1. Nutrition and Wound Healing Jennifer Kanetsky Dietetic Intern

2. Objectives Understand what nutrition is and its importance Identify the 3 macronutrients Identify healthier food choices Understand the importance of nutrition related to wounds

3. Why is it important to be healthy? Being overweight or obese can lead to… Hypertension High cholesterol Type 2 diabetes Heart disease Stroke Gallbladder disease Osteoarthritis Sleep apnea Cancer

4. Why is it important to be healthy? Being underweight can also lead to problems… Heart Disease Diabetes Breast Cancer Slow wound healing Infertility Osteoporosis

5. What is nutrition It is providing the proper nutrients to your body allowing for proper growth and development.

6. Blood sugar control Blood sugar goals ▫Pre-prandial: 90-130 mg/dL ▫Post-prandial: <180 mg/dL ▫Each episode of blood sugar out of range can delay wound healing.

7. What is in our food? Carbohydrates ▫ 4 calories per gram Protein ▫4 calories per gram Fat ▫ 9 calories per gram

9. Carbohydrates 50-60% of calories Purpose: ▫Provide the body with energy ▫Preferred energy source Types: ▫Simple ▫Complex

10. Simple Carbohydrates Easily broken down Provides quick energy Excess converted to fat for storage

11. Complex Carbohydrates Broken down more slowly ▫More fiber  Broken down slowly = fuller longer = longer satiated Majority of carbohydrates in the diet should be complex

12. Complex Carbohydrates Examples: ▫1 slice whole-grain bread ▫1 cup whole grain cereal ▫½ cup cooked pasta or rice

13. White Rice vs. Brown Rice White RiceBrown Rice 1 cup (158 g) 206 calories 0 g Fat 55 mg Potassium 1 g Fiber 4 g Protein 24 mg Magnesium 0.8 mg zinc 1 cup (195 g) 216 calories 2g Fat (mono and polyunsat) 84 mg Potassium 4g Fiber 5g Protein 86 mg magnesium 1.2 mg zinc

14. Protein Purpose: ▫Promotes muscle and connective tissue growth; ▫Formation of antibodies to strengthen immune system ▫Foundation of hormones, enzymes, and blood cells Found in: ▫meats, poultry, and fish ▫beans and peas ▫tofu ▫eggs ▫nuts and seeds ▫milk & dairy products

15. Protein Tips Choose leaner meats ▫Substitute ground turkey for beef Get hooked on fish! Eat fish twice a week for a great source of protein! Include protein at every meal to curb feelings of hunger

16. Fat—I can actually eat fat? 20-30% of calories Purpose: ▫Essential for absorption of some vitamins ▫Protects body organs Types ▫Saturated ▫Unsaturated

17. Saturated Fats The “bad” fat Solid at room temperature ▫White, visible fat found in meats ▫Dairy products  Whole milk  Butter  Cream  Hard cheeses ▫Coconut and palm oils

18. Unsaturated fats The “good” fat Liquid at room temperature ▫Examples:  Olive and canola oil  Nuts/nut butters  Fish oils  Avocado

19. Fat Tips Choose olive oil when cooking versus butter Choose low-fat or fat-free alternatives Avoid fried foods and bake or grill instead Substitute applesauce or plain yogurt for oil when baking

20. Vitamins and Minerals Vitamin C ▫Increases the strength of the wound as it heals, creates collagen in the skin, important in the creation of blood vessels, and helps with iron absorption. Vitamin A ▫Helps fight off infection, controls inflammatory response. Zinc ▫Helps body synthesize proteins and develop collagen

21. Beverages Don’t forget about liquid calories! Beware of beverages with added sugars ▫Gatorade, energy drinks, soda, mixed drinks, sweetened coffees, even juices and vitamin waters Interesting fact according to the CDC: ▫Over half of Americans consume sugary drinks daily, particularly teens and young adults

22. Coke: 8 oz of coke = 27 g sugar = 100 calories 20 oz bottle= 65 g sugar = 240 calories If you had 8 oz/day = 700 calories/week 10 week course= 7,000 calories To burn 100 calories: -Walk up 33 flights of stairs - Walk uphill for 15 minutes - Power walk for 20 minutes - Run 1 mile

23. Vitamin Water: 8 0z. = 13 g sugar = 50 calories 1 Bottle = 33 g sugar = 125 calories 1 Bottle day = 875 calories/week 10 week TFG program = 8,750 calories

24. Beverages Choose water as much as possible, but if you must… ▫Try adding lemon to water ▫Choose unsweetened tea or black coffee

25. Healthy snack options An apple with 1-2 Tbsp PB A piece of fruit with low fat string cheese Greek low fat/nonfat yogurt Whole grain crackers with fruit or vegetables Edamame

26. Keys to a Healthy Diet Variety Moderation Balance

27. Change of Plate? NewOld

28. Change of Plate Grains- 6 servings ▫Make half your grains whole grains  1 slice whole grain bread  1 cup whole grain cereal  ½ cup rice/oatmeal Vegetables- 2 ½ -3 servings ▫Vary your veggies  1 cup raw spinach  ½ cup broccoli  1 medium potato

29. Change of plate Fruit- 2 servings ▫Focus on fruit  ½ cup strawberries  1 large banana  ½ cup dried fruit ▫Dairy- 3 servings  Get your calcium-rich foods  1 cup milk  1 cup yogurt  1 slice cheese

30. Change of plate Protein- 5 ½ - 6 ½ ounces ▫Go lean with protein  1 oz meat/ 1 slice turkey meat  1 egg  ¼ cup cooked beans Oils- 6 teaspoons ▫Choose healthier unsaturated oils  1 Tbsp. oil = 3 tsp.  2 Tbsp. peanut butter = 4 tsp. oil  2 Tbsp. Italian dressing = 2 tsp.

31. Subway 6” Tuna Subway 6” Turkey Which do you think is better?

32. Subway 6” Tuna 530 calories 30 g Fat Subway 6” Turkey 280 calories 3.5 g Fat

33. Bourbon Whopper Whopper Jr. Which do you think is better?

34. Bourbon Whopper 910 calories 57 g Fat Whopper Jr. 340 calories 19 g Fat

35. How many calories do I need? To burn 1 pound of fat you must burn 3,500 calories 1 pound a week = 500 calories a day burned 2 pounds a week = 1,000 calories a day burned

36. Questions?