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Tag Archive for: healthy eating


Disability and Weight Management: Helping You Tip the Scales in the Right Direction

Julie Entwistle, C.Dir. (c), MBA, BHSc (OT), BSc (Health / Gerontology)

I find that while many of my clients initially lose weight following trauma (hospital food diet); eventually the net impact of a disability is often weight gain.  This is often the result of many factors – most interacting to make the solution difficult to isolate.  Medication side-effects, altered routines, reactive eating, friends and family that provide unhealthy sympathy foods, increased use of fast food because preparing meals is difficult, inactivity, depression, and even hormonal and physiological changes to the body as a result of the trauma.

But we do know that 70% of weight management is diet and assuming this is true, then the solution to weight management should be simple – you can’t eat it if you don’t buy it.  Purchasing unhealthy food is the first step to a weight problem.  And weight problems in disabled people are exponential.  Everything becomes harder – transfers, walking, completion of daily tasks, caregiving, and many pieces of equipment have weight limits that when exceeded result in equipment failure.

What is even more problematic is the role of the caregiver in the maintenance of weight in the person they are caring for.  When people cannot shop for food and cannot cook, then helping them to maintain weight becomes the job of the caregiver.  Just buy and prepare healthy foods – perhaps food prescribed by a nutritionist or dietician.  However, often caregivers rely on the disabled person to dictate the food choices but if people are emotionally eating, or eating out of boredom, then the caregiver cannot always rely on the individual to make the best decisions.  Often raising awareness about healthy eating starts with asking people to track what and when they are eating and drinking.  Then, problems can be identified, and a list of doable solutions can be developed. 

In one instance, in helping a client with weight loss as a functional goal, we discovered through tracking that she was barely eating breakfast and lunch but was consuming all of her calories from 5-10 pm.  We made the goal that, over time, she would consume breakfast, lunch, two snacks and dinner, and would stop eating after 7 pm.  Within a few short months, she lost 30 pounds, and this greatly improved her mobility and tolerances for activity.  Another client discovered through tracking that he was consuming far too many large bottles of pop a day.  By changing his large bottle to a smaller one, and eventually to only one pop per day and the rest water, he was able to drop 20 pounds.  In both cases, the problems, solutions, and commitment to change were made by my clients (with my guidance and support), making the results far more meaningful and lasting.  Further, the client was shown a framework for how to check and modify eating habits should they deteriorate again in the future.


Big Changes to Canada’s Food Guide – Will You Change Your Habits?

Last month the long-awaited revision to Canada’s Food Guide arrived and surprised many with some major changes to its design and content.  Personally, I am pleased with the changes which include a move toward plant-based proteins and I love the addition of guidelines around healthier eating habits like cooking meals at home, eating meals with others and more.  Check out Canada’s Food Guide and let us know what you think of the changes.

Canada’s Food Guide


The Healthy Menu Choices Act – Will This Trim your Waistline?

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

Here is some rocket science: being obese is a well-known contributor to poor health.  The secret to not being or becoming obese?  If you are obese, it is “move more and eat less”. If you aren’t, it is “keep moving and eat well”.  I was at the gym today and heard someone make a great comment “just show up and do something”.  Is it that simple?

In the interest of public health, Ontario has a new law effective January 1, 2017:  the Healthy Menu Choices Act.  In this, all food-service chains with 20 or more locations in must now post calorie information on menus for the food and drink items they sell.  Further, as of January 1, 2018, all menus must post the following statement:

Adults and youth (ages 13 and older) need an average of 2,000 calories a day, and children (ages 4 to 12) need an average of 1,500 calories a day. However, individual needs vary (1).

So, will this help continue to the better health of Ontarians?  People are complicated and behaviors ingrained, so do we know if having more information about calories will contribute to different choices? 

First, let’s define a calorie – it is actually “the energy needed to raise the temperature of 1 gram of water through 1 °C (now usually defined as 4.1868 joules).”  Huh?  So why does that matter?  Because in nutrition calories refer to energy consumption through eating and drinking, and energy usage through physical activity.  For example, an apple may have 80 calories, while a 1 mile walk might use up about 100 calories.  Our body uses calories as our energy source to breath, digest, circulate our blood, etc.  So, these are important and we get them from foods and beverages (2).  But knowing how many calories one person needs to maintain their weight and be at optimal health will depend on several factors including metabolism, level of activity during the day, age, and even genetics.  I need way less calories as a middle-aged active woman than the 12,000 calories per day consumed by Michael Phelps when he is training for the Olympics. 

So, to the common consumer that knows little about nutrition, but is interested in trying to eat well, will the calorie information on menus help?  Well, the math will be simple.  If the sign says I need an average of 2000 calories per day, and my Big Mac, Biggie Coke and fries is 1200 calories, I will consciously know that I have 800 left (for weight maintenance).  But when I go home, will I check labels, pull out a scale, and put together my remaining meals to not exceed 800?  Probably not because the common consumer does not tend to behave that way because if they did, we would not have an obesity problem in the first place.  However, for the educated consumer things might be different.  Personally, having fitness, health and body composition goals, I have already changed my food choices at fast food places because the calories in what I really wanted was starring me in the face, making me feel guilty already.  And I was still able to enjoy what I did order, recognizing that another element of health is “consistently making good choices” when most of the options out there (for convenience food anyway) are poor.  So I felt good (emotionally) making a better choice.  But when dealing with people and behavior, it is much more complicated than simple math.

It is also important to look at the stages of change when considering whether having transparent information about calories will actually lead to people making better decisions.  There are five stages of change – precontemplation, contemplation, preparation for action, action and maintenance (3).  Described briefly, in the first stage people don’t know they have a problem and the behaviors are risky and potentially life-threatening (like stress-eating, overeating and becoming obese).  In the second stage the person identifies they have a problem, or there are signs of the problem worsening (the number on the scale, bloodwork results, Diabetes starting etc).  In Preparation for Action, the person is ready to make a change and is seeking information and guidance.  This is when someone might start to understand what a calorie is, and how that relates to them.  In Action, the person starts actively changing.  This is where I see the Healthy Menu Choices Act being helpful.  It will provide people the information they need to make choices that are better than others, as part of their “action” towards improved health.  The Healthy Menu Choices Act will also be helpful in the last stage of Maintenance as people can use the calorie information to make choices that align with their desire to maintain the gains they have made, or to be healthily mindful in selecting foods.

From a health perspective, I think that the more information people can have about the choices they are making, the better.  Even if they don’t yet understand it, or choose not to use it, or it does not result in behavior change, it is there when they are ready for “Action”.  From a business perspective, restaurants and establishments might want to review their menus and look at the balance between their healthy and not-healthy choices.  Further, they will also want to look at how orders change with this new act.  If people stop ordering the White Chocolate Crème Frappuccino (at 510 calories) and instead sales of Iced Skinny Flavored Lattes (at 80 calories) soar, your consumers are telling you something.

Honestly, I am all for a nice bucket of poutine once a year, but beyond that I will pick the healthy options on a menu, if these exist.  If they don’t, I will go elsewhere.  It is that simple.  So I appreciate the added information the Healthy Menu Choices Act provides, and will use the calorie information in my meal decision making.






The Busy Community OT – Top Healthy and Fast Grab-and-Go Lunches Under 300 Calories

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

As a newer vegetarian, and someone who spends most days on the road, I am always looking for quick, but decent, lunch options.  While in an ideal world I would prepare my lunches and snacks ahead of time (including hand sanitizer!), sometimes life takes over and I am rushing out the door unprepared.  On some days that may result in me being undernourished and not eating again until dinner, on other days it does have me searching for healthy stuff en route.  So here is my list of the healthiest but fast meal options that are under 300 calories but can be grabbed quickly, as listed by restaurant name:


Veggie Delight (whole wheat bread without cheese or mayonnaise) 230 Calories


Side Garden Salad (no dressing) 40 calories

Chipotle Chicken Snack Wrap® with Grilled Chicken 230 calories

Grilled Chicken Snack Wrap® 230 calories


Full Asian Cashew Chicken Salad (no dressing) 190 calories

Chicken Go Wrap Grilled 260 calories


Garden Pita (no cheese or condiments, whole wheat pita) 227 calories

Tuna Pita (no cheese or condiments, whole wheat pita) 285 calories

Turkey Breast (no cheese or condiments, whole wheat pita) 286 calories


Perfect Oatmeal (plain) 140 calories

Spinach, Roasted Tomato, Feta and Egg White Wrap 280 calories (my personal favorite with the nutrition value quickly wasted by my latte add-on).


Chicken Ranch or Salad Wrap Snacker 190 calories

Chipotle Chicken Wrap Snacker 200 calories

Chili 290 calories

Soups (no bun) 80 – 230 calories


Warm Grilled Chicken Salad (no dressing) 150 calories

Warm Grilled Chicken BLT Salad (no dressing) 210 calories

Grilled Chicken Sandwich (no cheese or condiments) 280 calories


Tendergrill Caesar Salad (no dressing) 250 calories

Hamburger (no cheese or condiments) 260 calories

Veggie Burger (no cheese or condiments) 270 calories


No under 300 calorie meals.

Of course, calories are not the only consideration when consuming a healthy lunch.  However, this measure can provide an easy metric when looking for something fast while trying to avoid the unnecessary calories found in heavy carbs and bad-fat common to fast food meals.  For drinks, stick to water as not only is this often free (tap water) with your meal, but it provides an opportunity to rehydrate which is also important.

I hope this list helps you to also pick healthier options when on the road.


A Healthier Dining Out Experience

Dining out is a wonderful treat!  Who doesn’t enjoy a delicious meal without the labour intensive preparation or clean up?  However, dining out can often lead to poor nutritional choices and over-eating.  While it’s okay to indulge once and a while, we need to be aware of the health consequences.  The following infographic from Sunnybrook Hospital provides you with tips for a healthier dining out experience.  Bon appetite!




Eating Well Through Tough Financial Times

According to reports from University of Guelph the cost of food in Canada rose 4.1% in 2015 and is excepted to rise at least another 3 % in 2016.  With trips to the local supermarket costing much more, how can you manage to still eat well without breaking the bank?  The following from CTV News provides 5 great tips to maintain healthy eating during these tough financial times.

CTV News:  How to eat healthy amid soaring food prices


Eating Well in 2016

We all know that eating well translates into better health, however, sometimes our busy lives get in the way and make it difficult to plan, prepare and cook healthy meals 7 days a week.  How can you achieve this despite your busy schedule?  Proper planning!  Knowing how to create the proper balance your body requires from your meals and planning ahead can help you to stay on track.  The following from the Dietitians of Canada provides great information and tips on how to eat well and make 2016 your healthiest year yet!

The Dietitians of Canada:  Planning Meals Using Eating Well with Canada’s Food Guide



Your Best Thanksgiving Yet!

This upcoming weekend we celebrate Thanksgiving in Canada.  A time for delicious food, time with family and friends and feelings of gratitude.  If you are hosting Thanksgiving dinner this year the following guide from Canadian Living magazine will provide you with fantastic recipes and entertaining ideas to help you have your best Thanksgiving ever!

Canadian Living:  How To Have The Best Thanksgiving Ever


Peaches are Plentiful!

It’s August and that means it’s time to enjoy a very tasty and nutritious in season fruit —the peach.  Peaches have many nutritious benefits as shown in the following infographic care of  Enjoy them today before they’re gone!




Are Restaurant Meals Healthier Than Fast Food?

Many believe that when choosing to eat out, a sit down restaurant may provide healthier choices than the local fast food joint, however, a new study out of the University of Illinois shows otherwise.  Although restaurant meals may provide more nutrients than a typical fast food meal, research shows that high sodium levels and large portion sizes are putting diners’ health at risk.  Check out more on the study and tips for how to have a healthier “dining out” experience in the following article from Global News.

Global News:  Your restaurant meal is just as bad as fast food, study warns