BY CRYSTAL NWAKPADOLU
Health Promotion Specialist
​Interprofessional Primary Care Team

 Finally some good news!!!
 
“Stay Home” became the mantra since the COVID-19 pandemic and life as we knew it changed rapidly. To say things have been crazy would be an understatement. Through it all, you’ve demonstrated immeasurable strength, resilience, and a willingness to do what is necessary to contain the spread of COVID-19. As the saying goes, when life throws you limes, you rearrange the letters and throw back a smile. We are still not completely in the clear but we are getting there.
 
On April 30, 2020, we at Scarborough Centre for Healthy Communities (SCHC) sent out a needs assessment survey. The aim was to help us identify some emerging needs in our Scarborough community as a result of the pandemic which will then inform strategies to help mitigate those needs. We called and you answered and for that, we are grateful. The responses were informative. The survey results can be found on our Facebook page.
 
As you may already know, the provincial government has moved to the second phase( phase 2 stage 2) of the reopening process. Many of our programs and services were able to continue even during the lockdown. With the second phase in effect, we have now opened in-person visits for most of our programs as per public health guidelines. Our doors are open!
 
Understandably, some of you may have some fears or concerns about accessing healthcare services amidst this pandemic. Some concerns were already expressed in the survey responses. It is okay to be anxious about this, and we completely understand your reservations. We continue to offer a multi-modal service delivery system (both virtual and in-person) to accommodate all your health needs.
 
However, studies have shown that delay in accessing healthcare could lead to poor health outcomes. According to Cleveland Clinic, virtual care might not be suitable for all cases especially around preventative screenings, comprehensive physical exams,  and hands-on care like physiotherapy and chiropody (foot care). Further research is required to help understand the long term health impacts of solely accessing care virtually.

According to Dr. James Benedict, Ph.D., "this pandemic is revealing to us that health is a common good. Your health matters to me and my health matters to you”. We heard your concerns and we are dedicated to keeping you healthy and safe. Therefore here are the measures we are taking to alleviate some of your fears and to keep you safe while accessing services at SCHC.
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Infection Protection and Control (IPAC) Measures:

• Daily screening of staff before onsite shifts
• Deep cleaning every day
• Screening of all clients before appointments, session or program
• Cleaning high-touch areas every 2 hours
• Cleaning all equipment and exam/counseling rooms after each client visit
• Staff are wearing masks and face shields
• Hand sanitizing stations and facial tissues available in each program area
• Safety posters and health signages throughout buildings

 
Physical Distancing Measures:

• Spacing appointments to limit interaction between clients
• Spatial measures using signage and floor decals
• Spacing seating to allow for 2 meters between clients
• Removing unnecessary furniture for additional moving space

 
Our priority is to provide holistic client-centered care to the complex marginalized residents of our Scarborough community. We are working tirelessly to ensure that you are safe while accessing our services.
 
To ensure that we are serving you well, please feel free to leave us a quick google review or a comment on our website or other social media platforms to tell us about your appointment/ experience at SCHC.
 
Together we will get through this!
 
“You are braver than you believe, stronger than you seem, and smarter than you think”
- Christopher Robin

BY RUCHIKA WADHWA, RD, CDE
Diabetes Dietitian Educator
Diabetes Program​

​These are strange times indeed. Amidst the global pandemic many are housebound. While putting home-cooked meals on the table could be challenging, these unprecedented times also act as a good opportunity to improve your diet, expand your cooking skills, or even lose a few pounds. Infact, this is an excellent time to start.  
 
Regardless of where you are on the healthy eating journey, consider working toward a positive dietary goal while social distancing. Doing so can help improve your nutrient intake, your energy level and your mood and strengthen immunity.  
 
Where To Start?
 
By stocking up properly, you can eat healthy even when indoors. Being well stocked on healthy foods is just the first step. Take an inventory of what’s there in your pantry, fridge and freezer with their best before date. Make a shopping list to fill in the gaps. Get value for your $$$ by buying healthy foods and not filling up on empty calories and processed foods.

• Stock up on non-perishables like dry beans, lentils and their flours, quinoa, farro, cracked wheat, nut butters, unsalted nuts, hummus, whole grain crackers, roasted chickpeas and edamame.
• When buying produce, buy fruits and vegetables with varying ripening time to prolong the shelf life and reduce visits to the grocery store. You could even wash, clean, dry and freeze these in small portions or buy frozen fruits and veggies and keep those handy.
• Fresh cuts of lean or extra lean meats, fish and tuna are a better option than the processed versions which are loaded with sodium and fat.

Make sure, when you go grocery shopping, it is after a meal else you may accidentally find yourself a proud owner of the snack and pop aisle. 
 
What's Next? 

Whether you are working from home or are on a break, ensure you start your day with a wholesome, nutritious breakfast. If you start the day with nutrition in mind, you are likely to plan the rest of your meals and snacks with the same intent. This shall give structure to the diet for the rest of the day. “Structure?” Yes, you read right. Eating a well-balanced breakfast including whole grains, fruit and/or veggies, milk/alternative and a protein of choice helps keeps us away from unnecessary grazing through the day.

• Eggs and egg whites along with veggies of your choice can be tossed into an omelette or into waffles and combined with fruit, milk and whole grain bread.
• You could make a spread with avocado, herbs and spices and serve it on whole grain bread along with some Greek yogurt topped with fruits.
• You could also soak groundnuts/peanuts in some water and blend with a banana and eat it for those rushed mornings when the conference calls/ huddles are start soon

​Make Plant-Based Proteins A Staple 

Including plant-based proteins in your diet is an environment friendly, pocket friendly, sustainable food choice. Plant proteins are loaded with fibre important for gut health, heart, diabetes and weight. Additionally, they provide antioxidants and protective phytochemicals.

• Excellent sources of plant proteins include beans and lentils and their flours, tofu, tempeh, edadame beans.
• Beans such as kidney beans, black beans could be used to make vegetarian chilli, veggie meatballs and burgers.
• Simply, toss some in a green salad or blend chickpeas and lentils to make hummus, falafels. 
• Pancakes, who doesn’t like them…try bean and lentil flours stuffed with finely chopped or shredded veggies to make savoury pancakes minus the sugary syrups that shall add inches on the waist.
• Use tofu to make a scrambler, kebabs or add to stir fries; roast chickpeas to make a heathy, crunchy snack. There is so much you can do with beans to make fun, exciting, meals and snacks.

Visit www.lentils.org or www.pulsepledge.com to find mouth-watering recipes using beans and lentils. If feeling bloated after eating beans and lentils is your concern, ensure soaking beans and lentils, draining the water and using fresh water while cooking and yes, also maintaining adequate hydration since plant proteins are rich in fibre. 
 
Watch Your Portions: 
 
Making healthy food choices doesn’t give us the permit to eat unlimited quantities. Portion control is very important. If weight loss is your goal, use this time to get a handle on your portion sizes. 

Use measuring cups to portion out cooked grains, pasta, noodles and teaspoons and tablespoons for cooking oil and seeds. If you prefer using an eye-ball estimation, keep cooked grains, potatoes to your fist size; cooked meat, chicken and fish to the size of your palm and veggies filling 1/2 your plate. Consider serving your meal on a luncheon-sized plate (7 to 9 inches in diameter). 
 
Practice Mindful Eating: 

While you are at home, you may find yourself frequenting the fridge and cabinets more often - this may be out of sheer boredom or just trying to seek comfort in food. Take time to eat and enjoy your meals. Put down your cutlery between mouthfuls and chew thoroughly. Pay attention to the color, aroma, taste and texture of your food. Avoid distractions such as television, talking on the phone. Eat until you feel satisfied, not full. 
 
Remember, food is meant to be used as fuel for our bodies. If you’re using it for any other reasons, take a step back and ask yourself, “What’s up?” 
 
This is an excellent time to build a new routine for yourself and family around a healthy diet, that you can feel confident about maintaining when we emerge from this.           ​

The Occupational and Physiotherapy team at IPPC often ask their clients about what activities they enjoy most. Chronic pain and many other life situations can cause people to stop doing the things that they enjoy the most. This in turn drastically reduces their quality of life.
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The best thing that one can do to manage their chronic pain condition is to return to these activities or do an easy version of them as quickly and as safely as possible. Not only are these activities motivating and help ensure that you continue moving, they also often help your body release endorphins which are also called the “happy” hormones and make you feel happier and act as natural painkillers in your body. Taking up new interests and hobbies is also a wonderful way to bring joy and movement into your life.

Of course, with chronic pain there is often a hesitation about engaging in activities out of fear of re-injury or making the pain worse. This is where a therapist comes in. You can work with your OT and PT team to figure out how to adapt these activities and ensure a safe and more comfortable transition.  Here are some ideas of gentle activities to help get you inspired: 

• Tai Chi
• Gentle Yoga
• Gentle Dance or Aerobics
• Walking
• Playing Music
• Playing with Kids
• Chair Exercises
• Cycling
• Swimming
• Aqua Fitness
• Gentle Pilates
• Gardening
• Creating Indoor and Outdoor Art and Craft Projects
• Knitting or Sewing

TAKE THE QUIZ BELOW TO FIND OUT YOUR KNOWLEDGE ABOUT CHRONIC PAIN:

Improving bone health is essential, regardless of age. Developing and maintaining strong and healthy bones should never stop. Incorporating these foods and vitamins into your diet will help keep your bones healthy.

Why is Calcium Beneficial?
Maintaining a calcium-rich diet is beneficial not only for helping build and protect bones but also for other processes throughout your body. While most of our calcium is located within our bones and teeth, this mineral also helps our muscles and the clotting of our blood. Calcium also helps with structural components of our body, such as in the development of hair, skin, and nails.We cannot produce calcium on our own and need to get it from our diet. Every day, your body loses calcium that it must make up for. If you do not get enough calcium, your body will take it from your bones. This decreases your bone density and, over time, can cause your bones to become weak and brittle.
​
Sources of Calcium
In order to determine how much calcium is present in food, you will need to check the nutrition panel for the listed daily value. The daily value amount is based on a 1,000 mg recommendation. For adults who are 50 years and younger, the recommended amount is 1,000 mg daily. Women who are 51 years and older, as well as men who are 71 years and older, have a recommended amount of 1,200 mg daily.
 
Calcium can be found in many foods. Dairy products are typically very rich in calcium. These include milk, yogurt, and cheeses. However, dairy products may also be high in cholesterol. Other foods that contain calcium in smaller amounts than dairy products include cereals, juices, and certain breads.
 

• Oranges: one entire orange, which is a single serving, contains about 55 mg of calcium.

• Soybeans: an 8-ounce serving of green soybeans contains around 175 mg of calcium.

• Kale: an 8-ounce serving of frozen kale contains approximately 180 mg of calcium.

• Greek Yogurt: a 6-ounce serving of greek yogurt contains roughly 200 mg of calcium. 

If a person struggles with certain conditions, is on specific medication, or has dietary restrictions, they may have difficulty getting the recommended daily amount. Vitamin supplements are another way that a person can reach their recommended daily amount.

Why is Vitamin D Beneficial?
Vitamin D is essential in helping your body maintain proper bone health. It is important for protecting your bones and aiding in muscle support. Vitamin D plays a vital role alongside calcium, as it helps your body to absorb calcium. Younger children and adolescents are encouraged to get the proper amount of vitamin D to ensure their bones build up strong and healthy. Adults are encouraged to get recommended values to keep their bones strong.Sources of Vitamin DFor those who are under the age of 50, the recommended daily amount of vitamin D is between 400 and 800 IU. For those who are 50 or older, the recommended daily amount increases to 800 to 1,000 IU. The reason for the drastic range is that some people just require more vitamin D than others. Vitamin D’s upper limit is 4,000 IU daily.
 
Unlike calcium, there are three different ways to get vitamin D: from sunlight, your diet, or supplements. As a response to sunlight exposure, the skin produces vitamin D, which is then stored. However, the average person cannot receive their daily values of vitamin D from sunlight alone. This is due to seasonal changes, geographic locations, or even the age of your skin.
 
Vitamin D can also be found in food, although very few foods contain sufficient amounts. Sources of vitamin D in foods include fatty fish like tuna or salmon. Vitamin D is also sometimes added to certain milk or dairy products.
 

• Tuna: a 3.5-ounce serving of canned tuna contains around 268 IU of vitamin D.

• Salmon: half a fillet of sockeye salmon contains approximately 815 IU of vitamin D.

 
The average person may have difficulty getting their recommended daily amount of vitamin D from food alone. In these instances, vitamin supplements may be recommended to help that individual reach their recommended daily value.

Maintain a Healthy Diet
Maintaining a healthy diet is an important habit to develop not only your bone health but for overall health as well. Reaching your recommended values daily of vitamins and minerals is essential for maintaining proper bone health. According to Village Vitamin Store, calcium intake alone is not enough. If you are not able to meet these daily values, you can meet these values with the use of vitamin supplements. Now is the time to start investing in your bone health.