Disabled people, especially wheelchair users, want to know how to live a healthier lifestyle while sitting, and with health complications that may come from a disability diagnosis. They want to be stronger so they can be as independent as possible, live longer, and have a more positive mood. Most wheelchair users are concerned with their bone and joint strength (due to their inability to support weight on their legs), as well as losing weight, reducing their cancer risks, avoiding diabetes, and preventing strokes or heart disease. For some people living with a disability (or other chronic condition), the biggest challenges are managing energy levels, supporting immunity, reducing the potential for pressure sores, and preventing/managing constipation.
Safe Levels of Caffeine
Many people turn to caffeine for energy, but there are healthier food and lifestyle choices that provide increased energy that leaves them less likely to crash later. Christine Palumbo, MBA, RDN, FAND, says caffeine is the key stimulant found naturally in coffee and is widely consumed in beverages like tea, soda, energy drinks, and even coffee flavored yogurt or ice cream. Most dietitians educate their clients that due to genetic differences, some people can consume large amounts of caffeine with no issues, while others are quite sensitive to caffeine and can be adversely affected by a single cup. Consumers with lung conditions, such as myself, are prone to weakened hearts, so we have to be cautious about our caffeine intake and keep it under two cups of coffee per day.
Liz Broad, PhD, a senior sports dietitian with the United States Olympics and Paralympic Committee, makes her athletes aware that, from an immune perspective, too much caffeine can overstimulate the central nervous system, which can impact sleep quality. Quality sleep of seven to eight hours per night allows the body time to recover from the stress of the day. Consuming 400 mg of caffeine, or four 8-ounces cups of coffee, per day is generally safe. A 2017 study published by the Journal of Food Science also found that too much caffeine decreases our abilities to taste sweet food and drinks, which can increase the desire for sweets.
Carol Taylor, MCN, RD, LD, shares a study with her clients from the Linus Pauling Institute that reports caffeine might inhibit the metabolism of some medicines, causing a reduction of the amount of medication absorbed. This is important for people who take medications to manage their disabilities or chronic conditions. Vicki Shanta Retenly, RDN, author of Total Body Diet for Dummies and a speaker/consultant in Chicago, also reminds pregnant women that they should limit their caffeine intake to 200 mg, or about a 12-ounce cup of coffee, per day.
People get their calories from food. Most dietitians and other nutrition professionals remind patients, clients, and the public that calories are fundamentally good. Angela Lemond, RDN, LD, a national spokesperson for the Academy of Nutrition and Dietetics, tells her clients with disabilities that if they use wheelchairs, they need to balance their calories with the energy they need to propel the wheelchair, participate in adaptive fitness, and undertake activities of daily living. Another concern for wheelchair users and people with disabilities is managing their energy levels to achieve personal career goals.
She encourages balanced meals three times a day, and that each meal should include protein, carbohydrates, and healthy fats to provide a steady release of energy throughout the day. It’s also encouraged to reduce how many times you eat, not to eat too much, and only snack when hungry instead of eating when bored, unhappy, or isolated.
Fruits and vegetables provide key nutrients as well as add color and variety to the plate. Make it a priority to use fruits and veggies in creative and adaptive ways. Fruits will support the body in more ways and provide steady energy supply longer than simple carbohydrates, such as sugar, which is more quickly broken down and used.
Dr. Broad explains to her athletes that fruits and veggies are rich in antioxidants and other anti-inflammatory nutrients that guard our overall system, as well as fiber that promotes gut health and prevents constipation for wheelchair users. The National Academies of Sciences, Engineering, and Medicine determined that an adequate daily fluid intake is about 15.5 cups (3.7 liters) of fluids for men, and about 11.5 cups (2.7 liters) of fluids for women. This guidance does cover fluids from water, other beverages, and food. About 20 percent of daily fluid intake usually comes from food and the rest from drinks. Fluid intake does aid in relieving constipation.
Simple carbohydrates will give wheelchair users a fast boost of energy, but may cause them to run out of gas sooner, while whole grains have a slower release giving wheelchair users more high-quality energy. Vicki Shanta Retenly, RDN, likes to advocate that protein contains amino acids, which are the building blocks that make muscles stronger, which can increase endurance.
Fruits, vegetables, and whole grains are rich in macronutrients such as vitamins A, C, and E, as well as B vitamins such as folate and minerals like zinc, selenium, and copper. Wheelchair users or consumers with disabilities, who also have a chronic condition, like myself, might need to protect their immune system in a committed way. People with limited respiratory function may be more susceptible to a variety of bacterial infections, like urinary tract infections, flu and sepsis, if they don’t do anything to protect their immunity. Angela Lemond tells her wheelchair user clients that they should focus on whole foods with minimal consumption of added sugars. Consumers who use wheelchairs all the time want to pack each meal with various colorful plant foods such as fruits, veggies, beans, legumes, and whole grains, as well as lean protein with an emphasis on fatty fish, like salmon and tuna to boost immunity.
Low-fat dairy products aide in increasing quality calcium consumption that benefits bone strength, as well as healing damaged tissues after an injury. Adequate calcium consumption can aide in the healing process after any injury or surgery. Remember to work with a local registered dietitian nutritionist to find dairy substitutions if you have lactose intolerance or other milk allergies, which can be a big cause of the dreaded “bowel accident.” So, if you’re having these often, get some assistance from a properly licensed registered dietitian nutritionist to conduct a safe elimination diet to see if your bowels improve. Some consumers can add back low lactose foods, like aged hard cheeses such as parmesan, swiss, cheddar, kefir, or Greek yogurt, if they are diagnosed with lactose intolerance. *There are some great dairy alternatives that I will write about in the future. A wide variety of foods provide antioxidant benefits for immunity. Antioxidants are elements that protect human cells against free radicals, as well as promoting eye health and heart health. Wheelchair users may require more antioxidants to boost their immunity level to avoid getting sick as often during typical life, especially if they also experience added chronic conditions that might impact their lung function.
Preventing and Managing Constipation
Wheelchair users experience constipation quite often because it’s hard for people with spinal cord injuries and other physical disabilities to control their bowel health, and they are often less physically active than those without physical limitations. Some wheelchair users experience constipation because of medication they take to manage chronic pain or other conditions.
On top of that, most Americans are not getting enough fiber, which can help alleviate or prevent constipation. Some folks with disabilities also have secondary conditions that require the assistance of laxatives to relieve constipation. Julie Stefanski, RDN, registered dietitian nutritionist and a spokesperson for the Academy of Nutrition and Dietetics, says that fiber needs are individual and should be based on the amount needed to produce a bowel movement that is easy to pass without needing to strain. When increasing fiber, fluids like unsweetened tea, water, and fruit juice should be increased, otherwise an increase in fiber can cause more constipation. A healthy starting fiber goal for any American is at least 10 grams of fiber per day, and then slowly increasing fiber consumption. The Academy of Nutrition and Dietetics recommends that adults should aim for 25 to 35 grams of fiber per day.
Sources of Fiber chart by Tracy’s Plate
Sourced by Healthline and Mayo Clinic
|Food Item||Fiber Content|
|Chickpeas||2.2 grams of fiber|
|Black-eyed peas||11 grams of fiber|
|Lentils||1 gram of fiber|
|Oatmeal||4 grams of fiber|
|100% whole wheat bread||2 grams of fiber|
|Brown rice||3.5 grams of fiber|
|Barley||32 grams of fiber|
|Fresh Fruit||Varies from 3- 9 grams of fiber|
|Fresh Veggies||Varies from 3-10 grams of fiber|
|Almonds||3.4 grams per ounce|
|Chia Seeds||10.6 grams per ounce|
When dealing with constipation, some turn to laxatives because they’re readily available and don’t require a prescription. However, laxatives are medication, which means your trusted primary care provider would be and should be the best person to ask about personal use. Once a beneficial laxative is chosen, a registered dietitian nutritionist can advise on fiber and fluid intake.
Preventing Pressure Sores
Pressure ulcers are another factor that nutrition can have a positive impact on for wheelchair users. A good diet is a critical place to begin and can help address some of the issues affecting skin care such as being overweight, being underweight, or controlling your bowels or bladder. A registered dietitian can help wheelchair users to manage the risk of infection with the help of a healthy diet.
If weight gain or weight loss is achieved, wheelchair users should get fitted for a proper wheelchair cushion once or twice a year by a trusted doctor or physical therapist. From personal experience, finding a local adaptive fitness center is a great resource. Adaptive fitness and sports are a fun way to alleviate pressure and increase movement, because any type of movement in or out of a wheelchair will help to prevent pressure points and pressure sores.
Proper nutrition can impact the frequency of pressure points and sores for people who use wheelchairs. It is crucial for wheelchair users to stay hydrated during the winter months because the air, especially in heated places, may be much drier. Consuming high-quality protein from meat, fish, low-fat dairy, and legumes is vital to maintaining good skin condition. Also, a higher consumption of fruits and veggies provide wheelchair users with more vitamin C and antioxidants to build and maintain better skin.
I understand that it’s not easy to change your lifestyle to one of healthy living, especially if depression, anxiety, or proper assistance in shopping are barriers to this change. My goal is to help people with disabilities find the solutions that help them keep their commitment to being the best they can be with the PUSHLiving Lifestyle.
- A Unique View of Healthy Living for Wheelchair Users - February 26, 2020