Questions and Answers with Virginia Cail ~ PMH Registered Dietitian-Chronic Disease Education Program
In simple terms, how does nutrition contribute to the larger picture of overall health and well-being?
Most of us have heard the expression ‘we are what we eat”, and so know that what goes into our mouth is what becomes our body. For our bodies to do what we want them to do every day, the nutrition or nutrients we feed them, is key. When I eat only a few types of foods, say potato chips and pop, or only pizza and burgers, or even only beans and rice, there will be nutrients missing for rebuilding the billions of cells of my blood, bone marrow, hormones, organs, skin and hair.
In addition to this basic ‘food becomes me’ idea, is the impact of the process of eating on my well-being. That process starts with how much money I have to buy or land to grow food and where the grocery store is, and ends with what space I have to cook and eat it in, whom I’m with, and what I’m thinking about when I sit down to eat.
I love food and the science behind it. Some of the changes in nutrition science I’ve seen over the years since my biochemistry degree, have been in the areas of immunity, genetics, gut microbiome, and inflammation. Nutrition science, like climate science or pandemic science grows; each new discovery adds to our basic knowledge, and so helps guide our choices to be healthier than the people who lived before us.
As an RD, what is the scope of your interaction with patients …. and what kind of health issues/outcomes do you deal with?
As a Registered Dietitian with the Chronic Disease Education Program, the people I work with every day live with health issues like heart disease, diabetes, kidney disease, and bowel disease. So, on top of being mindful of basic nutrients and their eating environment, they also have to deal with adjusting their food intake to manage their blood pressure, blood sugar, and trips to the bathroom.
What I do is find out what their food and living situation is like, and help them apply the evidence-based guidelines to come up with small doable changes they’re willing and able to make. It might be as easy as choosing one more serving of fruit or vegetable per day, adding a tablespoon of ground flaxseed to their cereal or salad, or sitting down to plan their meals for the week. Some decide to call up someone in their COVID bubble to go walking with, or get back to those weights or treadmill they have in the house, or find an online exercise program. For others, it might be important to carve out (or schedule in) 15-20 minutes twice a week to do meditation, prayer, read something other than news, or turn all screens off 30 minutes before bed so they can sleep better. Nourish themselves without food, with a focus on mental, spiritual and emotional health.
With the challenges posed to health (mental, physical, emotional) by the COVID situation, what role do you think nutrition can play in striving to maintain a state of wellness?
You’re right, there are huge challenges to all those aspects of health with the COVID19 situation. The Canadian Nutrition Society points out that even basic access to food has been impacted, whether from job loss so less money to buy food, changes in agriculture, people isolating at home, or avoiding the grocery store because of the potential to be exposed to the virus.
Stress from the ever-changing reality around us, negatively impacts our immune systems, so we’re not able to protect ourselves from invasion by the COVID19 or other viruses, including influenza. To strengthen our immune system, we need both the macronutrients, protein, fat, and carbohydrates, and the micronutrients, vitamins A, C, D, E, B6 12 and folic acid, and minerals iron, zinc, copper, and selenium.
We know that there’s a higher risk of serious complications from COVID19, for those who have diabetes, lung disease, hypertension or have had a stroke. Since COVID19 is a respiratory illness, the lung disease connection is straightforward. For those with diabetes or heart disease, though we may not know exactly why yet, we do know, if they get COVID19, recovery goes better when their blood sugar and blood pressure have been in good control.
Are there other points you want to make about eating well during COVID?
Two things I’ve heard from my clients, is they feel under greater stress than usual and they’ve gained weight. What we eat can affect our energy, mood and brain function. The solutions? Get enough carbohydrate to fuel the brain, become more aware of your learned eating habits around comfort foods, be cautious with caffeine, and eat nutrient-rich foods: fruits, vegetables, wholegrains, some protein foods including oily fish.
In terms of weight, I think we tend to think there’s something wrong with people who live in large bodies. Yet that’s simply another human characteristic like eye color or personality. I like the message in the recently published Clinical Practice Guidelines to focus on health gains rather than weight loss. Ask yourself what’s one small thing you can do this week around your food, physical activity, relaxation, social connections or skills. Do that. Then add one more thing next week and so on.
Where can our readers go to find out more about your practice and other PMH resources for diet/nutrition/health?
For specific health conditions, there’s good information about basic management as well as COVID19 specific suggestions on their websites:
- Lung – See their MB Quits Cold Turkey challenge, an incentive to quit smoking to protect your lungs.
- Diabetes – See (and participate in) their research around the bidirectional relationship between diabetes and COVID 19.
- Heart - See their message to continue ACE/ARB medications for controlling blood pressure.
For education and support for people living with these or other chronic diseases:
- Programs and Services / Primary Health Care / Chronic Disease Education Program atprairiemountainhealth.ca. Call toll-free 1-877-509-7852 for an appointment to meet with one of the Nurse or Dietitian Educators (by phone or videoconference, or in person if required), or to register for courses like Craving Change.
For everyone, there are ‘food and nutrition links’ on the PMH website, and some good tips at these websites:
- World Health Organization - See list of best buys for food, and exercises to do at home.
- Ottawa Public Health - See the emergency preparedness checklist for suggested food items to buy.
- Dietitians of Canada public site - See the vitamins and minerals that come from food.
For help to access food, there are local food banks and other resources in communities, for example Under One Roof in Dauphin.