muscle recovery, and refueling your body. Ideally, a snack or meal should be consumed within 30 minutes of exercise to fully reap the benefits of your hard work. For post-workout snacks, protein and carbohydrates are key. For snacks, reach for things like 1-cup of chocolate milk, whole-wheat pita with hummus and vegetables, 2 eggs and 1 slice of whole wheat bread.

If you know you are going to have a late night at work or won’t have an opportunity to eat your meals at your regular time having a healthy snack on hand can help ward off hunger and reduce the likelihood of grabbing anything in sight (we have all been there!). Keeping fresh fruits and vegetables, nuts and seeds and a healthy granola bar on hand can help hold you over.

Are there certain times when we should stop snacking / say no / do something else?

If you are bored, tired, anxious or stressed and not physically hungry, ask yourself whether or not you need a snack. Sometimes our bodies mistake thirst for hunger so making sure that you are adequately hydrated can help to avoid the confusion between hunger and thirst. Listening to your own hunger cues and being mindful of why you are snacking is important. If it is just boredom or stress that has you reaching for food, try a healthier coping strategy like going for a walk, enjoying a cup of tea, or going through mindfulness exercise.

Anything else you’d like to add?

Remember that food gives us energy, we need to use that energy throughout our day or else it can get stored as extra fat. All day grazing, large portions and high calorie, low nutrient value snacking is what we should try to avoid. Keep in mind that even healthy foods can pack a lot of calories. Foods like nuts, cheese and avocados are all nutritious, but do contain higher amounts of calories than foods like raw fruits and vegetables. Portioning out your snacks can help you snack smarter and avoid overindulging between meals. If you are a grazer, try to keep the healthiest, lower-calorie snacks the most visible and easiest to grab.

Happy snacking!

(Check out some good recipes from the Dietitians of Canada to get more veggies and fruit into your snacks and meals)

More Resources:

Dietitians of Canada

Eat Right Ontario 

The post To snack or not to snack (and on what), that is the question appeared first on Your Health Matters.

But, I do at the very least try to stay up-to-date about the latest in nutrition information.

Lately, though, I’ve been a more confused than ever about healthy foods. Between news stories about sugar and fats, a new Canada Food Guide, and a bunch of Netflix documentaries each claiming some kind of food group is the devil, I’m not too sure what I should be focusing my attention on and keeping off my plate.

I spoke with registered dietitian Daphna Steinberg at Sunnybrook for some help: What’s the worst for me? Sugar, salt or fat?

“This is a complicated question,” she said, kind of as I expected. “Each has it’s issues.”

Here’s what else she had to say to help us understand each of these offending groups.

What’s the issue with eating too much salt?

About 50 per cent of Canadians are what’s called “sodium sensitive”. This means that eating too much salt will raise their blood pressure, which can put them at risk of developing heart disease or strokes.

What’s the issue with eating too much sugar?

Eating too much sugar can increase your risk for developing obesity and diabetes.

What’s the issue with eating too much fat?

Fat has a lot of calories, so eating too much total fat can lead to obesity. The challenge with choosing low fat versions of foods such as yogurts or peanut butters, among other things, is that the fat is often replaced with sugar or cornstarch to maintain the texture of the foods. So just switching to low fat isn’t a great option. Another challenge with fats is the type of fat: not all fats are created equal.

Can you remind us what’s the difference between saturated, unsaturated fats, and trans fats, please?

Saturated fats (those that are solid at room temperature) are found in foods like butter, coconut oil and meat. These increase unhealthy cholesterol.

Trans fats are made from hydrogenated vegetable oils and are found in things like packaged baked goods, hard margarine and snack foods. Trans fats not only increase unhealthy cholesterol but can actually cause heart disease.

Most unsaturated fats (those that are liquid at room temperature) like olive or canola oil are healthy and may actually improve cholesterol levels.

What’s the fat in fish? That’s a good fat too, right?

Yes, that’s another healthy fat: omega-3 fat. It is an essential fat, meaning that our bodies can’t produce it so we must get it from food. We know that omega-3 fat helps to decrease a fat in blood called triglycerides and improve blood pressure. It’s found in fatty fish like salmon or trout, and also in nuts and seeds such as chia or flax.

Where can we go to find good, reliable info about this kind of stuff? I feel like every time I read an article, it says the opposite!

The mainstream news can be confusing when it comes to reports on nutritional studies. Speaking to a registered dietitian is your best, most reliable source of information for nutrition information, as we know how to interpret the science and take more than the latest headlines, but the whole body of research into account in our recommendation and make them apply to foods that individuals eat. On Eat Right Ontario and you can email a registered dietitian for free. Or, visit Dietitians of Canada for more info.

Are there any good “rules of thumb” so to speak about salt, sugar or fat?

This rule may be disappointing for some, as it’s likely what you’ve heard since you were a child: moderation in all things.

The post Sugar and salt and fats — oh my 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”).

The post How to get more fibre into your daily diet appeared first on Your Health Matters.

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.

The post How to manage loss of appetite during cancer treatment appeared first on Your Health Matters.