Nutrition and Fitness

Everyone’s health benefits from exercise and a balanced diet. For people with spina bifida and/or hydrocephalus, there are some extra reasons to eat well and stay active.

Spina bifida raises the risk of being overweight or obese. If you have reduced muscle bulk, you’ll use far fewer calories than the average person. Mobility issues can also affect how much energy from food your body uses. If you take in more calories than you use, you’ll gain weight.

Being overweight or obese can lead to serious health issues, such as type 2 diabetes and high blood pressure. For people with spina bifida and/or hydrocephalus, obesity can also cause further problems with existing issues, including:

• mobility, as it’s harder to move a heavier body – this may in turn lead to further weight gain as the body is using even fewer calories
• skin breakdown, as obesity puts more pressure on the skin
• continence management, hygiene and other activities of daily living, as it can be harder to move and stretch
• mental wellbeing – obesity can affect self-esteem

Eating a healthy diet and being active can have many benefits, helping you to manage your weight, mental health and overall wellbeing, and maintain your independence. It’s not always easy to eat well and exercise but the simple tips here may help.^1-4

A healthy diet for people with spina bifida/hydrocephalus

A balanced diet looks the same for most people – we should all be eating more fresh fruit, vegetables and whole grain foods, and fewer foods that are high in salt, sugar and fat. When you have spina bifida/hydrocephalus, there can be some extra considerations.

Watch your calorie intake

Muscles use calories even at rest, so if you have reduced muscle bulk, you won’t need as many calories as the average person. You’ll also need fewer calories if you have mobility issues, which can affect how many calories you use.

Talk to your doctor – they can assess your current weight, help you set a target weight and give you advice on reducing your calorie intake. They may be able to refer you to a dietitian, who can give you more guidance and help you come up with a plan. You can also try the tips below.

• Avoid high-calorie snacks such as biscuits and chocolate. Don’t stock up on these foods – that way, you’ll have to make an effort if you really want them.
• Aim to grill, boil or steam food instead of frying or roasting – if others prepare your food, let them know how you’d like it cooked.
• Avoid takeaways and other convenience foods. Instead, try to cook big batches of healthier food and freeze portions you can heat up quickly.
• Watch your portion sizes – it may be helpful to use a small plate, so it looks full with less food.
• Avoid alcohol, which is high in calories – it can also have a negative effect on your mental health and your bone health.^1-4

Aim for more nutrients

A healthy diet isn’t just about managing weight. It should also give you the nutrients you need for your overall wellbeing. In general, this means:

• lots of fresh fruit and vegetables – at least five portions a day
• three or four daily portions of starchy foods like whole grain breads, cereals and pasta
• some protein foods – two or three daily portions of meat, cheese, fish, beans, legumes, eggs, nuts or tofu
• two or three portions of dairy or dairy alternatives
• small amounts of unsaturated oils and spreads

Focus on fibre 

A balanced diet, high in fibre, is important for helping to prevent constipation. Fibre-rich foods include fruit and vegetables, whole grain cereals and bread, beans and legumes. You should also aim to drink plenty of fluids, such as plain water, teas and juices.

SBH Scotland’s Health and Wellbeing nurses are used to supporting people with bowel issues, understand the challenges and can offer guidance. Call the SBH Scotland Helpline on 03455 211 300 or you can fill in this form to get in touch with our support team.

Include vitamin D

Vitamin D is important for healthy bones, teeth and muscles. Your body makes it from sunlight, but in Scotland, we don’t get enough sunlight from October to March. If you don’t go outside much, due to mobility issues or for other reasons, you may be at even higher risk of having low levels of vitamin D. Everyone should consider a daily supplement containing 10mcg vitamin D in the winter – talk to your GP about whether you should take it all year round.⁶

• For more guidance on portion sizes and healthy eating, visit the British Nutrition Foundation.
• The Bladder and Bowel Community has information about the fibre content of foods.

Moving more

When you’re living with spina bifida and/or hydrocephalus, physical activity has lots of benefits. For example, exercising can:

• build muscle, improve flexibility and balance, and strengthen bone density
• help you manage your weight
• improve your mental health and self-esteem
• support your daily living activities
• help you relax and sleep better
• improve bowel function^7,8

What to do

Everyone’s different. Some people with spina bifida and/or hydrocephalus play sport regularly, while others have very limited mobility. Plus, what you’re able to do may change at different times. It’s important to listen to your body – and speak to your GP before you start a new activity. Remember that any amount of activity is beneficial, however much or little you can manage.

Government guidelines state that all adults aged 19-64 should do at least 150 minutes each week of moderate aerobic activity – to the point where you breathe harder and get warmer. The guidelines also recommend muscle-strengthening activities on two or more days a week. ^7,8

Here are some examples:

• aerobic exercise includes walking, jogging, dancing and pushing yourself in a wheelchair
• strengthening exercise includes Pilates, lifting weights and exercising with resistance bands

You could also add in stretches to improve flexibility and help you relax.

If you’re not used to exercising, you may not hit these targets straight away. Many wheelchair users do a lot less activity than this. What’s important is to find something you enjoy, so you keep doing it. You can start slowly, aiming for a short amount of activity each day and building up from there. Your doctor can give you advice on what’s suitable for you and may refer you to a physiotherapist who can suggest special exercises and check you’re doing them correctly.^7-9

Try these ideas:

• exercise in water – such as swimming or water aerobics – can be especially beneficial ­because the water supports your body, reducing pain and allowing you to work on strength, endurance and flexibility
• online exercise videos make it easy to work out at home – you can find routines designed for wheelchair-users and all levels of fitness
• exercise doesn’t have to mean the gym –­ household chores and gardening can count too
• fit exercise into your day whenever you can– for example, walking or wheeling to the shops or doing some stretches in front of the TV
• think about joining a disability-friendly gym or sports club – you’ll make new friends, get fitter and learn new skills
• whatever exercise you’re doing, be mindful of your posture and form – a specialist trainer or physiotherapist can check you’re moving correctly
• setting goals can improve your motivation and help you check your progress – think about setting some goals with a buddy so you can motivate each other

Try Fundraising

Fundraising is a great way of getting fit, meeting people and raising money to keep our services running.

Why not set yourself a challenge and raise money for SBH Scotland? Check out our fundraising pages

Safety first

It’s natural to have some concerns about safety if you’re not used to exercising, especially if you have a shunt. Try not to let worries get in the way. While very few activities are off-limits, in general, it’s best to speak to your doctor about what’s safe for you. ^9,10

However, if you have an LP shunt, avoid activities that involve twisting at the waist, which could dislodge it – this may include golf and certain movements in gymnastics, martial arts or yoga.

Boost your confidence

Starting a new activity can feel daunting, for lots of reasons, including concerns about accessibility. You may find it helpful to join up with a local group, get a buddy to start exercising with you or think about trying a disability sport.

Be kind to yourself

It’s not always easy to make changes to your lifestyle so don’t be hard on yourself if you don’t always stick to your plan. Any positive changes you make will help your health, and you can build up slowly. Sometimes, making a plan for the week can help. Simply trying to move a little more, include more nutritious foods and cut back on sweets, takeaways and alcohol can make all the difference.

For more support and ideas on nutrition and fitness, call the SBH Scotland Helpline on 03455 211 300 or you can fill in this form to get in touch with our support team.

References

1. https://www.shinecharity.org.uk/self-care/general-health 
2. https://www.nutrition.org.uk/media/pwdjfvj5/your-balanced-diet_16pp_final_web.pdf
3. https://www.spinabifidaassociation.org/resource/obesity/
4. https://www.spinabifidaassociation.org/resource/nutrition 
5. https://www.shinecharity.org.uk/bladder-and-bowel-care/continence-issues 
6. https://www.nhsinform.scot/healthy-living/food-and-nutrition/eating-well/vitamin-d/ 
7. https://www.spinabifidaassociation.org/blog/how-to-exercise-if-you-have-spina-bifida
8. https://www.shinecharity.org.uk/bladder-and-bowel-care/continence-issues  
9. https://www.wheelpower.org.uk/getting-started/getting-started-health-and-fitness/ 
10. https://www.shinecharity.org.uk/advice/sport-and-exercise