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Nutrition and JIA

If you have active inflammation and painful joints, you might not feel like eating. This can lead to weight loss. On the other hand, if you are taking corticosteroids, you may have an increased appetite. This can lead to excessive weight gain.

Therefore, you really need to have a healthy diet. You need to choose healthy foods as much as possible. Reduce empty calorie foods such as sweets, fast foods, salty snacks, and convenience foods. Try to eat at regular intervals and include planned snacks.

If you are overweight or have gained weight due to the side effects of corticosteroids, the extra weight can put stress on your knee, hip and ankle joints. This can increase joint pain. It can even lead to joint damage.

The role of your dietitian or nutritionist

A dietitian or nutritionist is an expert in food and nutrition. Dietitians help promote good health through proper eating. Your dietitian can talk to you about your special diet requirements.

Supplements

You need additional calcium and vitamin D to help make your bones stronger. All young people need this. It is especially important because you have JIA.

Calcium

Calcium builds strong, healthy bones and teeth. It helps your muscles and nerves work properly. If you don’t get enough calcium in your diet, your body will use the calcium stored in your bones to supply the rest of your body. This will make your bones weak. They may become more likely to fracture or break. Most teenagers do not have enough calcium in their daily diet.

Check out this calcium calculator from the International Osteoporosis Foundation.  It will help you find out what your calcium intake really is!

Vitamin D

Vitamin D helps your body absorb calcium so you can have strong bones.

Sources of calcium and vitamin D

Dairy foods are very high in calcium, especially milk, yoghurt, and cheese. Other good sources include calcium-enriched rice/soy, almonds and oat beverages.

Milk (cow’s milk or enriched soy/rice milk) contains vitamin D. Fish, liver, and egg yolk are the only foods that naturally contain vitamin D. If you do not eat vitamin D rich foods often, you may want to consider taking a vitamin D supplement. Most multiple-vitamin supplements contain vitamin D.

 

Below is a chart outlining some different food sources of calcium and vitamin D.

Food item Serving size Amount of calcium (mg) Amount of vitamin D (IU)
Milk, whole, 2%, 1%, skim 1 cup 300 100
Yoghurt, low fat, plain 3/4 cup 300 Some brands of yoghurt contain vitamin D – check labels
Milk, evaporated Carnation 1/4 cup 165 52
Frozen yoghurt 1 cup 100
Swiss cheese 30 grams 240
Processed cheese slices, cheddar 30 grams 170
Fortified orange juice 1/2 cup 45
Fortified margarine 2 tsp. 51

Other tips for healthy eating

For those with a poor appetite:

• Try to eat small amounts of nutritious foods every two to three hours.

• Choose foods that you like.

• Try to choose a variety of foods from all five four food groups.

• Make sure to include high-protein foods during the day.

• Pediasure, Boost, Ensure, or Resource are high calorie drinks that can be used if you have a poor appetite and have lost too much weight. These are supplemental drinks available in the pharmacy.

• You can also make fruit smoothies with full fat milk and yogurt, and add in an egg.

• Choose high calorie foods such as full fat dairy (3.25% milk, ice cream, cheese, and yogurt), meats and alternatives.

• Add extra calories to your food by adding margarine, oil or cream to foods.

Some corticosteroids give a ‘false hunger.’ They tell your body that you are hungry even though your body has what it needs. In addition, your fatigue and joint pain may cause you to be less active. This combination can lead to being overweight, or in some cases, obese.

Below are some tips for healthy eating if you are taking corticosteroids:

• Avoid sweets as much as possible. Instead of juice or soft drinks, drink water. Try to save biscuits cookies and cakes for an occasional treat. Have low-calorie, healthy snacks available like raw vegetables, fresh fruits, unsalted crackers and unsweetened cereals. Microwave popcorn is another choice, but try not to add extra butter.

• Avoid fatty foods, like fried foods. Use oil, margarine and butter in small amounts. Switch to lower fat milk (1%) and low-fat yogurt. You can also get low-fat salad dressings and dips.

• Lower salt: Avoid packaged soups and sauces like soy sauce and tomato sauce, Stay away from preserved meats like hot dogs, sausage, bacon and luncheon meat. Try to look for low salt items.

• Multigrain bread, cereals and pasta, and brown rice contain fibre. This helps you feel fuller and provides more nutrients.

• Increase calcium for strong bones. For a healthy amount, teenagers require four servings per day of dairy foods. calcium. One serving is equal to one cup of milk, one large yogurt container, or one ounce of hard cheese. Make sure to choose lower fat cheese.

• It can be difficult if you want to eat out. Try to choose a place that offers low-calorie options.

• Plan ahead for special activities and events.

• Be as active as possible.

• Find fun or interesting things to do when you get hungry.

 

Welcome to the Taking Charge: Managing JIA Online Program! In this section you will learn what to expect in the program, how to get started and how to set goals to better manage JIA.

JIA stands for juvenile idiopathic arthritis. Find out what causes JIA, the different types of JIA and how it will affect you now and in the future.

Diagnosing JIA may be difficult as joint pain and swelling may be a part of many different illnesses. Diagnosis of JIA typically includes a physical exam, blood tests and imaging studies.

Pain, stiffness, and tiredness or fatigue, are common symptoms of JIA. These symptoms can lead to difficulties with participating in school and sports activities, and enjoying time with your friends. Learn about pain, fatigue, and stiffness, how to manage symptoms and how these symptoms can cause stress.

There are several strategies you can use to help you cope with pain, stress, and sleep problems. These include relaxation, distraction, and managing your thoughts. In this section, learn more about how each of these strategies work.

When you know about your medications, you can talk to your doctor about them and make good choices for yourself. Find out about the different types of JIA medications, how they work, common side effects, and the importance of talking to your doctor about your medication plan.

Did you know that there are many other therapies that you can use to manage JIA symptoms? They can help to prevent complications so that you can do all the things you want to do. In this section, learn more about physical, occupational, and psychological therapies; maintaining healthy nutrition; surgical options for JIA, and more.

Your role in making decisions about your treatment plan is very important. Your health-care team and other members of your support system are available to help you make these decisions. In turn, they can help you to manage your JIA.

Whether you have JIA or not, you need to maintain a healthy lifestyle. Find out how to stay healthy and active, learn about puberty and relationships, healthy body image, and making healthy lifestyle choices.

Sometime between the ages of 18 to 22, you most likely will transition from your pediatric rheumatologist to the adult health care setting. At that time, there are a number of things you, your family, and your health-care team can do to help make this change go smoothly.