How to eat well with a chronic illness
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What does ‘eating well’ mean in general
When people talk about ‘eating well’, what do we understand by this phrase? As no one diet fits all, individuals may have very different images of what this means for them. So let’s look at the different food groups included in a healthy, balanced diet.
The Eatwell Guide, published by Public Health England (PHE), provides easy to understand recommendations on what to eat to achieve this balance by following the latest evidence-based advice on dietary recommendations (1). The main messages include:
Eat at least 5 portions of fruit and vegetables a day. Try and aim for variation as greater diversity is thought to have a key role in good gut health.
Base meals on potatoes, bread, rice, pasta or other starchy carbohydrates and where possible choose wholegrains such as wholemeal pasta. There is strong evidence that a diet high in fibre is associated with a lower risk of heart disease, type 2 diabetes and bowel cancer (2). Don’t let the low-carb craze fool you.
Include dairy such as cheese and yoghurt as a good source of protein, vitamins and calcium. If you opt for a plant based alternative such as almond or soya milk, choose unsweetened and calcium-fortified versions.
Beans, pulses, fish, eggs, meat and other proteins including 2 portions of fish a week (one should be oily such as salmon).
Choose unsaturated oils and spreads such as olive oil and eat in small amounts
Keep hydrated by drinking around 6-8 cups/glasses a day including tea and coffee
In addition, we should all try to reduce our alcohol and caffeine consumption.
Is nutrition advice different if you suffer from a chronic illness?
With a chronic illness, there may be certain foods that you are unable to eat despite them being part of a recommended healthy diet.
It is essential for those with coeliac disease to maintain a gluten-free diet (3). If you have Inflammatory Bowel Disease (IBD), a low-fibre diet may be helpful during active flare-ups (4, 5). Following a low-histamine diet can help manage allergic type symptoms from every day foods such as yoghurt, avocados and fermented foods in those with histamine intolerance (6)
These diets can be tricky to manage whilst ensuring you don’t miss out on vital nutrients. You may come across a number of diets claiming to have cured everything from MS to IBD by juicing and detoxing. Don’t be fooled, quick fixes and fads don’t work. There is also a misconception that ‘free-from’ diets are healthier. There is no evidence that a gluten-free diet is beneficial unless you have a medical requirement and in some cases it may lead to a diet lower in fibre and higher in sugars and fats. A vegetarian or vegan diet is only as healthy as the choices made. They can still be high in salt, sugar and saturated fat such as coconut oil.
It is therefore important that you follow trusted and credible nutrition advice provided by a Registered Dietitian (RD) or Registered Nutritionist (RNutrs).
What are the barriers to eating well with a chronic illness?
Chronic illnesses may have a number of health factors associated with them. This can often mean managing a variety of symptoms occurring at the same time. Barriers to eating well can include trying to prepare food when feeling nauseous, chronic fatigue, pain, low mood and lack of appetite.
It’s important not to let these feelings overwhelm you. With a bit of planning you can manage your symptoms.
How to overcome the barriers
When fatigue gets in the way of cooking, don’t be afraid to use ‘ready meals’. There are plenty of nutritious ones available, just try and avoid those high in sugar, salt and fat. Don’t overlook the benefits of frozen and canned vegetables too. Nausea can be helped by having smaller meals or snacks rather than aiming for three larger meals.
Make use of online food deliveries, why waste your energy carrying heavy bags.
On good days try bulk cooking and then divide into single servings and freeze for later. Enlisting help from partners or friends can make the task of peeling vegetables more enjoyable.
Do remember that sleep is a very important part of managing your condition. To get good quality sleep at night, try and avoid napping during the day, take a little light exercise such as a walk and avoid caffeine in the afternoon.
It is possible to eat well with a chronic illness. With some trustworthy nutritional advice and small steps you will find a greater sense of control over these barriers.
Written by Sharon Kallos, ANutr. Edited by Harriet Smith RD.
References
Public Health England (2018) A Quick Guide to the Government’s Healthy Eating Recommendations
British Nutrition Foundation (2018) Dietary Fibre. Available at https:///www.nutrition.org.uk/healthyliving/basics/fibre.html
Coeliac UK
Crohn’s & Colitis UK, Food and IBD, Your Guide
Goh, J. & O’Morain, C.A. (2003) Nutrition and adults inflammatory bowel disease. Alimentary Pharmacology & Therapeutics 17(3) pp 307-320
Kohn, J.B. (2014) Is there a Diet for Histamine Intolerance? Journal of the Academy of Nutrition and Dietetics. 114(11) pp1860