Nutrition

Carbohydrates are an important source of energy, vitamins, and minerals, and should be included in any healthy diet. Quantities should vary according to how active you are, (e.g. more activity requires more energy and therefore more carbohydrate).

Wholegrain and wholemeal versions of carbohydrate are a great source of fibre. Other sources of fibre include vegetables, fresh (with the skin!) and dried fruit, beans, nuts, and oats. You should adjust your own fibre intake to maintain personal bowel movement.

Good sources of fibre and provide a wide range of vitamins. They also contain ‘antioxidants’; chemicals which will help fight infection and prevent disease. The ideal target is 5-a-day; one portion might be one medium fruit, one small plate of salad, one tablespoon of dried fruit, three tablespoons of cooked vegetables or a small glass of fruit juice. Include a wide variety of types and colours. Boil or microwave vegetables in minimal water or try steaming and keep cooking time to a minimum to prevent vitamins being lost.

Needed for growth and repair in the body. Opt for lean, low fat versions and use cooking methods that keep fat to a minimum such as grilling, poaching, boiling, or steaming. Including some protein at each meal will help you meet the recommended two to three portions a day. Meat (red and white), fish, eggs, cheese, milk, or vegetarian alternatives such as beans, lentils, tofu, and Quorn are all good sources. Red meat can also help ensure an adequate iron intake but if you choose not to eat it, take care to eat other iron-rich foods.

Fat plays an important role in your diet, it provides you with essential fatty acids and the fat-soluble vitamins A, D, E and K. Aim to eat small amounts of unsaturated fat (polyunsaturated and monounsaturated) but reduce the amount of saturated fat in your diet. y Saturated fat is found in foods of animal origin such as butter, lard, full fat milk, cream, and the visible fat in meat. These can cause fatty deposits to build up in your arteries so opt for leaner or unsaturated versions if possible.

• Monounsaturated fat is found in olive and rapeseed oil, nuts, seeds, and avocados. Olive oil can be used in cooking or as a salad dressing and is also used to make margarine.
• Polyunsaturated fat is further broken down into omega 6 and omega 3 varieties:

Omega 6 fats (sunflower, corn and soya oils and margarines made from them) do not cause the arteries to clog up in the way that saturated fats do.

Omega 3 fats (oily fish such as sardines, pilchards, mackerel, or kippers) do not produce fatty deposits in the arteries and are thought to protect the body from heart disease. The recommendation is that men, boys, and women past childbearing age can eat up to four portions per week of oily fish. Women of childbearing age, including pregnant and breastfeeding women, and girls can eat up to two portions per week.

• Don’t forget that any high fat food is also high in calories, so over-consumption will likely result in weight gain and potentially obesity, which in itself is a health risk, so keep an eye on your portion sizes.

Important for strong bones. It is therefore important to ensure that your calcium intake is optimal to aid bone health. Taking enough calcium into the body from food is possible and aiming for three portions of calcium-rich foods a day will help you meet your needs. Table 3 highlights some calcium-rich foods. If you can’t tolerate milk or dairy products, or have a family history of osteoporosis, you should take extra care to ensure your intake is sufficient and you may consider using a supplement if you struggle to meet your needs.

Vitamin D aids the absorption of calcium to support bone health. It is also an important vitamin to consider for immunity as it may enhance your ability to fight infection. The main source of vitamin D is produced due to the action of the sun on your skin, but small amounts can also be obtained from the diet from foods such as eggs, offal, oily fish and fortified margarines, juices or cereals. Supplementation is also an option during the winter months or for athletes that spend a lot of their time training indoors. As a minimum aim to get 20 minutes sun exposure three times a week. Safe exposure to the sun is important so do not stay out long enough to get burnt.

Iron is important because it is used in the formation of haemoglobin, a part of the blood that carries oxygen around the body. Those at risk of low haemoglobin levels, also known as anaemia, include vegetarians, endurance athletes, teenagers, and females. Foods containing iron include offal, fish such as pilchards, salmon and sardines, eggs, green leafy vegetables, nuts, pulses, and breakfast cereals fortified with iron. The absorption of iron can be aided by eating foods containing vitamin C e.g. tomatoes, green leafy vegetables, peppers, and citrus fruits at the same time as iron-rich foods and can be hindered by drinking caffeinated drinks such as tea and coffee, so drink them after your meal instead.

Fluid intake is vital for health. All aspects of a healthy body rely on good hydration, from brain function to good skin. Have a variety of drinks over the day such as fruit juices, squash and tea or coffee, but including some water is always a good idea. Don’t forget that you get fluid from your food too. Most people need at least 1.5-2 litres of fluid a day, plus more to cope with exercise and heat.

Good hydration is important when taking part in physical activity and exercise. However, individuals with upper limb amputations may find some sports bottles hard to use. Bottles with a straw-type attachment or drinks containers worn as a rucksack with a drinking tube attached (e.g. camel backs) may be useful.