Next Step

Healthy Eating and Healthy Body Weight

A healthy diet, along with physical activity, can help everyone maintain a healthy body and body weight. This is especially important for people with bleeding disorders. But with everyone’s busy schedule, eating right and exercising can be hard. By providing a basic understanding of nutrition, as well as stressing the importance of keeping active, parents can lay the foundation for their children to make good decisions about diet and exercise as they grow and become more independent.

Parents: Lead the Way—Eat Right and Exercise!

This section of Next Step will cover:

• Good Nutrition and Maintaining a Healthy Weight
• Healthy Eating
• The Importance of Iron and Calcium During Puberty

Good Nutrition and Maintaining a Healthy Weight

Eating healthy foods will help keep your child’s growing body strong and energized. Foods loaded with extra fat, added sugar, and empty calories can lead to excess weight gain and deprive your child’s body of the nutrients it needs to meet its growing demands. Being overweight is a particular problem for people with bleeding disorders. Excess weight puts added stress on joints and actually increases the number of painful bleeds. Over time, joint damage can lead to osteoarthritis, a form of arthritis in which cartilage, especially in the knees, which is a major target joint for bleeds, is lost. And because body weight determines how much factor a person needs to prevent or treat a bleed, maintaining a healthy weight can decrease the amount of factor your child needs.

For 9- to 15-year-old kids with busy schedules, eating is often on the run, which likely means frequenting fast food restaurants and grabbing vending machine snacks. Eating also becomes more and more of a social activity as preteens and teens eat outside of your view—at a friend’s home or pizza parlor. The result can be poor food choices. Besides not always providing the nutrients children need, this may lead to an excessive intake of fats, sugar, and calories. It is important to encourage your child to make healthy choices and eat a balanced diet when you're not around.

For nutritious ideas, click on Tips for Healthy Eating.

The Importance of Iron and Calcium During Puberty

During puberty, adolescents undergo dramatic physical growth and development, which increases their body’s requirements for energy, protein, and many vitamins and minerals. Their bones are getting longer as they get taller, and the muscles are growing to support those big bones.

Two important nutrients adolescents should include in their diets are calcium and iron.

• Calcium

  Bones grow rapidly during adolescence. Children aged 9 to 15 years need calcium to build strong bones, prevent tooth decay, and fight loss of bone density later in life. But many don't get the recommended daily amount of calcium.

  Preteens and teens need 3 cups of low-fat or fat-free milk every day, plus other calcium-rich foods. Calcium-rich foods include low-fat cheese and low-fat yogurt; and dairy-free foods, such as calcium-fortified juice and cereals; beans; and dark green, leafy vegetables (for example spinach, broccoli, and bok choy).

  Be mindful that certain foods and beverages, including sodas and caffeinated drinks, can interfere with the way the body absorbs and uses calcium.

  If your child is on a vegetarian or vegan diet, talk with your
  doctor, nutritionist, or dietician about how to ensure it supplies
  enough nutrients to keep you child healthy and strong,

• Iron

  Iron builds up blood cells, which may be especially helpful after a bleed or injury. Iron also helps blood carry oxygen to the body's muscles. During a bleed, a small amount of iron is lost. Your child can maintain adequate iron levels by eating naturally iron-rich foods such as liver, lean red meat, and poultry. Other sources of iron include leafy green vegetables, broccoli, dried beans, grains, and raisins. Combining iron-rich foods with good sources of vitamin C (such as orange juice) can help the body absorb iron. Certain foods can also block iron absorption; these include coffee, tea, egg yolks, milk, fiber, and soy protein. It’s best to avoid eating these and iron-rich foods at the same time.

  From puberty through the childbearing years, females need more iron than males because women lose iron with each menstrual period. Teenage girls and women who have heavy periods are at risk of losing too much iron and developing iron-deficiency anemia. Heavy menstrual bleeding (called menorrhagia) is, in fact, the most common cause of anemia in women.

  
  

  Here are some common signs of anemia:

  • Tiredness
  • Weakness
  • Tingling and numbness in fingers or toes
  • Sensitivity to cold

  Talk to your Hemophilia Treatment Center (HTC) about ways to fight iron loss and include iron-rich foods or supplements in your daughter’s diet.

Dietary Supplements

Many people use dietary supplements and herbal remedies to prevent specific ailments or to complement more traditional medical treatments. However, some of these can have be harmful for people with bleeding disorders because they may interfere with clotting or cause prolonged bleeding.

Remember, before taking any vitamins or supplements,
talk with your hemophilia health care provider.

Here are a few with potential harmful side effects:

• Bilberry
• Ginkgo biloba
• Bromelain
• Horse chestnut

Healthy Eating and Healthy Body Weight

This section of Next Step will cover:

• Nutrition Matters
• What Is a Healthy Diet?
• The Importance of Calcium
• The Importance of Iron

Nutrition Matters

Eating healthy foods will keep your body strong, energized, and well nourished. It will also help you maintain a healthy weight. Eating lots of foods with extra fat, added sugar, and empty calories will pile on the pounds. And being overweight is an even bigger problem for people with bleeding disorders than it is for others. It puts extra stress on joints and actually increases the number of painful bleeds. And because body weight determines how much factor a person needs to treat a bleed, maintaining a healthy weight can decrease the amount of factor you need.

What Is a Healthy Diet?

Eating a variety of healthy foods will help you get the energy, protein, vitamins, minerals, and fiber you need to grow and be healthy.

Here are some ideas for eating healthy:

• Make half your grains whole. Choose whole-grain foods, such as whole-wheat bread, oatmeal, brown rice, and low-fat popcorn.
• Vary your veggies. Color your plate with all kinds of vegetables. Go dark green and orange with your vegetables. Eat spinach, broccoli, carrots, and sweet potatoes.
• Focus on fruits. Eat them at meals and snack time, too. Choose fresh, frozen, canned, or dried fruits. But go easy on fruit juice.
• Get your calcium-rich foods. To build strong bones and prevent tooth decay, drink 3 cups of low-fat or fat-free milk every day, and eat other calcium-rich foods, such as yogurt and cheese. Other good non-dairy sources of calcium are broccoli, dark leafy green vegetables, calcium-fortified foods (for example, orange juice, cereal, and bread), soy, beans, and canned fish.
• Go lean with protein. Eat lean or low-fat meat, chicken, turkey, and fish, or try adding naturally protein-rich beans and peas to dishes. Add chick peas, nuts, or seeds to a salad; pinto beans to a burrito; or kidney beans to soup.
• Change your oil. We all need oil. Get yours from fish, nuts, and liquid oils such as corn, soybean, canola, and olive oil. These are considered “better” fats because they can help reduce cholesterol.
• Don’t sugarcoat it. Choose foods and beverages that don’t have sugar and sweeteners as one of their first ingredients. Added sugars contribute calories with few, if any, nutrients.

  For more nutritious ideas, click on Tips for Healthy Eating.

The Importance of Calcium

Bones grow rapidly during adolescence. For people with hemophilia, bone health may depend on several facts, including the number of joint bleeds. Children ages 9 to 15 years need calcium to build strong bones, prevent tooth decay, and fight bone loss later in life. However, many kids don't get the recommended daily amount of calcium. Try to drink 3 cups of low-fat or fat-free milk every day, and eat other calcium-rich foods. Calcium-rich foods include low-fat cheese and low-fat yogurt as well as dairy-free foods, such as calcium-fortified juice and cereals; beans; and dark green, leafy vegetables (spinach, broccoli, and bok choy). Be mindful that certain foods and beverages including sodas and caffeinated drinks can interfere with the way the body absorbs and uses calcium.

If you’re on a vegetarian or vegan diet, talk with your
doctor, nutritionist, or dietician about how to ensure you’re getting
enough nutrients to keep you healthy and strong.

The Importance of Iron

Iron builds up blood cells, which may be especially helpful after a bleed or injury since a small amount of iron is lost during a bleeding episode. Iron also helps the brain to function, the immune system to fight disease, and the blood to carry oxygen to muscles.

Good sources of iron are:

• Meats such as liver, lean red meat, and poultry.
• Leafy green vegetables such as broccoli, dried beans, grains, and raisins.

Foods rich in vitamin C (such as fruits and vegetables) can help the body absorb iron, but certain foods can lower the amount of iron your body can absorb. So, keep away from coffee, tea, egg yolks, milk, fiber, and soy protein at the same time you’re eating iron-rich foods.

Talking iron to women. From puberty through their adult years, women need more iron than men because women lose iron with each menstrual period. Heavy menstrual periods (called menorrhagia) can cause you to lose too much iron, which can lead to iron-deficiency anemia, a common, but easily treated problem.

Here are some common signs of anemia:

• Tiredness
• Weakness
• Tingling and numbness in fingers or toes
• Sensitivity to cold

Heavy menstrual bleeding is, in fact, the most common cause of anemia in women. Talk to your Hemophilia Treatment Center (HTC) about ways to include iron-rich foods or iron supplements in your diet. Women who have heavy periods should cut back on coffee, black tea, and soft drinks, which can hinder the body's ability to absorb iron.

Dietary Supplements

Many people use dietary supplements and herbal remedies to prevent specific ailments or to complement more traditional medical treatments. However, some can have a harmful impact on with people with bleeding disorders because they may interfere with clotting or cause prolonged bleeding.

Remember, before taking any vitamins or supplements,
talk with your hemophilia health care provider.

Here are a few with potential harmful side effects:

• Bilberry
• Ginkgo biloba
• Bromelain
• Horse chestnut

Healthy Eating Resources

• Choose my plate: www.choosemyplate.gov
• Bam Body and Mind: http://www.bam.gov/index.html
• The Yum-o organization: http://www.yum-o.org/
• Let’s Move: http://www.letsmove.gov/kids
• Empowerme2B: http://www.empowerme2b.org/