By: Lisa Dorfman, MS, RD, LMHC
Sandy Rosende, Food Fitness International, Inc.
When a drunk driver hit me head-on at the young age of 18, I
thought my life was over. The accident stripped away a portion of my face and took away my opportunity to be a professional flutist, my dream since I was a small child. After a time of healing and reflection, I learned how to cope with the challenges of eating, walking and wanting to live again. At that moment, I decided to change my career, help others to heal holistically and accelerate the recovery process from traumatic stress. Twenty five years later, I continue to work with stress and trauma victims worldwide as a nutrition therapist and author with advanced degrees in nutrition and mental health counseling.
Over the past two decades I have learned that while the healing formula is unique to everyone, one common theme is universal-the hope for normalcy and complete health. This is the first of a series of articles I will devote to Burn Survivors throughout the World, Inc. (BSTTW) a non profit organization for burn survivors. I will be sharing portions of my next book with tips, strategies, and resources and help those suffering from burns feel stronger and persevere further to reach their personal best in health and in life.
Stress Nutrition 101
According to the National Center for Health Statistics, adults experience a minimum of four major stresses in their lifetime. Stressful experiences typically include changing residences, getting married, having children, and/or the death of a loved one. Millions worldwide suffer more life-altering
traumatic incidents that impact their entire soul, affecting their physical, nutritional, emotional, and spiritual life.
When an individual is metabolically stressed from a burn, a number metabolic changes occur that impact the person's nutritional well-being and require immediate attention. These include fluid shifts, increased calorie, protein, vitamin and mineral needs and losses of isolated amino acids such as
Fluid losses are accelerated during the first 24 hours of a traumatic burn. In addition to fluid losses, electrolytes-minerals such as sodium, chloride and potassium are also lost. Long term fluid balance requires a minimal water consumption of 2-4 pints a day, with at least one pint from an electrolyte
replacement fluid such as Gatorade or a comparable sports drink or electrolyte replacement fluid. Fresh, natural fruit juice with pulp is also a healthy option, although less than 1 cup a day is recommended to limit total sugars. Sparkling waters, unsweetened ice tea and plain old tap are also acceptable-the ultimate goal of having a clear output-ones' urine should be devoid of deep yellow coloring.
Calories and protein needs also amplified during the recovery process. Immediate replacement is critical for healing, recovery, immunity, infection management, strength and stamina. Since calorie needs may double until the healing process is accomplished, a minimum of 25 calories per pound per day is recommended. If protein is not replaced due to poor appetite
or aversion to meats, dairy, fish or chicken or obstruction, it can result in poor and slow skin, muscle and organ recovery, hair
losses, depressed immune response and physiological depression. Approximately 2-4 grams of protein per kilogram bodyweight, or about
double to quadruple the needs of a healthy individual are recommended for burn recovery. Shakes, bars, puddings may be some easy ways
to ensure a minimum of 20-40 grams of protein until the desire for food and ability to eat has resumed.
Without eating adequate calories, protein is sacrificed to meet everyday energy needs. Therefore calories from carbohydrates such as grains, fruits, dairy and vegetables and protein from meats, fish, eggs, cheese, grains and vegetables is essential for rebuilding the entire body. If eating is not possible, tube feedings may be essential for meeting calorie and
protein requirements until eating is feasible.
Recent research suggests that glutamine, one of the amino acids, found primarily in high protein foods such as fish, chicken, turkey, meat, eggs, cheese, yogurt and milk might be needed in greater doses since there may be a 50% loss in muscle used to maintain blood levels. Some specialized drinks and formulas such as Juven by Ross Labs include extra glutamine for recovery from stress.
Vitamins and minerals may also be required in amounts in 10 to 100 times the requirements for normal health due to increased losses and needs. Professional guidance from a registered dietitian (RD) for these recommendations are advised while individualized dietary prescriptions should be supervised by a medical expert before embarking on a new dietary or supplement regimen.
Holistic healing begins after stabilizing a nutritious diet. Once nutritional deficiencies are reversed, physical recovery can begin. Movement exercises, meditation, prayer, aromatherapy and the arts all play a role in complete cure of the body, mind and soul. Alternative approaches and complimentary therapy can enhance the nutritional rehabilitation for burns and can accelerate the recovery process. Stays tuned for tips and recommendations on alternative approaches to recovery on our next visit to the
BSTTW site or visit us at www.foodfitness.com for the answers to your questions on food and fitness for health and for life.
Lisa Dorfman, MS, RD, LMHC-Nutrition Therapist, Miami Plastic Surgery, adjunct professor at the University of Miami and life and sport survivor, competitor in over 31 marathons and hundreds of running and triathlon events. Lisa's books and programs, The Anti-Stress Strategy (2006) , The Tropical Diet (2004) and The Vegetarian Sports Nutrition Guide (2000) are available worldwide and at her website, www.foodfitness.com. Sandy Rosende is available for food and dietary questions in English or Spanish at email@example.com.
Sandy Rosende is a dietetic intern with Food Fitness International and a student in dietetics and nutrition at Florida International University in Miami, Florida. Sandy is a Puerto Rican native, bilingual in English and Spanish and available for questions and consultations at www.foodfitness.com
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